What is Vaginal Delivery

Vaginal delivery means that you give birth by pushing your baby out of your birth canal (vagina). A team of health care providers will help you before, during, and after vaginal delivery. Birth experiences are unique for every woman and every pregnancy, and birth experiences vary depending on where you choose to give birth.

What happens when I arrive at the birth center or hospital?

Once you are in labor and have been admitted into the hospital or birth center, your health care provider may:

• Review your pregnancy history and any concerns that you have.
• Insert an IV into one of your veins. This may be used to give you fluids and medicines.
• Check your blood pressure, pulse, temperature, and heart rate (vital signs).
• Check whether your bag of water (amniotic sac) has broken (ruptured).
• Talk with you about your birth plan and discuss pain control options.

Monitoring

Your health care provider may monitor your contractions (uterine monitoring) and your baby’s heart rate (fetal monitoring). You may need to be monitored:

• Often, but not continuously (intermittently).
• All the time or for long periods at a time (continuously). Continuous monitoring may be needed if:
  • You are taking certain medicines, such as medicine to relieve pain or make your contractions stronger.
  • You have pregnancy or labor complications.

Monitoring may be done by:

• Placing a special stethoscope or a handheld monitoring device on your abdomen to check your baby’s heartbeat and to check for contractions.
• Placing monitors on your abdomen (external monitors) to record your baby’s heartbeat and the frequency and length of contractions.
• Placing monitors inside your uterus through your vagina (internal monitors) to record your baby’s heartbeat and the frequency, length, and strength of your contractions. Depending on the type of monitor, it may remain in your uterus or on your baby’s head until birth.
• Telemetry. This is a type of continuous monitoring that can be done with external or internal monitors. Instead of having to stay in bed, you are able to move around during telemetry.

Physical exam

Your health care provider may perform frequent physical exams. This may include:

• Checking how and where your baby is positioned in your uterus.
• Checking your cervix to determine:
  • Whether it is thinning out (effacing).
  • Whether it is opening up (dilating).

What happens during labor and delivery?

Normal labor and delivery is divided into the following three stages:

Stage 1

• This is the longest stage of labor.
• This stage can last for hours or days.
• Throughout this stage, you will feel contractions. Contractions generally feel mild, infrequent, and irregular at first. They get stronger, more frequent (about every 2–3 minutes), and more regular as you move through this stage.
• This stage ends when your cervix is completely dilated to 4 inches (10 cm) and completely effaced.

Stage 2

• This stage starts once your cervix is completely effaced and dilated and lasts until the delivery of your baby.
• This stage may last from 20 minutes to 2 hours.
• This is the stage where you will feel an urge to push your baby out of your vagina.
• You may feel stretching and burning pain, especially when the widest part of your baby’s head passes through the vaginal opening (crowning).
• Once your baby is delivered, the umbilical cord will be clamped and cut. This usually occurs after waiting a period of 1–2 minutes after delivery.
• Your baby will be placed on your bare chest (skin-to-skin contact) in an upright position and covered with a warm blanket. Watch your baby for feeding cues, like rooting or sucking, and help the baby to your breast for his or her first feeding.

Stage 3

• This stage starts immediately after the birth of your baby and ends after you deliver the placenta.
• This stage may take anywhere from 5 to 30 minutes.
• After your baby has been delivered, you will feel contractions as your body expels the placenta and your uterus contracts to control bleeding.

What can I expect after labor and delivery?

• After labor is over, you and your baby will be monitored closely until you are ready to go home to ensure that you are both healthy. Your health care team will teach you how to care for yourself and your baby.
• You and your baby will stay in the same room (rooming in) during your hospital stay. This will encourage early bonding and successful breastfeeding.
• You may continue to receive fluids and medicines through an IV.
• Your uterus will be checked and massaged regularly (fundal massage).
• You will have some soreness and pain in your abdomen, vagina, and the area of skin between your vaginal opening and your anus (perineum).
• If an incision was made near your vagina (episiotomy) or if you had some vaginal tearing during delivery, cold compresses may be placed on your episiotomy or your tear. This helps to reduce pain and swelling.
• You may be given a squirt bottle to use instead of wiping when you go to the bathroom. To use the squirt bottle, follow these steps:
  • Before you urinate, fill the squirt bottle with warm water. Do not use hot water.
  • After you urinate, while you are sitting on the toilet, use the squirt bottle to rinse the area around your urethra and vaginal opening. This rinses away any urine and blood.
  • Fill the squirt bottle with clean water every time you use the bathroom.
• It is normal to have vaginal bleeding after delivery. Wear a sanitary pad for vaginal bleeding and discharge.

