Birth is unpredictable. We never know exactly how it is all going to pan out. Birth shouldn’t be managed unless there is a medical reason, and that’s a whole another ball game.

Mothers and their health care providers need to understand birth isn’t completely within their control.

If all is well, having a normal, physiological birth is always the best option as the benefits certainly outweigh the risks. If there are concerns with the baby’s wellbeing, an early intervention birth might be the best option.

Pregnancy for normal birth

If you are having a healthy active pregnancy, generally your labor and birth will also be normal. The antenatal phase is the most important phase of the entire journey. If you get this right, the rest of it will flow.

Taking care of yourself physically throughout pregnancy has a huge influence on how your labor and birth will unfold.

Body therapy such as chiropractic or osteopathic work can keep your body aligned, help your pelvis muscles to relax and help your baby to get into the optimal position for birth.

A healthy diet and exercise during pregnancy will set you up for a positive birth experience. Exercise during pregnancy can even help you to have a shorter labor. Eating a wide variety of vegetables, lean protein and healthy fats will help to keep any weight gain within normal ranges. Being overweight during pregnancy can lead to complications that might mean you need interventions during birth, particularly induction and c-section.

Choosing the right health care provider who supports your beliefs about labor and birth is vital to achieving a normal birth. You can work through any fear of birth and if you’re supported by the right team of people, you can have a positive birth experience.

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Where will you birth your baby? Home, hospital or birthing center?

The environment you choose has a huge impact on how positive your labor and birth will be.

When a woman is taken into a hospital setting, the environment is not familiar or even comfortable. There are disruptions to the normal flow of things, such as interruptions by staff, and the need to have frequent checks.

Hospitals are noisy, bright places where strangers are often moving in and out of your space. It’s hard to achieve a normal birth under these circumstances.

Alternatively, birthing in an environment that is comfortable and safe for you is optimal for natural birthing. You’re in control of your environment and the people who are in your space. This allows the flow of hormones you need to labor efficiently.

Safety is really the key in making the choice between home, hospital, or birth center. Birth needs to occur where you feel safest. For some women, this might be a hospital if, for example, they’re having a preterm labor, or complications occur that might mean their baby will need assistance after birth.

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Choose the right health care provider for you

The right health care provider is someone who suits your philosophy of pregnancy, labor and birth.

If a health care provider is known to perform lots of c-sections and you want a natural water birth then it’s likely this health care provider is not the one for you.

Have some consultations with private midwives, obstetricians, and the hospital to see which is the best choice for you.

Water birth for a natural or normal birth

Water birth offers many benefits to both mother and baby. Many women who labor in water feel supported by the water and have a sense of privacy. Their bodies are relaxed, so they can have an active labor, move about how they wish, and get pain relief from the warm water. This also supports the perineum, allowing the tissues to stretch gently as the baby is born, and reducing the risk of tears.

The baby also has the benefits of a gentle transition into the world when birthed through the water. Baby is still attached to the umbilical cord, which provides oxygen, so he can be underwater with no concerns. The baby is going from one watery environment to another, which is less of a shock and he can adjust to life outside the womb more gently.

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Birth planning for informed choice

Birth planning is all about making sure you have the information you need to make an informed choice about what you want your birth to look like, and preparing for those unexpected hiccups.

Some people might roll their eyes when women have a birth plan; they think it’s impossible to ‘plan’ birth. A birth plan isn’t prescriptive; it is an information tool, to help a woman and her support team to make informed decisions about her care.

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Braxton Hicks contractions

Some people refer to these contractions as false labor contractions, but the term ‘practice contractions’ is probably more apt, as these contractions are preparing you for the real thing.

Braxton Hicks contractions feel like a tightening in your tummy. They tighten and then release and will usually ease off with a warm bath or shower. If they don’t, you’re in labor.

You might like to know more, so check out Braxton Hicks Contractions – What Are They?

What are preterm labor signs in pregnancy?

Some women have the ‘nesting instinct’ just before labor kicks in. This is when you’re frantically cleaning and organizing for baby, feeling like baby could arrive any day.

Listed below are some examples of how prelabor contractions might emerge before the first stage of labor begins.

These patterns can occur the day you start labor, 2 to 3 days leading up to the day you labor, or on and off for 2 to 3 weeks before the labor begins. There’s no guarantee that prelabor will happen at a certain time and it can definitely mess with your head to have on and off contractions for weeks.

Be patient with yourself, think of ways to get as much rest as you can, and try to carry on with life as normally as possible.

