The preparatory phase

The preparatory phase is the gradual transition from pregnancy to birth. This goes via practice and Braxton Hicks contractions, that can sometimes last a while. Some barely suffer from this, others a lot more. These practice and Braxton Hicks contractions and very irregular and cause a change of the cervix. This can also lead to some dilation, often 1 to 2 cm, but this isn’t always the case.

The latent phase

In the latent phase the real contractions have started and they are becoming more regular and frequent, with at least two contractions per 10 minutes. Labor has now really started! These are, however, still early contractions that can be easily dealt with; you can puff them away and can still talk during the contraction. Due to these contractions the uterus effaces and you become dilated up to 2-3 cm.
During this latent phase it is mainly a matter of waiting, and it’s best to try to find some distraction: watch a movie or walk around and rummage about the house.

Breathing during the latent phase

During the latent phase you can simply puff away your contractions. The best way of doing this is as follows: Inhale through your nose and exhale through your mouth. When inhaling, bulge your stomach and when exhaling you should try to relax as much as possible. This is the best way to deal with contractions and let them do their work.

Effacement

Due to your contractions, the cervix effaces. Before labor, this has a long, closed spout-shape. The effacement is the flattening of the cervix. The cervix also becomes weaker. In the beginning it is stiff like your nose and at the end it is as soft as your tongue. The cervix also opens: the dilation.

The active phase

This means: the real work has begun, you are getting regular strong and painful contractions. These contractions last 60-80 seconds and cause further dilation. You often also have a one-time blood loss here (indicating the loss of the cervical plug which served as protection in the cervix during the pregnancy) and sometimes, if your water has broken, you lose amniotic fluid.

Breathing during the active phase

Proper breathing during the delivery is very important, because it enables you to relax and by doing this you do not curb the active phase. Inhale and exhale in five or six puffs. You can also count together with your partner when exhaling so you are more aware of your breathing.

The active phase is the progressing of the dilation from 4 cm. For a first child this is on average a centimeter per hour, but as always with averages, things can go quicker for some and slower for others. At 10 cm the cervix has fully opened and the expulsion begins.

Expulsion phase

When you have reached 10 cm dilation, the expulsion phase begins. The dilation contractions now turn into pushing contractions. With these contractions you can push out your child. A real urge to push is a reflex and feels like the strong urge to poop. It is almost impossible not to give in to it. With 10 cm dilation and pushing contractions you can start to push.
When the baby is born, the obstetrician immediately places him or her on your bare belly. Enjoy this moment!

Afterbirth period

Your baby is now with you, all warm, but you’re not quite there yet. Immediately after the birth of the baby it is possible that you are given an injection in your upper leg to stimulate your uterus to contract properly. This causes the placenta to loosen more easily. The placenta usually comes out within 15 minutes after the birth of your baby. To enable the placenta to be born, the obstetrician presses hard on the belly and you are sometimes asked to press as well.

The delivery: a summary

In order to give birth you always need contractions. But how do you get these contractions? At the end of the pregnancy your body makes prostaglandins hormones. Prostaglandins are made in the membranes and are hormones that cause the cervix to ripen. They stimulate the production of the oxytocin hormone. Oxytocin causes the uterus to contract resulting in contractions. The more oxytocin you produce, the more contractions you get and the sooner you generally give birth.

A normal birth will go more or less as follows: Every delivery starts with the dilation phase, which can be divided into three other phases, which are the preparation phase, the latent phase and the active phase. This is followed by the expulsion, at which the baby is born, and the final phase is the afterbirth period.

No specific duration can be given for a birth. But you can get an indication of which duration is normal.

• The latent phase should not take longer than 9 hours
• The active phase takes between 4 and 14 hours
• The expulsion phase takes between 2 minutes to a maximum of 2 hours
• The afterbirth period takes between 5 to 60 minutes

For a second or third child, the delivery will generally go faster.