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Pregnancy refers to the duration between conception (fertilisation of the male and female gametes) and actual parturition (childbirth). It usually lasts 288 days or around 41 weeks and consists of three distinct trimesters. When childbirth occurs at the end of this period through the vagina, it is called normal delivery.

Delivery or childbirth is often a matter of concern for women and men and even their family members. It is governed by mixed feelings of joy, hope, worry and fear related to the health of the child and the nurturing mother.

Normal delivery is highly favoured since it is related to fewer complications and is a smoother process as opposed to cesarean section, which requires the procurement of a surgical procedure.

Though it has fewer complications, normal delivery is still associated with feelings of anxiety and fret among women. This article aims to answer all the possible queries related to normal delivery.

  1. Pregnancy normal delivery
  2. Normal delivery symptoms
  3. Normal delivery process
  4. Normal delivery tips
  5. Exercise for normal delivery

There is an ongoing debate regarding what must be regarded as a normal delivery and what is to be considered as a deviation from it. Normal birth or normal delivery is commonly defined as a healthy duration pregnancy with the onset of birth occurring between weeks 37 and week 42. Normal delivery poses lower health risks to the mother and the infant.

According to WHO, 70 to 80% of the women fall under this category. The characteristic of normal delivery is that labour is induced on its own and is also allowed to progress in this manner. It consists of free movements and free positioning of the mother to best facilitate childbirth with ease.

Following normal delivery, the mother and the infant are in absolute health and do not require prolonged hospitalisation. The infant is sent with the mother immediately and both are allowed to spend time incessantly without being worried about any health concerns or being troubled by any underlying medical conditions.

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Every woman experiences pregnancy quite differently, both physically, mentally and emotionally. But, certain signs and symptoms are experienced by all, which are indicative of a normal delivery. These symptoms are:

  • Strong, regular contractions. (Read more: Contractions during pregnancy)
  • Severe pain and cramping or tightening of the stomach, which may be felt as period pain by women.
  • Stomach upset.
  • Frequent urge to urinate. This is felt due to the foetus’s head being pressed in the area. This also leads to feelings of pressure in this area.
  • Pain in the back
  • Vaginal discharge, which may be clear or accompanied by blood. It is usually not a matter of concern and is indicative of the opening of the cervix to facilitate childbirth. This discharge is often called ‘show’ and implies that the mucus plug commonly present in the cervix has been removed.

The final symptom of a normal delivery is the rupture of membranes, which is commonly known as ‘breaking of the waters’. This is marked by the feeling of a slow gush of amniotic fluid, often felt like a tickling sensation. Some women may experience an urge to urinate, and amniotic fluid may be accompanied by urine.

Normal delivery or childbirth occurs in stages following the induction of labour. These stages are described in great details in this section, including the specific symptoms experienced at each stage and the duration of each.

Read more: Premature labour

Stage 1

The first stage of labour or normal delivery is usually quite long and consists of two stages, that is, early labour and active labour. Let’s try and understand them separately.

Early labour

This phase is usually the longest, continuing for a duration of 20 hours. It is particularly long for women who are giving birth for the very first time.

The foremost step in this stage is the opening of the cervix, which is the entry of the uterus. The cervix then starts to become thinner and subsequently opens wider and dilates.

The cervix dilates by 4 centimetres at this stage.

After this, contractions are experienced by women, which keep on becoming stronger. They last for about 30 seconds to a minute and are experienced every 5 to 20 minutes by the expecting mother. This is also accompanied by a clear or bloody discharge from the vagina.

What to do during this stage?

It is best to visit a nearby hospital at this stage. You may ask for help or assistance from a family member, your spouse or a friend, who would rescue you to the hospital.

You may experience an increased urge to urinate during this stage, which is also due to the release of clear discharge. Using a restroom before leaving home for the hospital may ensure a comfortable journey, especially if the hospital is located at a distance.

You may also need to pack a few items of emergency or urgent needs, which may be required by you during the journey or the hospital stay. It is essential to take care of these things before you leave your home.

Active labour

The second phase of the first stage is marked by contractions, which are often more intense than those experienced in the early labour. The most prominent symptom of this stage is that the contractions, which were experienced even earlier, tend to become prolonged. Contractions also possess a greater intensity and may even be accompanied by pain.

These contractions tend to be experienced more often in this stage, which implies that the duration between these contractions is reduced. As labour progresses, this duration is so diminished that the woman has no time to rest in between the contractions.

Due to these painful contractions, pressure or pain may also be felt in the lower back. Other than this, the cervix begins to dilate faster during this stage and expands to a size of 4 to 7 centimetres. The foetal movements may also begin.

What to do at this stage?

As already mentioned, you must rush to a nearby hospital. Other than that, it is important that you relax and allow your mind to be at peace. These painful contractions are a symptom of a normal delivery, which is experienced by all women prior to childbirth. It is not a matter of concern and is completely a physiological process, assisting in the gradual movements of the foetus out from your body.

Stage 2

The cervix, which was beginning to expand slowly is completely dilated at this stage. It has achieved a dilation of 10 centimetres, which is the maximum required for delivery. This implies that your body is ready for childbirth at this stage.

