Birth is one of the most special events you will experience in your life. At the same time, it is also an incredibly intimate and vulnerable moment for which you want to be especially well prepared. We have therefore summarized important information about the types of births and the birth process for you in this article.
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The extent to which a baby sees the light of day through a vaginal birth or a Caesarean section depends on various factors. This decision is not always in the hands of the expectant mother.
The Natural Vaginal Birth
Ideally, the baby is born naturally through spontaneous birth. In this case, the baby is delivered through the woman’s vagina. This has the advantage that the baby comes into contact with microorganisms in the mother’s vaginal area during birth.
This contact with bacteria stimulates the baby’s immune system. In addition, the contractions gently push residual amniotic fluid out of the baby’s lungs, and the baby can breathe powerfully right after birth.
Complications during pregnancy and birth can make a natural birth impossible. In that case, a cesarean section is the best solution. In this case, the child is delivered through an incision in the abdominal wall of the pregnant woman.
During the birth, doctors may decide to perform an emergency cesarean section if the heart sounds become weaker and there is a threat of hypoxia. To avoid wasting time, cesarean sections are then always performed under general anesthesia because it would take too long to inject the bone marrow.
If a cesarean section is planned, there is enough time for preparation. Then the mother usually receives an epidural anesthesia, or PDA for short, and is given the entire procedure. The PDA is an anesthetic for pain and is often used for cesarean sections. A cesarean section is usually performed 7-10 days before the expected delivery date.
There are many reasons for a planned cesarean section. Breech or transverse presentation of the baby can be a reason, or a multiple pregnancy. If the placenta is in front of the cervix, it is impossible to deliver the baby naturally. Previous operations on the uterus or an inappropriate size ratio of the baby’s head and the mother’s pelvis can be other reasons. If the mother has a contagious disease, such as HIV, the baby may also be delivered by cesarean section. Lastly, incredible fear of the pain of labor can also be a reason for a C-section.
Possible Places For A Birth
An important question that expectant parents ask themselves some time before the birth is where to give birth. Should the baby be born at home, in a clinic or in a birth center? It is important that the expectant mother feels safe and in good hands in this place, so that she can give birth to her child in a pleasant atmosphere.
Birth In The Clinic
Most couples choose to give birth in a hospital. The safety for mother and child is particularly high here. In case of complications that cannot be foreseen before the birth, a team of doctors is always on site.
An emergency C-section and other medically necessary measures can be initiated within a very short time. Pain treatment via an injection into the spinal cord, peridural anesthesia or epidural, is also only possible in a clinic. For many parents-to-be, a pediatric and a premature infant ward are also important.
Most clinics allow expectant parents to visit the delivery room and the premises in advance. They can then view the delivery rooms and find out more about the clinic’s facilities. This makes the decision easier.
Many pregnant women wish to give birth to their baby in a familiar environment. Therefore, they opt for a home birth. This is usually accompanied by an experienced midwife.
Since modern medical equipment and painkillers such as the epidural are not available at home, the pregnant woman deliberately chooses not to have them. Since there are no doctors and equipment available for medical measures in case of complications, a home birth is only allowed if no complications are expected.
Health insurance also covers the costs of home births. However, not all insurance companies cover the midwife’s on-call flat rate of about 300 euros. The health insurance company must be contacted in each individual case.
Delivery In A Birth Center
The delivery in a birth center combines in a certain way the advantages of the two previous places of birth and forms the middle between them. The medical care there is better than at home. In addition to midwives, doctors and medical equipment are available.
At the same time, the care is more personal than in a hospital and the atmosphere is not so reminiscent of a clinic. Nevertheless, when choosing, it should be taken into account that a clinic could be reached quickly in case of need.
How Does The Birth Begin?
Already a few weeks before the birth, exercise and lowering contractions occur, with which the body prepares itself for the birth. In the days before birth, the baby often slides deeper into the pelvis.
If you are past the 37th week and have no specific complications or problems, you do not need to go to the hospital or birth center when labor begins. At the beginning, the contractions are usually still irregular and have long intervals between them.
You can then make the final preparations in your familiar surroundings and do everything that is good for you. Relax, take a bath, move around or try to get some sleep. You might also pack a thing or two in your hospital bag.
There are also other signs that indicate the beginning of the birth. The leakage of amniotic fluid is an indication that the birth has started. This can happen drop by drop or in a gush. Other signs include the mucus plug coming off the neck of the uterus and bleeding.
When the contractions start coming regularly about every 5-10 minutes, it is time to head to the hospital or birth center, or in the case of a home birth, to inform the midwife.
