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The Design of Birth

“For you formed my inward parts, you knitted me together in my mother’s womb. I praise you, for I am wondrously made. Wonderful are your works! You know me right well.”— Psalm 139:13–14

Knowing how our bodies work gives us a better understanding of the basic design of birth. Basic knowledge can play a tremendous role in dissolving the fear that creeps into our view of birth as a result of media portrayal, horror stories we’ve heard, or simply our own ignorance of the female body’s design. Understanding also gives us more confidence in God’s design for our bodies and helps us make decisions well so we can have the best birth possible.

It’s amazing that many schools today cover the gamut when it comes to contraceptives and sexually transmitted diseases and all sorts of disordered sexual activities, but most high school students walk away from their biology and health classes with no idea how birth works, or even that sex and babies are designed to go together. Not only that, many have never studied the basic fertility cycles of the woman or the formation of the baby in the womb. They know about abortion but rarely know about normal birth.

In today’s culture fertility is a liability. Even the government continues to seek to make contraception universally available as “preventative medicine,”⁵² with the underlying assumption that the healthy female body somehow needs to be fixed and medicated. For the majority of parents today, their education in normal fertility, biology, pregnancy, and birth begins when they are actually going through it themselves.

This education vacuum is filled by the idea of pregnancy as punishment and birth as terrifying. The media’s depictions of birth, filled with screaming, the mother’s water breaking in some embarrassing place followed by immediate agonizing contractions and pushing, certainly don’t help. Most new mothers and fathers need to be told that it’s not usually like that.

When we understand how something truly works, we become empowered to utilize it. This is true with our fertility. In recent years, more and more women — Catholic and non-Catholic — have begun to realize the power and advantage they have when they better understand their fertility and monthly cycles. Our cycles are designed by God and we function best when we work with that design rather than against it.

There is a growing grassroots movement against the onslaught of contraception as women question whether it makes sense to tell their bodies not to function as they were designed. There are consequences to contraception that have become better known and studied as they’ve arisen. Intervening in the design of the woman’s healthy body with chemicals and intrauterine devices can greatly jeopardize both a woman’s short-term and long-term health, not only physically but mentally, emotionally, and spiritually.⁵³ When a woman understands her fertility, she can make better, informed decisions about healthcare, her prospects for a future pregnancy, when to be intimate with her spouse, and when she might not be fully healthy. There is a beauty and dignity to women’s understanding the design of the Creator for their bodies and claiming and using that knowledge.

So, too, with birth. Having a greater understanding of how her body is designed for birth gives a woman greater ability to make decisions and foster better short- and long-term health outcomes for herself and her baby. Respecting a mother’s intellect and her right to have good information recognizes her dignity as a woman and enhances her satisfaction with her birth.⁵⁴ Similar to fertility cycles and related decisions, there are also often unintended consequences to intervening without necessity in the natural design and process of birth. There is, of course, not a moral equivalency. There is no Church teaching on how a woman should give birth or make specific birth choices, as there is with contraception. Sometimes we can and should intervene in the natural process of birth. But learning how our body is designed to birth allows us to work better with that design and have a better, healthier, more informed experience for ourselves and our babies.

The Most Important Lesson

So what should a woman know about birth?

The female body was designed to give birth. Even if she never understands the precise logistics or anatomy of how it happens, a woman who has the confidence that her body was naturally designed to create and to bear life is at an incalculable advantage. As Pope Saint John Paul II expressed it: “The woman’s motherhood in the period between the baby’s conception and birth is a bio-physiological and psychological process which is better understood in our days than in the past, and is the subject of many detailed studies. Scientific analysis fully confirms that the very physical constitution of women is naturally disposed to motherhood — conception, pregnancy and giving birth — which is a consequence of the marriage union with the man.”⁵⁵ The pope reaffirms this truth: Women’s bodies are designed by God to birth. A woman’s fertility, her ability to carry, birth, and nurse a child, are all representative of good and normal health. As Catholics we reject the contraceptive mentality that tells us fertility is a disease to be cured and the birth of a child a punishment to those who haven’t been “responsible.”

