Pregnancy and Delivery: Super-Basic Edition

the super-basics about pregnancy and delivery

Pregnancy — especially as it progresses, and extra-especially if it results in birth — is one of the most complex and far-reaching events that can happen within the human body and to a person’s life and self whose body it’s happening in. There’s a reason there are many huge books on pregnancy: it’s a big and complex topic. This isn’t one of those (but you’ll find a few I like in the sidebar to the right).

This is just a very basic overview. It’s here if you’re thinking about becoming or are currently pregnant, or if that’s the case for someone else you know. It’s here if you cannot yourself become pregnant, but can co-create a pregnancy in someone else’s body with yours. It’s here if you need some facts in order to make choices about a pregnancy, whether those are about terminating a pregnancy or not or about planning your life with a pregnancy. It’s here if you just don’t know much about what it’s like to be pregnant at any or every stage and you want half a clue.

Some excellent and complete pregnancy and delivery guides in print are:

  • Our Bodies, Ourselves: Pregnancy and Birth, by the Boston Women's Health Book Collective
  • The Mother Of All Pregnancy Books, by Ann Douglas
  • Nurture: A Modern Guide to Pregnancy, Birth, Early Motherhood - and Trusting Yourself and Your Body, by Erica Chidi Cohen
  • The Birth Partner: A Complete Guide to Childbirth for Dads, Doulas, and Other Labor Companions, by Penny Simkin
  • Your Pregnancy & Newborn Journey: A Guide for Pregnant Teens, by Jeanne Warren Lindsay and Jean Brunelli PHN

If you don’t already know how pregnancy happens in the first place, you’ll probably want to start there. You can read up all about that right here, at: Human Reproduction: A Seafarer's Guide. If you’re looking at this because you’re currently having a pregnancy scare, this piece will likely be less helpful than the information you’ll find on these pages: The Pregnancy Panic Companion.

As explained in our piece about how pregnancy happens, once a fertilized ovum implants itself into the uterine wall, you’ve got yourself a pregnancy. All in all, the process from the moment ejaculate enters the vagina to implantation — what’s medically recognized as a pregnancy — tends to take anywhere between around five days to two weeks.

Some people will choose to continue a pregnancy. Others will choose to terminate it with an abortion procedure. A pregnancy may also end on its own any time before delivery (birth) due to miscarriage or other complications.

Pregnancy can last anywhere from just literally minutes to, if it ends with a live birth, around forty weeks. Here’s the lowdown on what is or can be happening within that time.

Within the first few months of pregnancy—the first trimester—a person may experience:

  • Feeling more tired than usual
  • General nausea or morning sickness
  • Frequent urination, gas, constipation, and indigestion
  • Physical and emotional symptoms similar to PMS

Often, after the first few months, emotional issues such as feeling irritable or emotionally unstable may pass, and into the second trimester, many people begin feeling better about being pregnant than they were in the first trimester, although hormonal changes and new frustrations—like not fitting into clothes, feelings about weight gain, fears and doubts, and other issues—may still cause moods to be erratic. Being crabby during pregnancy isn’t just about hormones: a lot of it is just about all the challenges being pregnant presents, especially in a world or a life that isn’t supportive or accommodating of a pregnancy.

Appetite increases during the first trimester, and food cravings as well as food aversions may appear. Weight gain should also have begun by now, and you will need to make a sincere effort to gain weight during the rest of the pregnancy. It’s very important for fetal health to gain weight during pregnancy, so if this is a real issue or challenge for you, you’ll want to be sure to talk honestly with your healthcare providers about it and ask for help. That help can include treatment for disordered eating if you need it.

If someone is choosing to have an abortion procedure, they will usually do so before the end of the first trimester. For information on abortion, you can check out our basic guide to abortion procedures here: All About Abortion, or look at the tag for abortion on the site for all of our abortion information and content.

If someone is choosing to continue a pregnancy, starting regular prenatal care early is important — ideally around 8-10 weeks in. Adequate nutrition, plenty of rest and activity, reduced stresses, emotional support, and the practical and financial means to obtain all of those things are also needed for a healthy pregnancy. Because of increased health risks and social disparities, people who are pregnant as teens or emerging adults need to be more dedicated to these issues than older people, not less, and should be given more help accessing all of these things, not less.

