Normal Delivery

One of the most significant journeys for a woman is pregnancy and the most awaited experience is giving birth to a baby. Many women find that having a normal (vaginal) delivery is the safest way to give birth.

A normal delivery occurs when the baby is born through the birth canal without use of extensive surgery. With a normal pregnancy and no medical problems, getting the baby out vaginally is usually advised as it will help the baby recover quicker, involve less risk, enable the baby to breastfeed earlier and stay in the hospital for a shorter period.

Respectful maternity care, having a birth plan, pain relief, continuous foetus monitoring, delayed cord clamping, skin-to-skin contact with baby as soon as possible after birth, and early initiation of breastfeeding are all now high priorities for the healthcare provider. These evidence-based practices have a positive impact on the physical and emotional health of mother and newborn.

What is Normal delivery?

The normal delivery or vaginal delivery is the natural process in which the baby is born naturally in the birth canal of the mother, without the need of big surgery. Usually occurs between 37and 42 weeks gestation when labour starts naturally or is induced when necessary.

The cervix also softens and thins out (effaces) and dilates (opens up) to allow the baby to pass through the birth canal during a normal delivery. In the second stage of labour, the mother pushes for the baby’s birth and the uterus will contract periodically to help the baby come down. After birth the placenta is shed, making the birth process complete.

Who can have Normal delivery?

Maternal Health: Women who are healthy and are without serious complications like Hypertension, preeclampsia, Diabetes or active infections like genital herpes are ideal for normal delivery.

Fatal Position: The position of the baby must be in head- down (cephalic). Transverse and breech position usually require C-section.

Placenta position: The position of placenta must be normal. When the placenta covers the cervix conditions like placenta previa require C-section.

Previous Deliveries: Women who had a successful past history of vaginal deliveries are eligible for normal delivery.

Labour is normal if contractions are regular and the cervix begins to dilate early.

What are the benefits of Normal delivery?

Benefits for Mother

• The recovery of health in a short
• There is no risk of infection
• There is less chance for blood transfusion, as blood loss during delivery is low.
• Strong bond between mother and baby.
• Risk of complications became lower in future pregnancies.

Benefits for the Baby:

• Improved lung function due to removal of fluid from the lungs at birth.
• Bacterial exposure to healthy bacteria from the mother’s birth canal, which aids in baby’s immune system development.
• Skin-to-skin contact earlier.
• Temperature regulation is better.
• Breastfeeding can be carried early.

How can I prepare for Normal delivery?

Physical preparation

• Have a balanced diet food that is high in iron, calcium, protein and folic acid.
• Exercise daily for 1 hour, Do pelvic floor (Kegel) exercises.
• Regularly do breathing and relaxation skills.
• Maintain a proper diet and keep a healthy weight.
• Take proper 7-8 hrs of sleep.

Emotional preparation

• Learn about the birth process: Take proper knowledge of stages of labour. Proper understanding helps to feel less fear.
• Discuss your concern openly: Share any concern with your doctor, partner, family members about any questions or fear you have.
• Practicing relaxation techniques: Meditation, prenatal yoga daily helps to keep your mental and physical health strong.
• Focus on positive birth stories.
• Take care of your mental health.

What are the signs that Labour has started?

Common signs include:

Regular and strong contractions- The contractions that last for 30-45 seconds, and become stronger over time, and it continues even if you walk, rest or change position.

Water Breaking– The rupture of an amniotic sac which is surrounding the baby before or during labour is called water breaking. If this starts then contact your doctor, because immediate medical action is needed if fluid is green, brown, foul smelling or mixed with large amounts of blood.

Lower Backpain and pelvic pressure– continuous lower back pain and pressure increase in pelvis and rectum are the strong signs that baby moves lower into the birth canal.

Cervical Changes- During labour, the cervix becomes soft, becomes thinner and dilates from 0 to 10 centimetres.

What are the stages of Labour?

Each woman’s childbirth experience is unique, but labour can be broken down into three stages, each with a specific function and body changes.

Stage 1 (the longest stage)-

First stage starts at the start of regular labour contractions and ends at a fully dilated cervix (10cm). At this time, the cervix slowly softens, thins (effaces), and dilates to let the baby pass through the birth canal.

This stage has two stages:

Early labour

• Dilation of cervix from 0 to 6 cm.
• Contractions are mild to moderate, and happen every 5–20 minutes.
• They usually last 30–45 seconds.
• You may experience a bloody show, back ache or the water breaking.
• During this stage, many women can continue to stay at home, as recommended by their healthcare provider.

Active labour

• The dilation of the cervix from 6 to 10 cm.
• Contractions take on more strength, more duration (45-60 seconds), and are repeated every 2-5 minutes.
• The baby slides down into the pelvis.
• During this stage, most women are admitted to the hospital and the health care team will keep track of the baby’s and the mother’s health.

Stage 2

The second stage starts once the cervix is completely dilated and lasts until the baby is born.

During this stage:

• There is a strong urge in the mother to push with every contraction.
• The baby moves through the birth canal.
• The baby’s head is visible at the vaginal opening (crowning), followed by the shoulders, and then the rest of the body.
• The baby is typically placed on the mother’s chest immediately after birth for skin-to-skin contact and is encouraged to breastfeed within the first hour or so, if both are stable.
• This can be a few minutes or several hours – depending on things like if it’s the mother’s first baby, the baby’s position, and the strength of the contractions.

Stage 3

The third stage starts after the baby is born and ends when the placenta is delivered.

During this stage:

• Mild contractions keep the placenta from falling from the uterus.
• Placenta is typically delivered within 5-30 minutes.
• Your health care provider checks the placenta has come out and for bleeding.
• Medicines can be administered that will assist the uterus in contraction and minimize the risk of excessive bleeding.

What are the modern innovations which help to improve Normal delivery?

Several evidence-based innovations have been added to modern maternity care:

• Antenatal consultations, education and follow up, via telemedicine.
• Track pregnancy and contractions mobile apps that enable women to keep track of symptoms.
• Fatal and contraction monitoring equipment that can be worn in certain health care facilities.
• Respectful maternity care – women involved in decisions and emotionally supported.
• Delayed umbilical cord clamping, which is beneficial to the newborn’s iron stores.
• Immediate skin to skin contact (SSTC) for enhancing breastfeeding success and bonding.
• Enhanced Recovery After Birth (ERAB) protocols – encouraging early movement, nutrition and breastfeeding.

For women who have a healthy and low risk pregnancy, normal delivery is a natural and safe way to give birth to their baby. Although labour is different for everyone, when it is time for labour to begin, women can learn about the stages, recognise when labour has begun, become physically and emotionally prepared and attend regular antenatal checks to help them to feel more confident and less afraid when it is time to give birth.

It is also crucial to keep in mind that there is no right or wrong way of giving birth, the main concern is to ensure the mother’s and baby’s health and safety.

New developments like personal birth plans, non-pharmacological pain relief strategies, delayed clamping of the umbilical cord, skin-to-skin contact, early feeding, shared decision making, telehealth antenatal education, digital pregnancy tracking and more are helping to enhance maternal satisfaction and birth outcomes.

These developments allow women to take an active role in shaping care decisions with the utmost of care and caution.