Vaginal Childbirth: What You Need to Know About Labor and Delivery

What is a “normal” vaginal delivery? 

A vaginal delivery is when a baby is born through the vaginal canal. It can happen spontaneously, when the body decides it is time for labor to start, or it can be “induced,” which is when a medical intervention is used to kick off labor. 

The only alternative to vaginal delivery is cesarean section, or C-section. This is a surgical procedure in which the baby is delivered through an incision in the abdomen. This kind of delivery is sometimes recommended when problems happen in labor. C-section and vaginal delivery are different experiences with different risks and recoveries. 

During pregnancy, it is very normal to think and worry about labor and delivery. Childbirth is a monumental experience, to be sure. But, because of how it’s represented in movies, books, and television shows, it can be difficult to know what is normal and what is fiction. 

Here’s a guide to real vaginal deliveries, including the phases of labor, risks, and recovery.

Why trust us

Our Author:

Alethea Robbins, WHNP-BC

expand_more

Alethea Robbins is a board-certified women’s health nurse practitioner and medical writer. She is interested in all things related to women’s health and integrative medicine. She also has extensive experience with creative leadership at various arts organizations and has worked as a professor at colleges and universities. Alethea is a firm believer in empowering women to reach their health goals through education and collaboration.

Is vaginal childbirth for you?

When possible, a vaginal delivery is recommended because it is typically the safest way to deliver your baby. If you’ve had a healthy pregnancy and your baby is in the correct position (head pointing down), then your delivery will likely be vaginal. Recovery after a vaginal delivery is typically easier, but everyone’s experience is different. 

Having a vaginal delivery can benefit your future deliveries: You are more likely to have a vaginal birth next time you’re pregnant, too. Successful vaginal delivery is still possible after having a C-section, but this comes with a unique set of risks — including an increased risk of uterine rupture. Although this is very rare, it can be life threatening. 

Fortunately, most people have successful vaginal births. A study by the Centers for Disease Control and Prevention showed that approximately seven out of ten deliveries in 2019 were vaginal. 

How can I have a normal vaginal delivery?

How you deliver your baby depends on several factors — many of which are not in your control. However, there are some things that can make a vaginal delivery more likely.

Weight gain

Gaining an appropriate amount of weight during pregnancy can decrease your risk of needing a C-section. At your first prenatal visit, your provider will recommend the amount of weight you should gain, based on your starting height and weight. Gaining the right amount helps your baby grow well: not too big or too small. If a baby grows too big, it can be difficult for it to fit in the vaginal canal. If you do not gain enough weight, your baby could be at risk for premature delivery or low birth weight. A low birth weight can make it more difficult for the baby to eat, fight infections, and grow at a normal rate.  

Exercise

Exercise is often encouraged during pregnancy and may reduce your risk of needing a C-section. Regular activity, such as walking or swimming, can help keep your weight gain in check. It also decreases your risk for gestational diabetes. Be sure to discuss your exercise plans with your obstetric provider, especially if you’re new to exercise.

Induction

One large study has shown that induction of labor at 39 weeks in low-risk first pregnancies leads to a lower number of C-section deliveries. This may be because the risk for complications goes up when pregnancies progress past 39 weeks, which comes with an increased risk of having an emergency C-section. Although avoiding these risks and inducing labor can be appealing, induction has risks, too. As such, it’s best to discuss the options with your medical provider.

Choosing a healthcare provider and birth team

When you are choosing a healthcare provider for your pregnancy, it can help to do some research. If having a vaginal delivery is a priority for you, it’s OK to ask your obstetric provider what their C-section rate is. You can also talk about their approach to labor and delivery and how they minimize the risk of needing a C-section. 

Having a support person during labor can be a source of comfort. This person can be a: 

• Partner

• Parent

• Friend

• Doula

A doula is someone who has training to help manage the discomforts of labor. They can advocate for the parent throughout the birth experience, and they are trained to give physical and emotional support to the laboring parent and their partner. And having a doula present at your labor may reduce your risk of needing a C-section. Keep in mind, a doula is an extra cost to consider budgeting for. Some hospitals offer volunteer doulas, so ask whether this is available where you live.

What happens during a vaginal delivery?

Every vaginal delivery has its own unique story, but some aspects of each labor are similar. For most people, labor starts between 38 and 41 weeks of pregnancy and progresses through three stages. It starts with contractions (cramps of the uterus) and ends with the delivery of a baby and placenta. The placenta is an organ that grows during your pregnancy and provides your baby with oxygen and nutrients. 

