The Physiological Birth
When discussing childbirth, three stages are often mentioned:
- The active dilation phase
- The pushing phase
- The afterbirth phase, which involves delivering the placenta and fetal membranes.
I think this gives an overly straightforward impression of childbirth because if childbirth is anything, it is certainly not straightforward. Based on what I've learned, childbirth can be divided into at least seven stages.
1. Entering the "birth bubble"
Even before the first contraction is felt, the birthing person often begins turning inward and withdrawing into themselves. This phase may involve intense nesting behaviors, such as frantic cleaning and preparing things "just in case" before the baby is born. This phase can last hours, days, or even weeks.
At this stage, it's important for the birthing person to listen to themselves and do whatever feels right. You can prepare for this phase well in advance during pregnancy by sharing only a vague due date or even just the due month with others. This way, you can avoid most of the "Is it happening yet?" and "Still in one piece?" messages.
2. The latent phase
The latent phase begins when either labor contractions start or the waters break. During this phase, the cervix softens, and the cervical canal starts to shorten. This phase can last from a minute to several days, and for first-time birthers, its duration can often be challenging. It's typical for contractions during this phase to come and go, sometimes easing off to allow the body to rest before gradually intensifying again.
At this stage, rest, nourishment, and hydration are crucial. You can go for a walk, enjoy life, forget about time, and continue living normally. Labor will progress when the time is right. A TENS machine can be helpful as soon as it feels needed. Boost oxytocin with your partner by massaging, kissing, laughing, or even taking a hot shower together. You can also engage in sexual activity alone or together, but if the waters have broken, any vaginal penetration should be avoided. On the other hand, if labor starts at night, just sleep!
If you've downloaded a contraction-tracking app, delete it. Enjoy your time together—your baby has begun their journey to your arms!
3. The active dilation or opening phase
At this stage, the cervical canal has disappeared, and the cervix begins to dilate. The duration and speed of dilation vary greatly and cannot be constrained to a timeline. Dilation doesn't happen linearly, even though some sources suggest the cervix opens one centimeter per hour. There may be plateaus where dilation doesn't progress for a while, and at other times, it may advance quickly. It's important to remember that the cervix is just a cervix, not a crystal ball that midwives can use to predict how long the birth will take.
This phase typically includes two "despair phases" at around 4 and 7 centimeters, where the birthing person may feel like they can't go on. At these times, it's essential for the partner to encourage and maybe suggest some changes, like trying the shower or switching positions. Otherwise, support the birther by being present, using the non-medical pain relief techniques learned in birth classes, and reminding them to eat, drink, and use the restroom.
As the birther, it's important to let the waves of labor carry you instead of fighting against them. Relax your jaw and pelvis, breathe calmly, vocalize, and move in tune with your body's sensations. Between contractions, rest, eat, and drink.
4. The transition
In this phase, the cervix is either fully dilated or nearly fully open. The birthing person often emerges from their "bubble" due to the increased adrenaline in their body. This adrenaline surge helps the birther and uterus endure through the birth (pushing) stage.
A strong pressure sensation may already be felt in the lower pelvis, especially during contractions. It's common at this stage for the birther to experience intense doubt about their ability to continue. It's not unusual for them to express feelings like "I want to die," "I need my mom," or to beg someone to "just take the baby out."
During the transition phase, contractions may become less frequent and feel very different from those of the dilation phase. The birthing person should move as their body directs, perhaps rotating their pelvis, and remember that even despair can be part of this stage. If your contractions pause, "rest and be thankful."
A midwife might suggest testing out some pushing at this stage, but in my opinion, practice pushes aren't necessary and could unnecessarily exhaust you. Trust that your body knows when it's the right time to push.
For the partner, a bit of a poker face might be needed here: your loved one doesn't actually want to die—they need encouraging words and a sense of safety. It's a good idea to offer juice or an electrolyte drink and remind the birther to use the restroom.
