What happens in labour

In the movies, birth usually starts with a dramatic waters breaking, a mad dash to the hospital and then out pops the baby with the mum barely breaking out in a sweat. In real life, there's a bit more to birth than that!

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However, it isn't always as painful and traumatic as some mums-to-be are lead to believe either, which is why we've asked midwife Anne Richley to give you the (not always) painful truth about what to expect in labour.

From the first stage of labour until you meet your baby, here's what giving birth really feels like.

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Stage One

First stage of labour

In the first stage of labour it’s all about your cervix dilating. It needs to get to 10cm and to achieve this you’re going to need contractions. As they begin, here’s what to expect…

What contractions feel like

Ever had cramp in the back of your leg? Imagine that across your bump. Gradually your abdomen will feel tighter and tighter and the discomfort (or pain) will build to a peak with the contraction. Then, just when you think you can’t bear it any longer, your bump will start to relax and you’ll feel the contraction easing off. It’s a bit like climbing a mountain and just when you think there’s no way you can go any further, you find yourself going down the other side.

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Try to relax during contractions

Some women do describe the pain from contractions as the worst they’ve ever felt and say they can feel the pain through every nerve ending in their body. Others say it’s more like a pressure than a pain and that it’s not nearly as bad as they were led to believe. One thing is undeniable, and that’s that the uterus is made of muscle and the more tense you become, the more painful it’ll be. So, although it might seem like an odd time to relax – that’s what you have to do! Remember, your body will have time to recover in between contractions and you’ll find that you can get a much-needed rest.

Enjoy the moments of calm between contractions

Once the contraction has worn off, you’ll feel absolutely fine and might find yourself chatting quite happily, or even dozing off. Eventually you’ll start to feel the build-up again, but rather than tensing and anticipating the peak of the contraction, you need to actively try to relax: controlling your breathing will help support this. Doing this will make a massive difference in helping you cope.

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Transition stage

Transition stage

Just before you get into the second stage of labour, there is a period of transition that affects women in different ways.

For some mums-to-be, it’s the calming ‘rest and be thankful’ stage. Contractions stop, and your body restores some energy before the effort of pushing your baby out into the world.

For plenty of other pregnant women, transition is not quite as calm a time. You might find yourself genuinely wondering if you can carry on – and shouting “Don’t touch me any more!” or worse. For us midwives it’s a great sign, as we know that the birth is pretty much imminent. As soon as a woman starts pleading that she can’t go on, we know she’s almost there.

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Stage Two

Second stage of labour

Now the cervix is completely open it’s time for your baby to make his way down the birth canal – but he's going to need your help. This is the second stage of labour and, for most women, it feels completely different from the first. There’s nothing to stop the baby being born, but he won’t suddenly shoot out – he’ll make his way down gradually. Here’s how it will feel…

The urge to push when you have a contraction

The contractions will change: they’ll no longer feel painful or tight across your bump, but will become really expulsive. That means each one will build up like before, but at its peak you’ll feel the most overwhelming urge to bear down and push. It’s completely uncontrollable. I’ve heard mums compare these contractions to everything from sneezing to vomiting or even an orgasm – all very different.

Don't fight the urge to push

Even if you suddenly decided you didn’t want children and tried to tighten your buttocks for dear life, your body would insist on your baby being born and spontaneously push with each contraction. You don’t need to be told to push – your body will know what its doing and you just need to go with the flow. It can feel a bit overwhelming, but as long as you don’t fight the urge to push, it gets easier. If you’ve watched women giving birth on TV, this bit often looks as if it’s the most painful as it’s when they can get quite vocal, but it’s the power of the expulsive contraction that can make women yell out, rather than the pain.

You’ll want to poo

At this point you’re likely to feel as if you need a really big poo! That’s because your baby is pushing down on your back passage making you feel you need to go. The only person who will know is your midwife and she’s certainly not going to draw attention to it. At the peak of a contraction you’ll probably feel as though you’re losing control of your bowels, and that somebody is prising your buttocks apart.

Your baby's coming

Inevitably your midwife will encourage you by saying "I can see some of the head now" just when you’re starting to think your baby’s never going to make an appearance. If you pop a finger in your vagina or look at the baby's head with a small mirror, it can encouarge you even more and reassure you that your baby really isn't very far away.

Your baby feels like he's coming and going

With each expulsive contraction you’ll probably feel more of your baby moving forward, and then when the contraction’s gone, he’ll move backwards a little. Imagine a tortoise poking his head out of his shell and then pulling it back in. Obviously there’s no room to spare, so you’re likely to feel the resistance as the head does this. But your vagina is very lubricated, so it’ll be a smooth – if tight – feeling. It’s all very clever as this movement is stretching your perineum (the area between your vagina and your back passage) nice and gently.

Crowning

Eventually, your baby won’t retreat any more, but will continue to move forward. Now your midwife will be able to see more and more of his head, and the opening of your vagina will be stretching and thinning. This is known as crowning. Picture your head being pushed though a tight-fitting polo neck – that’s kind of what it looks like.

Your baby's head is out

Some women describe a burning sensation as their baby crowns, but it will only be for a moment, as any minute now the head will be out. It’s been described as anything from pooing a melon to shelling peas, so as you can see it feels very different to each woman and no one can predict how it’ll be for you. Your midwife will encourage you to use special measured breaths during the contraction to try and slow down the baby’s exit and get the head out nice and slowly: this will help to minimise tearing. Once the head is out, you’ll wait for a final contraction and with that the baby’s body will follow.

Your baby is born

Some women experience overwhelming feelings of joy and love when they first hold their slippery little newborn, but for others the truth is that they’re exhausted and just want to sleep. You’ll be encouraged to cuddle your baby against your skin, to keep him warm, but if you’d rather not then that’s also fine.

When your baby is born, assuming there are no problems, he’ll be placed straight on to you, unless you state otherwise. He’ll be warm and slippy and sometimes have a bit of blood or vernix (white greasy substance that kept him warm and waterproof inside of you!). He will also be wet, so the midwife will dry him and encourage you to cuddle him against your skin, which will keep him warm. Some women say their baby has a unique subtle smell, which they adore, to the extent where they have refused to have their baby cleaned for days until the smell has gone!

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Third Stage

Third stage of labour

Once your baby's born, there's one final stage of labour left. While you’re cuddling and getting to know your baby, you’ll still have a bit more work to do delivering the placenta. There are two ways to do this, either active or natural…

Get the midwife to do it

If you’ve chosen what’s called ‘active management’, you’ll have been given a hormone injection as your baby’s shoulders are being delivered. This makes your uterus contract quickly after the birth. When your baby is born, the cord will quickly be clamped and cut and the placenta will be delivered by the midwife gently pulling on the umbilical cord. Whether the midwife pulls on the cord to expel the placenta or you push it out yourself, it doesn’t hurt. The placenta can be the size of a dinner plate but is soft and feels like you’re passing a large clot of period.

Do it yourself

If you’d prefer to do this bit naturally, there’s no need for the injection. Your baby will stay attached to the cord for longer, until you feel the contraction ready to deliver your placenta. This can take around an hour. You probably won’t be paying too much attention at this stage, as you’ll be too busy gazing at your baby, so it might feel a bit uncomfortable, but no more than that.

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Your newborn baby won't be all clean and fresh straight after birth - check out our guide to what newborns really look like.

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