What is normal delivery?
Vaginal delivery is best for the baby. It is known as natural, since the mother’s body is made for the baby’s passage through the vagina. Unlike cesarean sections, normal delivery has a fast recovery, less risk of complications and encourages lactation.
The name itself says a lot about the topic addressed. Normal childbirth is the best alternative for conceiving a healthy child, and all doctors agree. Of course, there are exceptions in which complications are found for the mother or baby, so other methods are adopted.
In normal birth, all or most of the process is conducted only by the body itself. According to the World Health Organization (WHO), if all is well with the mother and baby, there is no reason to intervene medically.
This does not mean that WHO is encouraging women to have their children away from motherhood, but that childbirth is a natural physiological process, so if everything happens properly, medical intervention will be minimal.
No, you did not read it wrong. There is more than a normal birth. They are:
Induced normal childbirth
Contrary to what many people think, induced vaginal birth is still natural. After all, when we refer to the words “normal” and “natural”, the meaning used is where the fetus will be expelled, instead of the process that leads to it.
Normal childbirth can be induced when labor does not start on its own, and it is necessary to intervene, for the health of the mother and baby.
Usually, the intervention is carried out when the pregnancy has passed 41 weeks, the bag has broken and the contractions have not started in at least 24 hours, the mother is diabetic, hypertensive or has lung diseases, or even when there is a decrease in the amniotic fluid .
In normal induced childbirth, the obstetrician (with the mother) will analyze the case and see if it is possible or not to induce labor without any complications for the mother or the fetus. The method used to induce labor depends on the conditions of the cervix.
If the organ has already started to thin or dilate, it falls into the “immature” category. In this category, the doctor may apply hormones or mechanical methods before induction.
This is often enough for a woman to go into labor and, when it does not, the bag can be broken artificially. Many mothers complain that the method is uncomfortable, but it is not painful.
It is only possible to rupture the pouch when the cervix is at least 1.5 centimeters dilated. Another way to induce labor is via medications, which can be administered directly into the vagina, through the vein or orally.
If the cervix is in the “mature” category, that is, thin and dilating, the obstetrician will apply, in the vein, the synthetic hormone Oxytocin, which will cause contractions in a rhythmic way.
It is worth remembering that none of this is necessary when vaginal delivery is spontaneous, as the body itself produces the hormone.
Contraindications for induced normal birth
Induced normal birth is not indicated for cases where:
- The fetus is dead;
- The baby is in pain;
- The child exceeds 4 kg;
- There is active genital herpes;
- There is gestation of twins or more;
- The mother has more than two caesarean sections in the history;
- The baby’s heart rate is slowing.
Other ways to induce labor
Non-medicated ways to induce normal childbirth are:
- Breast stimulation;
- Raspberry leaf tea;
- Sexual relations;
- Practice of exercises.
However, remember that, before taking any action, it is necessary to consult your obstetrician for an analysis of the case and possible guidance.
Normal water birth
Normal water birth, better known as humanized birth, is when the woman is immersed in a bathtub or pool with water heated between 36 and 37 ºC. Because it requires a specific apparatus, water birth must be idealized months beforehand, between the obstetrician and the mother.
This delivery process is relaxing, both for the mother and the baby. Pain and labor time tend to be less, as the warm water causes the ligaments, pelvic joints and muscles to relax, including the perineum (tissue between the anus and the vagina).
With this decrease in tension in the muscles, the feeling of tiredness drops dramatically, making the woman feel able to exert more strength if necessary, or can take more advantage of the baby’s first seconds of life.
Water birth is also called humanized, as the connection between mother and baby is greater. Experts indicate this birth as the least likely for the mother to develop postpartum depression .
For the baby, water birth is the least traumatic. After all, the internal and external temperature will be the same, the number of external noise is minimal and the artificial light is almost zero, because in this case the environment is left in half light.
When expelled from the uterus, who will bring it to the surface will be the mother herself, which increases the bond between them, as it will be the first face that the child will see.
The woman can enter the water as soon as contractions begin, as the warm water speeds up labor. All future mothers who have had a healthy pregnancy with no or low risk, with no complications during pregnancy and with a fully healthy baby, can have a normal water birth.
However, this method is not suitable for women who have already had a cesarean section, or who have:
- Pre eclampsia;
- HIV positive;
- Hepatite B;
- Genital herpes with active lesion;
- Twin pregnancy, or more.