For good or for bad, a woman brings her past, her social environment, and her deepest beliefs and fears into her birth. When a woman comes from a line of women who have successfully and confidently given birth, when she maintains a healthy body image, when she views her marriage and motherhood as a calling from God, when her husband has confidence in her ability to give birth to their baby, and when she hears confident and beautiful words about her womanhood and motherhood from her provider and even leaders of the Church, she will then have deeper confidence that she was truly made for and capable of this work. On the opposite end, if a woman has only heard horror stories about birth, if she has never seen a woman undergoing normal labor, if her husband doubts her, or if she has come to believe that her body is broken, then she will often bring that into her approach to birth.

We know that the effects of original sin mean everything does not always go according to God’s original plan. Infertility occurs. Miscarriage happens. Birth complications do happen. We know that the original design is the healthiest way for a baby to be born. When complications arise, intervening for the sake of the mother or baby also should be considered part of God’s plan. Science and medicine are meant to be a gift to the world — at the service of life. We thank God for the obstetricians, doctors, and midwives who use their gifts to serve women and babies and intervene when appropriate.

Still, we trust that God planned birth, and he knew what he was doing. His design has been bringing new babies into the world for thousands of years. It makes sense, and it works.

The Everyday Miracle

Most of us know by now how conception works. The husband’s sperm meets the wife’s egg. At that very moment God infuses a new, never-before-existing soul into a new body. Within a week or two that blastocyst baby has traveled through one of the woman’s fallopian tubes and becomes embedded in the uterus, an incredible miracle every time. There, he or she will hopefully stay tucked away in the mother’s womb for another nine months or so, growing at phenomenal rates, developing organs, sustained by the mother’s blood. The baby is attached via an umbilical cord from the abdomen to the placenta. That place where the umbilical cord is attached will eventually become a belly button. The placenta, truly an amazing thing and sometimes referred to in the birth world as “the tree of life,” is an entirely new organ that the mother grows in order to feed and nourish her baby. It is firmly attached to the uterus on one side and to the baby via the umbilical cord on the other. It is the only organ that the human body routinely grows from scratch and then discards. For the baby in utero, it functions as almost every major organ at once.

All of this occurs with very little conscious “doing” on the mother’s part. She may be eating well and supplementing with vitamins and doing her best to take care of herself for her baby’s sake, which are all good and helpful, but she doesn’t have to consciously do any of the growing or nourishing of her baby. Her body is giving, nourishing, and growing this baby, while she works and plays, sleeps and eats. We sometimes hear about women who don’t even realize they are pregnant until halfway through or even further along in their pregnancies. Their body grew a baby without their awareness that it was happening. This, of course, does not mean that pregnancy is always successful. We know the heartbreak of miscarriage. Not every baby develops properly — sometimes this is avoidable and sometimes it isn’t. But this doesn’t discount the fact that the baby’s development lies mostly outside of the mother’s conscious will and work.

Where the miraculous meets the natural, a baby develops and grows against all odds and yet outside of any drastic intervention. The same holds true for birth itself. We can cooperate with our body’s good design, work with it, understand what is happening, and have a good provider so that appropriate measures can be taken to help if needed. But it’s truly transformative for a woman to realize that her body already knows how to give birth and the majority of the time would do it just fine without a whole lot of help.

When Are You Actually Due?

Before we discuss the biological interplay of how birth happens, let’s talk about how long a pregnancy truly lasts.

When will that baby finally be ready, anyway? Babies are considered “at term” when they are anywhere from thirty-seven to forty-two weeks. This means, contrary to what your due date suggests, there is actually a full five weeks during which mom could naturally go into labor. Almost all women, when left on their own, will naturally go into labor sometime during those five weeks.

This is why it’s helpful to consider your due date an estimate, and it’s vitally important that it be accurately calculated. Women who practice natural family planning or who at least have an understanding of their cycles and fertility have an advantage in this area. They have a better idea of the signs of ovulation and can better estimate within a day or two when baby was likely conceived.

The standard for dating a pregnancy, even today, is still to go by the start date of your last period and count from there. This means that, according to the dating system most in use, pregnancy begins before the baby was even conceived! So, when a woman talks about being six weeks pregnant, her baby is actually only about four weeks old. And that’s only if she ovulated right on day fourteen of her cycle — which is a big, and often incorrect, assumption. Using the date of your last period to determine your due date assumes that you experienced the “official” twenty-eight-day cycle and ovulated on day fourteen. But how many women have that textbook cycle every month? (It’s worth noting that the same medical system that mocks the “rhythm method” actually uses it when dating pregnancies this way.)

