The 4 phases of natural childbirth

You have waited nine months for this day, and then suddenly it is here: the first signs that your baby is on its way appear, and labor begins. To help you understand what to expect and to prevent any fear, this article explains how a natural delivery unfolds and what happens during the different stages of childbirth.

How do I know that labor is starting?

Around the estimated due date, many women are especially attentive and waiting for a signal from their body that it is finally starting. There are some signs of the upcoming birth to watch out for. In some cases, the birth is announced by the Loss of the mucus plug from the cervix. The mucus plug has sealed your uterus from the outside during pregnancy and protected it from bacteria. It dissolves as the cervix gradually opens. The appearance and consistency of the mucus plug can vary greatly. You may notice increased discharge or a thick mucus, whitish or with traces of blood. Some pregnant women, on the other hand, do not consciously notice that their mucus plug has dissolved. Also, the Breaking of the amniotic sac , the so-called water breaking, is an indication that your baby is slowly making its way: it marks the beginning of labor in approximately 90% of cases. It does not necessarily mean that the amniotic fluid gushes out in a flood, as often depicted in movies. More often, it happens drop by drop, but sometimes only later in the course of labor or not at all. Usually, you don't need to rush to the hospital immediately upon these first signs. It will probably still take several hours before it becomes serious. However, in some cases, you should head directly to the hospital at the first signs of labor. This includes water breaking in transverse or breech presentation of the baby or in a multiple pregnancy, if it occurs before the 37th week of pregnancy, or if the amniotic fluid has a greenish color.

"Even a strong nesting instinct at night can indicate that labor is imminent," reveals LILLYDOO midwife Sissi. She explains in our video "" what else you can notice that shows your baby is on its way.

1. Latency and Opening Phase

Approximately 80 percent of births begin with the so-called Latency phase . This refers to when initial contractions subside again and completely disappear. The contractions during the latent phase prepare the body for birth and open the cervix up to three centimeters. A good indicator that birth is imminent is the Bathtub Test : When the contractions relax as soon as you get into the warm bath, it is usually still practice or lightening contractions. Then you can lie down again, try to relax, and gather your strength.

However, if the contractions persist and occur regularly every 20 to 30 minutes, it is likely to be early labor pains, which mark the beginning of the longest phase of labor: the Opening phase . It is time to head to the hospital or notify your midwife when the contractions occur at a frequency of three to six minutes.

After your arrival at the hospital or – if you are planning a home birth – the arrival of your midwife, the progress of the birth will first be assessed. The midwife will measure the frequency and intensity of the contractions and palpate the position of the baby as well as the dilation of the cervix. During the dilation phase, the contractions will become increasingly stronger and longer, until they towards the end every two to three minutes lasts about one minute. Each contraction gently pushes your baby forward a little. Its head presses against the cervix, causing it to open further and further. If your amniotic sac hasn't already broken before the contractions begin, it may do so during the dilation phase. If the labor stalls, the amniotic sac can also be manually broken with a small instrument. Once the amniotic sac can no longer serve as a cushion, the pressure on the cervix becomes more direct, which usually results in stronger contractions and speeds up the labor.

During the opening phase, your baby's heartbeat will be monitored regularly. Additionally, the midwife will repeatedly check how far the cervix has opened. Through the vagina, she can also feel how far your baby's head has already descended and whether it is turning correctly.

2. Transition phase

The transition phase marks the short but usually intense transition to the Ejection phase , which is also partly counted as this. The cervix opens to eight to ten centimeters and thus reaches its full opening for the birth of your baby. You will usually notice the transition phase because the contractions become stronger and irregular, and the rest periods in between become shorter. Nausea or trembling can also occur during this phase. Many women find the transition phase to be the most exhausting part of labor. If you feel like you are at the end of your strength, the support of your partner or your companion can now be especially helpful.

3. Expulsion phase or passage phase

Once the cervix is fully dilated and the baby's head enters the pelvis, the expulsive or passage phase begins. Birth climax . During the pushing phase, you will feel strong contractions that gradually move and turn your baby further into the birth canal. This increases pressure on the rectum, which also triggers the natural, reflexive urge to push. Many women feel relieved that, after the previous phase of weakness, they can now actively give in to the downward pressure and push once the baby's head is in the correct position. The contractions are most intense during the pushing phase, but your body also releases increased amounts of hormones that dull the pain and give you renewed strength. Many women describe this phase as a euphoria in which they block out everything around them and focus solely on their body and the birth. Since the Labor contractions very exhausting for you and the time in the birth canal strenuous for your child, you should still pay attention to your midwife's instructions on when it is time to push and when you should gather your strength.

If you are in a childbirth preparation course Breathing techniques you learned for childbirth, you can apply during the pushing phase. Many women also find it helpful to ease the Support contractions with sounds . Also the choice of the Birth position can have an impact on your well-being: Whether it is most comfortable for you in the bathtub sitting, crouching, or lying down is entirely individual and can be decided spontaneously. Surely, you will instinctively sense what is best for your body at the moment.

After some pushing, your baby's little head will become visible from the outside. When the time comes, your midwife will likely support your perineum from the outside to gently slow down the baby's head. This way, the pressure on the delicate tissue is cushioned and prevents tearing. Unfortunately, it cannot always be completely avoided. With one contraction, the back of your baby's head is born first, then the forehead, and finally the face. With the next contraction, the shoulders and body follow. As soon as your baby is born and has taken its first breath, you can finally welcome it. Usually, only a brief amount of mucus is removed from its face, and then it is placed directly on the belly or chest, still connected to the and .

4. Postpartum phase

Shortly after the birth of your child, the uterus contracts strongly – the Afterbirth contractions . Due to the contractions dissolves the Placenta from the uterine wall and is expelled from the uterus with a strong contraction. Your midwife will guide and support you in bringing the placenta into the world through gentle pushing. Usually, the placenta detaches on its own within 15 to 30 minutes; in rare cases, it takes longer. In such cases, it can help to place your baby on your breast: During breastfeeding, the hormone oxytocin is released, which has a contraction-promoting effect and supports the detachment of the placenta.

The expulsion of the placenta does not hurt because it is significantly smaller and softer compared to your baby. Along with the placenta, about 300 milliliters of blood are expelled from the uterus. Afterwards, it is carefully checked whether the afterbirth has fully separated. If tissue remnants remain in the uterus, they may be removed with a curettage to prevent infections. If injuries such as a or an episiotomy occurred during birth, these will be treated and stitched if necessary. While you are being cared for after the exhausting birth, your newborn will also be examined, measured, and weighed for the first time before you can get to know each other in peace.

What happens after birth?

During a birth in the hospital, you will probably spend some undisturbed time with your baby and your partner or your companion in the delivery room. Occasionally, your midwife will stop by to ensure that you and your baby are doing well. If you wish to breastfeed, she can also assist you with that, . If you feel stable enough after about two hours in the delivery room, you will either be transferred to the postpartum ward or, in some cases, you may leave the hospital after a few hours to continue your bonding time at home.

Many expectant mothers feel relieved to know exactly what will happen during childbirth. Even if every birth is different, we hope that this article has answered some of your questions about what to expect during delivery. Whether you are approaching the birth with calmness or if the thought makes you a little nervous: the first moments with your baby are in any case something very special, and many mothers report, not without reason, that all the hardships of childbirth were forgotten as soon as they held their child in their arms.