Labour and birth: what to expect

Vaginal birth and caesarean birth

A vaginal birth is usually the safest way for your baby to be born. But sometimes health problems or pregnancy complications might make a caesarean the safest option for giving birth.

Even if you’re planning a vaginal birth, it’s good to find out about giving birth via caesarean. You might need a planned caesarean for medical reasons like placenta praevia. Unplanned (emergency) caesareans can happen when there are problems in pregnancy or during labour.

It’s also worth knowing that birthing mothers who’ve had a caesarean birth are usually physically able to try a vaginal birth after caesarean (VBAC) next time around.

If you’re wondering about your options for giving birth, it’s always good to talk with your doctor or midwife about your health, your baby’s health and the best options for you.

Your due date

A baby born after 37 weeks is described as ‘term’. A premature baby is one born before this – that is, at 36 weeks and 6 days or earlier.

If you’re worried that you might be in labour but you’re not yet due to have your baby, call your midwife, doctor or hospital as soon as possible.

If you’ve reached your due date and haven’t gone into labour yet, don’t worry. Very few babies are born on their due dates. If you haven’t had your baby by 41 weeks, you’ll have more frequent checks to make sure you and your baby are healthy. Your doctor or midwife will talk about options for when your baby is overdue.

Labour signs

Before labour starts, you might experience:

a show
more pressure in your pelvis as your baby’s head shifts lower in your uterus and into the pelvis
cramping in your lower pelvis, a bit like period pain
more Braxton Hicks contractions
your waters breaking either in a slow leak or a big gush – phone the hospital or let your midwife know.

You might be in labour if you:

feel labour contractions that last for a minute or more
have contractions that are coming at regular intervals
have contractions that are getting stronger, longer and more frequent.

If you have one or more of these labour signs, call your midwife, doctor or hospital straight away.

If you’re having your baby in a hospital or birth centre, the midwives will let you know when to come in. If you’re having a homebirth, your midwife will come to your home.

The professionals that help you during birth will depend on your birth setting. You can read more about giving birth at a public hospital, private hospital, birth centre or homebirth.

Stages of labour

Once labour starts, it has 3 stages.

First stage of labour
In this stage of labour, your contractions get stronger, longer, more frequent and often more painful.

These contractions help to soften your cervix so that it starts to dilate. When your cervix is dilated to about 5 cm, you’re in established labour. Your midwife might do internal examinations to see whether your cervix is dilating.

Once you’re in established labour, the second stage of labour will probably start within about 12 hours. But this can vary, and it can often take longer in a first pregnancy.

Second stage of labour
This stage starts when your cervix is fully dilated at about 10 cm. Your midwife might do an internal examination to check. This stage of labour generally involves pushing to help with birthing your baby.

In this stage, your contractions will usually be longer. You’ll feel the urge to push. The midwives will encourage you to go with your body’s urge to push with each contraction and rest in between. Each push helps move your baby down the birth canal.

Towards the end, you’ll be able to feel your baby’s head at the opening of your vagina. You might need to ease off on your pushing, so your baby’s head and body can come out gently.

If all goes well, you or your midwife can lift your baby onto your chest as soon as your baby is born. You can meet your baby, have skin-to-skin contact, and start breastfeeding.

This stage usually takes up to 2 hours. It can be tiring and intense, so do what you need to do to get through this stage and stay as comfortable as you can. Your doctor or midwife will be with you constantly during this stage. You can also get support from your birth partner and other support people.

Third stage of labour
This is after your baby is born. It’s when the placenta comes out. You might have an injection to help with delivering the placenta. You’ll still feel some contractions, but they won’t be as intense as the earlier contractions.

This stage usually takes 20-30 minutes, but it can take up to an hour.

Skin-to-skin contact is great for you and your baby. It calms and soothes your baby and helps them to breastfeed well. It also helps you bond with your baby. If you and your baby are both well, it’s good to have skin-to-skin contact for an hour or more soon after birth.

After birth

After birth, a doctor or midwife will check that you and your baby are both well. Your baby will be given an Apgar score, and their umbilical cord will be cut when appropriate.

Once your baby has fed and you’re ready for a shower, the midwife will weigh, measure and carefully examine your baby and give them vitamin K and hepatitis B injections (with your permission).

If you give birth at a hospital or birth centre, you’ll most likely be transferred to the maternity unit a few hours after the birth. If you and your baby go home within 24 hours of birth or sooner, your baby will have newborn screening tests at home or at the hospital.

If you have a homebirth, your midwives will stay at your home for several hours after the birth and then come back again to check on you and your baby within 12-24 hours. If there are health concerns for you or your baby, the midwives will arrange to transfer you and your baby to a hospital.