The human pelvis has a complex shape, making your baby negotiate several manoeuvres during labour and birth.
Every mother’s pelvis is widest side to side at the entrance – because of this, most babies enter the pelvis looking left or right. The exit from the pelvis is widest from front to back, so babies almost always turn face up or face down.
These manoeuvres occur from forces of labour and the resistance provided by the birth canal. In addition to making these turning manoeuvres, the baby is simultaneously descending further down the vagina.
Finally, the top of your baby’s head appears (crowns), stretching your vaginal opening. When the vulva has stretched enough, the baby’s head will emerge – usually by extending the head, lifting its chin off the chest and thus emerging from under your pubic bone.
The baby usually emerges face down but will turn to one side very quickly as the shoulders turn to take the same route. The rest of the body is born and then you can hold your new baby!
Oxytocin: Known as the hormone of love, oxytocin is secreted during sex, after ovulation and during labour, birth and breastfeeding. It creates nurturing and loving feelings.
Endorphins: Endorphins are produced in response to pain and stress. Endorphins have calming and pain-relieving effects. As labour progresses and pain intensifies, endorphin levels steadily increase in unmedicated labours.
Adrenaline: Adrenaline is also known as the ‘fight or flight’ hormone. Adrenaline is secreted in response to stress, fear and extreme pain. If a woman experiences these feelings during labour, too much adrenaline may be produced which can slow labour.
More information: Hormones in labour: oxytocin and the others – how they work
Labour is divided into four stages.
The main signs of labour starting are:
The first stage of labour is made up of three different phases and involves the thinning of the cervix and its dilation to around 10 centimetres.
Latent phase
Active phase
Transition
Throughout the first stage of labour, careful monitoring and recording of your wellbeing, your baby’s wellbeing, and the progress of your labour, is important. This helps us to know whether your labour is progressing normally, to recognise any problems early and for clear communication. Ideally, you will experience the latent phase in the comfort of your home. You may wish to come to hospital as you move through the active phase.
More information: Queensland Clinical Guidelines parent information – Early labour
Birth partner’s role
Helping yourself in first stage
More information: Pregnancy, Birth and Baby – Giving birth - first stage of labour
The second stage of labour is the birth of your baby.
The second stage of labour starts when your cervix is fully dilated, and you will usually have a strong urge to push because of the pressure your baby’s head is placing on your pelvic area.
At this stage your baby is moving from your uterus into your vagina and out into the world.
The second stage can last from 10 minutes to two hours.
Helping yourself during the second stage
Birth partner’s role
More information: Pregnancy, Birth and Baby – Giving birth - second stage of labour
After the birth of your baby, your uterus gently contracts to loosen and push out the placenta. This may occur five to 30 minutes after the birth of your baby.
The muscles of the uterus continue to contract to stop the bleeding. This process is always associated with a moderate blood loss – up to 500 millilitres. In this stage of labour, one of the potential problems is excessive bleeding (postpartum haemorrhage), which can result in anaemia and fatigue. This is why the third stage is carefully supervised.
There are two approaches to managing the third stage:
What is a natural third stage?
A physiological or natural third stage means that you wait for the placenta to be delivered naturally.
After your baby's birth, your midwife will delay clamping the umbilical cord to allow oxygenated blood to pulse from the placenta to your baby.
Your uterus (womb) will contract, and the placenta will peel away from the wall of your uterus. The placenta will then drop down into your vagina, ready for you to push it out.
Delayed cord clamping
For baby
The benefits of delayed cord clamping for the baby include a normal, healthy blood volume for the transition to life outside the womb; and a full count of red blood cells, stem cells and immune cells which results in higher iron stores in the baby for up to six months.
For mother
Delayed clamping keeps the mother-baby unit intact and can prevent complications with delivering the placenta.
Benefits of an active third stage
The advantage of an active third stage is the lower risk of very heavy bleeding immediately after the birth. Your midwife or doctor will recommend you have an active third stage if you had complications during pregnancy or labour, such as:
Active third stage
Immediately after the birth of your baby, the midwife or doctor gives you (with your consent) an injection of oxytocin, clamps and cuts the umbilical cord, and then carefully pulls on the cord to speed up delivery of the placenta.
Modified active third stage
This is a combination of active and natural. It is similar to active third stage but it includes delayed cord clamping.
After the birth, you and your partner will be given time with your baby so that you can get to know one another.
While you are holding your baby, your midwife or doctor will do a check called an ‘APGAR score’.
The APGAR score will be done twice, at one minute and five minutes after birth. You probably won’t even notice it’s being done, as the midwife can do this while baby and mother are skin to skin.
It helps the midwife or doctor to know whether your baby needs additional care following birth.
The APGAR score is based on the baby’s:
Blood loss after birth is normal.
Bleeding in the days or weeks after birth (also called lochia) is completely normal and occurs regardless of whether you have a vaginal birth or caesarean birth.
What is normal blood loss after birth?
Women’s experiences of bleeding after birth vary considerably. In the first few days after birth, most women experience moderate to heavy bleeding. Over the first few days to weeks this bleeding will gradually decrease and will change colour.
Most women will stop bleeding between four and six weeks after birth. It is also common for bleeding to be heavier after breastfeeding.
More information: Queensland Clinical Guidelines parent information – Bleeding after birth
Stages of labour, 23 Mar 2023, [https://oss-uat.clients.squiz.net/health/children/pregnancy/antenatal-information/stages-of-labour]
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