We talk a lot about birth at Giving Birth with Confidence. We've discussed choices, fears, providers, healthy birth tips, interventions, and lots more. With this new series, we want to take a step back and help describe to expectant families what birth is like. Of course, as many people say, "you'll never know until you know," but for people who like to feel as prepared as possible and who tend to read every description and juicy tidbit about birth they can get their hands on, we wanted to provide some basic information. In this series, we'll review separately the topics of physical sensations (in this post), emotions, what the experience might be like for a partner, and recovery. We also will review the same topics for cesarean birth in the series.
Vaginal Birth - What's It Like, Physically?
As you read through the following descriptions, keep in mind that no two births are exactly the same. Many women describe the sensations of labor and birth differently. That said, there is a range of commonly shared experiences that may help you to better understand the physical aspects of labor and birth.
Usually, the first very noticeable physical changes in early labor is the sensation of contractions. Different than Braxton Hicks contactions, early labor contractions usually make you sit up and take notice! Many women report saying to themselves, "Wow, that was different!" after experiencing early labor contractions. While it can vary from woman to woman, early labor contractions typically cause you to feel an all-over hardening of your mid section (which is due to the uterus contracting), along with either lower back pain (usually dull and achy, but sometimes sharp) or lower uterine cramping, or both. These contractions are short-lived (less than a minute) and usually light in strength. They can cause you to feel like it's taking your breath away, or like you need to focus on your breathing until it releases. Once the contraction "lets go," you feel like your old self again. Of course there are other physical symptoms that can also happen during early labor, including feeling overly sleepy, a burst of energy (referred to as "nesting"), losing all or pieces of the mucous plug (which may or may not be blood-stained, ie "bloody show"), and loose stool/diarrhea. Those symptoms also can happen in advance of early labor and without any contractions. Early labor can also feel tiring, depending on how long it lasts (which can be anywhere from a few hours to a few days). It's notorious for disrupting sleep and causing and heightened sense of impatience.
Active labor is where the process begins to ramp up physically. Think of it as the difference between a "warm up" and the actual workout. In active labor, women report feeling contractions more intensely -- so think a tighter "squeeze" that is felt wrapping from your back to your front and vice versa (check out our post on the many different descriptions of what a contraction feels like). Contractions feel stronger and they are also lasting longer (at least a minute up to a minute and a half generally). What this also means is that a woman's mental focus has shifted. While small talk and jokes may have been happening in early labor, typically a laboring person is quiet and fiercely concentrating in active labor. It's generally difficult to think about routine tasks like moving around, going to the bathroom, signing papers, or answering questions. Physically, for most people in labor, standing, sitting, or leaning feels best. It's also normal for a woman to breathe heavily or focus on a breath pattern, and to moan or use her voice during contractions.
As active labor carries on (and again, the length can vary widely), it's normal for a woman to feel exhausted, depending on the amount of sleep she's had, how much she has eaten, and the length of labor thus far. It can also be common to feel any variation of the following: cold/chilled, hot, nauseous, significant back pain (depending on baby's position), thirsty, not hungry, dry mouth and lips, and shaky.
Transition (the period of time from 7cm-10cm) has many physical hallmarks. The first and most notable are the contractions, which are longer and more intense. Thankfully for most women, transition is generally the shortest phase. Apart from the marked contraction difference, transition is generally when the laboring person has a harder time coping, may become nauseous and vomit, experiences body shakes, and begins to feel more pressure on the perineum (the "bottom"). Transition may also provoke irrational thoughts like, "I don't want to do this anymore -- can we go home now?"
Time to push! Pushing has many varying physical characteristics. Many women report feeling a sense of great relief when they can work and do something with their contractions rather than passively experience them. Others report disliking pushing. For most, pushing is the most physically arduous part of labor -- it's hard and exhausting work! With pushing, a person will feel pressure on the perineum, a bulging sensation as baby gets closer to emerging, and a stretching and stinging sensation as baby's head crowns (this is the very last and a short-lived part of pushing, however). It's also common to become quite hot during pushing. Pushing also can last for longer than what you might expect. It's not uncommon to push for 1-3 hours for first-time moms. Sometimes babies will come out in only a few pushes, but that experience isn't as common for first time parents. Once baby is out, moms generally feel near complete physical relief.
Immediately after baby is born, many moms report feeling tender in their perineal region, but not quite as noticeable as it is later on during postpartum. If there was a tear and/or stitches, moms will report increased pain, stinging, and discomfort. In the few days that follow, many new parents will report a very tender and swollen vulva and perineum. Ice packs generally feel fantastic! It's also common to feel general all-over muscle soreness, depending on the length and physical movement that took place in labor. Feet and ankle swelling also can be common in the first few days after having a baby.
Have you had a baby recently? What would you add to these descriptions? We want to hear in the comments!