Giving birth - What happens when giving birth?

There are a few ways to prepare for the arrival of a baby. In addition to the preparations made for life with a baby, such as shopping for clothes, preparing the baby’s room, and coming to terms with parenthood, one may also prepare for birth itself in several ways. After all, giving birth is a completely new experience for women and couples expecting their first child and also often a unique event for those who have experienced births before. Birth preparation includes packing a bag with the essentials for a hospital stay (many other articles revolve around the contents of the bag, which would go beyond the scope here). In addition, each person who will experience birth, whether as a woman giving birth or as a companion, should have familiarized themselves with the process of childbirth. Good birth preparation courses are helpful, and so are videos of beautiful births.

In addition, it can be helpful to prepare mentally for birth. Some people use hypnosis to be able to relax well during birth. Others learn a specific breathing technique to help with labor and some prefer to prepare by collecting knowledge for all eventualities. The midwife’s tip for preparing for birth is to write a birth plan. In this plan, you can formulate how you imagine your birth, what you want to have urgently or what you refuse completely. You can give this plan to your accompanying midwife, regardless of whether you are having your baby at home, in a birth center, or in the hospital, and if you have time for it, you can also discuss it with the attendant. 

In my childbirth preparation courses, the most frequently asked question about the beginning of labor is: how do you actually notice the beginning of birth and how do you notice contractions? 

Let me tell you right away: There is no such thing as ‘the beginning’ of labor. Of course, there is a point in time defined in medical definitions as the beginning of birth. However, when experiencing a birth, there is a smooth transition between pregnancy and birth. I will discuss this transition in more detail later. 

There are several ways in which childbirth can begin. A birth can make itself felt either by the opening of the amniotic sac and the loss of amniotic fluid. Or with the onset of contractions. When the amniotic sac opens and the amniotic fluid comes out, it is not always accompanied by contractions. In some cases, it may take hours or even days before uterine contractions begin. On the other hand, in the course of childbirth, the amniotic sac may open much later than the onset of regular contractions, or it may not even open until the baby is born. Now to the mystery of labor pains. Before you’ve experienced childbirth yourself, it’s hard to imagine exactly what contractions feel like. Especially since the term ‘contractions’ does not describe exactly what that feeling is. The word implies only one thing: pain. But that’s not exactly what it has to be. In order to bring a child into the world, the uterus contracts. Women may already be familiar with these contractions from the abdominal sensation during menstruation: commonly known as period cramps. In pregnancy, on the other hand, such contractions are also very noticeable from the outside, because the muscle that makes up the uterus is now very large and very close under the abdominal wall. When the uterus contracts, the abdomen becomes hard and usually rounder. But not all contractions are the same. Even during pregnancy, the uterus contracts without the baby being born. These contractions are there to stimulate blood flow and thus ensure the blood supply in the placenta. It also helps build muscle cells, since the uterus needs a lot of muscle power to hold and deliver the baby. Then there are also the descending contractions toward the end of pregnancy, which move the unborn baby toward the pelvis.

So labor pains are not recognized by the mere existence of contractions. Contractions that actually lead to the birth of the child are regular, get stronger and stronger, and do not stop again without good reason.

The birth of a child is divided into different phases. These phases merge smoothly, but each has characteristic milestones. The very first phase of birth is the latency phase, the transition from pregnancy to active birth. I have already briefly touched on this phase above. In the latency phase, the cervix “matures”, i.e. it is prepared by the body to open and already begins to open the first 3-4 cm. This happens through the help of hormones and is often accompanied by contractions. How much a woman feels these or even perceives them as strenuous or painful varies greatly. Likewise, the duration of this phase cannot be estimated. Anything from a few hours to several days is possible here. There is one thing I think is important to mention: the latency phase is part of childbirth and it is okay and right to want support and care during this time or even to actively need help. However, it is just as okay and right to want peace and quiet during this time. No matter where and how you want to spend this first phase of childbirth, the only important thing is that you feel safe, secure and calm.

The next phase of childbirth is the opening phase and as the name suggests, during this time the cervix opens from 3-4 cm to 10 cm. This makes it “complete” as they say in technical terminology. The baby is already moving a little deeper into the pelvis during this time. This period also varies in length, and each woman giving birth experiences the intensity differently.

Next comes the main act: the birth phase. Now the child is born, in which it travels the rest of the way through the pelvis and the birth canal with contractions and active movements and slowly bit by bit and contraction by contraction becomes more visible. Whoever now thinks that everything is over with the birth of the child, may think again, because there is still something missing: The afterbirth phase! It is still too often left under the table, but it is just as important as the rest of the process. The baby is already in the world and lies (in the best case) on the mother’s bare skin, but in the uterus, the placenta is still waiting for its appearance. The organ that provided the baby with everything it needed from the outside during pregnancy has now done its job and is no longer needed by the baby. The mother’s body doesn’t need it anymore either, so it detaches from the wall of the uterus and is also ‘born’, leaving a wound in the uterus about the size of a palm, which is the cause of the postpartum flow that starts immediately afterward. When the full-term placenta is born, the birth process is complete. Most midwives will also congratulate you on the birth of your baby only now, because for us the whole process, including placental birth, is part of it. 

Another item on the list of possible preparations is language, and therefore the words we use to talk about childbirth. Language does a lot to us: the terms we use, shape our attitudes about individual topics. Mindful choice of words in relation to giving birth can help change the focus and put things that may be negative in our minds in a different light. For example, even in medicine, people quite often refer to childbirth as ‘delivery’. This word makes birth something passive and sounds more like getting rid of something troublesome in the process. But a woman is not ‘delivered’ from her pregnancy and child, but she gives birth to a child. Something similar can work with the word labor pains. Here something painful is already predicted, although the contractions of the uterus do not necessarily hurt in principle. Nevertheless, thanks to the word used, one expects exactly that. So let’s rather use another expression. In hypnobirthing, for example, the term ‘waves’ is used and I personally like to stay very much with the neutral medical term: contractions. The list of words we can change is almost endless and above all one thing: a very personal choice. So as mental preparation for childbirth, feel free to consider which terms you feel comfortable with and which in turn need an upgrade to fit your idea of a good and beautiful birth process.