If the baby does not start labor even two weeks after the due date, it is possible to induce labor. This involves using medication to induce labor. After that, the birth takes place in a natural way, if possible.
The Stages Of Birth
Birth is the whole process of the baby coming out of the uterus and into the world. Spontaneous birth is the natural way of birth. Because of today’s medical means of monitoring birth, the possible risks to the baby are now very low. However, it is impossible to predict exactly how each birth will occur.
Nevertheless, a normal birth usually lasts between 4 and 18 hours and has 3 phases: The opening phase, the expulsion phase, and the postpartum period.
The opening phase of a birth is characterized by contractions coming more regularly at 3-6 minute intervals. They cause the cervix to open. It is impossible to say exactly how painful the contractions are for the expectant mother. Each woman’s perception of pain is very individual and therefore opening contractions are perceived as painful in very different ways.
With regular contractions of 5-10 minutes, the time has come to go to the clinic or birth center, or in the case of a home birth, to have the midwife come. Then the baby’s heart tones are measured regularly. In addition, the cervix is palpated again and again. This determines how far it is already open and where the baby’s head is located.
In the delivery room, the expectant mother can take a bath in the birthing tub and assume various positions to reduce the pain somewhat. If the pain is unbearable for the pregnant woman, there is the option of pain medication.
Contractions Open The Cervix
Contractions are coordinated contractions of the uterus controlled by the hormone oxytocin. That means during labor, the muscle tissue of the upper cervix contracts more and more. This happens because during the pause in labor, the muscles do not expand back to their original length.
As a result, the lower parts of the uterus keep retracting, which is also called refraction, and the cervix opens. Thus, the baby’s head slides lower and lower, and the vagina forms a funnel.
Often, the water breaks at this stage. Sometimes it is also deliberately opened by obstetricians to speed up the birth. If the bladder is broken, the baby’s head pushes more strongly into the pelvis. This in turn leads to stronger contractions.
The opening phase ends when the cervix is fully open to about 10 cm. In first-time mothers, this phase lasts between 8-12 hours. In women who have already given birth to one or more children, the duration of the opening phase is reduced to about 6-8 hours. However, the exact duration cannot be predicted because the times are very variable and differ from woman to woman.
Towards the end of the opening phase, many women are very exhausted. They lose courage and become very emotional. It helps if the partner or other companions encourage her and motivate her with kind words to persevere.
Regular breathing puts the expectant mother into a kind of trance state. It helps her to endure the pain of labor. In the process, the body releases endorphins. These are the body’s own pain-relieving hormones. At the end of the phase, there is often a short pause in labor, during which the expectant mother and also the baby can regain some strength.
The expulsion phase follows the opening phase and begins when the cervix is fully open. The contractions at this time are regular and strong and come about 6-7 times in a quarter of an hour. Then they stop for about 60 seconds.
If the water has not broken yet, it usually happens now. Then the baby’s head is in the birth canal. The baby slides deeper and deeper, pressing its head against the mother’s rectum. This triggers her natural urge to push and push along. This urge is like a reflex, and the expectant mother has difficulty resisting it.
The best way to push along is for the woman to exhale slowly and forcefully. Together with the pushing contractions, the mother pushes the baby out of her belly. It usually turns 90 degrees during this process because it fits through the pelvis with the least resistance.
The Pushing Contractions
For many women, pushing is a relief because it allows them to actively support the birth from the feeling. Before the pregnant woman pushes, the baby’s head should come down as far as possible to the bottom of the pelvis. The lower the head, the shorter the distance to emergence and the shorter the pushing phase.
This reduces the effort for the woman giving birth, because the pushing contractions can be quite strenuous. In total, the pushing phase should not last longer than 30 minutes, because otherwise the stress for the baby will be too great.
During pushing, the expectant mother should follow the instructions and guidance of the midwives and doctors as far as possible. This is not always easy, but they have the most experience and know when it is time to take a breath, hold it and push along.
The CTG is usually used to continuously monitor the baby’s heart tones during this phase. Nevertheless, throughout the time of pushing and the entire birth, the expectant mother should have the chance to turn, move and assume a posture that is comfortable for her, according to her needs.
An optimal posture may be to pull the legs to the body to facilitate the passage of the baby’s head. Often, a squatting or kneeling position also helps birth because it takes advantage of gravity.
The Final Phase Of Expulsion
In the final stage of expulsion, the baby is born head first. If the head passes through the perineum, this is also called “cutting through.” During this process, the perineum should be protected by the midwife providing care as much as possible to avoid injury as much as possible.