This method of dating, based on gestation of ten lunar months, follows Naegele’s Rule, attributed to a nineteenth-century German doctor. This method calculates the estimated due date by adding one year to the first day of the last menstrual period, subtracting three months, and adding seven days. The result is approximately 280 days (forty weeks) from the start of the last period, and this is how the paper-wheel calculators in your provider’s office or online calculators usually work. It is actually unclear whether Naegele himself used the first day of the period or the last day to calculate the due date, which would change the calculation significantly.⁵⁶

Clearly, there are many ways in which using the first day of the last menstrual cycle can give a flawed result. An accurate due date can make the difference between going into labor naturally with a simple, complication-free birth and being pressured into an induction (and the risks included) for being “late” because the doctor thinks the pregnancy is further along than it truly is. This can even mean the difference between a healthy baby and a baby sent to the NICU or who has other struggles simply because they were taken out before they were ready.

Many obstetricians nowadays use early ultrasounds to date pregnancy. Using the ultrasounds and measurements of the baby, they can make a fairly accurate estimate of gestational age and when the baby is due. While this method is more accurate in determining the gestational age of a baby than the last menstrual period is, there is still room for error. The most accurate ultrasounds are those done in the first trimester. Many moms, however, are concerned about ultrasounds since, despite widespread and frequent use, their effects have not been sufficiently studied in controlled trials.⁵⁷ The American College of Obstetricians and Gynecologists has also warned against non-medically indicated ultrasound use,⁵⁸ stating that it hasn’t been adequately studied and additional side effects could be discovered. Dating a pregnancy can be considered a medical use, and it may be necessary for some women, but, if possible, the most accurate “official” due date comes from knowing within a day or two when the baby was conceived and calculating from there.

What we call the due date is simply the day of the pregnancy counted forward to forty weeks (based on the last menstrual cycle). This is the midpoint of when a healthy woman will typically go into labor. It’s interesting to note that the number forty is used often in Scripture by God to represent the fullness of something. Certainly, this shouldn’t be considered a coincidence! Recent studies have shown that (using the traditional dating) the median date for women going into natural labor with their first baby and an uncomplicated pregnancy is actually forty-one weeks plus one day. For multiparas (mothers who have already given birth), the median was forty weeks plus three days.⁵⁹

It is important not only to know your true estimated due date, but also to know that the date is not an expiration or “eviction” date, as you may have heard some people say. Nothing dramatic happens on that date, and your baby does not have a calendar in the womb to know when his or her “due date” is. It is important for you to know how far along you actually are, as well as the current standards of care, which do not consider a baby “overdue” until past forty-two weeks.⁶⁰ New standards have been put into place and encouraged since 2013 based on research that showed when babies at term had the best outcomes. Those new standards broke the five-week span into three groups:

Early term — 37–39 weeks

Full term — 39–41 weeks

Late term — 41–42 weeks

Notice that it is only when a mother goes past that forty-two-week mark that she is considered “overdue” or “post date.”⁶¹

Consider your estimated due date just that — an estimate. It might help to think of it and talk about it as a “due time” or “due month.” The end of pregnancy can be challenging, and it can be discouraging to a mother when she and others have this magical date in mind. Some women don’t even tell others the exact date because of the pressure then felt to have the baby, or to “perform” by that date. If you think others will be overly excited to have the baby born by that date, putting unrealistic or unhealthy pressure on you and the baby, consider telling people “sometime in May” rather than the exact forty-week mark. Remember, the due date is simply the date in the middle of the five-week window when you might have the baby. It is not an expiration date. Special circumstances aside, your baby will come when your baby is ready.

So-o-o, How Does It All Work?

Sometime during those five weeks at term, you will go into labor. When your body goes into labor, you are flooded (usually unbeknownst to you) with hormones that begin the work of opening the uterus wide enough to allow the baby to pass through. We break this down into three observable “stages” of birth:

Labor (First Stage): The womb contracts and gradually opens the cervix (simply the opening of the uterus).

Pushing (Second Stage): The baby is pushed out of the uterus by a different type of contraction.

