Vaginal Delivery

What is a vaginal delivery?

A vaginal delivery is when a person gives birth through their vagina. It's the most common method of childbirth. During a vaginal birth, your uterus contracts to thin and open your cervix and push your baby out through your vagina (or birth canal).

Healthcare providers prefer vaginal deliveries because they're usually safest for the fetus and the birthing person. A vaginal delivery occurs most often between weeks 37 and 42 of pregnancy.

How common are vaginal deliveries?

According to the Centers for Disease Control and Prevention (CDC), there were more than 2.5 million vaginal deliveries in 2020. Vaginal deliveries account for about 68% of all births in the United States and 80% of births worldwide.

What are the types of vaginal delivery?

There are different types of vaginal deliveries: spontaneous, induced and assisted.

• Spontaneous vaginal delivery: A vaginal delivery that happens on its own and without labor-inducing drugs.
• Induced vaginal delivery: Drugs or other techniques initiate labor and prepare your cervix. This is also called labor induction.
• Assisted vaginal delivery: A vaginal birth that occurs with the help of forceps or a vacuum device to get your baby out. Both spontaneous and induced vaginal delivery can be assisted.

What are the stages of a vaginal delivery?

A vaginal delivery can be broken into three stages: labor, birth and delivering the placenta.

Labor

The first stage of labor begins with uterine contractions and ends with your cervix being 10 centimeters dilated and 100% effaced.

Labor can be classified as early labor, active labor and transitional labor.

• Early labor: The time when contractions begin and your cervix starts to open (dilate) and thin (efface). Your cervix may be about 5 centimeters dilated at the end of early labor.
• Active labor: This stage of labor consists of strong contractions that last up to one minute each and happen about three minutes apart. Some people request an epidural during this time because contractions can be painful. Healthcare providers may also give you oxytocin (Pitocin®) to speed up labor.
• Transitional labor: This is the time just before your cervix is 10 centimeters dilated. It's a short but intense time when your contractions come very quickly and last longer than one minute. This phase may make you sweat, vomit or feel shaky. It happens just before you begin to push.

Birth

The birthing stage begins when you reach 10 centimeters and ends with the birth of your baby through your vagina. In this stage of labor, you experience strong contractions and begin pushing. You may feel pressure or like you need to poop. Your healthcare provider may coach you through pushing, especially if you've had an epidural and can't feel contractions. This phase can last a few minutes or a few hours. Generally, birth is quicker if you've had a prior vaginal delivery.

Delivering the placenta

The last stage of labor is delivering the placenta (commonly called afterbirth). It begins after your baby is removed from your vagina and ends when your placenta is delivered. Your healthcare provider may ask you for a few more pushes. This stage begins a few minutes after your baby is born and lasts up to 30 minutes.

It's important to remember that labor and childbirth are different for everyone. Certain factors can play a role in your labor being longer or shorter. For example, if you get an epidural, you won't experience the same pain level as a person who doesn't get an epidural. Also, your labor may be longer if it's your first baby. Factors like the size and position of your baby and how quickly you dilate can all affect how long a vaginal delivery takes.

What are the risks of having a vaginal delivery?

Vaginal deliveries generally carry the least risk. The most common complications during a vaginal delivery are:

• Failure to progress: This is when labor slows or stops and your cervix doesn't dilate. Your healthcare provider may give you oxytocin to stimulate contractions and progress labor.
• Irregular fetal heart rate: This is when your baby's heart rate slows down because their head or umbilical cord is compressed.
• Hemorrhage: This is excessive or life-threatening bleeding during or after birth. Sometimes a person doesn't bleed until several hours after delivery (postpartum hemorrhage).
• Vaginal tears: These are tears in the tissue around your vagina and rectum that happen during childbirth.
• Deep vein thrombosis: These are blood clots that develop in your legs or pelvis shortly after delivery.
• Postpartum preeclampsia: This is excessively high blood pressure in a person who has just given birth.