First stage of labor

Cramps, or contractions, will begin during the first stage of labor. For most people, these are very obvious. The cramps may come and go. This first stage of labor can last anywhere between a few hours and a few days as your body prepares for active labor. During this stage, your cervix will start to dilate. This is something that can be checked by your obstetric team, and it’s a pretty good indicator of how fast labor is moving along.   

Getting an epidural

During the first stage of labor, some women decide to get an epidural. If you choose to get one, an anesthesiologist uses a needle to place a small tube called a catheter into your lower back. Pain medicine can be given through this tube to lessen the pain of your contractions if you are finding them hard to tolerate. 

It is worth knowing that an epidural can make your legs weak, which usually means that it’s not safe for you to walk or move around on your own, and the positions that you can labor in might be limited. For example, you won’t be able to labor on the floor. You’ll also be connected to a tube at this point, and you may need a urinary catheter, so you might begin to feel less free. Even with an epidural, you should still feel pressure in your pelvis as labor progresses, and you may still feel vaginal exams.

Second stage of labor

The second stage of labor begins when your cervix is dilated to 10 centimeters and ends with the delivery of a baby. Once you are “fully dilated,” it is time to start pushing the baby through the vaginal canal. Most people feel an overwhelming urge to push at this stage, as the body’s natural urges kick in. For first deliveries, this stage can last up to 3 hours. For second and subsequent vaginal deliveries, it is usually much faster.  

Third stage of labor

The third and final stage is the time after the baby is born until your placenta is delivered. Your provider may place pressure on your abdomen over the top of your uterus to help move things along. This last part of your delivery lasts 5 to 30 minutes. Once the placenta is delivered, your provider will check to make sure it is in one piece. This is important: If any fragments are left behind (called retained placenta), they can lead to infection and bleeding.

How common are vaginal tears?

Tearing during childbirth is common. One of every two vaginal deliveries will result in vaginal tearing. It is natural to tear because of the tremendous pressure from pushing the baby through the vaginal canal. The time it takes to push and the size of the baby can affect the likelihood of tearing. 

Sometimes, the tearing is minimal. This kind of tear tends to heal quickly and cause less pain. If you had an epidural, the tear may feel less intense. Sometimes, the tearing is deeper and larger, affecting several layers of skin and muscle. The repair and healing of this kind of tear will likely be more painful. Deeper vaginal tears are repaired with stitches immediately after delivery. 

Vaginal tears are no fun. Recovery can be long and made worse by pain and infection. Sometimes, nerve damage or scarring can cause long-lasting problems.  

What is an episiotomy? 

An episiotomy is a cut into the back wall of the vagina that your obstetrician will make during the second stage of labor if they feel that there is a risk of deep and damaging vaginal tearing. The cuts can create space for delivery of the baby while preventing uncontrolled tearing. This procedure is only done if needed for the health of the laboring parent or the baby.

Is vaginal delivery recommended over C-section delivery?

Yes: When possible, vaginal deliveries are recommended. Although scheduling a C-section may sound convenient, the recovery is usually much more difficult. Additionally, because C-section is a surgery, it poses other risks, such as infection, blood loss, and anesthesia complications. 

However, there are times when — even though you are trying to have a vaginal delivery — a C-section may be best for you, your baby, or both of you. The C-section is a safe and wonderful option to get the baby out quickly, when necessary. 

There are other benefits to a vaginal delivery. When you deliver a baby through the birth canal, they get exposure to the biome, or natural bacteria, of the vagina. It’s possible that exposure to this biome could help your baby’s immune system. Children born via C-section are at higher risk of immune disorders and asthma.

A vaginal delivery may also make breastfeeding easier. After the delivery, you may feel more comfortable getting up and down and moving your baby from the crib to your chest. A C-section is an abdominal surgery, which can make it painful to lift a baby and get up from a reclined position. 

Last, after a vaginal delivery, you will likely have a shorter hospital stay, of one to two nights. The length of your stay depends on how you heal and your insurance coverage.

What are the risks of vaginal delivery? 

Vaginal deliveries are thought to be safer in general, but they are not without risk. Here are some of the risks and challenges of vaginal delivery:

• Tearing is a common risk and can happen in as many as one in two vaginal deliveries. 

• Sometimes, the cervix doesn’t fully dilate. This can be frustrating and tiring — and can end in an emergency C-section, without any of the perks of avoiding labor.

• There could be complications with the umbilical cord. It can get wrapped around the baby’s arm, leg, or neck. Most of the time, your provider is able to safely move the umbilical cord out of the way.

• Sometimes, the baby’s shoulders get stuck in the birth canal. This is called shoulder dystocia, and it can harm your baby.