Afterbirth (Third Stage): The woman’s womb contracts again to release the placenta and begins to shrink back down to its pre-pregnant size.

What Starts Labor?

Interestingly, very little is known about how God designed labor to begin and what actually “triggers” it. We know that most babies do best when they are allowed to gestate until they are ready to come out, and theories have been growing that in a healthy mom it actually is the baby that decides when he or she is ready. Scientists have recently discovered that babies release a protein in their lungs that plays a part in triggering mom’s body to go into labor.⁶² We know the mother responds to that release with increasing amounts of oxytocin, and that is what stimulates the uterus to begin to contract and open up.

It is amazing that we don’t actually know more about what “flips the switch,” but we do know that God designed labor and birth, so it is wise to be very careful about intervening without sufficient reason. Babies that are brought out too early often have breathing difficulties, struggle with nursing, and are more vulnerable to infection and being sent to the NICU. If a mother’s body isn’t ready, the birth is more likely to have complications and end in a cesarean section. When it is possible and other situations don’t arise, waiting until the baby’s and mom’s bodies are both ready gives the best possible chance for a simple, complication-free birth.

It can take a great amount of trust, especially at the end of a pregnancy, to know that your body will go into labor. Support and encouragement from your husband, like-minded friends, and provider are invaluable at this time. Have a project or two that you leave until those last few weeks, and keep making plans that you can look forward to. I even recommend making plans past the estimated due date, knowing that you can always cancel. Most women find it’s more helpful to have things to do and stay active and positive, rather than clearing the schedule only to sit around waiting for labor to start. Those last few weeks of pregnancy are challenging enough without adding internal pressure and frustration with your body and your baby into the mix.

There are most certainly situations that can arise where it is best to intervene and artificially induce labor for mom or baby. A good provider will be diligent in care but prudent in intervening, doing so only when it is of pressing concern.

Opening the Womb

When labor begins, the body begins to release large amounts of oxytocin into both the bloodstream and the nervous system, and the uterus begins to contract. Oxytocin, known as the “bonding hormone,” or “love hormone,” is released in torrential amounts during three main times: orgasm, labor contractions, and while breastfeeding. It is also released in much smaller amounts through touch, kissing, low lighting, good smells, and good memories. Because it is a neurotransmitter (unlike the synthetic form Pitocin), it affects both our brain chemistry and the rest of our body.

One of the main purposes of this hormone release is to bond two people together, emotionally and chemically, as happens between husband and wife. This tells us something amazing about God’s plan: husbands and wives are designed to be bonded for life, and mothers are designed and biologically created to have a real and lasting bond with their baby. God’s plan of family is written into our very bodies. This is one reason why it hurts so much when a sexual relationship ends, why a mother who never knew her baby past birth can still feel eternally connected to him or her, and why we can feel bonded after birth to the people who were with us during it. Our bodies are meant to work with our souls and are designed to reinforce and work with spiritual reality.

Oxytocin release is encouraged when a mother feels safe, respected, and private. The opposite is also true. If she feels threatened, exposed, judged, or vulnerable, it can inhibit the release of this incredibly important hormone. This means that a woman’s environment (both people and place) matters greatly to the birth process itself. The release of oxytocin begins contractions that are usually subtle at first but continue to grow and intensify. Most women who go into labor naturally have a difficult time pinpointing when exactly labor began. For most, early contractions begin gradually and gently, and are often not all that notable. There is usually not a concrete “this is it” contraction that begins labor, as we often see in the movies. The majority of women do not have their water break before labor begins, also contrary to most television and movie portrayals.

Usually, beginning contractions don’t follow a specific pattern. Some women describe them as a “tightening,” some as menstrual cramps that increase in intensity, and others like back pain that wraps around to their abdomen. Part of how they experience a contraction can be influenced by the baby’s position (whether the baby is anterior or posterior) as well as whether this is their first birth or not. The contractions (or “surges,” as some people prefer to call them) increase in intensity, working to pull the uterus muscle up and stretching the cervix open. The cervix, again, is simply the opening to the uterus. Before birth, it is thick, tightly closed, and sealed with mucous, protecting your baby until the time of birth. If you picture the uterus as a balloon with the opening pointed down, the contractions are first thinning out that opening, then pulling the opening wider, dilating it until it is about ten centimeters wide and big enough to allow the baby through. Contractions usually occur in a “wave.” You can begin to feel it coming, it grows and reaches a peak, and then slowly releases. In a natural labor, there are breaks in between the contractions, allowing you to rest and reenergize for the next one. There are three stages of this opening: early labor, active labor, and transition.