If you’re pregnant and thinking about bringing a pregnancy to term:

  • Tobacco, alcohol, and recreational drug use should be stopped, pronto. Fetal health may also be compromised if the person who’s pregnant was doing any of those things shortly before pregnancy or when they became pregnant, so someone pregnant with a recent history of smoking, drinking, or doing drugs should ideally to be honest with their doctor (and themselves) and ask for whatever help they need to change those habits or address any existing risks. Partners of pregnant people who do any of these things and plan to stick around should also quit because of the way some of those habits can indirectly affect a pregnancy or just to show solidarity and to make changing habits a lot less challenging for the person who’s pregnant (who is the person with way, way more challenges, period).
  • If someone pregnant has an eating disorder or chronically diets, that should be addressed with a healthcare provider. For a healthy pregnancy and child, gaining weight is important.
  • If someone is sexually active while pregnant, it is vital for them to reduce STI risks because STIs can create health risks for a fetus or pregnant person during pregnancy and at birth.

Into the second trimester, many of the symptoms from the first few months continue, and a person may also experience:

  • Greater fatigue or dizziness
  • The pregnancy showing
  • Swelling of the ankles and feet
  • Changes in vaginal discharge, skin, and hair
  • Enlarging breasts
  • Headaches or sinus symptoms
  • Backaches
  • Fetal movement a pregnant person can feel also begins and increases

In the last few months of pregnancy, the third trimester, many of the symptoms from previous months continue, and, in addition, people usually experience:

  • Heavier vaginal discharge
  • More intense back and body aches
  • Some breast leaking
  • Hemorrhoids
  • Greater fetal movement
  • Trouble sleeping
  • Occasional contractions
  • Shortness of breath
  • Varicose veins
  • Clumsiness
  • Emotional issues, like feeling seriously sick of being pregnant or big worries about childbirth or parenting

Midwifery: Before we had OB/GYNs, we had midwives. Through most of human history, midwives or doulas have helped deliver babies and have provided prenatal and postnatal care. Most of the practices Western doctors use today for childbirth are based on techniques midwives developed over the centuries through active learning. You can find references to midwives in the Old Testament. Midwives are still around today; you can see a midwife privately if you are pregnant, and some hospitals and healthcare systems even include midwifery among their available services, so ask your doctor or insurance provider about it. Too, if you’re young and pregnant or are otherwise struggling to afford or procure prenatal and delivery care—or are dealing with discrimination in your prenatal care as a result of your age—midwives are often incredibly generous with their help and services for young pregnant people in need. For a starter list of doula and midwifery resources, take a look at Miriam Zoila Perez’ resource page at Radical Doula.

Labor Day

Labor and childbirth consist of three different stages: (1) labor (subdivided into early or latent labor, active labor, and a transitional phase), (2) childbirth, or delivery, and (3) delivery of the placenta, or afterbirth. The whole process takes around fifteen to twenty-four hours, on average, for first-timers.

Early labor is the longest stage of labor and delivery, lasting many hours or even a couple of days, but it is also the least intense. When short contractions—which feel like very intense menstrual cramps—start to occur within twenty to thirty minutes of one another over a period of a few hours, and the lapse between them gets progressively shorter, early labor has begun. Before that time, usually over a period of days, the cervix has been slowly thinning out (effacement) and dilating (opening) to about three centimeters.

When contractions are a few minutes apart and become stronger, active labor has begun, and it generally lasts a few hours. The transitional phase is usually the most difficult and tiring part of labor for most people: contractions are intense, longer, and very close together. The cervix completes dilating during this phase, opening to around 10 centimeters to be ready for delivery. People in the transition phase of labor may feel heavy pressure on the back, rectum, and bladder; body temperature tends to fluctuate erratically; and cramps, nausea, chills, shakes, and an overall feeling of exhaustion and/or serious moodiness or irritability are common and normal. Vomiting, a bowel movement or bloody discharge may also occur.

When delivery begins, many people get a second wind and are glad to be able to start pushing (if you bear down as you might when pushing out a bowel movement, you can get a vague idea of what pushing is like, sans baby). Is it painful? Pretty much always, to varying degrees. There are a range of different pain management options and techniques available for delivery: breathing techniques, positions, massage, medications and other medical treatments or interventions, meditations and even good vibrations (masturbation is earnestly one way to manage this pain).

Pain during delivery is also often exacerbated by other factors—by being alone, if that isn’t desired; by certain hospital environments or birthing approaches; by lack of preparation or knowledge of what’s happening; by stress or anxiety, embarrassment, shame, or fear; and, most of all, by the expectation of a lot of pain. So, it is often more painful for plenty of people than it should be, and the environment a person is in, and their state of mind, count for an awful lot. Some people may also experience emotional pain, particularly those who have experienced previous sexual, medical or birth trauma. Pregnant people should be sure to talk with their healthcare and birth team about any or all kinds of pain that may occur, all their options, and make a plan together about how they want to manage pain.

