Labor and Delivery

You may have felt an occasional squeezing or tightening across your belly during your pregnancy, usually during your second or third trimester. These are called Braxton-Hicks contractions, and they’re a normal part of pregnancy.

The uterus is a large muscle. A Braxton-Hicks contraction is your body’s way of flexing that muscle to get it ready for the process of true labor. These usually feel like mild menstrual cramps, but they can get stronger near the end of your pregnancy.

How do you tell the difference between Braxton-Hicks contractions and the true contractions of labor?

Braxton-Hicks Versus True Labor

Braxton-Hicks contractions typically:

• Are felt in the front of the belly or in one specific area
• Aren’t painful
• Can change or stop if you move to a different position or change activities
• Don’t get closer together as they go
• Don’t get stronger as they go
• Don’t last longer as they go
• Have no regular pattern
• Involve no blood or mucus

However, true labor contractions typically:

• Are felt in the middle of your back and wrap around toward the middle of your belly.
• Are painful.
• Don’t change or stop with different positions or activities.
• Get closer together as they go.
• Get stronger as they go.
• Last longer as they go.
• Have a regular pattern.
• Involve a pink- or red-tinged plug of mucus from the cervix called the “bloody show.”

How to Treat Braxton-Hicks Contractions

There aren’t any medical treatments for Braxton-Hicks contractions. However, there are things you can do to ease the feeling:

• Change your activity level: If you’ve been exercising or walking, try sitting or lying down. If you’ve been sitting for a while, try taking a walk.
• Drink water: Braxton-Hicks contractions are more common if you’re dehydrated.
• Try to relax: Do something soothing, such as reading a book or listening to calming music. Breathe slowly and deeply.

Fetal Movement Can Feel Like Braxton-Hicks Contractions

As your baby moves around within the uterus, it can sometimes mimic the feeling of a contraction. You can tell the difference by placing your hands on your belly near the top and sides of the uterus. If it’s a contraction, your uterus will feel hard all over and tight against your fingertips. If your uterus feels hard in some places but soft in others, your baby’s movements are probably causing the sensation.

Labor involves three stages. It includes childbirth and the delivery of the placenta. Here’s what you can expect in each stage:

Labor Stage 1

There are three phases of the first stage of labor:

Early Labor

Early labor can last eight to 12 hours and typically involves mild, irregular contractions. During this phase, you should try to relax, stay hydrated and eat small snacks. You can do light, simple activities around your home.

Keep track of your contractions, or ask your partner or support person to help with this. Your contractions will start to become more noticeable, lasting 30 to 45 seconds and happening between five and 30 minutes apart. Your contractions will get stronger and more regular as your labor progresses.

Active Labor

Come to the hospital or birthing center when your contractions are strong and consistently five or fewer minutes apart. A good rule of thumb is “5-1-1”: Come to the hospital when your contractions are five minutes apart, last one minute each and have been this way for at least one hour.

During active labor, your contractions become intense. Your partner or support person can help by:

• Staying by your side.
• Speaking with you soothingly.
• Massaging your belly or lower back.
• Reminding you to change positions frequently.
• Providing distractions, such as soft music or reading to you from a book.

Transition

This is the shortest phase of labor, but it is challenging. Your contractions will be very strong and very close together. You will start to feel an overwhelming urge to push. Tell your doctor or midwife when this happens. Our team will help guide you through pushing.

Your contractions can be painful and overwhelming. Make sure you and your doctor have a plan ahead of time for how to handle your labor pain. You can include some of these in your birth plan.

Labor Stage 2

During this stage, you’ll be pushing hard to help in the delivery of your baby. This stage can last anywhere from 20 minutes to about two hours. You’ll feel a strong urge to push and pressure at the rectum.

Once your baby’s head crowns (becomes visible in the opening of the vagina), your doctor or midwife will tell you to stop pushing to avoid tearing. You may feel an initial stinging or burning sensation that turns to numbness as your baby’s head stretches the vaginal walls enough to block the nerves. Your doctor will help guide your baby out.

Labor Stage 3

The last stage of labor involves delivering the placenta. It can take between five and 30 minutes. Your doctor or midwife will watch for small contractions that indicate the placenta is separating from the uterine wall and is about to be delivered.