The First Stage of Birth — Labor

Early Labor

In early labor, the cervix is thinning out and beginning to open. You may begin to see lots of mucous or what is called “bloody show,” which is part of or possibly the whole mucous plug, sometimes tinged with a bit of blood, that was sealing up the cervix and protecting the baby. Contractions may be consistent or sporadic. You usually can go about your day in between these early contractions and should eat and drink and rest if you can so you have the energy you will need for later. It’s important to know that for some women this stage can last for days. If you can talk between contractions, you’re still in early labor. If you plan to birth at a hospital, it’s not time to go in yet. If you can sleep, do so!

Early labor is usually defined as the cervix dilating from zero to about four centimeters, but it’s helpful not to have numbers in mind. Just let your body do what it needs to do. Many women find the best coping strategy during this time is to go about their normal day as much as possible, “ignoring” the labor in a way. Keep a good attitude, knowing that the process could take a while and that the time frame between contractions can be all over the place.

Active Labor

As the surges pick up in intensity, you may find yourself gradually getting more and more serious. Your mood shifts, and your body begins to buckle down more in the work of labor. You are no longer excited and may find it more difficult to talk during or even between contractions. You are less likely to be joking around and aren’t able to go about your normal tasks anymore, even when trying your best. You find the surges cannot be ignored. You need to breathe deeply through each one and focus. When a contraction comes, you will find yourself focusing inward, perhaps needing silence, your body swaying or leaning, or sometimes needing to be completely still, breathing deeply and intentionally.

Many women talk about the phenomenon of “labor land” during this part of labor, where reality seems to shift a bit. Time is strange and almost feels suspended. You are mentally, emotionally, physically, and spiritually in a different place. The time between contractions usually begins to lessen. The muscular walls of the uterus are pulling up and “collecting” at the top. The contractions grow in intensity, and many women begin to vocalize in moans or sighs.

Transition

Transition is usually defined as the cervix opening from seven to ten centimeters. It is the hardest work of labor, but, thankfully, for most women it is usually the fastest. This is the time many women begin to feel as if they cannot do it anymore, and they often say so. Surges can seem to come one on top of another, and they are most often very painful as the cervix opens that last bit to allow the baby through. At some point, as the contractions progress through transition, you will begin to feel slight pressure that continues to build. The pressure often comes at the peak of the contraction and feels like the urge to have a bowel movement. Most women unconsciously begin to grunt, and a skilled provider or attendant will know that you are getting close to pushing. The contractions build until you are fully dilated and the pressure is causing you to push.

The Second Stage of Birth — Pushing

When you are fully open, your body will begin to switch over into pushing mode. All of that uterine muscle that has stretched to open the cervix is now collected on top and ready to literally push the baby out. You can push along with your body, but even if you don’t, your body would push anyway: this is called the “fetal ejection reflex.” Your body is designed to do this. For many women, there is a period of rest between being fully dilated and being ready to push. For some, contractions may ease significantly as the body transitions to the pushing stage. Typically, there is no reason to hurry or to push before you feel that pressure and have the urge. This could be the body’s way of building up some more energy for the big work ahead. When it comes time to push, if you have not had any anesthesia, you will most likely feel an uncontrollable urge to bear down as though you are having a bowel movement. In fact, that is exactly the way you will push. You will usually experience intermittent pushing contractions with breaks in between, just as before, but this time your body is bearing down with the contraction. As your body pushes, the baby moves down the birth canal, your vagina. The speed is determined by how hard your body is pushing, how the baby is positioned, and how you are positioned. For some women this can take hours, for others just a few minutes.

