I feel like I’ve set the stage with general information about birthing, why it’s important, and the people who are pivotal in the process. One of the curiosities that naturally follows is about the actual physical process of birth. Before I began my learning there was a ton of mystery around the whole idea of it. It was actually more attractive to not know the details. I had curiosity but I also had a lot of resistance to learning more. I had no clue what the process was about and I definitely didn’t understand any of the details. As a woman, for me as an individual, this learning process has been rich and full. It’s been satisfying, empowering, fascinating, “cool” like the way I would talk about a neat science experiment, and a little nauseating when I’ve thought about it too hard or gone too fast without taking breaks.
In that light, for this post, I’m going to do my best to make understanding the physiological process easy, but be careful not to simplify it. Birth should never be simplified. It is where we are so close to the line between life and death. I’m writing this sentence again even though I did in my last post: we have got to hold the spiritual big picture here.
That being said, let’s dive into the physical process of birthing babies. This change that happens in the woman’s body is possibly the most dramatic that can occur in a human. In lean terms, this process involves more movement, shape-changing of organs, prolonged physical sensation and stimulation, and more effort than do any other physiological functions of the body (like yawning, swallowing, digesting, laughing, crying, orgasm, coughing, peeing, farting, etc). These are the functions we experience on a fairly regular basis (some more than others). Ina May refers to birth as Mt Everest of the physical functions of any mammal and for a woman, it is a huge and sometimes difficult to imagine task.
There are a few parts of a woman’s body that are very important to know and understand for birth that are mentioned frequently. The uterus is a bag of salty fluid that contains the baby and the umbilical cord. Before the uterus holds the baby and cord, it is a hollow organ that fills and empties with a woman’s menstrual cycle. The umbilical cord leads to the placenta which is an organ that is planted in the uterine lining of the blood vessels and does so much of the work that will later be done by the baby’s lungs, digestive system, liver, organs, and the chambers of the baby’s heart that don’t function much during pregnancy. The placenta literally feeds the baby.
The cervix is a circular opening at the low end of the uterus (when a finger is inserted into the vagina, the fingertip often can bump up against the cervix). The cervix is a powerful band of muscles that holds the uterus tightly closed until labor begins. This cervical muscle has to be strong enough to hold the uterus shut even though there is a lot of pressure being applied by the baby, placenta, and fluid. Think 15 pounds and even more than that in the case of twins / multiple pregnancies. The cervix should and needs to remain closed until labor begins. Then the job of the cervix is to become thin, thin, and thinner, until it gets out of the way and opens fully (fully “dilates”) and the baby can begin to come out. The cervix is sealed during pregnancy with a plug of mucus, which is expelled during the hours before labor begins. This mucus is called “show” (or a mucus plug) and is often tinged with a light amount of blood. This signals labor will begin soon.
Side note: The top part of the uterus is muscle tissue, but it is different than that of the cervix. These layers of the uterus are extremely powerful yet also flexible and stretchy. They have to expand to contain a lot more than “usual”, and still be able to push everything out during labor.
Extra side note: if you’re just learning about your (or that of someone in your life’s) body, you may want to explore and better get to know yourself and others in these ways, before such a huge rite of passage such as birth occurs. This is rich territory and a part of our being, and can lead to beautiful integration of ourselves and our power. If you’re unsure about the cervix, insert your fingers into your vagina during different times of the month and feel for the soft and spongy tissue at the tip of the finger. All cervixes are in slightly different positions, so don’t be discouraged. It may feel a little tender at first touch. When you’re close to menstruation or right after bleeding is finished, the cervix will be closer, softer, and “easier to reach”. The cervix “drops” around the cycle. During other times of the month when the cycle is not as near, the cervix may be “pulled back” more and harder to reach. Another way to get to know this space is to do a “kegel” exercise (which you can do by imagining you’re peeing, and trying to stop the urine flow). This engages the muscle of the cervix (also called the pelvic floor). It’s like a little weight lift for the cervix. These exercises lead to more strength and flexibility of the cervix which can wildly help birthing. It can also make sex more enjoyable, enhance and give the possibility for cervical orgasms, ease menstrual symptoms, and can serve as a grounding exercise if you feel disconnected from your body. If you want to soften or puff out / relax the cervix, bear down slightly as if you’re trying to have a bowel movement. If you have your finger against the cervix, and you do these exercises, you should be able to feel the difference in what the cervix does. The nice part is, the more comfortable you get with touching this space, the more pleasurable it can feel! Short version: strengthening and getting to know your cervix or that of your partner has endless benefits. If you’re unsure about the uterus, put your hands on your lower belly in the shape of a heart with the pinky finger pointing down and the thumbs coming together below the belly button. The fingers should be around the pubic bone. This is a general idea of the whereabouts of these places and diagrams can be helpful references.
The phases of labor. There are different stages of labor and delivery, and while the process can often seem confusing and like there’s “no way to predict” (which is true, all births and women are different), there are some signs that make it a bit easier to navigate and observe what’s happening.
Ripening: hormones called prostaglandins are released during this phase before labor officially begins. The hormones soften the thick muscle of the cervix and allow it to start becoming thinner. Contractions may start and stop here, and can often feel confusing for the mother, but just know the body is beginning to do the work and it is a work in progress. The body is gearing up. Contractions can come and go for hours or a few days before the cervix actually begins to have noticeable change.
First stage: this is where the cervix begins to open. This is a natural time to feel restless. This is the time when the baby is pushed, jostled, wiggled, and turned into the most prime position to pass through the birth canal. When fully dilated, the cervix is about 10 centimeters in diameter. This is when contractions become much more strong and closer together. This is a good sign! This transition time while the cervix is opening to full dilation is often when mothers can become tired and need to conserve their energy and learn to “ride the waves” of contractions so they can get to the point of full dilation without becoming too exhausted to keep going (look for future posts about how to resource and be well energized and taken care of so this phase isn’t too hard).
