Vaginal birth is the natural way for the female body to deliver babies, and recent studies have shown through evidence that it is the safest form of birth for both the mother and the baby. This confirmation has come to challenge birth statistics that previously had C-section as the primary means of delivery and to reassure women and change perceptions—as well as to teach what a vaginal birth is really like.

Vaginal birth has become increasingly common thanks to growing awareness about this delivery option and also due to new laws that only allow cesareans in cases of necessity and risk. Of course, the law is not always followed as it should be, but we have already seen a sharp decline in unnecessary and non-indicated C-sections, also known as elective C-sections.

There is no set rule for having a vaginal birth, as every body responds to labor in its own way. Some women, with a high tolerance for pain, face this moment calmly, while others require relaxation techniques or even anesthesia to see it through. If we do a quick search online for vaginal births, we’ll see all types of videos of this moment.

Vaginal birth itself is divided into three stages: the labor phase, during which contractions intensify until there is a complete dilation of 10 centimeters; the second stage is expulsion, where the woman must exert all her strength so the baby can be delivered; the third is the delivery of the placenta, where a new strong contraction is necessary so the woman can push out the placenta as well.

Throughout this process and journey, the body itself is preparing. Some women experience back pain, others feel it in the belly, and some simply feel the urge to push—labor is truly unique for every woman.

Vaginal birth, besides reducing the risk of hemorrhage for the mother, also prepares the baby’s respiratory system during expulsion so it can adapt to the world outside the uterus, and provides a quicker recovery than aC-section, as well as a shorter hospital stay. Breast milk also typically comes in right after the baby is born, aiding breastfeeding.

Step by Step of Birth

Everything begins with labor, when the uterus starts to have contractions at slow, controlled intervals. These contractions will become closer together and more painful over time. Usually, they start every 10 minutes and become stronger as their intervals decrease. When contractions are still far apart, it’s possible to walk and do other activities, which actually helps manage the pain and supports the dilation process.

First Phase

This first stage can last hours, so stay calm, eat light foods, and try to walk and breathe as peacefully as possible. It is often advised not to head to the hospital during this phase if you don’t want to be hospitalized for hours; in some hospitals, if you’ll be admitted, they may give you oxytocin to speed up contractions and dilation, which also increases pain intensity quicker.

Second Phase

When you’re in the second stage, where active labor is underway and your contractions are close together, it’s time to go to the hospital or call your doctor. The doctor will tell you that you’re in active labor if you have about 3 to 4 centimeters of dilation. Your own body will find the best position for you to be in during painful contractions.

You can choose to take a warm shower, which often eases irritability and pain, bringing more comfort at this time. Walking is highly recommended to relieve discomfort and also to accelerate dilation, positively supporting the labor process. Breathing is essential right now, so calm down, breathe deeply, and try to relax, as hard as it may be.

If your amniotic sac has not yet ruptured, your doctor may choose to break it to speed up labor. Don’t worry, this is totally painless, although it will increase the pain of contractions somewhat. If requested and if available, anesthesia can be given at this stage to relieve the severe pain involved.

Contractions will be coming one after another, and when the cervix is fully dilated to 10 centimeters, it’s time to push. Your uterus will push the baby out through the vaginal canal, and with every contraction and push, the baby will move down a little more. This can take some time until the baby’s head crowns. At this point, you’ll feel a stronger burning sensation and you’ll know you’re close to the end.

If the baby is in the right position, the head will emerge and the doctor will guide your contractions and tell you when to push or stop, to reduce the risk of tearing. If the doctor thinks it’s necessary, they can perform an episiotomy to help the baby come out, but this should only be done if absolutely needed. If you have chosen anesthesia, the doctor and nurses will tell you exactly when to push, so rest assured!

Third Phase

The third stage happens after the baby is born, and for many women, the contractions return to aid the expulsion of the placenta—of course, this is much less painful than delivering the baby. Expelling the placenta can take 5 to 15 minutes after the birth, and it’s normal for the woman to feel the urge to push again. The doctor will check by palpating your abdomen to ensure all placenta and its residues have been expelled.

