Labor and Delivery

MEDICAL ANIMATION TRANSCRIPT: During a vaginal childbirth, the first stage of labor lasts about 12 to 19 hours, and starts when your baby settles lower into your pelvis. In response, your cervix begins to efface, or become thinner, and dilate, or widen. During this time, you may feel strong, regular contractions occurring every 5 to 20 minutes, and lower back pain and cramping that doesn't go away. You may see a brownish or reddish mucus discharge, which could be the mucus plug at the opening of your cervix falling out. Your water may break, which can either be a large gush of fluid or a continuous trickle. If you experience any of these symptoms, contact your doctor or midwife to see if you should go to the hospital. At the beginning of stage 2 of labor, which can last from a few minutes to 3 hours, your cervix is fully dilated to 10 centimeters, and your baby's head has moved beyond the cervical opening into your birth canal. During this stage, you will begin to push your baby out. You may instinctively push when you feel the urge, or you may need coaching from your doctor, midwife, or labor nurse as to when to push and when to rest. In a normal delivery, your baby's head will rotate to face your back. During active labor, your uterus is divided into an active segment that contracts, pushing the baby downward, and a flexible passive segment that remains relaxed, stretching to provide more room for the baby to pass through. In some cases, when the top of your baby's head appears, or crowns, your doctor may make a small cut, called an episiotomy, to enlarge the vaginal opening. Then you will continue pushing your baby out. As your baby's head passes through the birth canal, it molds into an elongated shape. An elongated head shape will resolve itself within a few days as the skull bones shift back into place. After your baby's head exits the birth canal, his or her head and shoulders will rotate to help the shoulders pass through the birth canal. Your baby's shoulders are delivered one after the other, in order to fit through your pelvis. Once the shoulders emerge, the rest of your baby slides out easily. After your baby is born, his or her umbilical cord will be cut. In stage 3 of labor, which may last 5 to 30 minutes, mild contractions will help push the placenta out of the uterus. During this stage, you and your baby may begin bonding through skin-to-skin contact and breastfeeding.