Second stage: Once the cervix is completely open or fully dilated, contractions of the uterus in combination with pushing from the abdominal muscles pushes the baby out. Gravity can greatly assist (or if not utilized, prohibit) progress of the birth. One of the things people seem to rarely know about is the rest periods. A rest period can occur during different stages of labor and can last for up to 30 minutes. This is literally just a little break, where things seem to “pause”. Do not be alarmed! If everything seems ok track, these are to be savored and appreciated. They can give the mother energy to get through it, to allow for connections with partners and family and caregivers which can replenish faith and motivation.
The water bag: Contrary to popular belief, the water doesn’t always break in a huge rush. That is a myth. The water bag breaks sometimes before, sometimes during, and sometimes it intact at birth and is broken and peeled away by the professional so the baby can take the first breath. Sometimes the bag is intentionally broken by professionals who are impatient and trying to speed up the labor. They may not know that breaking the bag intentionally can be dangerous when the baby’s position is still high enough to leave room for the umbilical cord to be swept out of the uterus by the rushing fluid. This can pinch off the circulation of oxygen-rich blood to the baby if the cord is caught. Be certain to ask questions and use caution if someone suggests this in an attempt to be “more efficient” in regards to time.
The pelvis and the myths: Only rarely do the dimensions of a woman’s pelvis interfere with the birth of the baby. The hormones released before and during labor and delivery allow the woman’s ligaments and tissues to move in a way specifically allowing for birth. Naturally, the bones, ligaments, tissues, and supporting features of the woman’s body shape-shift and mold to allow for the birth of most babies. At the same time, the skull of the baby is made of separate bones that are held together with flexible ligaments…so it is able to temporarily mold itself for easier passage through the pelvic bones. (This is why sometimes when babies are first born their heads look a little “brainy” or like a walnut, and the skull will later harden with time). These two pieces working together at the same time allow for the miracle of birth. Yes, something “so large comes out of such a tiny place”….but it can be done and it can be done well.
Third stage: the uterus will continue to contract after the baby is born, and quickly decreases in size to become as big as the placenta. The contractions break the placenta away from the uterine lining. This usually comes with dark red blood within 15 minutes after birth of the baby. Gravity can help this process, and sometimes a gentle tug on the umbilical cord is all that’s needed for the placenta to come out.
Fourth stage: let us not assume that once the baby is birthed, the process is done. There is a period of about 6 weeks after the delivery of the baby, that is considered the postpartum / newborn period. This is the time when the mother’s body heals and adjusts to new motherhood. This is a tender and potent time for families and should not be forgotten or diminished.
The Hormones: The hormones at play during labor and birth are extremely complex. They are one of the most fascinating but little understood organic processes that can occur in human life. Prostaglandins, oxytocin, adrenaline, and endorphins produce natural combinations within the woman’s body at different times for different purposes. They regulate and moderate timing of uterine contractions. They stimulate the maternal and infant responses (emotions and actions) that are vital to survival. Prostaglandins as mentioned before soften and thin the cervix for labor. Oxytocin causes the uterus to contract and after the baby is born causes a rush of emotion that starts a dance between baby and mother that mirrors falling in love (unfortunately when interventions are used, mother / baby often miss out on this bonding). Adrenaline is what pumps us up. High levels of adrenaline increase the heart rate and makes us stronger and faster so we can fight / flee. They can also make labor stop if the mother is afraid or mistrusting. High adrenaline levels could possibly be one of the reasons so many women find themselves no longer in labor once they land in a stressful environment. If trust and comfort disappears, the body of the woman instinctively halts the process. This is where sometimes unnecessary interventions often happen (stay tuned for later posts about those). Endorphins are the opiate of nature. After we use a high amount of physical effort, the levels of endorphins rise. They especially rise when we are feeling warm, loved, and supported…and above all when we are not frightened. They can reduce the feelings of pain. They give us the feeling of pleasure when we’re hard at work or finished a big task.
One more note about fear: if we can remember one thing, it would be good to etch it into our brain that women who are afraid secrete hormones that can delay or inhibit birth. This is true of all mammals and is part of nature. The beautiful thing about humans is that we have the ability to impact the emotions of the mother that sometimes those in the animal kingdom do not. Those who aren’t afraid are more likely to secrete the hormones that make labor and birth easier and less painful (sometimes it can even be pleasurable…I’ll touch on orgasmic birth in another post). One of the main points is, if you’re afraid, you may need more interventions to take away that pain. Taking away the pain can be helpful, but you also miss out on all the good feelings and the attachment and bonding with the baby. And the baby may feel pretty alone, abandoned, frozen, drugged out, numb, etc (anything the intervention does to the mother’s body, the baby feels it too just like whatever you eat, the baby gets it). I’m not bashing interventions, I’m just highlighting knowing what can happen if and she they are used and knowing that they can be remedied and helped. I’ll touch on interventions and side effects much more in a later post.
A very helpful book that outlines all of the details of the physical process of birth (very practical explanations of what to expect and what to do if you’re the mother or if you’re a caregiver or birth partner) is The Birth Partner by Penny Simkin. This book delves into a lot of the nuances that I simply can’t explain here because it’s too much.
I suggest taking a walk, doing some deep breathing, or getting your mind off birthing if this information is overwhelming or over-stimulating to you. As always, please write to me if the call is there. And til next time, take it slow. With love, Alicia