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Delivery, What to Expect

Once the first stage of labor is passed, the placental sac has broken, the cervix has dilated and contractions are regular and frequent, the second stage of labor - actual delivery - begins. Of course, there's no bright line dividing the first from the second. Where one leaves off and the other begins will vary from woman to woman and birth to birth.

There's a wide variation among women in many aspects of the process. The length of time is different for everyone and from child to child. The amount of pain differs. And the post-birth consequences will vary for each individual person and baby. In 75% of women who carry to term, delivery is within 12 hours. Only 2% will be in labor for more than 24 hours.

During the active delivery phase contractions are frequent, though there are breaks in between. Here that training you spent so many hours to practice kicks in. Proper breathing technique differs between the resting phase and the contraction and pushing phase. Use both.

Drugs are an option but both mothers and physicians try to keep them to a minimum. Anything the mother receives still makes its way into the child. Pain medication crosses the placenta and can slow the baby's heart rate and make breathing sluggish.

Analgesics are enough for most women, but they can produce side effects such as rapid heartbeat or nausea. A regional block may be appropriate for some women. This can offer pain relief without interfering with the ability to push, but it's not for everyone. Hot pads, ice packs and a hand to hold can often substitute for the time needed to get through the toughest phases.

Develop a plan with your physician well in advance to cover all the possibilities.

Transition is the interval during which the cervix dilates the final two centimeters (about an inch). It produces the most intense and frequent contractions, but may last only a few minutes. Rarely is it longer than an hour. Here again, breathing techniques and a good partner are great aids to staying focused and minimizing pain.

Deep breaths are best for those resting periods, short and sharp ones for the period of active pushing. Shallow chest breathing is best for the most intense contractions. This helps keep the blood well oxygenated and the mother focused as well as possible on something other than the pain.

When the widest part of the baby's head has moved into the birth canal, the second stage has begun in earnest. Contractions slow to four or five minutes apart. When the head is even with the lower pelvic bones, it's said to be at '0' station. It will progress through 1, 2, 3, and so on, measured by the baby's exit.

The excitement rises as the baby becomes clearly visible. Tiring by this time is normal, but adrenaline helps keep most mothers at it during this final stage. Then, success!