A vaginal birth is the safest way for most people to give birth. People recover faster from a vaginal birth, and vaginal deliveries don't have the same health risks as C-sections.
But vaginal births don't always go according to plan. That's why it's a good idea to deliver in a hospital, with doctors who can respond to complications with you or your baby.
Here's what you need to know about what happens before, during, and after a vaginal birth.
A vaginal birth is when you push your baby out through the vagina. Approximately 68 percent of all births in the United States are vaginal deliveries.
When you have a vaginal birth, you go into labor. Labor is when the uterus contracts (squeezes), and the cervix opens so the fetus can move down the birth canal. This process happens on its own around 80 percent of the time.
The rest of the time, doctors induce labor. Doctors do this when labor doesn't happen naturally or when an earlier vaginal delivery would benefit the fetus or pregnant person.
In most cases, pushing is adequate for birthing the baby. About three percent of the time, doctors use a vacuum device or forceps to pull the baby out gently.
A vaginal birth is painful, but medication can help to reduce and even eliminate pain. Alternative pain relief methods like massage, movement, and water therapy can also help.
A vaginal birth is the best and safest option for most people to deliver their baby. That's because a vaginal birth means a shorter recovery time compared to a cesarean section (C-section). A vaginal birth has lower risks of bleeding, infection, and injury than C-sections.
When you're pregnant, the baby has to come out. The alternative to vaginal birth is to have a C-section when a surgeon cuts open the abdomen to remove the baby from the uterus.
For some people, a C-section is a good idea because a vaginal birth is too risky. Vaginal birth may be risky if you have a heart condition, a placenta problem, uterus scarring from previous C-sections, or another reason.
If you don't need a C-section for a medical reason, the risks of a vaginal birth are lower than the risks of C-section.
Doctors will monitor you and your baby for signs of complications during labor and birth. Doctors can intervene during labor or birth to prevent health problems if necessary. Interventions include medicines, induction, assisted birth, an emergency C-section, or other treatments.
Vaginal birth complications include slow or stalled labor, fetal distress, bleeding, and infection.
Doctors call slow or stalled labor a "failure to progress." It happens when labor takes longer than it should. It can happen when contractions are too weak or the baby's head is too large compared to the size of the birth canal. The baby's position can also slow labor (for example, babies don't move as easily through the birth canal if they're facing upward).
Sometimes, walking or changing positions can help labor that is too slow. In other cases, doctors may need to use medication to speed up labor. They may also use medical instruments to pull the baby out of the vaginal canal. If necessary, they may need to perform an emergency C-section.
Treatments depend on the length of labor, the stage of labor, and the health of the pregnant person and fetus.
Fetal distress occurs when the baby's heart rate slows down more than it should. A slowed heart rate may be due to pressure on the baby's head or umbilical cord, problems with the placenta or uterus, or low iron in the blood.
Your doctor will monitor your baby's heart rate periodically in labor. If you have a high-risk pregnancy, or you or your fetus show signs of possible problems, they will use continuous monitoring.
Sometimes, changing position can resolve fetal distress. Doctors may also give oxygen, IV fluids, or both to promote blood supply to the baby. For induced labor, stopping medications that stimulate contractions can also help.
If the fetal heart rate drops too low, or fetal distress lasts for too long, doctors may suggest an assisted birth (with a vacuum device or forceps), or an emergency C-section. Treatment depends on the stage of labor, the degree of fetal distress, and the pregnant person's overall health.
Everyone who gives birth will bleed heavily in the days after giving birth. But some people bleed too much during or after birth.
In most cases, this happens within 24 hours after birth. But people who give birth are still at an increased risk of bleeding for up to 12 weeks post-birth.
Bleeding during or after vaginal birth can happen because:
Losing too much blood is dangerous; it can even be fatal without prompt treatment.
Doctors may treat blood loss with one or more of the following treatments:
In rare cases, bacteria can enter the uterus during vaginal childbirth and cause infection of the uterus. If it's not treated quickly, infection can spread from the uterus to other organs. It can also spread to the blood (sepsis).
A uterine infection can cause serious health problems and even death if not treated. Doctors treat a uterus infection (endometrisis) with IV antibiotics.
Signs of infection usually show up within ten days of delivery. But infection can develop up to six weeks after childbirth. (See warning signs at the bottom of this article).
Some people who had preeclampsia (dangerously high blood pressure) before labor continue to have preeclampsia after delivery. It's also possible to develop postpartum preeclampsia even if you have normal blood pressure throughout your pregnancy.