Your doctor or midwife may put a little pressure on your belly or gently tug the umbilical cord still attached to the placenta to help the process. Once your placenta is delivered, your body may start to shake significantly. This is normal and will stop soon.

Immediately or very shortly after birth, we’ll place your newborn skin-to-skin on your bare chest. This practice promotes bonding, calming of both you and your baby and the start of breastfeeding.

Congratulations! You’re a parent. Relax, and spend some quiet time holding and getting to know your baby.

Recovering From a Vaginal Delivery

Vaginal Soreness

If you had an episiotomy (an incision between the vaginal opening and the anus) or vaginal tearing during delivery, you’ll likely feel sore in the area for a few weeks. These steps can help you find relief:

• Sit on a padded ring or pillow.
• Pour warm water over the perineum (the area between the vagina and anus) with a squeeze bottle when you urinate.
• Sit in a shallow bath of warm or cold water, just high enough to cover your buttocks and hips, for about five minutes.
  
  

If your vaginal pain becomes more severe or persistent, tell your healthcare provider. This could be a sign of an infection. Also, if you’re having trouble moving your bowels, ask your healthcare provider for a stool softener or laxative to prevent constipation.

Vaginal Discharge

Expect a heavy red discharge in the early days after childbirth. This is from the mucous membrane that lined your uterus during pregnancy. It will gradually lessen, changing to pink or brown and then more yellow or white over the next few weeks.

Call your healthcare provider if you have heavy bleeding (soaking a pad in less than an hour), especially with a fever and pelvic or uterine pain.

Recovering From a C-Section

If you had a C-section, you’ll need help from your partner, support person, family members or friends. Your healthcare provider will likely tell you not to carry or lift anything heavier than your baby and not to engage in strenuous physical activity for a few weeks until you heal. Talk to your provider about how long you should take it easy.

As with any surgery, a C-section comes with normal, temporary side effects and some more serious risks.

What’s Normal After a C-Section?

You may notice the following after a C-section:

• Mild cramping.
• Bleeding or discharge for about four to six weeks, including bleeding with clots.
• Pain at your incision site.

Signs of Serious Problems After Childbirth

Whether you had a vaginal birth or C-section, you may be at risk for serious issues after childbirth.

Childbirth is a major medical event. And, as with any such event, there is a risk for serious or life-threatening complications that can require urgent medical care. These complications include:

• Blood clots
• Infection
• Postpartum hemorrhage (a rare complication that involves heavy bleeding)
• Postpartum preeclampsia (high blood pressure and too much protein in your urine)

These can occur as early as the day after childbirth or as late as 12 weeks or more afterward.

When to Call Your Healthcare Provider for Complications After Childbirth

Signs of an Infection

Call your healthcare provider if you’re experiencing any of these symptoms after childbirth:

• A fever higher than 100.4 degrees Fahrenheit
• Redness, swelling, pain or discharge around an episiotomy (an incision between the vaginal opening and the anus) or tear of the perineum (the area between the vagina and anus)
• Painful, frequent urination and/or pain in your lower back. This could be a sign of a urinary tract infection
• Red streaks on your breasts or new, sore lumps in your breast. These are signs of mastitis, an infection of breast tissue that is associated with breastfeeding
• Severe pain in your lower stomach. This could be a sign of endometritis, an inflammation of the uterine lining
• Foul-smelling vaginal discharge. This could be a sign of a bacterial vaginosis infection

[H5] Signs of a Blood Clot

Call 911 or go to the emergency room if you notice any of these potential signs of deep-vein thrombosis (a life-threatening blood clot that can move into the lungs):

• Pain, redness, swelling or warmth in one leg
• Shortness of breath or trouble breathing
• Chest pain
• Dizziness or fainting
• Chills or clammy skin
• Rapid heartbeat

[H5] Signs of Postpartum Hemorrhage (PPH)

Call your healthcare provider right away or go to the emergency room if you experience these potential signs of PPH:

• Heavy, continual bleeding (soaking a pad in less than an hour)
• Dizziness, weakness or feeling faint
• Blurry vision
• Nausea or vomiting
• Rapid heartbeat
• Swelling and pain in the vaginal area or perineum

Signs of Postpartum Preeclampsia

Call your healthcare provider right away or go to the emergency room if you experience these potential signs of postpartum preeclampsia:

• Blurry vision
• Swelling of the hands or face
• Severe headache or stomach pain