In Brazil, this method is still gaining strength and acceptance. Thus, few hospitals offer this type of delivery free of charge, but in some states, doctors and nurse midwives who perform this delivery at home can be found.
Always remember that decisions must be evaluated together with the doctor responsible for prenatal care.
Spontaneous normal delivery
Spontaneous normal birth, as the name implies, occurs independently of the parents or doctors’ wishes. It runs automatically in the woman’s body, and all she has to do is let her older instincts take action.
One of the biggest difficulties when it comes to births in Brazil is spontaneity. Mothers choose the cesarean section several times, instead of waiting for the natural birth of the child.
According to the Unicef representative in Brazil, spontaneous labor is the only way to ensure that the baby is 100% ready to be born.
The main advantages of normal birth for the mother are:
- Lower risk of infection;
- Shorter hospital stay;
- Faster recovery;
- Risk with anesthetic complications are less;
- The uterus returns to its natural size more quickly;
- Increases the hormones responsible for well-being;
- Affective bonds occur more intensely and quickly;
- Favoring the production of breast milk (when the baby is born naturally, the body starts milk production more easily).
However, it is not only for mothers that normal birth offers several benefits, but for the baby as well, some of them are:
- More tranquility;
- Greater receptivity to touch;
- Easier breathing (when passing through the birth canal, your chest is compressed, causing the fluids from inside the lung to be naturally expelled);
- More activity at birth (before the umbilical cord is cut, the baby can find the mother’s breast without the help of others).
Among the various reasons that lead future mothers to question themselves about normal childbirth, we have the duration of the process. But know: each delivery is a case, each case is an organism, so there are no effective ways to categorically predict how long the delivery will last .
Everyone has heard one or more stories about someone who spent more than ten hours in labor. What these people forget to say is how their bodies responded to each stage of labor.
Another factor that directly influences the time of delivery is the number of normal births in which the woman has already undergone, that is, the first pregnancy is always the longest, as the organism is going through the entire process for the first time.
Along with this, we have the good old story of “time is relative”. It may be that, as it is a new experience, time seems to have extended much more than, in fact, it happened.
With the mystification of normal childbirth, many women end up thinking that the process is the most frightening thing in the world, when in fact it is the most rewarding part of the entire pregnancy.
To decrease anxiety , information about how each step occurs is essential. Altogether there are three major stages in normal childbirth, they are:
Dilation is the most extensive phase of labor. This stage is the longest, exactly because it is the first, that is, when the body is preparing to go through everything that is to come.
Normally, nine months after fertilization (40 weeks), the fetus is already fully developed. When hormones identify that the fetus has reached the greatest possible development for the body, it begins the dilation process. The dilation is subdivided into three other stages, which are:
Latent phase: from 0 to 3-4 centimeters of dilation
If, during the prenatal period, the pregnancy was passed without complications, then the latent phase will be spent at home. In this stage, the contractions are irregular and spaced, with low intensity of duration, and the cervix dilates up to 3 or 4 centimeters.
As the contractions increase in frequency and duration (approximately three contractions every 10 or 15 minutes), the woman definitely goes into labor. This is the time to go to motherhood.
Often, when they feel the first contractions, many mothers are already going to the hospital. When the doctor says that it is not yet time for the baby to be born, they do not understand and end up getting nervous, which further complicates the process of relaxation and the accumulation of energy for childbirth.
Active phase: from 4 to 7 centimeters of dilation
Some women go straight to the active phase of childbirth, where contractions occur more quickly and intensely (with an average of 2 to 3 minutes between each other), which can last from 60 to 90 seconds.
With stronger and faster contractions, it is common for pregnant women to be unable to speak, which creates even more anxiety and nervousness. Therefore, it is essential to maintain control of breathing, as this offers help to keep calm and in control.
In some cases, the contractions stop and the dilations start to regress in size or even stabilize. When this occurs, the ideal can be to change your position, go to the bathroom or even relax under the warm or hot water.
Transition phase: from 8 centimeters of expansion ahead
As the name says, in the transition phase, the body is moving from the stage of expansion to the phase of expelling the baby from the body.
It is possible that the vaginal canal expands up to 10 centimeters and the urge to exert force appears with all its apex.
Birth of the baby
It is natural that, along with the irresistible urge to push, anxiety comes.
