The Simple Story of Birth
During the last weeks of pregnancy, a series of physical changes sets the stage for your baby’s birth. The changes happen slowly and predictably, and each change is a vitally important event in the drama of labor and birth. Your baby is ready to be born. And your body knows this. Together, your body and your baby dance into motion.
Dramatic hormonal shifts orchestrate this entire process. In the final weeks of pregnancy, your body begins to release more prostaglandins to soften your cervix. Your baby settles lower in your pelvis. You may notice strong (but typically not painful) uterine contractions. Sometimes they become rhythmic, then go away. This is exactly what your body needs to do.
You may not realize you’re in labor at first. Women often describe early labor contractions as mild, cramp-like pains that start deep in the abdomen and move downward toward the groin. Or, you may feel early contractions as back pain.
Labor—especially early labor—is a process that’s easily affected by your surroundings. Most mammals seek quiet and privacy when they’re in labor, and if they sense danger of any kind, labor stops. This frees them to move to safety, or lets them wait until danger passes to birth their babies. Human labor fits this pattern: Early on, it can be shut down by anxiety, fear or anything that makes you feel unsafe. That’s why it’s important to choose a birth site and caregiver that help you feel confident and secure.
As labor progresses, your body releases increasing amounts of oxytocin to make your uterus contract (tighten and relax) in a steady rhythm. As your body releases more and more oxytocin, your contractions grow stronger and stronger. These contractions slowly efface (thin) and dilate (open) your softened cervix and encourage your baby to move downward in your pelvis.
You can think of contractions like waves at the beach. Early labor contractions are like gentle waves. You might notice them, but you don’t have to work hard to stay afloat. Gradually, the contractions grow stronger, longer and closer together—the waves grow higher and deeper and more difficult to ride.
When your contractions are lasting a minute long and are less than five minutes apart (from the beginning of one contraction to the beginning of the next), and are gaining strength, you’re in active labor. It can take anywhere from a few hours to a few days to reach this point in labor. As labor becomes more intense, your focus will move inward as you draw on your body’s inner wisdom to work with labor. Your body will release hormones called endorphins, which decrease pain perception and help you enter a dreamlike state. You may rest, or even sleep, between contractions.
At exactly the right time, as your baby rotates and descends through your pelvis, you begin to feel an urge to push. Pushing is a reflex, and like other reflexive behaviors (such as sneezing), it doesn’t need to be taught. It happens naturally and is, in fact, difficult to stop. Responding to this urge, you move and change position frequently to find the best position for pushing. While you may be tired, you can expect to feel more alert and the contractions may not feel as intense as they had been. You may feel some burning as your perineum stretches around your baby’s head. Often, a baby’s head will move back in a little between contractions, allowing you to stretch gradually. When your baby’s head is born, the body may not be born until the next contraction. In the meantime, you can rest and gather your strength for the final push. You will then be able to welcome your baby into your arms, exploring the little body that grew inside you.
Read more about natural labor in The Official Lamaze Guide: Giving Birth with Confidence, 2nd edition.