A cesarean section—or C-section—is a surgical birth procedure in which an incision is made in the abdomen and uterus to deliver an infant that way rather than vaginally. A person is given regional anesthesia (to block sensation in the lower body, rather than put the patient to sleep) for a C-section, and the doctor then removes the infant through the incisions.

Some people schedule C-sections or plan on them in advance, but C-sections are typically suggested or done because of multiple births or vaginal birth complications. C-sections are also usually done with those who are HIV-positive or who have active genital herpes sores during labor.

Because it involves surgery, a C-section can carry more risks. Rates of cesareans are at a record high, and although there are good reasons for some people to have a C-section, many obstetric advocates, midwives, pregnancy and natural childbirth activists, and medical organizations such as the Kaiser Foundation have voiced concern about C-sections being done needlessly or without accurate information about options and risks. If you’re pregnant and planning to deliver, talk to your doctor or midwife in advance about your birthing options, and get the facts first if your healthcare provider suggests a C-section delivery for you.

With a vaginal birth, the doctor, midwife, or birthing coach and/or partner can aid with delivery and help the person who’s actually in labor to keep pushing and stay as energized but relaxed as possible. Although typical hospital deliveries have had people in delivery lying down, many are starting to catch on and adapt to use more natural positions that are helped by gravity, like partially sitting or squatting.

When a baby begins to “crown,” or its head first is visible at the vaginal opening, the birthing partner, midwife, or doctor helps ease the baby out of the vaginal canal as the person in labor continues pushing, until the entire infant is through the birth canal. The umbilical cord may be clamped, cut, or left in place until after the afterbirth has been delivered. Just so you know, brand-new babies, even when cleaned off, rarely look like newborns in the movies: most retain a slightly wooly body hair called the lanugo, and they often look a little blue and pretty oddly shaped, including the head, which sometimes even looks cone-like. They can look more weird than adorable.

The actual vaginal delivery in full lasts an hour or two on average but sometimes as little as fifteen minutes or as long as a few hours, especially if there are complications during birth.

The final stage of labor is the delivery of the placenta, or afterbirth—the tissue mass that provided nourishment for the infant during pregnancy. After delivery of the infant, the uterus begins to contract again, and a few more pushes are needed to expel the placenta. This generally takes five to ten minutes.

There aren’t hard-and-fast rules on what someone feels emotionally during labor and delivery, and there’s no one way everyone feels. Most people are glad when labor and delivery are over, not just because the exhausting process is complete and they can rest but also because, for many, experiencing the whole process and giving birth to a child—and seeing their child—is seriously satisfying. But it’s also normal for people who have just given birth to feel depressed, overwhelmed, or just too plain tired to know (or care) what they’re feeling.

It takes a few days to months after delivery for the physical and emotional aftereffects to wear off. At first, someone who went through labor and delivery may experience physical effects like cramps, discharge (including lochia, postpartum bleeding that generally lasts for four to six weeks), exhaustion, and overall genital and breast soreness or discomfort. A wide range of fluctuating emotions can occur, including postpartum depression (which can be a major long-term problem for as many as 25 percent of all people who’ve delivered) and wild elation, and often swings between the two, as well as decreased sexual desire. Within about six weeks, most people return to feeling normal (albeit “normal” in the way that now includes living with a brand-new infant and a completely changed life).

A person who has just given birth may need a bunch of different kinds of help and support afterwards. By all means, that is usually things like help changing diapers and taking care of the new infant (or infants, in the case of a multiple birth). Help with transportation for self-care, cooking, cleaning, or just keeping someone company while they recover from pregnancy and delivery and get used to tiny humans engaging in complete and total domination of their lives for a while are also big things.

But help can also mean things like counseling from a professional and emotional support from friends and family in the event of post-partum depression, anxiety, or other emotional changes, Even a positive birth experience can be followed by intense and unexpected emotions. Birth parents who aren’t raising the baby also help with the physical and psychological aftermath of the experience of pregnancy and delivery.

Like I said at the start of all this, this is just a barest-of-bare-basics guide to pregnancy and delivery. It also doesn’t include any information about what happens after a pregnancy — no matter how that pregnancy ends. If you’d like more information about pregnancy, check out some of the books in the sidebar way up top: you can probably find most of them at the library.

To find out more about the most basic kinds of reproductive choice — choosing to terminate a pregnancy with abortion, or remain pregnant and either parent or arrange an adoption, use our search function on the top left, or talk with a reproductive or sexual healthcare provider. To find out how to prevent pregnancy, you can start by checking out some of our content on contraception.

Excerpted and adapted from s.e.x.: the All-You-Need-to-Know Sexuality Guide to Get You Through Your Teens and Twenties by Heather Corinna (DaCapo Press, 2016).

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