Reasons to avoid vaginal delivery

A vaginal delivery is usually the preferred delivery method. However, certain conditions make a vaginal delivery dangerous. Your healthcare provider may recommend a C-section delivery if:

• Your baby is in a breech position.
• You have placenta previa or a problem with your placenta.
• You have an untreated infection or open genital lesions from herpes simplex virus.
• You have a chronic health condition.

What are the advantages of a vaginal delivery?

A vaginal delivery offers several benefits to both the birthing person and the fetus.

The benefits of vaginal delivery for the birthing person are:

• Shorter recovery time.
• Lactation begins sooner.
• Lower chance of future pregnancy complications.

The benefits of vaginal delivery for the fetus are:

• Lower chance of respiratory conditions.
• Improved immune system function.
• More likely to breastfeed (chest feed).

Is a vaginal delivery painful?

Yes, it can be painful. There are many options to help manage your pain during a vaginal delivery. Some people choose to get an epidural block. An epidural numbs your body from the waist down. Discuss your options for pain relief with your healthcare provider.

What side effects can I expect after a vaginal delivery?

You may have physical and emotional changes after giving birth. It's common to experience:

• Constipation.
• Engorged breasts.
• Pain and soreness in your vagina, especially if you tore.
• Mood swings.
• Vaginal bleeding.
• Hemorrhoids.
• Headaches, hot flashes or sweating (from hormonal changes).
• Cramps.
• Lochia (a type of vaginal discharge).

Some people experience the "baby blues," postpartum depression or postpartum anxiety. Hormonal changes may cause sadness, crying or other emotions within the first few weeks after a vaginal delivery. If you still feel sad, anxious or have mood swings several weeks or months after your baby is born, talk to your healthcare provider.

How long does it take to heal from vaginal delivery?

Recovery time for a vaginal delivery varies. Generally, healing from a vaginal delivery is faster than it is for a C-section. Several factors can influence how quickly you heal. One of those is if your vagina tears and how severe that tear is. If you've torn, you may feel sore for several weeks. Going to the bathroom, sitting and standing or performing everyday tasks may be painful. It's normal to experience swelling and itching around the tear. Most people will have swelling, bruising and general soreness in their vaginal area for a week or two, regardless of vaginal tearing. Putting cold compresses or cooling sanitary pads on your vaginal area may help.

How long do you bleed after a vaginal delivery?

It depends on the person. Some people will bleed for less time than others. It's normal to be bleeding at your postpartum visit several weeks later. Contact your healthcare provider if your bleeding increases over time or you're still filling extra thick sanitary pads after several weeks.

How long after vaginal delivery can you have sex?

Most healthcare providers recommend waiting at least six weeks or until after your postpartum visit to have sex. This gives your body time to heal and allows your provider to examine your vagina to make sure it has healed. Also, consider birth control options and future pregnancies before engaging in sexual intercourse again. Just because you aren’t menstruating and have just given birth doesn't mean you can't get pregnant again.

Can you prepare for a vaginal delivery?

You can try to prepare by creating a birth plan, but there's no way to know what will happen when the time comes. Every labor and delivery is unique. It may help to discuss your wishes with your partner, family, friends and healthcare provider. Asking questions beforehand can also help you know what to expect.

What questions should I ask my healthcare provider about a vaginal delivery?

It's hard to know what to expect from a vaginal delivery, especially if you've never given birth. Even if you've had previous vaginal deliveries, each delivery is unique and different.

Some common questions that people ask their healthcare provider about a vaginal delivery are:

• What are the risks of a vaginal delivery?
• How will I know when to push?
• How can I reduce my risk of vaginal tearing?
• How will I know labor is starting?
• When should I go to the hospital?
• How long will it take to recover from vaginal delivery?
• Is there anything I can do to improve my chances of a normal delivery?

A note from Cleveland Clinic

Giving birth is an exciting and life-altering event. Every pregnancy, labor and delivery is unique. A vaginal delivery is the most common way to give birth. It's hard to know what to expect until you've experienced it, but talking to your healthcare provider and asking questions can help you prepare. Vaginal deliveries are generally low-risk and highly successful. Your healthcare team is trained to manage any complications that arise and help you welcome a healthy baby into the world.