My partner and I are considering pregnancy; I’m nervous about the process of giving birth. What does it usually look like to go through a labor and delivery?

RC: That is a great question!  For each person/process, it may go differently.  In this post, unlike most, I am actually going to be writing as the IRL or Context Expert and will speak from my own experience delivering two babies.  As AG mentioned in a prior week’s post, 45% of pregnancies in the United States are unplanned.  That was certainly true of both of mine.  One of the most important things that my partner and I had to consider upon finding out that we were pregnant was where we hoped to deliver.

AG: There are many different options when thinking about the birthing process that you want to have. First, you may decide where you would like to give birth: in a hospital, at home, or in some other location (for example, a birthing suite). Depending on the state, home births are generally attended by midwives; some people choose to include doulas, pets, children, relatives, and/or friends in the process as well. If you choose to give birth in the hospital, you can either give birth vaginally or via a caesarian section. People will make these decisions for many different reasons and it’s important to consult with a healthcare provider in the process.

RC:  Many providers offer the option of completing a birth plan, which lays out the ideal labor and delivery and often includes details about back-up preferences.  These may include questions about epidurals, c-sections, music, choice of lighting, people in the room.  I did write one for the birth of my first child--many of the elements I named went somewhat as I had hoped; some did not.  With my second labor and delivery, I made sure that I had clearly communicated about my wants, needs, and non-negotiables with my partner and birth team in advance, so felt that my process would be honored without a formal birth plan.  Again, for each person and each process, it may look different.  Please note, if, at any point, complications arise, your birthing team will be able to advise you regarding the best ways to ensure the safety of you and your baby(ies).

AG: Typically during the third trimester of pregnancy (and as early as the second trimester), people may experience something called Braxton Hicks contractions, which are basically the uterus “practicing” for the birthing process. They are generally infrequent/irregular in pattern (unlike actual labor), and for some the sensation may be intense.

RC:  One of my favorite takeaways from one of the books about mindful birthing that I read before my first child was born offered a different framework for thinking about contractions and the accompanying sensations.  Rather than describing the muscular contractions as painful or not painful, the book offered that we use the language of strong versus less strong sensation.  This does not add a value judgement or prime our brains to anticipate the physical sensation as anything other that whatever it is in the moment.  I found this really helpful; as an athletic person who really enjoys noticing what’s happening in my body, this reframe allowed me to observe and delight in the activation of a muscle I had never used in that way before.

AG: The process of actual labor can be mapped onto several stages, which correlate with the dilation of the cervix (it is considered fully dilated at 10 centimeters) and what is happening with the baby. The first stage of labor can be broken into early (the cervix is 0-3 cm dilated), active (3-7 cm), and transitional phases (7-10 cm). As these phases progress, contractions often become more frequent and more intense. The water may (or may not) break anytime within this first stage of labor.

RC:  With my first child, born on January 1st, we were celebrating New Year’s when my contractions began.  A friend actually decided he wanted to be responsible for tracking them, which was great!  They began around 8:30 pm on December 31st and after ringing in the new year, everyone left, my partner and I went to sleep, and I slept until 5:30 am, at which point the intensity and frequency of the contractions kept me from sleeping.  I don’t think I called any of our birth team until 8:30 or 9 that morning.  It’s important to note that there is no set timeline for the duration of a labor and delivery.  In both mine, my water didn’t break until much later in the process.  With my second, my water broke as I delivered. Some people report that they didn’t notice their water breaking at all, later to discover that it had.

AG: After the cervix is dilated to 10 cm the “active” stage of labor begins. In this stage, the person generally feels compelled to push so that the baby(ies) can move from the uterus through the vaginal canal, in the cases of vaginal birth. You may have heard people talk about episiotomies; routine episiotomies are no longer recommended, although they may be medically necessary in some cases.

RC: After the (last) baby moves through the vaginal canal, which is often called delivery, the last stage of the birth process begins: the delivery of the placenta.  In some cultures, people eat some of their placenta, other folks may choose to get it encapsulated in pill form, others may choose to bury it under a beloved plant, and still others may dispose of it.   

AG: At this point the delivery is complete! It’s often really helpful to ensure that the baby and the delivering parent have enough support to navigate a new phase of life. It’s also important to note that both parents (in a two parent dynamic) may experience a range of emotions and likely both will benefit from screening for depression and anxiety during this time.

RC:  While we have outlined a lot of technical information in a linear manner, it’s really important to note that everyone’s experiences of labor and delivery are different and may include a number of factors, people, babies, etc. that aren’t explicitly named in this post.  I also want to make sure that, as the IRL writer, I note that each labor and delivery involves risk and may not go as intended.  That was certainly true for me; there are risk factors for different populations that are really important to note and consider as one goes through this process.  It’s especially important to call out in this space the health disparities that women of color face when growing and delivering babies in America.  Serena Williams’s experience is a high-profile example of exactly that.