5. Birth phase (pushing phase)
As the birth phase begins, the birthing person often starts to grunt, and their voice may deepen. Many feel relieved that they no longer have to simply surrender to the contractions but can now actively push. The uterus is a large, powerful muscle that doesn't take orders or ask for permission. When labor has been allowed to progress naturally and with minimal interventions, the spontaneous reflex of the uterus—FER (fetal ejection reflex)—pushes the baby downward and out.
Before the baby's head is born, the birthing person typically passes stool. No worries—everyone in the room is used to it. It's also common for the baby's head to move gradually downwards, millimeter by millimeter, and then retreat slightly between contractions. This is actually beneficial for the tissues, which are given time to stretch gently, reducing the risk of significant tears.
As the baby's head begins to crown, the birthing person might feel a stinging or burning sensation as the outermost layers of the pelvic floor stretch. This moment is often referred to as the "ring of fire." Once the head is born, the baby usually rotates slightly before the next contractions help them emerge fully. In a hospital setting, the staff typically dries the baby a little before placing them on the birther's chest. In water births, the birther often lifts the baby onto their chest themselves—there's no rush since the baby is moving from water to water.
During the pushing phase, the birther should follow their body's instincts and trust they know how to push in alignment with their sensations. Changing positions whenever it feels necessary is always a good idea. Use as much or as little sound as feels right for you. Remember to breathe—this helps both you and the baby conserve energy to cross the finish line.
For the partner, the most important thing is to stay close, let the birther squeeze your hand until it's numb, and offer encouraging words and drinks between contractions. You can also cool their face with a cold cloth, as the birth phase often makes people sweat.
At the end of this phase, whether it was long or short, the effort is royally rewarded when you finally hold your baby on your chest. ❤️
6. Resting phase
Many describe the moments following the birth of the baby as the greatest sense of relief and euphoria in their lives. Immediately after the baby is born, the birther's body contains more oxytocin than at any other point in life. The birther might seem shocked, bewildered, or a bit dazed about what just happened. If the labor was particularly long or challenging—or if synthetic oxytocin or epidural anesthesia was used—they may feel numb or detached rather than euphoric. This is normal and temporary.
Once the baby is born, the uterus rests and regathers strength for the placental phase.
The baby takes their first breaths with a cry, opening their lungs. After this, they usually calm down and begin "seeking" their parent by opening their eyes and seeking eye contact. Instinctively, the baby starts to crawl toward the chest, kicking against the abdomen, which helps stimulate the uterus to contract and prepare for the placenta to detach.
The resting phase can last anywhere from minutes to hours. It's essential to give the birther time to rest and bond peacefully with their newborn.
7. Placental phase
Once the baby has made their way to the chest, their nuzzling and rooting, along with their kicks on the abdomen, stimulate after-pains. These contractions not only help detach the placenta from the uterine wall but also ensure the uterus contracts well, keeping postpartum bleeding manageable. The birther instinctively knows how to deliver the placenta and membranes themselves. Typically, the placental phase lasts minutes to hours, and in a hospital setting, the delivery of the placenta is usually awaited for up to an hour.
If no synthetic oxytocin or epidural anesthesia was used during labor, an oxytocin injection to speed up the placenta's delivery is usually unnecessary.
As the birther, the best thing you can do after your baby is born is rest, admire your baby with your partner, and let the baby find their way to the chest at their own pace. Once the placenta is delivered, the labor is officially complete. However, when each person feels the birth journey is truly over varies greatly.
I think this seven-phase perspective provides a more accurate picture of childbirth and its often-wave-like progression. While childbirth officially ends with the delivery of the placenta, the experience of the birth journey ending can differ widely. For some, the placenta's delivery goes unnoticed, and they feel the birth is over as soon as the baby is on their chest. For others, such as those who have undergone a cesarean section under general anesthesia, the birth journey might not feel complete until they meet their baby for the first time, hours after the birth.
<3: Henna