Normal Delivery Procedure: A Step-by-Step Labour Guide

Every normal delivery follows a sequence of changes that prepares your body for your baby's birth. While the experience differs from one woman to another, labour usually progresses through three distinct stages, each with its own physical changes and medical observations. Understanding the normal delivery procedure can help you know what to expect and why your obstetrician may recommend certain interventions as labour progresses.

The active phase of labour begins at around 5 cm cervical dilation and, in most first-time mothers, usually progresses within 12 hours. Understanding these labour and delivery stages can help you know what your body is doing, what your care team is monitoring, and what to expect as labour moves forward.

Vaginal Delivery Steps

There are three separate stages of labour and delivery in the physiology of having a baby, and each has its own set of physical changes for the expectant mother and different medical interventions and monitoring methods that the clinical staff need to employ in order to keep up with each development.

Stage 1: Cervical Dilation and Effacement

The first stage, which lasts the longest, involves the process of dilation and effacement (thinning) of the cervix in preparation for birth. Based on clinical data from the WHO guidelines for the care of intrapartum patients, the active phase of the first stage of labour can be expected to begin at 5cm and progress at 0.5-1 cm/hour in first-time mothers. Doctors watch the rate and strength of your contractions and how your baby responds to each contraction by assessing the fetal heart rate through use of a cardiotocography.
The Contractions: This stage of labour can be split into two stages.
●     Latent or Early and Active phase labour: Contractions begin weak and far apart, and gradually become stronger and more frequent. Clinicians monitor cervical progression, along with fetal heart tracings. There are systematic cervical changes due to regular, coherent and coordinated contractions during the first phase of active first-stage labour.
●     Coping With Labour: Pain management during normal delivery may include deep rhythmic breaths, movement to different positions or localized pain treatments during labour, such as epidurals administered earlier or taking a warm bath.

Stage 2: Fetal Descent and Birth

Once the cervix is completely dilated (stretched 10 centimeters), the vagina delivery moves into the pushing phase.
●     How It Works: Uterine contractions, in addition to the woman's expulsive effort, assist in moving the baby down and out the vaginal canal.
●     What Clinicians Do: Obstetricians track the baby's progress and position. An episiotomy during delivery may sometimes be considered if the baby needs additional space to be delivered safely, during the delivery to facilitate the exit if resistance from soft tissue makes it difficult to do so.

Stage 3: Delivery of the Placenta

This last phase of a normal delivery begins soon after the baby's birth and continues until the expulsion of the placenta. Within minutes of the birth of the infant, the uterus clamps down well to separate the placenta from the uterine wall. Active Management of the Third Stage of Labour, which consists of a uterotonic drug (oxytocin) and cord traction, is generally practised by obstetricians for delivery of the placenta, which is very efficient and greatly diminishes chances of postpartum haemorrhage.

Prepare for Childbirth Wisely

The routine process for normal delivery requires honest prenatal follow-up and communication with your healthcare team to allow birth plans to evolve if there is a medical necessity to do so. Successfully overcoming each of these milestones depends on collaboration with a caring obstetrician, one who understands the individual's needs and whose foremost priority is to safely deliver a healthy baby and mom. Have questions about what to expect during labour? Book a consultation with TWH's obstetrics and maternity team.