A woman's pelvis has a complex shape. It is wider to allow the baby to perform various maneuvers during labor. Most babies in the womb are positioned laterally, facing right or left. However, as delivery approaches, babies are typically positioned head down or head up, because the space in the pelvis is greater vertically.

The human body is a perfect machine, which is why we can say that a woman's pelvis is perfectly designed to accommodate the baby until the end of pregnancy and has an ideal shape to allow the baby to turn in the correct direction at the time of delivery.

The baby's maneuvers during labor are driven by contractions and the resistance offered by the birth canal. In addition to these rotational movements, the baby also descends along the vaginal canal.

During labor, as soon as the vulva has dilated enough, the baby's head can begin to emerge. Usually, the baby is born head down, but will quickly turn onto its side.

Hormones during labor

Oxytocin: known as the love hormone. Oxytocin is secreted during sex, after ovulation, and during labor, childbirth, and breastfeeding. It creates feelings of nurturing and love.

Endorphin: Endorphins are produced in response to pain and stress. They have calming and pain-relieving effects. As labor progresses and pain intensifies, endorphin levels steadily increase in non-medicated labors.

Adrenaline: Adrenaline is also known as the "fight or flight" hormone. It is secreted in response to stress, fear, and extreme pain. If a woman experiences these sensations during labor, she may produce too much adrenaline, which can slow labor down.

Stages of labor

The labor is divided into four phases

1. The first phase of labor is called prodromic and consists of the slow opening of the cervix and the loss of the mucus plug.

2. The second phase, called dilating , is the actual preparation for childbirth.

3. The third phase, called expulsive , is the birth of the baby.

4. The fourth phase, called secondment , is the expulsion of the placenta.

I principali segni dell'inizio del travaglio sono

• Contractions

• Loss of vaginal mucus or bleeding

• Water breaking

First stage of labor

The first stage of labor consists of three different phases and involves thinning, softening, and shortening of the cervix until an initial dilation of 4 cm.

Dilatant phase or first stage

Generally, this phase is the longest and least painful part of labor. The cervix thins and dilates from zero to 4/6 cm. This phase can last for hours and may be accompanied by mild contractions. The contractions can be regular or irregular, or sometimes not noticeable at all.

During the first stage of labor, it is important to carefully monitor and record the woman's well-being, the baby's condition, and the progress of labor. This helps determine whether labor is progressing normally, identify any issues promptly, and ensure clear communication. Ideally, you can experience the initial phase in the comfort of your own home.

Expulsive phase or second stage

The next phase is characterized by strong and painful contractions that tend to occur every three or four minutes and last from 30 to 60 seconds. The cervix dilates from 4/6 to 8 cm.

Third stage

The cervix dilates from 8 to 10 cm (that is, it is fully dilated).

The contractions can become more intense, painful, and frequent. It may seem as though the contractions are no longer separate, but follow one after another.

It is not uncommon to feel a sensation of loss of control and even a strong urge to go to the bathroom, as the baby's head moves along the birth canal and presses against the rectum.

What to do during the first and second stages of labor?

• Ask your partner for support

• Frequently change positions and choose comfortable ones.

• It might be helpful to dim the lights, play some music, or follow some hypnobirthing techniques.

• Stay as relaxed as possible and take care of your needs.

• Sometimes, humor can lighten the atmosphere, if appropriate.

• Stay well hydrated.

• Eat lightly, as the digestive system naturally slows down and nausea may occur. Some easily digestible foods are fruit, yogurt, or toasted bread.

• Stand upright to help your body and your baby work with gravity and encourage the baby's downward movement.

What to do during the third phase?

During this phase, the woman is close to childbirth, so we assume she is already in the hospital and being assisted by experts.

During this phase, it is advisable to push during a contraction and relax between contractions.

It is more effective to do two or three pushes with each contraction, breathing between each one, rather than a single long push.

Relaxing the pelvic floor muscles around the vaginal opening and staying in an upright position can be helpful.

Partner support during childbirth

During childbirth, you can decide who will be by your side, whether that's your partner or a loved one. They can help you get into the position that feels most comfortable and calmly and firmly repeat the midwife's advice. We do not recommend cheering or words of encouragement.

Second stage or the fourth stage

After the birth of the baby, the uterus gently contracts to loosen and push out the placenta. This may occur 5 to 30 minutes after the birth of the child.

After the birth of the baby, the midwife delays clamping the umbilical cord to allow oxygenated blood to pass from the placenta to the baby.

The uterus contracts and the placenta detaches from the uterine wall, then descends into the vagina, ready to be expelled.

The uterine muscles continue to contract to stop the bleeding. This process is always associated with moderate blood loss, up to 500 milliliters. In this stage of labor, one potential problem is excessive bleeding (postpartum hemorrhage), which can cause anemia and fatigue. For this reason, the fourth stage is carefully monitored.

The child's birthday

After birth, the mother and partner will be given time with the baby so they can get to know each other.

Skin-to-skin contact is important, ideally for the first two hours after birth.

After that, the child will be examined, weighed, measured, and given one or more identification bracelets.

The child can then be dressed and wrapped in a warm blanket.

Checks after the birth of the baby

During the initial skin-to-skin contact with the baby, the midwife or doctor will perform a check called " APGAR score ".

The APGAR score is performed twice: at one minute and at five minutes after birth. This assessment helps the midwife or doctor determine whether the baby needs further care after birth.

The APGAR score is based on:

• respiratory rate

• heart rate

• skin color

• muscle tone

• reflexes

Blood loss after childbirth

Blood loss in the days or weeks following childbirth (also called discussions ) is completely normal and occurs whether you have a vaginal delivery or a cesarean section.

What is the normal blood loss after childbirth?

Women’s postpartum bleeding experiences vary greatly. In the first days after childbirth, most women have bleeding that ranges from moderate to heavy. Over the following days or weeks, the bleeding gradually decreases and changes color.

Most women stop bleeding between four and six weeks after childbirth. It is also common for bleeding to be heavier after breastfeeding.