Labor and Delivery Tips for First Time Moms

Getting ready to welcome your first baby into the world is such a fun and exciting time for new moms and the whole family! But if you’re the one giving birth, there may be some uncertainty and anxiety involved when you think about your baby’s birth day. But don’t let that worry you—the majority of first time moms have a lot of questions about how they can prepare for birth or what they should expect during delivery. Let’s take a look at some of the topics you can discuss with your family and healthcare provider before the big day. 

I want to first acknowledge that birth is a physical, emotional, and spiritual event. Each person will have their own priorities and preferences about their birth plan and while it’s important for you to check out all of your birth options, it’s essential for you to make your own decisions about what you want or don’t want. Taking a childbirth education class, hiring a doula, or reading birth books are all good ways to learn more about this important life event. All of these methods will provide you with the various paths you can choose from. You can also find birth plan templates (like the one from Motif Medical!) that will help walk you through the topics you’ll want to consider before you’re in labor.

A birth plan will let your healthcare providers know who you want to be with you during your delivery, what your plan is for pain medication, if you plan on breastfeeding your baby, and other logistical information about the care you want for you and your new little one. A birth plan is easy to print out and have with you when you go into labor and means that your birth team can all be on the same page as you without you having to talk about your choices. 

Before labor your cervix is about 3 to 4 centimeters thick and by the time you give birth is will be as thin as a piece of paper. Much of the early work of labor is softening and thinning out this part of the uterus. Your cervix also starts to dilate in early labor, often going from tight and closed to around 6 centimeters dilated. Early labor contractions can be a bit irregular, ranging from 5 to 30 minutes apart and lasting 15 to 45 seconds. You’re probably still able to walk and talk during the contractions, even if they are strong enough to make you stop what you’re doing. In between contractions you’ll be able to continue your projects and carry on a conversation. Early labor can last 2 – 24 hours or more.

The second phase of labor is called active labor. During active labor your cervix will become completely effaced and dilate from 6 – 8 cm. Contractions in active labor are generally 3 – 5 minutes apart, lasting 60 – 90 seconds long and much more intense than in early labor. Active labor may last 30 minutes to 10 hours or more and is when you’ll probably start using deep breaths, movement, or other comfort measures during your contractions.

The third phase of labor is transition. This is when your cervix will become completely dilated (10 centimeters) and your baby will descend into your birth canal. Transition contractions can be as close together as 2 or 3 minutes and last 60 to 90 seconds. Transition is often the most intense and also the shortest part of labor. 

You’ll want to have a plan for what you want to do about pain relief during the three phases of labor. Using movement and breathing techniques can be an effective way to help your body keep labor progressing while also managing the intensity of the contractions. I recommend that my clients move as much as possible during labor, moving through positions that are both upright and laying down. I encourage people to change their position every 20 to 30 minutes during labor and this is a great task to assign to one of your support people because you will not be keeping track of time while you’re laboring (nor do we want you to be focused on that!). Using a birthing ball, peanut ball, rebozo, birth stool, shower, birth pool, massage, and counter pressure are all wonderful comfort techniques to help you with pain management, if your goal is an unmedicated delivery. If your pain management plan is to get an epidural, you’ll want to request that during one of those three phases of labor. 

Once you are completely dilated and start feeling the urge to push with your contractions, you are in the second stage of labor—pushing. Pushing feels different for everyone, but many people who are planning a vaginal birth feel like this active part of labor feels so much better than the passive, “try to relax” part that comes before it. Your childbirth class might cover breathing techniques that work well for pushing, but if you don’t have an epidural the best thing you can do is listen to your body! Most people feel a need to push and are able to notice the pressure of their baby’s head on their pelvic floor to let them know where to direct those efforts. Some people don’t feel a strong urge to push during labor and if you’re one of them, you can always ask your doctor or midwife to help you figure out how to effectively move your baby down and out. 

After your baby is born, you are now in the third stage of labor, which is when the placenta is delivered. Some people think the postpartum begins as soon as baby comes out, but technically you are still pregnant until the placenta is born, too! If you have a physiological, natural birth most placentas are born about 8 to 10 minutes after the baby. Many hospital policies incorporate active management of third stage after a vaginal delivery, which means receiving Pitocin after baby is born, which often prompts a faster delivery of the placenta. In the hospital setting, active management of third stage is associated with a lower risk of postpartum hemorrhage and has been shown to improve birth outcomes in the United States. If you have a cesarean birth, your doctor will remove the placenta as part of the surgery. 

So what should you do when you go into labor? This is a really great question to discuss during your prenatal appointments with your doctor or midwife during your third trimester! Every provider has their own protocol and preference for how their clients should communicate with them and when they want to know about any signs of labor. In general, you’re going to want to let your provider know when you’re in active labor, so when you’re having contractions that are 4 to 5 minutes apart and lasting 45 to 60 seconds each. Typically, this is a good time for you to make your way to the hospital or birthing center, or to have your midwife come check on you if you’re planning a home birth. Sometimes Braxton hicks contractions can mimic early labor contractions, so if you give those time to either change in length or strength it will help you tell the difference between the two. 

A baby may prefer to breastfeed when they are not desperately hungry or at certain times of day. You want the baby to enjoy being at the breast, so anything you can do to avoid making breastfeeding a battle ground will be useful. It’s better not to force the baby into a breastfeeding position but to enjoy time skin-to-skin contact and present opportunities gently.

You may need to use encouragement when bringing them to the breast. IF you have any milk flow yet, you can hand express some drops of milk into baby’s mouth, or you might pump for a moment to get the flow of milk started.

Or you might have been planning for a vaginal birth and need to have a csection at some point in time. There is no one right or wrong way to give birth! The whole process is about you becoming informed and educated so you can make the best decisions for you and your baby. Think of your birth plan like their a list of your preferences—it’s what you’d like to have happen. But if you find your plans need to change, walk confidently in your decision, knowing that you made an educated choice about how to keep you and your baby safe and healthy. 

As you’re thinking about your baby’s birth day and considering the options that come with welcoming a new baby into the world, make sure you set aside a little time to request a free breast pump through your insurance company! Thanks to the ACA, all pregnant members are eligible for a free breast pump if they are due to give birth soon or are breastfeeding. Motif Medical offers an entire line up of breast pumps to meet your individual needs and help you reach your breastfeeding goals!

Information provided in blogs should not be used as a substitute for medical care or consultation.