Pre-labor contractions might:

Start with regular contractions that are 10, 15, or 30 minutes apart and last approximately 20-40 seconds. A regular pattern can start to emerge as the contractions become stronger, longer, and closer together over time until early labor becomes established
Be strong contractions lasting 20-30 seconds, coming about 5 or more minutes apart. This could happen early every morning or late at night, last a couple of hours and then stop. It can also happen on and off for a couple of days or weeks before active labor starts
Come in the form of irregular contractions at the end of the day when you are feeling tired or trying to get some sleep. The contractions can be strong, and some women will use a bath, shower, or hot water bottle to relieve them. Most women eventually fall asleep after a while, waking up ‘still pregnant’
Be a dull ache in the lower belly, upper thighs, and/or lower back. Some women experience strong, period-like cramping, lasting 2-3 minutes or more, over many days, on and off, for 2-3 weeks
Come as a series of labor pains that are irregular contractions (e.g. 3, 5, 7,10,15,30 minutes apart at various times) and lasting for 20-40 seconds around the clock for two or more days. There appears to be no regular rhythm developing with them, and it is difficult to rest or sleep
Be painful or mild contractions but not severe enough to stop you from doing normal tasks
Not be particularly noticeable. You might have slept through most of them during the night, or you could confuse them with the discomforts of late pregnancy.

Here is more information on Contractions | Everything You Need To Know.

What is labor in pregnancy?

Each stage of labor is often characterized by different types of contractions.

During the first stage of labor, each contraction makes the uterine muscles shorten slightly and, in doing this, they pull the cervix up into the lower segment of the uterus. The shortening of the uterine muscles decreases the size of the uterine space so, eventually, the baby is pushed down and out of the vagina, or birth canal.

The waves of contractions start at the top of the uterus (called the ‘fundus’) and radiate down the uterus to the cervix. Simultaneously, the lower segment of the uterus is being pulled up to open the cervix.

When the cervix is fully dilated, transition occurs. This is often the moment many women will doubt themselves, and say ‘I can’t do it!’ The midwife and support people, of course, are telling her she can.

The second stage is when the fetal ejection reflex takes over and you have the urge to push and birth your baby.

The third and final stage is the birth of the placenta.

Giving birth

If all is well with the baby and the mother, the key to this stage is there is no rush to push the baby out. It is often called the pushing stage, but coached pushing or ‘purple pushing’ isn’t advised, unless there is fetal distress and baby needs to be born urgently.

Often, in first-time mothers, the amniotic sac ruptures at this stage. This will be a relief, as the bulging sac of waters can create intense pressure.

Allowing the stretch of the perineum to happen slowly will minimize any tearing as the baby’s head crowns. At this point, some women might want to put their hands over their baby’s head, which can encourage them to realize they’re very close to meeting their baby.

You might like to read Purple Pushing / Directed Pushing – Why Avoid It?

Birthing the placenta

In a hospital setting, the birth of the placenta is managed, unless the mother chooses a natural third stage.

The woman is given a shot of synthetic oxytocin, then the midwife will place a hand on her belly to guard the fundus and the placenta is pulled out. This is termed ‘controlled cord traction’ (CCT).

If you wish to have delayed cord clamping, you must be very clear about this on your birth plan and during discussions with your birth team.

You can opt to have the oxytocin injection after a certain time when the umbilical cord has stopped pulsing, or you can choose to wait for the placenta to be expelled on its own.

The third and most natural option is a physiological third stage, whereby the placenta is birthed once separated from the wall of the womb. The uterus contracts, the placenta separates, there is some slightly bloody vaginal bleeding, and the placenta comes down the vaginal opening.

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What is a support person during labor?

Your partner is likely to be your biggest support, along with your midwife, doula, and any other significant others you want at your birth.

The support people might:

Breathe with you and remind you to take deep breaths into your body
Maintain eye contact if you’re looking lost
Help with hot packs to your lower back and abdomen
Rub your back with warm oil (rubbed between their hands to warm it)
Give you a foot and shoulder massage
Do a ‘body check’ after every contraction, to make sure you relax your body
Offer you fluids after each or every other contraction
Remind you to urinate every 2 hours
Suggest, and physically help you into other positions
Stay calm and stay relaxed
Help you have an active labor.

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Why is natural birth better than c-section for baby?

C-section birth has become all too common these days, often as a result of failure to progress after induction. Once an induction is started, there is no other option but to give birth. If the induction fails, then c-section is the end result.

The risks of c-section to mothers are actually higher than those of a normal vaginal birth. The recovery afterwards is much more prolonged, and after c-sections there is also a greater chance of complications for babies, such as respiratory distress. Babies born via c-section can also be at greater risk of poor health outcomes when they’re older.

Not all women are able to have a vaginal birth, for various reasons. There are still some things you can do to make the c-section a more positive experience for you and baby.

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Who should be in the room while you are giving birth?

You need a birth team of people you can trust and who will support you in labor and birth on your terms. People who make you feel nervous, stressed or anxious definitely don’t belong in your space when you are a laboring woman.

Have a think about who you really want at your birth and read our article Saying ‘No’ to Unwanted Birth Support People.

If you’re having problems connecting with any of the hospital staff, it’s perfectly ok to say so and ask for someone else to care for you.

Birth rights are human rights

Pregnant women are entitled to be treated with respect and dignity, and to make decisions for their care and that of their babies.

Health care professionals who try to intimidate or frighten a woman into making decisions that aren’t in her best interest are not respecting her human rights to health care.

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Australian Charter of Healthcare Rights | Australian Commission on Safety and Quality in Health Care

Your Rights At 42 Weeks Of Pregnancy.