Often, especially if this is your first birth, the baby’s head will take “two steps forward and one step back” as it opens up the birth canal for the first time, coming down a little bit lower with each push, but going back up in between. This is totally normal. The baby’s head is beautifully designed to fit through the birth canal. In fact, the skull bones of a newborn are separate and able to overlap for the journey, allowing the baby’s head to fit as needed. For some babies, a longer pushing stage will leave them with a little bit of a “conehead” after birth, but it will eventually round out in the hours or days after birth. For an ideally positioned baby, the crown of his or her head will move its way down the vagina first, gradually coming into view. The baby’s head reaches the labia, called “crowning,” and the woman will usually feel a burning and very intense stretching of the skin of her labia and perineum. Slow pushing is often encouraged at this point to allow the skin to stretch gradually and avoid a tear.

At this point she is so close to meeting her baby! As the head, the biggest part of the baby, crowns and is born, the relief is immense. Usually it takes just one or two more contraction pushes for the rest of the body to slide out.

What about That Water Breaking?

Every woman is different regarding her amniotic sac releasing. For some women, their water releases before they’ve felt any contractions, and it does prompt gentle contractions that gradually lead to birth. For others, their water breaks, but contractions don’t start for hours or even days. For the majority of women, the membranes will rupture sometime during active labor or transition. There are even rare instances of a baby being born “in the caul,” or still in the amniotic sac! Some cultures consider it good luck (and it certainly is neat to see). For some women, the release is a big “pop” and a gush of fluid; for others it is a slow trickle.

The amniotic sac serves an important purpose for the baby throughout pregnancy, holding the fluid and protecting him or her from germs and bacteria. During labor, it helps provide a cushion for the baby and for the mother during contractions. The water also makes it easier for baby to move around to get into a good position for birth. Many women notice a significant increase in intensity when their water releases, although some experience it as a huge release of pressure, especially if they are in transition. If a woman’s water does break before active or any labor, she should be in communication with her provider. The release of her water means that baby will need to come out within the next few days to keep him or her safe from infection. Different providers have different recommendations about how soon after a woman’s membranes have ruptured the baby should be born.

The Third Stage of Birth — The Afterbirth

While it may seem as if you should be done after pushing out that baby, you still have one important step of birth left. Your body will usually give a good rest as you meet and hold your baby for the first time, and then it will begin to contract again, this time a bit less intense than it was as the baby was coming out. The placenta after birth begins to close off the blood vessels that were securing it to the uterine wall and prepares to release. Once it is completely detached, it will slide to the uterine opening. You will be exhausted, but you will need to push a bit more to get the placenta out. This is not nearly as much work as the baby, thankfully, and the placenta usually comes out in one or two pushes once you feel the contractions again. It is important to wait until the placenta has completely detached from the wall of the uterus. Unless there is a serious concern, no one should be rushing the placenta along, but it is also important to make sure it comes out soon after birth and is intact. Many women want to see the placenta, and it truly is an amazing thing, this organ that has been the constant supply of oxygen and food and blood to your baby!

After the Birth

After birth, your body will immediately begin the process of recovering and healing. The uterus will continue to contract so that it can return to its pre-pregnancy size. These postpartum contractions are important for stopping the blood flow from the site where the placenta was attached. If the placenta is pulled out before the blood vessels have time to begin to close off, or if your uterus is not sufficiently contracting, it can cause a loss of blood that may be dangerous.

This is where that oxytocin knowledge helps again. Oxytocin is what causes the uterus to contract again. Remember the third time that oxytocin is released in huge amounts? When a baby is nursing! When the baby begins to suck at the breast, the released oxytocin not only helps stimulate your body to produce colostrum and then milk from your breasts, but it stimulates the uterus to keep contracting. This is one of many reasons why it’s important to keep you with your baby and help the baby to nurse right away. If your baby cannot nurse (or if a doctor is concerned about blood loss), you may be given Pitocin, the synthetic form of oxytocin, via an IV in order to mimic that natural response.

Your body will still bleed heavily for the next few days, gradually lightening over the course of a few weeks. Thinking of it as the menstrual periods that were missed over the last nine or ten months is a helpful way to understand it. The lining of the uterus is still shedding as it used to, but this time it has had nine months to build up. Small clots are normal, and the overall flow should resemble that of a period — heavy red the first few days and getting lighter and browner as the days and weeks pass. If you begin to go back to bleeding more heavily, it is usually because you are not getting the rest you need and are being too active. One doctor explained it like this: the site where the placenta was attached needs to close up and heal. It’s like a scab, and if you are doing too much before it is completely healed, you risk opening that scab back up and bleeding again, which means you need to heal again.