After labor is over, you may feel weak and shaky, but you’ll be elated! Your desire to hold your baby will be so great that your discomforts will seem minor. Don’t feel bad for wanting to rest or just thinking about a good meal—your body needs to restore its energy, and once you have recovered, your focus will be fully on your baby. In the meantime, hold your baby, if possible breastfeed and enjoy this moment—it’s truly unforgettable!

Natural Vaginal Birth

The dream of 8 out of 10 women, vaginal birth is a symbol of our mothers, grandmothers, and many previous generations. For a birth to be beautiful, it needs love, no matter the way the baby is born. But let’s be honest, it is wonderful to see a mother deliver her child in such a natural, ancient way that is so beneficial for both her and the baby.

That’s why I call indigenous women and all those who have their children without any help warriors and lionesses. It’s incredible strength for one person, but I think that motherhood, this unique moment in a woman’s life, brings out this courage.

Having a child in the age of anesthesia has become easy and practically painless, as long as you have a good pelvis, courage, intuition, and a doctor who supports your choice. Yes, even if a woman is determined to have a vaginal birth, nowadays many doctors prefer cesareans because they are better paid for them and because it’s more convenient to schedule a surgery and avoid odd hours and the “unnecessary rush.” But as my doctor, Dr. Roberto, said, we have to go with what’s best for the health of the mother and the baby—if everything goes well, that’s what matters. I fully agree with him.

Did you know labor begins long before we imagine? Yes, practice contractions start way before the mucus plug comes out, the water breaks, or “the moment” occurs, as they say—they are present in every pregnancy, no matter what kind of birth the woman will have. But this is one of the ways the mother’s body prepares for the moment when it’ll have to push the baby out of the uterus, that most protected place in the world for babies.

A natural birth means everything begins with progressive labor; contractions start, and you need enough dilation for delivery. Usually, that’s 10 centimeters, but I’ve seen cases where the baby is small and 8 or 9 centimeters is enough for the head to pass, since that’s the most critical part of labor proper—the latent phase.

In the hospital, they often speed things up to avoid distress for mother and baby by giving oxytocin intravenously, and then things really get moving. Another way to help labor progress is to break the water if it hasn’t happened yet.

Epidural anesthesia is given after 7 centimeters of dilation. It greatly reduces the mother’s pain but doesn’t remove it completely, so she can still feel when it’s time to push. You may head to the hospital if you experience the typical signs of labor:

  • Contractions every 10 minutes or regular contractions regardless of timing
  • Any sign of blood
  • Mucus plug discharge

The woman must pay close attention to any of these signs, and it’s very advisable to always have the obstetrician’s phone number nearby in case of need. And remember, God prepares the best for us—if, for some reason, you cannot have a vaginal birth, don’t feel sad. This is a very complex topic, with many chapters. I still want to talk about home birth, humanized birth, and many others. The first I discussed was the C-section, which we’ve already covered.

Below is a vaginal birth in one of the best maternity hospitals in São Paulo, Santa Joana. But know that there are many birth videos on YouTube. I just don’t see a need to put such an explicit one here, haha—but if you really want to see, just search for one, ok? Oh, I found this really cute video, one of the most beautiful births I’ve seen on YouTube.

Vaginal Birth with Anesthesia

A moment of pure tension and fear of the unknown, the moment of birth is one of the most anticipated for mothers, but also brings many fears, especially due to the pain described by those who’ve experienced it. Unlike in the past, when women had no second or third alternatives, women today can choose and request methods that minimize pain and discomfort, as with vaginal birth with anesthesia.

Many women, frightened by the pain of vaginal birth, tell their OB during prenatal visits that they want a C-section to avoid the experience altogether. Others prefer to wait and let their body do its job, allowing their baby to be born as nature intended and let their body work for their baby’s birth, enduring and facing the pain as a natural part of the process, which truly it is.

The pain of vaginal birth is very subjective and cannot be compared from woman to woman, because each body works in its own way, and pain tolerance varies for each person. That’s why there are plenty of women who say their vaginal birth was quick, painless, and comfortable (every woman’s dream!), and others who say it’s the most pain they’ve ever felt. But none of this pain takes away the shine from the moment, which is truly magical and special.