Summary

• Vaginal delivery means that you will give birth by pushing your baby out of your birth canal (vagina).
• Your health care provider may monitor your contractions (uterine monitoring) and your baby’s heart rate (fetal monitoring).
• Your health care provider may perform a physical exam.
• Normal labor and delivery is divided into three stages.
• After labor is over, you and your baby will be monitored closely until you are ready to go home.

Vaginal Delivery, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after vaginal delivery. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions.

What can I expect after the procedure?

After vaginal delivery, it is common to have:

• Some bleeding from your vagina.
• Soreness in your abdomen, your vagina, and the area of skin between your vaginal opening and your anus (perineum).
• Pelvic cramps.
• Fatigue.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic until it is finished.

Driving

• Do not drive or operate heavy machinery while taking prescription pain medicine.
• Do not drive for 24 hours if you received a sedative.

Lifestyle

• Do not drink alcohol. This is especially important if you are breastfeeding or taking medicine to relieve pain.
• Do not use tobacco products, including cigarettes, chewing tobacco, or e-cigarettes. If you need help quitting, ask your health care provider.

Eating and drinking

• Drink at least 8 eight-ounce glasses of water every day unless you are told not to by your health care provider. If you choose to breastfeed your baby, you may need to drink more water than this.
• Eat high-fiber foods every day. These foods may help prevent or relieve constipation. High-fiber foods include:
  • Whole grain cereals and breads.
  • Brown rice.
  • Beans.
  • Fresh fruits and vegetables.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Rest as much as possible. Try to rest or take a nap when your baby is sleeping.
• Do not lift anything that is heavier than your baby or 10 lb (4.5 kg) until your health care provider says that it is safe.
• Talk with your health care provider about when you can engage in sexual activity. This may depend on your:
  • Risk of infection.
  • Rate of healing.
  • Comfort and desire to engage in sexual activity.

Vaginal Care

• If you have an episiotomy or a vaginal tear, check the area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• Do not use tampons or douches until your health care provider says this is safe.
• Watch for any blood clots that may pass from your vagina. These may look like clumps of dark red, brown, or black discharge.

General instructions

• Keep your perineum clean and dry as told by your health care provider.
• Wear loose, comfortable clothing.
• Wipe from front to back when you use the toilet.
• Ask your health care provider if you can shower or take a bath. If you had an episiotomy or a perineal tear during labor and delivery, your health care provider may tell you not to take baths for a certain length of time.
• Wear a bra that supports your breasts and fits you well.
• If possible, have someone help you with household activities and help care for your baby for at least a few days after you leave the hospital.
• Keep all follow-up visits for you and your baby as told by your health care provider. This is important.

Contact a health care provider if:

• You have:
  • Vaginal discharge that has a bad smell.
  • Difficulty urinating.
  • Pain when urinating.
  • A sudden increase or decrease in the frequency of your bowel movements.
  • More redness, swelling, or pain around your episiotomy or vaginal tear.
  • More fluid or blood coming from your episiotomy or vaginal tear.
  • Pus or a bad smell coming from your episiotomy or vaginal tear.
  • A fever.
  • A rash.
  • Little or no interest in activities you used to enjoy.
  • Questions about caring for yourself or your baby.
• Your episiotomy or vaginal tear feels warm to the touch.
• Your episiotomy or vaginal tear is separating or does not appear to be healing.
• Your breasts are painful, hard, or turn red.
• You feel unusually sad or worried.
• You feel nauseous or you vomit.
• You pass large blood clots from your vagina. If you pass a blood clot from your vagina, save it to show to your health care provider. Do not flush blood clots down the toilet without having your health care provider look at them.
• You urinate more than usual.
• You are dizzy or light-headed.
• You have not breastfed at all and you have not had a menstrual period for 12 weeks after delivery.
• You have stopped breastfeeding and you have not had a menstrual period for 12 weeks after you stopped breastfeeding.

Get help right away if:

• You have:
  • Pain that does not go away or does not get better with medicine.
  • Chest pain.
  • Difficulty breathing.
  • Blurred vision or spots in your vision.
  • Thoughts about hurting yourself or your baby.
• You develop pain in your abdomen or in one of your legs.
• You develop a severe headache.
• You faint.
• You bleed from your vagina so much that you fill two sanitary pads in one hour.