Baby is born
Learn what to expect during labour and the birthing process.
The birth of the baby
Once the baby’s head has passed through the cervix, the baby then moves down onto the perineum. This generally happens slowly as the uterus continues to become smaller with each contraction. It can even be a time for a nap. If you have already given birth before, this part generally tends to move along faster. As the baby moves down further onto the perineum, the pressure may feel as if you need to go to the bathroom. Try to soften and loosen to ease the baby’s journey.
If coaching seems needed, you may be encouraged to actively push. You may rotate through several different positions to maintain comfort and to encourage your baby to come down.
Protecting your perineum
Once the baby has moved down onto the perineum and under the pubic bone, the baby’s head (or bottom if a breech) will be visible as they descend with each contraction. Intuitive spontaneous urges to push may happen at this stage. You may feel a lot of rectal pressure.
Using one or all of our senses may help at this stage:
- Hearing: Listen to the voices of encouragement, support and coaching.
- Seeing: Viewing with a mirror to direct and encourage effort and is especially helpful if an epidural has removed any sensation and intuitive pushing urges. (Fake those urges if you can!)
- Touching: If you are able to reach with a hand to gently cup baby’s head, or perineum, a sense of touch can be comforting and reassuring. A birth attendant (or support person) can also gently hold with a warm or cool cloth if it feels helpful to you.
Baby's first moments after birth
You or your provider will lift baby to rest on your chest.
As your baby takes their first breath, your nurse/midwife/doctor will watch, dry and massage to ensure your baby is safe. Generally, there is no hurry to clamp and cut the (umbilical) cord and baby stays with you.
If baby needs more stimulation, then the cord is clamped and cut and baby is assessed on an infant warmer in your room, which is designed with equipment to help support a baby. Occasionally, a newborn may need help with breathing for a brief time and then is returned to you as soon as baby is stable.
If your baby needs longer, ongoing support, the pediatric team would be present and baby may be transported to the Special Care Nursery (SCN). Your support person can accompany baby so that you know where baby will be cared for. Baby may need time and support to adjust to life outside of you. The special care nursery nurse and pediatrician will be there for you and baby, and will explain what ongoing care baby may require.
It may be emotionally difficult for you and your partner to be separated from your baby. As soon your placenta is birthed, and you have had some time to recover, you would be taken to the nursery on your way to the post-partum unit. You will see and talk to your baby, hold hands, and meet the team caring for your child. It may or may not be possible to breastfeed at this time. Perhaps you have already hand-expressed some colostrum, which the baby will receive when ready to feed.
Skin to skin: "The Golden Hour"
Once your baby is born, either by vaginal delivery or by caesarean section, it is encouraged to have your baby placed skin-to-skin with you. Skin-to-skin offers many benefits for both you and your baby, such as making sure your baby stays warm and promoting bonding, soothing, and breastfeeding/chestfeeding.
It is encouraged to keep baby skin-to-skin with you for the first hour after birth or until completion of the first breast/chestfeed. Skin-to-skin can be provided by your partner if you are unable, or do not wish to do so. If your baby requires some assistance after birth, they will be taken over to the infant warmer and assessed by the medical team. You will be encouraged to resume skin-to-skin contact with your baby once we determine they’re stable.
Medical interventions
Medical interventions may be offered to ensure the safety of you and your baby. Your health-care provider will talk with you about options that are not part of routine care. Assisted deliveries (use of a vacuum or forceps to help the baby come out) and Caesarean Sections are two common medical interventions that might be presented if deemed medically necessary.
Even if you plan on having a vaginal birth, it's a good idea to know about them in case the unexpected occurs.
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Caesarean Section (“C-Section”)
A Caesarean Section (commonly referred to as a “C-Section”) is a surgery in which your baby is delivered through a cut in your belly and uterus. The majority of people having a C-Section will receive a regional anesthetic (either by an epidural or a spinal). In this case, you are awake during the surgery and birth, but your pain is controlled.
Your partner or support person can be in the operating room. You’ll likely be able to hold your baby skin-to-skin right after or soon after the birth. If you’re too sleepy or unable, your support person can hold the baby skin-to skin until you’re ready to do so. If you require a general anesthetic, you’ll be asleep during the surgery and birth and your partner will not be permitted in the operating room.
The need for delivery by C-section is based on the baby's and new parent’s well-being and medical conditions. In most cases, the birthing parent is awake during the birth but given very strong pain medications. Newborns can stay with their parents soon after birth for skin-to-skin in the operating room.
Depending on the reason for your first C-section and the type of incision that was made, you may be able to deliver your next baby vaginally. For more information, see Vaginal Birth After Caesarean (VBAC)
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Assisted delivery
Medical assistance is offered if the labour becomes stalled during the pushing phase and/or if the baby has heart rate concerns and needs to be delivered quickly. This is usually done by using vacuum or forceps. At times, an incision to the base of the vagina (called an episiotomy) may be performed in addition to the vacuum or forceps.
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For a vacuum-assisted delivery, your doctor will place a soft plastic cup on the baby's head and suction is used to help pull the baby out. The baby’s head must be very close to the outside of the vagina in order for a vacuum to be offered. The cup can leave a bruise and swelling, but this will fade a few days after birth. A vacuum is often offered if there is a prolonged pushing stage of labour, the birthing person is exhausted and unable to push effectively, and/or the fetal heart rate slows, showing signs of distress.
For a forceps-assisted delivery, your doctor will gently place two metal instruments around the baby's head to carefully guide the baby out. The baby’s head must be relatively close to the outside of the vagina. Forceps can leave temporary red marks or slight bruises on the baby's head and face. They are used if a birthing person has a prolonged pushing stage of labour, for exhaustion, signs of fetal distress, and/or the angle of the baby’s head needs to be changed slightly in order to give birth vaginally. A baby will have increased monitoring after a vacuum-assisted delivery.
An episiotomy may be offered with either a vacuum or a forceps delivery, which widens the perineum by an incision performed by the doctor or midwife. An episiotomy is only offered if the provider is worried about the degree of perineal tearing that might occur as a result of the assisted delivery. The provider will always ask for consent before doing an episiotomy.
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