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Birth phases: what to expect

by Josephine Andrews
Published: Last Updated on 374 views

A birth generally lasts several hours and can be divided into different birth phases: opening phase, expulsion phase, afterbirth phase. Different types of labor accompany each stage of labor. What contractions start when, how long does a birth last, what support do obstetricians provide? You can read the answers to these questions and more about birth phases here!

Three stages of birth

Irregular contractions set in three to four weeks before the birth . As the name suggests, they help lower the tummy, allowing the baby to slide lower towards the pelvic floor. A few days before the birth, irregular and strong contractions (pressure: up to 40 mmHg) cause the child’s head to be pressed firmly into the entrance to the pelvic floor. The transition to the opening contractions of the opening phase (first of the three birth phases) is fluid.

1st phase: opening phase

The birth begins with the longest phase, the opening phase: regular and strong opening contractions (pressure: 40 to 50 mmHg) develop from the preliminary contractions. They each last 30 to 60 seconds and occur every five to 20 minutes. As the birth approaches, the intervals between contractions become shorter.

The cervix shortens due to labor and certain metabolic processes . In addition, the cervix expands from zero to about ten centimeters. So the child’s head can step even deeper. The head increasingly presses on the amniotic sac until it ruptures (timely rupture of membranes ) and passes through the bony pelvis of the expectant mother.

In first-time mothers, the opening phase lasts up to twelve hours, in women who have already given birth to (at least) one child, on the other hand, it takes an average of two to eight hours. The reason is that in first-time mothers, the cervix shortens first and then the cervix opens. In multiparous women, on the other hand, these two processes happen simultaneously.  

Premature or delayed rupture of membranes

Occasionally, the amniotic sac bursts before the opening contractions and thus before the cervix is ​​fully open. Because then there is a risk of ascending infections, the pregnant woman should go to the hospital as soon as possible.

If the amniotic sac only ruptures during the expulsion phase, this is referred to as a delayed rupture of membranes. Midwives or doctors then open the amniotic sac with a small instrument.

2nd phase: expulsion phase

In the second phase of birth, the expulsion phase, the cervix opens completely and the child is born. First, the regular expulsion contractions (pressure: 60 mmHg) set in. They occur every four to ten minutes. When the baby’s head reaches the pelvic floor, it puts pressure on the mother. This sets in motion a maternal reflex to actively push, which is also reflected in the frequency and strength of the contractions: every two to three minutes, pushing contractions occur – the most intense type of contraction (pressure: 200 mmHg).

Thanks to the contractions and the reflex cooperation of the mother, the head is pushed deeper and deeper into the vagina until it passes the vaginal opening at the end of the expulsion phase. With the head first (usually) the child sees the light of day! If the head goes through the perineum, it is called cutting through. To prevent a possible perineal rupture, midwives press lightly against the perineum. During the next contraction, the shoulders and the rest of the baby’s body usually follow very quickly. If everything is fine with the child, you will have it placed on your stomach or chest.

During the expulsion phase, the obstetrician, especially your midwife, will be at your side. They tell you exactly how you can actively participate.

In primiparae, the expulsion phase usually lasts up to an hour, in multiparae often only 20 to 30 minutes. Active participation by the woman giving birth can shorten this phase.

If the baby doesn’t want to come, primiparous women are given a helping hand after about an hour, and multiparous women after 20 to 30 minutes: the child is carefully pulled out with a suction cup or forceps .

3rd phase: afterbirth phase

A few minutes after the birth of the child, the third of the birth phases begins: the afterbirth phase. It lasts an average of 10 to 20 minutes and ends with the expulsion of the placenta . Detachment and expulsion of the placenta are made possible by the afterbirth contractions, the intensity of which gradually decreases.

In the postpartum period, final after-pains set in. They are used to shrink the uterus and stop bleeding.

Birth stages: how is the baby doing?

There is no doubt that the stages of childbirth are difficult for the mother-to-be. But the birth process also means a lot of effort for the child. It is therefore part of the job of midwives and doctors to continuously monitor the health of both.

During the birth phases, for example, the mother’s heart rate, blood pressure and temperature are measured every one to two hours. Experts can determine how far along the birth has progressed through regular vaginal examinations. Among other things, the width and consistency of the cervix and the position of the child’s head are checked.

The child and mother are monitored during the birth with a so-called contraction recorder (cardiotocograph). It records both the infant’s heartbeat and contractions. There are also other monitoring options, such as taking some blood from the child’s head for analysis or examining the condition of the amniotic sac.

Don’t worry about labor pains

Birth pain can be alleviated with the help of peridual anesthesia (PDA). To do this, the doctors place a catheter near the spinal cord, which directs an anesthetic into the body. Because the sometimes very painful contractions in the birth phases serve a very positive purpose – namely the birth of their own child – many women can bear the pain of birth well.

The pain can be reduced with various methods of alternative pain relief. These include massage and acupuncture. Alternating postures, relaxation or breathing exercises, and relaxation aids such as full baths or foot baths are other good ways to deal with the pain.

Home remedies and other alternative medical methods in childbirth care are mostly not based on reliable scientific evidence, but often on experience gained over generations.

No heavy diet during labor stages

A birth usually drags on for hours and costs the expectant mother a lot of energy. At the same time, strong contractions can cause some women to vomit. Therefore, eat light but energy-giving food such as muesli bars, glucose or chocolate  during the birth phases .

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