Vaginal Birth: Recognising Labour, the Process and When to Go to Hospital

Vaginal birth is the baby being born through the birth canal. Understanding whether labour is real or a false alarm, knowing the general stages of the process and learning which signs mean you should contact a health facility can help you approach this period better prepared. Labour differs from person to person; the information below offers a general framework, and your health team assesses your own situation.

What is vaginal birth?

Vaginal birth describes the baby being born through the vagina with labour that starts by itself. According to the Turkish Ministry of Health's safe birth framework, quality standards based on scientific rules and patient-safety principles are applied in birth services; this general framework applies to all births, whatever the mode of birth. Vaginal birth may be an option some people choose by themselves, and for others it is an option that needs to be assessed separately with regard to the mode of birth; the decision takes shape together with your doctor according to your situation.

How does labour start, and how can it be told apart from a false alarm?

Real labour generally shows itself with contractions that come at regular intervals, become more frequent over time and get stronger. These contractions generally do not go away with rest or a change of position. By contrast, the irregular contractions (Braxton Hicks type) that are common later in pregnancy and popularly known as "false labour" do not become more frequent or stronger over time; they may ease with rest. Signs such as your waters breaking or leaking, bleeding or a decrease in the baby's movements can appear together with labour or independently of it, and need separate assessment. If you are not sure which situation you are in, you are advised to contact your health team.

What stages does the birth process consist of?

Labour generally consists of three stages: opening of the cervix (the dilatation stage), the birth of the baby and the separation of the placenta. How long each of these stages lasts varies from person to person; this being your first baby, earlier birth experiences and personal differences can affect this time. Current guidelines on care in labour point to the importance of a woman-centred and respectful approach in this process. The health team monitors you and your baby throughout the process and informs you when needed.

When should you go to the hospital or your delivery room?

When you think labour has started, or when you notice any of the signs listed above, you are advised to contact your health team or go to your delivery room or hospital. When you are not sure, you are advised to call your health team rather than wait.

Can you share your preferences with your team during birth?

Yes. In a low-risk labour that has started by itself, your health team can consider low-intervention approaches when appropriate. You can talk with your health team early in pregnancy about subjects such as who can be with you during birth, your preferences for movement and position and your wishes about pain management; you can also update these preferences during birth. You can also tell your team which relaxation methods you would like to try, such as moving, changing position or breathing exercises. It is not guaranteed that your preferences will all be met in exactly the same way; if the situation changes, you reassess together with your team. If an earlier birth experience causes you anxiety, sharing this can help your team support you better.

What happens if the situation changes during birth?

The health team monitors you and your baby throughout birth. If a concern arises about the baby's condition or the process does not progress as expected, the team shares this with you and updates the plan; in some cases the mode of birth may change and a caesarean may need to be considered. This does not mean "failure"; it is a decision made by a shared assessment that suits your situation. Having made a birth plan does not prevent this decision from being updated together.

Is it normal to ask for support with pain management or to feel anxious?

Yes. Asking for support with pain management does not make birth harder and is not "shameful"; it is a matter of preference. Having had a difficult birth experience before or having anxiety about birth is not something you should be judged for; sharing these feelings with your team can help you approach the process better prepared. Not having prepared a birth plan does not mean you are unprepared either; you can also share your preferences verbally during birth.

What happens just after birth?

Just after birth, if your condition is suitable, you may be offered the chance for first skin-to-skin contact with your baby and an attempt at breastfeeding. The placenta separates and comes out, and the health team checks you and your baby. In the postnatal period your health team goes on monitoring you and your baby; the details of postnatal care are determined according to your situation.

How can you support yourself?

• Learn the general signs of labour beforehand.
• Talk about your preferences with your health team early in pregnancy.
• Be clear beforehand about which signs should prompt you to contact them, and how.
• When you are not sure, call your health team without waiting.
• Plan beforehand the person you want with you.
• Share with your doctor your worries about your previous birth experience.

What can you ask your doctor?

• Whom should I call, and how, when labour starts?
• Which support options are suitable for my situation during birth?
• How does the process go if a problem comes up during birth?
• Can I change my pain management preference during birth?
• Could you explain to me what will happen just after birth?