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Labor and Childbirth: Vaginal Delivery

A Mother with her newborn baby at the hospital a day after a natural birth labor

When it comes to childbirth, labor, and delivery, no two experiences are the same. Some women even have completely different labor and delivery experiences if they have more than one child. No matter the type of delivery, your certified nurse-midwife (CNM) will be there in full support of you and baby throughout the entire process. If you have a vaginal delivery, here is some information that we hope is both helpful and reassuring. 

We first suggest writing a birth plan. This plan can help provide a framework during what can often be an overwhelming time. 

Early Stages of Labor

Water Breaking / Amniotic Sac

Commonly referred to as your “water breaking”, the amniotic sac, which is the membrane your baby is in, will usually break before birth. Although it can remain unruptured until the baby is delivered in some cases. For most women, the water breaks before going into labor or at the very start of labor. The fluid from the amniotic sac should be colorless and odorless. If something doesn’t seem right, notify your midwife immediately. 


Many women experience contractions that feel like pressure or cramping as the uterus contracts and releases. As contractions grow closer together and last longer, it’s likely that labor is getting close. The contracting and releasing of the uterus is the movement that helps move the baby through the cervix. 


The cervix connects the uterine cavity to the vagina. When it’s time for labor, the cervix opens, making enough room for the baby to pass through. Active labor starts when you are dilated 3 centimeters or more. 

Labor and Delivery

When the cervix is dilated 10 centimeters, the baby will be able to move through the birth canal. A vaginal birth means that as the baby reaches the vagina, the skin and muscles around the vagina are stretching to make room for the baby. 

As the skin between the vagina and the rectum continues to stretch, this could cause discomfort and you could feel a burning sensation. 


If the skin cannot stretch any further and action needs to be taken quickly, your doctor might decide to perform an episiotomy. “An episiotomy is an incision made in the perineum — the tissue between the vaginal opening and the anus — during childbirth.” While these procedures used to be commonplace in labor and delivery, they are not performed as routinely and each case is considered unique. 


With a vaginal birth, once the baby’s head comes through, you will likely feel some relief from the pressure and pulling. You will pause pushing for a moment while the baby’s mouth and nose are cleared of fluids. The baby’s body will be adjusted to be straightened out while still inside of you. Next, you’ll push through to pass the baby’s shoulders. After that, there will be one last push and you’ll deliver the baby. 

The Placenta

If the placenta isn’t delivered right away, you might have to work for a few minutes to make sure it is pushed through. Your midwife might massage your lower stomach to help with the placenta delivery. 

Some women like to see the placenta or preserve the placenta. If that is the case, please ask your midwife. 

Talk to A Midwife

At City of Oaks Midwifery, our goal is to help patients in Raleigh and the greater Triangle area achieve the birth that they desire. We believe in watchful waiting and non-intervention in normal birth process, but work in collaboration with other members of the health care team as needed to provide optimal health care for both the mother and her baby. To schedule an appointment with one of our certified nurse-midwives, call (919) 351-8253.

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