Immediately after birth, you will still look about five to seven months pregnant. The after cramping that comes with the uterus getting back down to size intensifies with each baby, since the uterus has more work to do to get back to that size. In the day or two following a birth, your provider or nurse will be checking your uterus to make sure it is firm and contracting well. The checking can be very uncomfortable! However, it is important to make sure that your uterus is contracting. Within a few weeks your uterus should be back to pre-pregnancy size. A good provider will make sure that this is happening well, that bleeding is controlled, and that your body is healing properly. You will be checked a day or two after birth, possibly a week later, and then there is usually a six-week checkup to ensure that your body has done the major recovering and there are no serious issues. Within two to four days your breasts switch from producing the extremely important thick yellow colostrum for baby to filling up with normal breast milk.

By natural design, baby will usually want to nurse frequently during these first few weeks. You often can’t do much else but lie or sit and nurse the baby. The frequent nursing helps to heal your uterus and forces you to lie down and rest so your body can recover. This is the time when mothers need a good support system in place to take care of the home and other children, provide meals, and offer emotional support. This help is vital to a mother’s physical, mental, and emotional well-being. The task of growing and birthing a baby is monumental, and it would be wise for us to recognize that a mere few weeks is not enough to heal and feel back to normal. This time is a tremendous opportunity for family, friends, the Church, and neighbors to pay their respects and play a part in building a culture that honors motherhood and birth.

The Fertility Cycle Design

Another interesting part of the design of the woman’s body is that typically there is a period of natural infertility after birth (called amenorrhea). Each woman is different in how long it will last, but breastfeeding releases hormones that tell your body to suppress ovulation. It is nature’s way of spacing births so that mom and each baby get the time they need before another pregnancy. The more often you nurse and the more that baby relies on your breast, the more often those hormones are released that potentially delay the return of fertility. For some women, the return of regular cycles can take eighteen months; for some it is only a few weeks. Factors that may increase the length of this time include nursing exclusively and not supplementing with formula or food, sleeping near the baby, nursing the baby during the night, not timing feedings but feeding on the baby’s cues, and soothing the baby with the breast rather than with pacifiers or distraction. The more often your breasts are releasing milk (and prolactin and oxytocin), the more your body will know that it’s not yet time to return to normal fertility. However, each woman is different, and God’s timing may be different, too. It is definitely possible to get pregnant before the period returns if ovulation occurs before that first cycle. So, a woman who is hoping to avoid pregnancy should be observing her body and noting any signs of fertility, even if her period hasn’t returned.

Familiarity with some form of natural family planning (NFP), or at least an awareness of your body’s personal fertility cues, can be helpful to know what is going on and if fertility is returning soon. An NFP instructor, through an official method such as Billings, Creighton, Sympto-Thermal, or Marquette, can be invaluable to a woman who is experiencing confusing signs (which is normal postpartum), especially if there is a need to delay another pregnancy.

That, in a nutshell, is how the female body and birth are designed to work. It is absolutely amazing to realize that we are still learning the many interconnected ways that the systems of our body and our baby’s body interact for the great act of birth.

The design is remarkably complex and intricate, and unless there is reason to intervene, mothers and babies have the best outcomes when the natural design is respected. We know that we have an all-knowing God who has planned us from all eternity, and that he is a God who desires only our good. His design for our bodies is not haphazard. We can honor and respect that design, which functions very well, while still acknowledging that sometimes we must intervene for good reason. We can thank God and praise him for the amazing design of our bodies, and we can use our bodies to give glory back to him. Our bodies are a gift to us, beautifully and intricately designed at the service of life. We truly are wonderfully made.

It’s so strange to me now that the only thing we learned in school about our fertility was how NOT to get pregnant. I don’t necessarily think it’s the school’s job to teach that stuff, but the irony is not lost on me that we didn’t learn how the female body actually works, just how to keep it from working. It wasn’t until I was an adult that I even fully understood my cycle. Learning NFP was really empowering for me. It taught me that my body made sense! I think that helped as I prepared for birth. I still had a lot to learn, but underneath [there] was a new confidence that my body worked, and when it was time, it would know how to birth.

— Teresa A., mom to five on Earth and one in eternity