During expulsion, in which the uterus pushes the baby through the birth canal, it is normal for there to be a pause between one expulsion attempt and the next. In these moments, mother and baby rest, and then return to the rhythm of delivery.
When the contractions return, the baby’s head can be felt between the legs. However, each time the contractions recede, the head also recedes. The feeling is that nothing is advancing, when in fact it is natural for the process to be carried out gradually by the organism.
For those who love a cinematographic production, they have already seen that moment several times when the doctor screams “It’s crowning!”, So the mother is even stronger and everyone cries with emotion at the baby’s birth. In real life, the moment is not so glamorous, but it is still exciting.
When saying that the baby “is crowning”, the obstetrician (doctor specializing in childbirth and female reproduction) refers to the fact that the central part of the baby’s skull is already visible through the vagina. For the woman, this moment causes burning and a hot sensation in the vagina.
In certain cases, the doctor will ask the woman to increase or decrease the strength exerted.
For cases in which force reduction is required, the goal is to make the baby be born more slowly, so the mother suffers less lacerations, that is, prevents the passage from breaking more skin than necessary.
In cases where it is requested to increase the strength, it is because the doctor saw that there is no great risk of lacerations for the mother.
When the baby comes into the world, it is covered by the caseous vernix, which means creamy varnish. This varnish is nothing more than a layer of fat wrapped around the entire skin of the newborn.
This occurs for two good reasons: the newborn baby’s skin is extremely sensitive, so this varnish is in charge of protecting it. The second good reason is that this fat helps the baby to slide out of the vaginal canal, functioning as an organic lubricant.
However, many hospitals are hesitant to remove this natural protection from the baby, so that it is “clean”. This is harmful, as the varnish is actually a protection for the first days of life outside the uterine environment.
Some good tips for mothers-to-be: avoid holding your breath and, if you are not able to apply force, check with your doctor if there is a possibility of changing your position. On several occasions, the lateral position on the left part of the body facilitates the baby’s passage through the vaginal canal.
Expulsion of the placenta
Now that the baby is born, the most laborious, intense and longest part has passed. However, the work is not yet completed, as the placental expulsion is missing. Like everything that involves the human organism, the expulsion time is relative.
Spontaneously, the placenta must be expelled within a maximum of 30 minutes after delivery. Along with it, the amniotic fluid bag is expelled. Their expulsion is also caused by contractions, but with less intensity and duration.
If spontaneous expulsion does not occur, it can be removed manually or instrumentally. When the placenta is expelled, the uterus contracts and the blood flow to this area decreases.
The doctor examines the remains of the placenta and amniotic pouch to see if there is anything left to get out. After the check, he palpates the abdomen to confirm that the uterus is contracting and to contain the bleeding where the placenta was.
After childbirth, the woman tends to feel shaky because of the adjustments that the body had to make during pregnancy, and is now forced to break up in a much shorter period.
Some women with low blood pressure or anemia even experience fainting after childbirth, but it is not at all serious. This is due to the extreme energy that the body had to release, so it ends up shutting down almost immediately to replace the expense.
To get rid of the pain of childbirth, the mother can opt for anesthesia, but it is necessary to check with the doctor if this is possible or not.
Fortunately, epidural anesthesia is released for most cases, making the only pain to be felt from contractions. This pain is necessary, because through it the woman and the doctor will know when it is necessary to apply more or less force.
In the body of some women, in addition to removing the strongest pain, the epidural alters the sensitivity to contractions. In these cases, the obstetrician uses a device that is capable of measuring contractions.
There are other means that doctors recommend for pain relief, without the need for anesthesia. The most frequent are:
Relaxing massages between contractions
The muscles are tense and the belly is heavy. Combining this with the anxiety generated by childbirth, the woman is left with a pile of nerves, which only contributes to increase her pain.
Therefore, a massage on the bottom of the back, with gentle circular movements or a body massage using a moisturizing cream becomes a good strategy.
The contact of the hands with the skin helps to reduce stress , which relieves tension and consequently pain.
Techniques for breathing deeply
Breathing deeply has several health benefits . So it is a good technique to help at the time of delivery. At that time, you should fill your chest with air as if you are smelling a flower and release it slowly as if you are blowing a wound.
This helps to maintain oxygen long enough for a correct contraction, which reduces the pain.
Acupuncture or acupressure
Acupuncture can be extremely helpful in times of pain, as the needle is able to reach the nerves with great precision and release endorphins, a substance that eases pain.