One of the biggest risks in a vaginal delivery is excessive bleeding. While rare, these emergencies can lead to excessive bleeding:

• Placental tearing or retention: Sometimes, the placenta doesn’t come out in one piece, or a part of it remains in the uterus. 

• Uterine atony: The uterus doesn’t contract after delivering the placenta.

• Episiotomy: It is normal for an episiotomy incision to bleed. Usually this settles with pressure and stitches, but sometimes the bleeding can be excessive. 

• Injury to the uterus: This is very rare after a vaginal delivery, but sometimes the uterus can rupture or turn inside out. 

It is important to note that not everyone’s risks are the same. For example, Black women are two to three times more likely to die from pregnancy and childbirth complications than are white women. This risk stems from structural racism, bias, and less access to quality healthcare.

Is vaginal delivery safe if I have had a previous C-section?

If you become pregnant again after you’ve had a C-section, you may be wondering whether you could try a vaginal delivery. For many, this is possible, and it can be cathartic if the first C-section was not planned. 

The benefits of having a vaginal delivery after C-section (called VBAC) are the same as those that come with having a vaginal delivery during your first pregnancy: shorter recovery and a lower risk of infection. There are some unique risks, though, including a higher chance of your uterus rupturing during labor. This is rare, but can be dangerous for you and your baby. And, if things get complicated, it’s possible you could still end up delivering by emergency C-section. 

Your obstetric provider can help you decide if a VBAC is a good option for you. It will depend on a few things: 

• Why you had a C-section in your previous labor

• What type of incision you had

• How old you are

Recovery after a vaginal delivery

Recovering after vaginal childbirth is different for everyone. But whatever your experience, there will be some recovery — and sometimes more than you may think. Your own recovery journey will depend on: 

• Your physical and mental health before your pregnancy and delivery

• How straightforward or complicated your delivery was

• Your home circumstances

• Your support network  

Physical recovery

After the birth of your baby, you can expect some real discomfort and fatigue. Try to rest as much as possible to encourage healing and to regain your strength. Your energy may start to pick up after a week, but continue to rest as much as you can to help you get through the nights when your sleep is disturbed. Remember, it’s a marathon, not a sprint, and many babies continue to wake several times a night for most of the first year. 

You’ll likely experience soreness everywhere for a few days, but that will slowly improve every day. Your external genital area will be tender for up to 10 days, and your breasts may feel full and uncomfortable as your milk comes in. If you feel any new or worsening pain that isn’t improving day by day, that’s a sign that something isn’t right. Pain can affect your sleep, your mood, and your ability to care for and bond with your baby — so don’t delay a call to your obstetric team if things are not feeling right.

It will take 6 weeks for your uterus and cervix to heal following delivery. In this time, the uterus will return to its original size (that of a fist), the cervix will close, and your vaginal bleeding will stop. If you had vaginal tearing, this should also heal within 6 weeks. 

How much bleeding is normal?

You’ll have heavy vaginal bleeding after your delivery and for the first 3 to 4 days. This is called lochia, and it’s entirely normal as your uterus heals and contracts to its pre-pregnancy size. The bleeding will lighten in volume and change from thick, bright red, and clumpy to thin, light-brown spotting in the weeks following vaginal delivery. By week 4, the bleeding should have stopped completely or be close to it. 

Sometimes, bleeding will increase if you are up and about, doing too much too soon. Take a break, put your feet up, and see if the bleeding lightens. If you are soaking through a postpartum pad every hour for 3 hours in a row and you are feeling light-headed, that’s a sign that you need to check in with your obstetrics team.

Recovering from a vaginal tear

Vaginal tearing is uncomfortable. The first few days will be the worst. You will feel pain at the site of the tear, and you’ll probably feel stinging with urination. As the stitches start to dissolve and the wound heals, you’ll feel itching and soreness. 

Typically, you will feel a little better every day. The good news is: Most vaginal tears heal by the 6-week mark. If things don’t get better, or they get better first and then get worse, this could be a sign your wound is infected. 

If you have pain after 6 weeks, please let your obstetric provider know. There are other treatments that may help your ongoing recovery.

Emotional recovery

During the first few days and weeks after delivery, your emotions may be all over the place. This is completely normal — even if you think of yourself as an emotionally resilient person. Initially, you may feel like you’re on a euphoric high: You might not rest as much as you need to, and you might keep busy with lots of visitors. Or, you may feel tearful, guilty, and overwhelmed. One set of emotions can rapidly give way to another, leaving you totally confused. 

