Giving Birth

There are four stages of childbirth. In Germany, these phases may be named and measured differently than what you are familiar with: here, labour begins with the ‘opening phase’, followed by the ‘transition phase’, the ‘expulsion phase’ and the ‘postpartum phase’. Before the first contractions begin, the birth may already be announced by a slightly bloody discharge. Another sure sign that it's about to begin is the rupture of the membranes, otherwise known as your water breaking. During rupture of the membranes, the amniotic sac that surrounds your baby during pregnancy empties. Every birth is different. However, the sequence of birth stages is usually the same.

Labour begins with the ‘opening phase’. In most cases, it is the longest of the four phases. For people who have already given birth, it might last only two hours. However, for people giving birth for the first time, the opening phase can be as long as 14 hours. The first contractions are still quite irregular. They come about four to six times an hour. Each of these first contractions lasts half a minute to a minute and a half. Over time, contractions become more frequent and regular. As soon as the contractions start coming regularly at every 10 minutes, you should make your way to the hospital or birth centre. In the case of a home birth, you should now notify your midwife. Generally speaking, the rupture of the membranes also occurs during this phase. However, it can happen earlier. In addition, the cervix now begins to open slowly and shorten. With each contraction, the muscles of the uterus tighten and become hard. This will slowly push your baby towards the pelvic outlet and gradually open the cervix. You can support this process with certain breathing techniques. Once the contractions come every three to five minutes and last an average of 60 seconds, the next phase of birth begins.

The intervals between contractions become shorter and shorter during the ‘transition phase’. In addition, the uterus contracts more and more, which also makes the contractions more painful. As a rule, your child will make a quarter turn until their face is in the direction of your tailbone. The cervix widens further and is almost completely open. It is then eight to ten centimeters open. With this, the birth moves on to the next phase. It is good to know that some German doctors still count the transition phase as part of the opening phase.

The ‘expulsion phase’ can last a few minutes, but in some cases it can be up to two hours. The strength of the contractions continues to increase. However, they are not as regular now as they were before. Also, there may be longer pauses between contractions. Many people are less sensitive to pain at this stage. Your baby's head is pressing on your bowels during the expulsion phase. This gives you a reflexive urge to push. It's further enhanced by your abdominal muscles. However, if you have had an epidural, that urge to push may be less strong or suppressed altogether. Once your baby's head has left the bottom of the pelvis, they will make another quarter turn with the next contraction. This allows the child's shoulders to leave the pelvic opening. Usually the rest of the body follows directly after.

Until a few years ago, the umbilical cord was cut immediately after a baby’s birth. Today, it is more common to wait until the umbilical cord stops pulsating or until the placenta, i.e. the afterbirth, has been expelled. The delivery of the placenta sometimes takes a few minutes, but can take up to over an hour. Afterwards, the doctors or midwives check whether everything is there. It is important that the membranes, the umbilical cord and, where applicable, the amniotic sac are accounted for. If not, the parts remaining in the uterus must be detached by certain hand movements or minor surgery. This prevents later infections.

Immediately after delivery, your baby's condition will be checked. This is repeated again after five and ten minutes. The results are recorded with what is known as an Apgar score. This is already part of the U1, your newborn’s first check-up. Once the baby has passed the first check, the newborn is placed on your chest or stomach or given to your partner. Already you can breastfeed it for the first time. During this time, there may also be afterpains. They help your uterus shrink again. Breastfeeding can enhance this effect and support it.