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Providers at ���ϸ����� Langone offer the guidance and support you need for a safe vaginal delivery. During a vaginal birth, the uterus contracts and releases, and the cervix thins and opens so you can push the baby through the birth canal.

We work with you to make sure your birthing experience reflects your wishes and to ensure the safe and successful delivery of your baby. A first labor typically occurs between 37 and 42 weeks of pregnancy.

Most routine vaginal deliveries at ���ϸ����� Langone are performed by our general obstetricians. Midwives can attend deliveries and work with our general obstetricians.

Specialists from maternal–fetal medicine services are involved in complex deliveries and perform cesarean surgery when necessary. 

Preparing for Labor and Fetal Monitoring

After you are admitted to the hospital during labor, a physical exam is performed to check your cervix. A fetal monitor may be strapped to your abdomen to check the baby’s heart rate.

Fluids may be administered through a vein with intravenous (IV) infusion to prevent dehydration during labor. Oxytocin, a hormone that induces contractions, may also be provided through a vein with IV infusion.

Vaginal Delivery

Vaginal labor and birth occur in three stages.

First Stage, Early Labor

During early labor, the cervix—which is the opening between the uterus and the vagina—begins to thin and open, also called effacing and dilating, to prepare for birth. During this time, you begin to feel contractions of the uterus. Contractions typically last about 30 to 45 seconds and occur between 5 and 30 minutes apart.

Your water may break during early labor. This means that the amniotic sac, which contains the fluid that protects and surrounds the baby, has torn, causing fluid to leak from the vagina.

Second Stage, Active Labor

In active labor, the cervix continues to efface and dilate, and contractions—which are stronger and longer-lasting than those during early labor—occur more often, typically every three to five minutes.

Third Stage, Transitional Labor

In the transition phase of labor, the cervix fully dilates to 10 centimeters, and contractions can last up to 90 seconds, with 30 seconds to 2 minutes between each contraction. You may feel pressure in the lower back and rectum and experience nausea, shaking, shivering, and sweating. Though intense, this is the shortest phase of labor.

When the cervix is fully dilated—about 10 centimeters—and the baby has advanced into the birth canal, providers may tell you to push, using your abdominal muscles. This process can last minutes to hours.

During delivery, the skin on your perineum, the area between the vagina and the rectum, may tear as the baby is born. If this occurs, your doctor stitches the tear soon after delivery.

Our team of maternity nurses applies an antibiotic to the baby’s eyes for protection against bacteria that may have been in the birth canal. They also inject vitamin K into one of the baby’s limbs to prevent irregular bleeding in the brain.

The umbilical cord is clamped and cut, and the baby’s health is evaluated with an Apgar score, which measures the baby’s activity level, heart rate, reflex response, skin color, and breathing rate.

The nurses dry and swaddle the baby and then hand the baby to you.

Delivery of the Placenta

After the baby has passed through the birth canal, you may feel the uterine contractions continue. This helps you to deliver the placenta, which is the temporary organ that carries oxygen and nutrients from the mother to the baby in the womb. This typically occurs within 30 minutes.

Pain Management

Prior to labor, your doctor discusses your plans for pain relief. Keep in mind that your plans may change as labor and vaginal delivery progresses.

Pain is typically managed with anesthesia given with an epidural, a safe and effective injection. It is given in the space surrounding the spinal cord.

We may offer IV pain medications if you cannot tolerate an epidural or it is contraindicated for health reasons. Your doctor discusses the benefits and possible side effects before administering any pain medication.