For those who are afraid of needles, or just don’t like the idea of being pricked, acupressure can be a good way out. She does not use needles, she uses pressure at the point of pain.
Keep the body going
Standing still is nowhere near a good idea, it increases anxiety and leaves you with a feeling of loss of control over your body.
When moving, the feeling of dominance over the situation is greater, and this control helps to reduce anxiety and pain.
Good tips to keep moving is to do light walks, squats, sit on a pilates ball and perform small rotating movements, as if you were drawing an eight with the ball.
Hydrotherapy means using water to calm and relax the body, so it is not difficult to guess the way this technique is performed.
Being immersed in a bathtub or a shower of warm water can be very calming for many future mothers, as it relieves pressure on the body, promotes muscle relaxation and may even decrease the need for medication.
For most women, knowing that they are expecting a child is quite a thrill. Imagine, then, discovering that you are expecting two at once!
That twin pregnancies require more care is nothing new for anyone, but it is important to note that, following frequent monitoring and without any complications with the mother or babies, two babies can be born by normal birth. However, above two, normal delivery is not recommended.
As in any other case, pregnancy must be closely monitored by the health professional, that is, the obstetrician. He will know whether or not it is possible to have a normal birth.
What often happens is that the twins end up being born prematurely. If the doctor assesses that they are both fully able to be born by normal birth, without posing risks to the mother or to themselves, the process for labor begins.
For the natural birth of twins, the first baby must have its head between the pelvic bones and the placenta must not be blocking the cervix. Only the position of the first twin is taken into account because the position of the second has almost no effect on natural birth.
However, if the first child is not in the proper position, it is necessary that the delivery is cesarean. The most common is that the two twins are upside down. This increases the chances of successful vaginal delivery by 40%.
The biggest fear of many twin pregnancies is having to go through two types of delivery. Unfortunately, this occurs with a certain frequency, with the first one having a normal delivery and the second one by cesarean section. This happens when the second baby does not turn into the correct position even after the first twin has left, or when the doctor induces him to the vaginal delivery position.
It is worth remembering that the second baby can be born a few seconds, minutes or even half an hour after the first twin. This is not very common, especially in Brazil, as the rate of normal birth is low.
However, there are rare cases in which one of the twins is born prematurely, because he is already formed, and the other may spend more time in the mother’s belly, waiting for his own “moment”.
As in the case of just one baby, normal delivery has a rapid recovery, with the uterus returning to its natural size in a maximum of 4 hours.
There are several advantages for the mother and baby in normal delivery, but recovery, although faster than cesarean delivery, is still very difficult and delicate. The main complaints are:
The body has been constantly changing in recent months and, now that the baby is no longer demanding from the body, he needs to readjust with the space and its functional capacities.
In addition to all the changes in the last few months, at the time of delivery, the abdominal muscles have been completely stretched, this can leave them half asleep, and with this numbness the mother will present:
- Urinary incontinence;
- Affliction or difficulty when urinating, either by fear or burning;
- Unwillingness to go to the bathroom until the bladder starts to hurt.
Difficulties to defecate
Yes, the situation will cause discomfort and no, the moment should not be postponed. The entire pubic area will be very sensitive, but it is necessary to take it easy and not try to postpone it, as the stools can dry out and become even more difficult to expel, causing sharp pains and bleeding.
Good tips for getting rid of the problem are:
- Stay hydrated;
- Eat foods rich in fiber (fruits and vegetables);
- Drink papaya and plum juice;
- Take short walks.
It is extremely important to ask your doctor about the use of laxatives or suppositories.
Pain in the vaginal area
The most sensitive area is, without a doubt, the area that has made the most efforts.
So, it is normal and completely understandable that there is pain in the region of the vagina and especially the perineum (tissue between the vagina and the anus), which is also sensitive, especially if you have suffered lacerations or stitches.
The pain in the area should improve in a few days, but there are cases where the pain lasts for weeks.
Useful tips to ease the discomfort are:
- Vary position;
- Use cold compresses;
- Rest as much as you can;
- Immersion in warm water;
- Whenever you are urinating, throw a glass of warm water at the same time, so the urine is diluted and the burning in the perineum is less.
Hemorrhoids are a problem that plagues many women during pregnancy, and in the postpartum period they tend to get slightly worse, but the tendency is to heal quickly.
