The Journey of Labour: What Really Happens During Vaginal Birth
Stage one: opening
Each contraction pulls upward on the cervix, thinning it (effacement) and opening it (dilation). Early labour is slow and irregular — the cervix softens and opens to about 6 cm. Active labour is faster and unmistakable: strong contractions 3–4 minutes apart that you cannot talk through. Meanwhile your baby's head presses down, flexes chin-to-chest to present its smallest diameter, and begins the long rotation. In this video — the longest on this site — I take you through every step of the journey, so when your day comes you can picture exactly what your body is doing.
Stage two: the descent and the birth
- Descent: with each contraction and your pushes, the baby moves down through the pelvis.
- Internal rotation: the baby turns so the back of the head comes under your pubic bone — the widest fit for the birth canal.
- Crowning and birth of the head: the head extends under the pubic bone, born slowly to protect your perineum — this is the famous 'ring of fire' moment, brief and purposeful.
- Restitution and the shoulders: the baby turns again to line up the shoulders, and with the next contraction the body follows — usually in one smooth motion into waiting hands.
Stage three: the placenta
The uterus keeps contracting, the placenta shears away from the wall and delivers, and the contracting muscle clamps the blood vessels shut — nature's own haemorrhage prevention. Your team watches the bleeding, checks the placenta is complete, and examines you for any tears. Then the journey of labour is complete, and a different journey starts.
Common questions
What makes labour start?
A conversation between your baby's maturing lungs and brain, your hormones, and your uterus — prostaglandins soften the cervix, oxytocin drives contractions. Nobody can trigger the exact day, which is why due dates are estimates, not appointments.
What if labour stalls?
Labour that slows is assessed, not panicked over: your team checks your hydration, position, bladder, and the contraction pattern, and may suggest breaking the waters or an oxytocin drip. Changing position and resting are sometimes all it takes.
Is monitoring continuous?
Low-risk labours are usually monitored by listening to the baby's heart at intervals, so you can move freely. Continuous monitoring is used when there are risk factors or an epidural — ask your team what's planned for you.
Natural Birth: Before, During & After
Next, natural birth before, during, and after — how to prepare, and what each stage feels like.