It’s important to point out that the pain of vaginal birth is actually beneficial for women who manage and control their contractions, in addition to knowing just when to push so their baby is born. Similarly, both pain and the best and most comfortable position during labor depend on each woman.

Having family and trustworthy professionals around you during this time makes all the difference in helping you face the moment as calmly as possible. And if, despite all precautions, a vaginal birth with anesthesia is needed or requested, it can happen smoothly. Every woman knows her own body and limits, and these must be respected—it’s her moment, hers alone, and the baby’s.

Being prepared with ample discussion with your OB or doula, if you choose one, helps you know what to expect, how to minimize the pain and how to control your body enough to hold on until birth. Get answers to your questions about anesthesia and clarify your fears, learning what can help or hinder your labor experience. Feeling safe makes all the difference at this time!

How is it administered?

Anesthesia in vaginal birth is a reason to celebrate for many women, as it helps so much in this beautiful and special moment. Why not experience a vaginal delivery without so much pain? And knowing you’ll have anesthesia during the most intense pain provides a feeling of calm and comfort at this time.

There are two types of anesthesia for this: epidural and spinal (peridural). Both are administered in the lumbar region of the spine, acting from the waist down. This allows the woman to be fully awake and alert for the delivery phase.

The anesthesia is totally painless; a local anesthetic is applied first, and then the anesthesia is given. Upon administration, a sensation of heat and pressure is felt, followed by immediate relief. It is usually given in advanced labor, near full dilation when the pain is strongest but can be requested earlier if needed. If you’re unsure about epidural anesthesia for your delivery, talk to an anesthesiologist. They can answer all your questions!

Birth Story by Cristiane Fonseca

My princess Millena showed signs that she was ready to come into the world at 39 weeks and 1 day. It was a sunny Sunday morning when I noticed a light bleeding—I had read about it and knew it was the famous “show.”

Our first trip to the hospital was at 10 am on Monday, when I started feeling painless contractions. There, we learned I was entering labor, but only 2 centimeters dilated and with no pain. We went back home, and I was advised to walk and take warm showers if the pain came and to return to the hospital when contractions were every 5 minutes (I was living in the United States at the time, where everything about birth is different from Brazil).

By 10 pm, I was having a lot of pain, but contractions were irregular, so I decided to return to the hospital because it was becoming unbearable. I was frustrated—still just 2 centimeters. Sent home again.

That night, I didn’t sleep, taking warm showers and getting back massages from my husband, but nothing seemed to help when contractions came, still very irregular. I held out until 5 am, when I called the hospital and begged to be admitted, as I was afraid to stay home (in South Carolina at the time, you could only be admitted with 5 centimeters dilation).

At the hospital, relief, I was at 5 centimeters. But the doctor on staff said my princess was facing the wrong way, but would probably turn as labor progressed, so I relaxed and waited for my epidural.

After the anesthesia, I felt great relief—it was given in a way that I could still feel when contractions were coming, but without pain. Labor progressed after 5 am, and by 10 am Tuesday, I was 10 centimeters and ready to push.

Push after push was what they asked me to do—I didn’t know where to find more strength, and for an exhausting 2.5 hours, I pushed and still my little one wouldn’t be born. When the doctor came with an ultrasound machine, we saw she was still facing the wrong way, and in a split decision to save my baby’s life, he turned her by hand and she was born at 12:31 PM on June 1, 2010, weighing 3773kg and measuring 53cm.

I couldn’t see her when she was born, and her father couldn’t cut the umbilical cord as she was purple and didn’t cry, being taken immediately for oxygen and heart massage. Half an hour later, they brought me my bundle of love—the princess I had prayed so much for was in my arms and wanted to nurse, one of the best feelings I’ve ever experienced.

We stayed in the hospital for 3 days because of a fever I had during delivery and she needed antibiotics. My postpartum was not the best because I suffered a third-degree laceration when the doctor turned her inside me; the 8 stitches hurt a lot, burned, and going to the bathroom was a nightmare. But after that period, it was all joy—I was able to breastfeed, and she grew healthy!

See also: Vaginal or C-Section Birth – Is It Really a Choice?

Photo: Oriana Eliçabe