In this case, hemorrhoids were caused by issues of hormonal imbalances. They disappear over the first few weeks, as soon as the woman’s body is able to regulate hormones.
Other symptoms that may appear are:
- Swollen feet;
- Vaginal bleeding;
- Small burst veins (in the eyes, cheeks and chest).
Is it possible to have a normal delivery, even if the baby is big?
The answer to this question is variable, as it depends on the child’s weight, which is verified on ultrasound, and also on the mother’s structure.
Doctors analyze whether the baby will be able to pass through the vaginal canal without being at risk or bringing risks to the mother. The goal is always the safety of both.
Does every normal delivery have an episiotomy?
Not to the mothers’ delight, no. Episiotomy is the cut in the perineum, space between the vagina and anus, to increase the opening at the moment of expulsion of the baby in women who do not have the elastic canal so elastic.
This is necessary so that there are no local tears, as the baby would injure the region anyway (in non-elastic cases) but, without medical help, the injuries would be much worse for the mother.
Does exercising during pregnancy help with normal childbirth?
Yes, and a lot. When performing physical activities, the woman gains more physical conditioning and flexibility, so at the time of delivery, with the acquired physical resistance, she will be able to push the baby more easily and, with flexibility, reduces the chances of needing an episiotomy.
It is important to carry out mainly activities that help with bone flexibility and opening, always consulting the obstetrician, as he will know how to indicate the correct activity for each mother.
Or normal delivery lengthens the vagina?
No. The woman’s body was biologically prepared for this moment, its function is to stretch and then return to natural size.
Is forceps always used in normal delivery?
No. The forceps (an object similar to pliers, which serves to pull the baby’s head) is an instrument that should only be used in extreme needs.
For example: when the child is standing in the vaginal canal. When used in the necessary occasions and in a wise way, the forceps saves lives, but it is not always used.
How long after normal childbirth can a woman have sex?
The woman must go through a quarantine period , known as 40 days, without sexual activity.
After this season, you need to go to the gynecologist to see if everything is okay with your vagina. He is the only one able to say whether the woman can resume sexual activities or not.
However, most women return to sex normally after 40 days.
In normal water birth, can the baby drown?
No. The baby does not drown, as it has a drowning reflex that does not allow him to inhale while not out of the water. This reflex has existed since the baby is in the mother’s belly, surrounded by amniotic fluid.
Can babies with an umbilical cord ring be born by normal birth?
Yes. Most of the time, even with a circular cord (wrapped around the neck), it is possible to perform a normal delivery, but each case is a different situation and only the doctor will know whether or not it is ideal to perform a normal delivery.
Do I have to shave the genital area before delivery?
It is not mandatory that there is complete epilation of pubic hair. However, doctors recommend that the woman remove excess hair on the part of the vulva and also between the legs, as this facilitates the moment of touching the uterus and identifying the baby’s crowning moment.
Does normal childbirth hurt?
This is the main reason why most women opt for cesarean section: pain. It is useless to say that it does not hurt, because it does. The woman’s body goes through several changes, hormonal and physical, so that the baby’s exit is carried out, and all this ends up generating pain.
To avoid or alleviate pain, women may prefer anesthesia, massage or even water birth.
Is it true that women with broad hips are more likely to have a normal birth?
No. This is a very old popular belief, but the size of the hip does not interfere with normal childbirth.
What can actually facilitate or hinder a normal delivery is the size of the pelvis, as the woman may have a broad hip and a tight pelvis. This point is addressed at the time of prenatal care, during physical examinations.
Can babies in a pelvic position be born by normal birth?
Sometimes, but it is not indicated. In these cases, the butt and even the arms come out, but sometimes the head cannot come out. This causes damage so serious that it can lead the baby to death. When this happens, the ideal is to perform a cesarean section.
Is it possible to have a normal delivery without dilation?
Yes. According to Wagner Rodrigues Hernandez, master’s degree in obstetrics at the Faculty of Medicine of the University of São Paulo (USP), what actually happens is the lack of patience to wait for the contractions to act on the cervix.
When the process is extremely slow, contractions can be induced, but doctors rarely advise this method.
Childbirth is an unavoidable condition that all women who wish to have a child biologically will pass. The only way to go through the process as calmly as possible is to maintain regular consultations with the obstetrician, as only he will know what is the best way to bring your child into the world.
If you know any future mom who is unsure about the long-awaited birth of the baby, share this article with her!