Introduction
The birth of a child is an exciting experience for the parents. Especially with the first child, many parents are not clear what to expect. Pregnancy and childbirth are not an illness, but quite natural events to which the woman’s body is adapted.
Most women know instinctively what to do. The process of giving birth is similar for all women, but not exactly the same. The time from the beginning of the birth until the child is born can be very different in length and can also take different courses. Hospitals and birth centers offer numerous birth preparation courses and are also available to answer questions.
When does the birth begin?
A normal pregnancy lasts between 270 and 290 days in humans. Only about four percent of all babies are born exactly on their calculated date. The actual birth thus begins plus minus 10 days around the calculated date.
The women go into regular contractions and the cervix dilates. Before the actual birth, many women have down pains, which serve to push the child’s head further into the mother’s pelvis. Although these are harbingers of birth, they do not mark the beginning.
How long does the birth take?
The duration of a birth is very individual and depends on many factors. A mother expecting her first child is often in labour longer than a mother who has already given birth. The size of the child is also a decisive factor in the duration of the birth.
A medical distinction is made between a drop birth, in which the baby is born within minutes to hours, and a protracted birth, in which the mother lies in labour for many hours. A protracted birth lasts longer than 18 hours for the first birth and longer than 12 hours for a further birth. A long birth can be caused by a child weighing more than four kilograms, regional anaesthesia or irregular contractions.
In some cases a birth is also induced by medication and thus accelerated. A normal birth, i.e. between the two extremes, takes between three and 18 hours. The size of the mother’s pelvis is also relevant for the duration of the birth, as this marks the narrow point through which the baby has to pass at birth. In the event of a birth arrest, a caesarean section may be necessary. Birth arrest means that the birth has already started but is not progressing.
The opening phase
Before the actual birth, the woman has so-called sink pains, in which the child’s head is pressed further into the pelvis. The actual beginning of the opening phase is marked by the first regular contractions. These contractions are called opening contractions.
The contractions are rhythmic muscle contractions of the uterus, which serve to push the child out of the mother’s body. If the mother is not yet at the clinic or birth centre, now is the time to go to the clinic or to inform the midwife. The cervix begins to dilate until it reaches a diameter of about ten centimetres.
A rough guideline is that one centimeter dilation per hour is to be expected. This is also called cervical maturation, i.e. the maturation of the cervix in preparation for birth. The opening phase lasts up to 12 hours for first-time mothers and about eight hours for a further birth.
First-time mothers have a longer time in the first opening phase. When the cervix is opened about two centimetres, the opening phase takes about the same time for all mothers. The opening of the cervix can be supported by the woman walking or climbing stairs.
The muscles of the uterus also prepare for the actual birth. The roof of the uterus becomes thicker and stronger, so that pressure is exerted on the child’s body from above. The baby presses against the cervix with its head or the part of the body that is below.
Part of the amniotic sac is pressed through the cervix. In this phase, the bladder usually bursts and the expectant mother loses amniotic fluid. In some women, however, the so-called premature rupture of the amniotic sac occurs even before birth.
In the opening phase, the baby’s circulatory situation and the contractions are regularly monitored with a CTG. For this purpose, a sensor is placed on the mother’s abdomen and moved until the child’s cardiac activity can be well recorded. Regular blood pressure checks are also carried out on the mother.
At the end of the opening phase, the woman may feel severe pain and develop a strong urge to push. This urge should be suppressed until the cervix is fully opened. With the end of the opening phase the actual expulsion of the child begins.