How Childbirth Proceeds

Childbirth is a major, moving event—and it’s perfectly normal to look forward to it with a mix of anticipation and respect. The birth itself takes place at the hospital to which the referring physicians refer you; there, you’ll be supported around the clock by an experienced team. On this page, you’ll learn how childbirth works, what induction means, and what pain relief options are available—so you can go into it informed and a little more at ease. A word of advice to start with: Go into childbirth without any overly rigid expectations. Many women experience it very differently than they expected—and that doesn’t have to be a bad thing.

When It’s Time to Go to the Hospital

Two signs tell you that the time has come: regular, strong contractions—they come about every three to five minutes and are so strong that you can no longer speak during a contraction—or your water breaking, when amniotic fluid leaks out. Especially with your first child, it’s not always easy to tell the difference between false labor and real labor contractions. If you’re unsure, call the hospital at any time; the midwife on duty will tell you whether you should come in.

The Three Stages of Labor

Childbirth proceeds in three stages. During the dilation stage, the cervix gradually dilates to about ten centimeters—this is usually the longest part of labor. During the expulsion phase, pushing contractions move the baby through the birth canal until it is born. In the postpartum phase, the placenta finally detaches and is expelled. How long this takes varies greatly from woman to woman—it usually takes longer with the first child than with subsequent ones.

Induction of Labor

Sometimes it’s better not to wait for labor to start on its own, but to gently induce it—this is called labor induction. If this comes up in your discussions: Labor induction is quite common these days. In Switzerland, about one-third of births are induced, and the trend is rising. So you don’t need to be afraid of it.

There are good reasons why inductions are becoming more common: Expectant mothers are, on average, older today and more often have health concerns—and there is now strong evidence that an induction at the right time can actually have benefits. A large study showed that inducing labor around the end of the 39th week in uncomplicated pregnancies tends to lower rather than increase the cesarean section rate, without any harm to the baby (ARRIVE study).

Typical reasons for induction include: going significantly past the appointment (usually at or after about 41 weeks), premature rupture of membranes without subsequent contractions, gestational diabetes, high blood pressure, or preeclampsia, as well as abnormalities in fetal growth or amniotic fluid volume.

Induction is carried out step by step: First, the cervix is “ripened” using a medication (gel or tablet) or a small balloon catheter; then, labor is induced via an IV drip and—if possible—the amniotic sac is ruptured. This may require some patience, especially with your first child; the team will be with you the entire time.

Options for Pain Relief

Labor contractions are painful, and no one can predict how well you’ll tolerate them. The important thing is: You decide if and when you’d like pain relief—there’s no reward for enduring as much as possible. Let your midwife know in advance so there’s enough time. There are several options to choose from:

• Without medication: Movement, a warm bath, breathing and relaxation techniques, and changing positions often provide noticeable pain relief.
• Nitrous oxide: You inhale it yourself as needed; it works quickly and is easy to control.
• A patient-controlled analgesia (PCA) pump: Using a button, you administer a small dose of a short-acting pain reliever (opioid) into your vein as needed—this way, you stay in control.
• Epidural anesthesia (PDA): the most effective form of pain relief. Pain is specifically blocked via a thin catheter inserted into your back. Thanks to modern, low-dose medications, you’ll still have sensation in your legs and can often even move them a little.

Who Will Be With You

You won’t be alone during childbirth. The midwife will be with you the entire time, supporting you and independently managing a normal delivery. The doctor will monitor the progress and intervene if a medical procedure becomes necessary. For the epidural, an anesthesiologist will join the team. And as soon as your baby is born, they will be placed directly on your skin whenever possible—this first skin-to-skin contact (known as “bonding”) is the goal and benefits both mother and baby. Only if your baby needs immediate care will the pediatrician attend to them and bring them to you as soon as possible.

When Support Is Needed

Sometimes the final stage requires a little help. An episiotomy is no longer performed routinely today, but only when it truly benefits the baby or protects the perineum. If the baby’s heart rate slows down or the mother is exhausted, the birth can be gently completed using a vacuum extractor (rarely forceps)—you don’t need to be afraid of this; it’s part of the skilled practice of obstetrics. And if a vaginal birth isn’t safely possible, a cesarean section will be performed (more on this → “Spontaneous Birth or Cesarean Section?”).

You’re in good hands

You don’t have to know or plan everything in advance. Our job is to prepare you during your pregnancy, answer your questions, and ensure that you feel well taken care of at the clinic. And if you’re afraid of giving birth: Talk to us—we take this seriously and will tackle it together.