Stage 2 may last anywhere from 20 minutes to several hours, and like the first stage, lasts for a long time in first-time mothers. During this stage, the woman may begin ‘pushing down the baby’. This is a natural process and is initiated by the woman herself due to her desire to push as if she is experiencing a bowel movement.

Women tend to feel pressure on the rectum as the baby progresses its way through the vagina. The head of the baby moves out at first, which is also called crowning. Some women, particularly those experiencing pregnancy for the first time may feel intense pain and may require medications.

What to do at this stage?

First of all, it is important to be immensely relaxed and inform your healthcare provider or nurse about your experience. They will help in guiding the baby out of your vagina, by instructing you to push harder or breathe heavier. You are advised to carefully follow these instructions.

If you are experiencing intense pain, inform your caretakers, they will provide you with some relief medications as well. It is important to note that childbirth occurs during this stage itself, following which the symptoms gradually fade. So, it is important to be relaxed and careful for this stage to pass through.

Stage 3

Stage 3 marks the last stage of delivery lasting about 30 minutes until the placenta is eliminated. At this stage, the infant is retrieved out of the woman’s vagina, following which the umbilical cord (channel connecting the mother to the foetus, responsible for foetal nourishment with the help of the placenta) is carefully cut by the health care provider or it may come out on its own.

Once the baby is out of the body, the umbilical cord clearly serves no purpose. The caretaker may ask the woman to push and may also gently pull out the umbilical cord while massaging the uterus. This will help in retrieving the placenta.

Sometimes, medications may be given to ease pain or bleeding. After childbirth, the mother often experiences chills or shakiness, and contractions may begin 5 to 10 minutes later.

What to do at this stage?

You can just relax and follow the instructions of your doctor if they ask you to push out the placenta.

Due to the side-effects of a cesarean section, normal vaginal delivery is the ideal form of childbirth. C-section, which involves incision of the belly and the uterus to facilitate childbirth, is often a complicated procedure being more painful and less aesthetically pleasing in the long term. To avoid an emergency c-section, which can be harmful to your health and that of the foetus, it is recommended to follow these tips.

  • Eat a healthy, balanced diet, including carbohydrates, fats, proteins, vitamins and minerals in the correct proportion. Eating high fibre food will help in relieving constipation and will improve your digestion.
  • It is important to keep a track of your weight, which is indicative of foetal and maternal health and is a significant determinant of the delivery process. Different women gain different amount of weight during pregnancy, the average being 11.5 to 16 kilograms of weight. Lower weight gain may result in complications during childbirth.
  • It is essential to include the desired micronutrients like iron, iodine and folic acid to prevent foetal abnormalities. (Read more: Pregnancy diet chart)
  • It is important to consult with your doctor regarding the best diet to ensure the best maternal and foetal health, enabling a normal delivery.
  • Other than this, visiting a doctor is also essential to keep a track of your health and to understand the importance of vaginal delivery. (Read more: Check up during pregnancy)
  • You may also choose your specialist wisely.
  • In addition, improving your own knowledge about pregnancy by joining a club for pregnant women and reading more often may help in achieving your best health during this stage.
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Food certainly is the determining factor of maternal and foetal health, but, contrary to the popular belief, exercising during pregnancy is equally important. Limited physical activity during pregnancy is associated with foetal abnormalities, which may hinder a normal delivery. Exercise also helps you to build the stamina required for normal delivery. So, it is recommended to follow an exercise routine as follows:

  • Start with light exercises, like walking for 15-20 minutes, which you may gradually increase up to 40 minutes.
  • Work out in optimal weather conditions and ensure enough hydration during and before the sessions.
  • Avoid sitting in one place for a prolonged duration, and try being more physically active.
  • It is recommended to not indulge in back exercises or any heavy high-intensity workouts.
  • Wearing comfortable and loose clothing is recommended while exercising, but it must not be flowy or hanging, to avoid imbalance and prevent falling.
  • Balance exercises must be avoided during pregnancy since an imbalance can cause risks. Refrain from activities like running, bicycling, skipping, etc. especially after the second trimester.
  • If any unusual symptoms like, dizziness, shortness of breath, blurred vision, abnormal contractions, intense abdominal pain, vaginal bleeding or excessive foetal movements are experienced, it is recommended to stop exercising and immediately visit your doctor.
  • Meditation, relaxation, breathing techniques, yoga and spas are recommended for the relaxation of the mind and the body.

References

  1. Ione Brunt. Normal Birth. Perm J. 2005 Winter; 9(1): 96–98. PMID: 21687497
  2. healthdirect Australia. Giving birth - the signs and stages of labour. Australian government: Department of Health
  3. State of New York. Your Guide to a Healthy Birth . Department of Health [Internet]
  4. Eunice Kennedy Shriver National Institute of Child Health and Human. What are the stages of labor?. National Health Service [Internet]. UK.
  5. National Institute of Diabetes and Digestive and Kidney Diseases [internet]: US Department of Health and Human Services; Health Tips for Pregnant Women.
  6. National Health Portal [Internet] India; Pregnancy
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