Sometimes an episiotomy may be necessary, performed by the obstetrician. This is necessary if the mother’s tissue is stretched by the baby’s head to the point where it threatens to tear uncontrollably. If the episiotomy is performed at the height of a painful contraction, the pain of the incision is usually not noticeable by the expectant mother. Other birth injuries, such as vaginal rupture, sometimes cannot be stopped either.
A few pushing contractions later, the baby’s head is completely out in the open. Then, with the next contraction, the birth of the body takes place after the backward rotation. This means that the obstetrician carefully turns and lowers the head so that the anterior shoulder can pass through. This is usually followed smoothly by the rest of the upper body, as well as the torso and legs.
For first-time mothers, the expulsion phase lasts from a few minutes to about 2 hours. For women who have already had a child, the upper limit is more like an hour. Nevertheless, each birth is very individual and may differ from these times.
Most expectant mothers certainly don’t like to hear this, but it is not a myth that bowel movements occur frequently during the pushing phase. Many pregnant women do not want this and use the option of an enema before the start of the birth, which ensures that the bowels are already empty during the birth.
From a medical point of view, there is nothing against this, yet it is a natural process and those present at a birth deal with the processes surrounding a birth on a daily basis and also consider them normal. Therefore, there is no reason to be ashamed of anything.
The First Acquaintance
If everything goes without complications and peculiarities, the child is placed on the mother’s belly immediately after birth. This is a very magical moment for you and makes up for all the strain and pain of the last few hours. You are finally holding your baby in your arms and have almost completed the birth.
This first contact has a positive influence on the mother-child bond and is very special and important for both of you. After all, it’s the moment you’ve been looking forward to for the last 9 months in concrete terms and otherwise perhaps for almost your whole life. In addition, the shared physical contact ensures that the hormone oxytocin is increasingly released. This shortens the postpartum period and ensures less blood loss.
The actual birth is followed by the postpartum period. The birth is not completed until the placenta is completely detached. The placental birth or postpartum period usually lasts 10-30 minutes.
Because of possible later complications, utmost care is important during this phase. The placenta is checked for completeness outside the body. Remaining parts in the uterus can cause heavier bleeding, infections or growths. If parts of the afterbirth remain in the body, a short scraping is performed under anesthesia.
After the afterbirth, possible perineal tears or a performed perineal incision are sutured with local anesthesia. Meanwhile, the child is washed. Once mother and child are well and cared for, the obstetricians withdraw. In this way, they give the newly born little family space and time to get to know each other in peace.
Pain During Birth
Pain is unfortunately part of childbirth. If this pain is unbearable even after a relaxing bath or trying different positions, there are various options for pain relief. Pain can still occur after birth due to postpartum contractions.
During labor, pain medications may be given intravenously. In some hospitals, nitrous oxide is still administered through a breathing mask. Both briefly impair the mother’s consciousness and also have effects on the child. The methods must therefore be used with caution.
Relief Through PDA, Pudendal Block And Co
There are also options that can be used even before the birth. These are means that have a local effect. Examples are PDA, spinal anesthesia and pudendal block.
Peridural anesthesia, or PDA, uses a catheter to deliver an analgesic medication into the space between the vertebrae and the spinal cord. Because the catheter is placed once, the medication can be re-dosed over and over again. This catheter is placed at the onset of labor, but the cervix should preferably already be 5 cm open at this time.
Spinal anesthesia is a procedure that is very similar to PDA. However, the medication is injected directly into the spinal canal and the needle is removed immediately afterwards. The method is used for planned cesarean sections or when an epidural was not placed at the beginning and then a cesarean section becomes necessary during the birth. However, in the case of an emergency cesarean section, general anesthesia is used because it is the fastest-acting method.
In the pudendal block method, an anesthetic is injected into the ischial tuberosity. This prevents the pain transmission in the perineal tissue and the external genital. The effect of the drug does not pass to the child and is most often used late in labor. The procedure results in a reduction of pain but not complete freedom from pain. It is often used when childbirth aids such as a suction cup or forceps are needed during delivery.
All The Effort Is Worth It
Childbirth is a painful but, above all, beautiful event in life. If you have respect or fear of child birth, that is quite normal. Especially because with your first child you don’t know what to expect.
But always remember that birth is a natural process. Countless women before you and after you have already given birth or will do so in the future. Trust your body. In addition, with your midwife and doctors and obstetricians, you have a team at your side that supports you. You are not alone.
All fears and worries will be forgotten when you hold your son or daughter in your arms. The sight of your baby will enchant you and make you forget all your efforts.