Whatever you feel — know that it’s completely normal in the first few weeks after childbirth. The combination of hormones and sleep deprivation are a perfect storm for all sorts of feelings. Be sure to reach out to family and friends if you need support. If things are starting to feel like they’re getting out of control and you are having trouble functioning or caring for your baby, don’t delay reaching out to your medical provider. Perinatal depression is common and treatable.  

Tips for recovery

The first few days after a vaginal delivery are the hardest, but luckily there are many ways to help your body and mind recover:

• After you deliver, you may receive a peri bottle from the hospital. You can also buy your own. A peri bottle is a plastic bottle that is similar to a water or ketchup bottle. Fill the peri bottle with warm water and squeeze it over your genitals while you urinate to lessen stinging. It is a good alternative to toilet paper when your perineal skin — the skin over your perineum, the area between your vagina and anus — is feeling tender.

• Buy the thickest pads you can find. They will help with the bleeding, and the thickness can act as a comforting cushion to your tender perineum when sitting. A donut cushion can also come in handy.   

• Applying ice packs can help your perineum heal, especially after a vaginal tear or episiotomy.

• Sitz baths (sitting in warm, shallow water) can ease perineal tenderness. 

• Do your best to keep your bowel movements soft. Sometimes, medicine used in labor can make you constipated and fearful of your first bowel movement after delivery. Drink lots of water, eat fiber-rich foods (such as fruits and vegetables), and take a stool softener, such as docusate. Try applying gentle upward pressure to your perineum, using your hand and some tissue or a pad, while you pass your first bowel movement.   

• If you have hemorrhoids — or even if you don’t — refrigerated Tucks pads in your underwear can feel really soothing. Tucks pads contain witch hazel and are available over the counter. 

• Rest when possible. Everyone will tell you to nap when your baby naps. It may drive you crazy — especially when you have so much to do like shower, eat, catch up with texts and emails, and spend time with other children and visitors. But your newborn will only sleep for 20 to 40 minutes at a time, so take every opportunity you can get to rest. If someone offers to help — practice saying yes! 

• Eat nutritious food and drink lots of water. 

• Avoid baths, vigorous exercise, and penetrative sex until after your 6-week postnatal check-up. 

After a vaginal delivery, your pelvic floor can change, and that can result in decreased control of your bladder or bowels. If this happens to you, be sure to let your provider know. Therapies, such as pelvic floor physical therapy, may improve this common condition.

Are there any medications that help with pain after a vaginal delivery?

Over-the-counter pain medication can be helpful immediately after delivery. Staying on top of your pain can help you focus on your baby and sleep better. Ibuprofen (Advil, Aleve) and acetaminophen (Tylenol) are safe to take while nursing and can decrease your pain.

The over-the-counter stool softener docusate or supplemental fiber can also ease discomfort related to constipation.

Opioid pain medicines are not recommended after a vaginal delivery.

What to watch for

After a vaginal delivery, there are a few things to watch out for. These symptoms could mean that something else is going on, such as infection, a blood clot, or high blood pressure: 

• Severe pain in your lower abdomen 

• Heavy bleeding (more than one pad per hour for 3 hours or more)

• Fever (over 100.5°F)

• Severe or persistent headache

• Changes in vision

• Chest pain

• Shortness of breath

• Pain, redness, or swelling in your lower leg

Call your obstetric provider if you experience any of these or other concerning symptoms.

Keep in mind

Every pregnancy and delivery is unique. While all vaginal deliveries have some things in common, there is a lot of variation. How long a labor lasts, how much pain different people experience, and recovery varies from person to person. Setting goals to personalize your delivery can be very fun, but setting realistic expectations can help with your journey into parenthood. Consider establishing birth goals rather than a birth plan.

Unfortunately, vaginal deliveries and C-sections are painful. Epidurals and other pain medications help, but most women experience some discomfort, either during their labor or after delivery. Luckily, there are lots of things that can ease pain in labor and after your delivery. 

With proper rest, healing happens at a steady pace after a vaginal delivery. This can be difficult — especially if you have other children at home that need you. Coordinating childcare for after your delivery can be helpful. If people offer to help, let them. Resting immediately after delivery can help reduce risks later on. 

Whether this is your first delivery or your sixth, this is a time of change in your life. It can be exciting and stressful at the same time. Don’t be afraid to ask for help if you are not feeling well or need support.

Why trust our experts?

Written by:

Alethea Robbins, WHNP-BC

Alethea Robbins is a board-certified women's health nurse practitioner. She has a bachelor's degree in fine arts from Watkins College of Art and a master’s degree in nursing science from Vanderbilt University.

Edited by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

Our editorial standards

Meet our experts