This condition is dangerous. Without treatment, it can cause stroke, seizures, and even death.
Postpartum preeclampsia happens most commonly within 48 hours of a vaginal or C-section delivery. But it can occur up to six weeks after birth. Doctors treat preeclampsia with medicine to lower blood pressure and prevent seizures.
Here's what happens before, during, and after vaginal birth.
At 36 weeks, your prenatal visits will become more frequent, often one visit per week. If you're close to or past your due date, your doctor or midwife may check your cervix. They will look for signs your body is preparing for labor, like softening and thinning of the cervix.
They may also perform a "membrane sweep," which involves pushing the uterus away from the cervix. This procedure can sometimes help stimulate labor.
You may notice "lightening" or the baby dropping into the pelvis, which can happen anywhere from a few weeks to a few hours before labor. This change is when the baby's head moves lower in the pelvis ahead of labor. You'll feel less pressure on your diaphragm once this happens.
You may also experience Braxton Hicks contractions in the weeks before birth. (Some people feel them as early as the second trimester). These "practice" contractions aren't regular, usually aren't very painful, and go away if you rest or change positions.
If you have pregnancy complications, you may plan for an induction during your 39th week of pregnancy.
To prepare for a vaginal birth, you'll want to pack your labor bag and prepare recovery materials, like pads and pain relief, for when you get home. You'll also want to plan to be away from home for a few days and away from work after delivery if you take parental leave.
On average, first-time labor and birth last 12 to 18 hours. Those who have given birth before often have faster labor and deliveries, around eight to ten hours, on average. However, your labor and delivery could be much shorter or longer than this range.
You'll know you're in labor when your water breaks or you start feeling regular contractions. At first, these feel like mild cramps and don't last very long. But they will get stronger and closer together with time. This slow ramp-up is the first stage of labor.
Spending this part of labor at home is usually the most comfortable since it potentially lasts many hours. Doctors typically recommend going to the hospital when your contractions are five minutes apart and last about a minute each. They likely won't let you eat after arriving at the hospital.
The cervix dilates (opens) from zero to ten centimeters during labor. Many find the part where the cervix opens from five to ten centimeters to be the most painful, as contractions are strong and frequent.
You can request pain medication at any time during labor. An epidural, which delivers pain medication through a tube inserted in your lower back, is the most common type of pain medication during vaginal delivery. It numbs your pelvic area and legs, so you'll feel little to no pain.
Once you're 10 centimeters dilated, the baby moves out the cervix opening and down the birth canal. This movement of the fetus is the second stage of labor.
It may take a few hours or move quickly. Your care team may have you 'labor down' to give the baby time to move down the birth canal if you have an epidural.
Soon enough, you may feel an urge to push. If you have an epidural, you may not feel a strong desire, but your health providers will tell you when to push.
Your doctor or midwife will tell you when they can see the baby crowning (when the head is starting to come out of the vagina). They'll have you push during your contractions.
They will catch your baby and can place your baby in your arms right away if neither of you needs medical care.
Shortly after birth, your health team will clamp and cut the umbilical cord (alternatively, your partner can do this). They will weigh and measure the baby.
Amid all the excitement, you will deliver the placenta. This delivery is the third stage of labor and often happens five to 30 minutes after birth. Your health provider will check the placenta to make sure you delivered the whole placenta. If you've had a tear, they will stitch you up. You may not even notice these things are happening if you have an epidural.
A nurse may apply eye ointment to prevent infection and give your baby a vitamin K injection to promote blood clotting. Your team will explain the test and treatments before they proceed. They'll also monitor the baby's breathing and responsiveness using the APGAR test.
You may also want to try breastfeeding shortly after delivering your baby. Your nurse or a lactation consultant can help you position and latch your baby.
You will stay at the hospital for two nights after birth so your care team can monitor your health. They will check your blood pressure and temperature and ask about your symptoms. You can eat, walk around, and have visitors during this time. You'll spend time caring for yourself and your baby and resting as much as possible.
While at the hospital, the nurse will help you with breastfeeding or formula feeding and newborn care, including bathing.
After you return home, you'll have a follow-up visit with your obstetrician or midwife. It takes six weeks to fully recover from a vaginal delivery. Learn more about recovering from childbirth and caring for your newborn.
If you have the following symptoms after a vaginal birth, seek prompt medical care. It could mean you have a complication like bleeding, an infection, or postpartum preeclampsia.
Watch for these warning signs:
By UPMC Editorial Staff. Last reviewed on 2024-09-05.
