How The Uterus Muscles Its Way Through Labor

Written by Shay Gabriel // Photography by Annica Quakenbush and Brianna Trammell

uterus, u-ter-best

Did you know that the uterus is arguably the STRONGEST muscle in the human body!? Not to mention the fact that it’s an organ that grows an organ (the placenta) that sustains the life of a whole new human…NBD, right? Actually, we think it’s friggin awesome, and we’re here to fan-girl over it.

The uterus fulfills so much incredible work in order to grow and give birth to a baby. Let’s take a closer look at how the uterus muscles its way through labor…

First Stage / "Up" Stage of Labor

The uterus consists of two layers of muscle: 1) the outer layer, made up of vertical muscles, and 2) the inner layer, made up of horizontal muscles. During a contraction, the outer layer (vertical muscles) draws up. The inner layer (horizontal muscles) relaxes. As the vertical muscles draw upward, the horizontal muscles are slowly gathered up.

This pattern of muscle movement, paired with baby's weight coming down, encourages the cervix to dilate. This pattern continues until the birthing person is "fully dilated."

Try "up" breathing during this stage of labor!

“Up” breathing consists of a deep breath in for 4 counts, followed by 8 slow breaths out through the lips. Inhale for 4…exhale for 8…all throughout a contraction. This type of breathing promotes relaxation and encourages us to let the body do its job without interference. Oxygen is essential for the uterus to do its job effectively, efficiently, and with less pain. Learn more about this topic here.

Photograph by Annica Quakenbush

Second Stage / "Down" stage of labor

Now that the muscles of the uterus have drawn up to the top, it's time for them to work baby down and out!

The muscles of the uterus will begin to move in a new pattern: the inner layer (horizontal muscles) that have been slowly gathered upward will now push downward, naturally easing the baby out through the fully dilated cervix.

Throughout this stage, some birthing persons experience “coached pushing” or “purple pushing” — as if you have to actively do the work to push baby down and out. Most often, coached pushing isn't actually necessary. The muscles of the uterus are designed to push baby down all on their own; often we need to just "get out of the way" of inhibiting this process. The "fetal ejection reflex" tends to feel like you can't *not* push – the body takes over whether you're actively trying to push or not!

Again, aiming to work with the body by providing ample oxygen can help support the incredible muscles of the uterus during this most important job. And, taking your time to allow the baby’s head to slowly mold and your tissues to slowly stretch lends to a smoother birth that minimizes tearing.

Try "down" breathing during this stage of labor!

“Down” breathing consists of quickly and deeply breathing in as you feel a contraction building, then breathing “down through your body” with purpose — much like you’d blow out a birthday candle — but more targeted “downward” into your body. When you keep inhaling and exhaling with intention during these contractions, it can help you work with rather than against the intensity of your uterus working to push your baby down and out.

Photograph by Annica Quakenbush

Pro tip: Try practicing “down” breathing on the toilet when you take a poo! While the muscles at work aren’t quite the same in these circumstances, you’ll still feel the impact of drawing oxygen toward the part of your body that is naturally muscling something down and out from your body. It can make for a much more relaxing, smooth experience on the toilet, particularly if you’re feeling a bit constipated.

Read more about supporting labor hormones here.

The Third Stage of Labor / Birthing the Placenta

This is the stage of labor when your uterus continues contracting in order to release the placenta.

Throughout this stage, the “I did it!!!” high, skin-to-skin baby snuggles, and latching to nurse can help distract you from any discomfort as the uterus wraps up its birth to-do list. Continuing to breathe normally and naturally will provide the oxygen necessary to support the uterus as it completes its job.

Photograph by Annica Quakenbush

After birthing the baby and the placenta, the uterus will begin to shrink. It will continue to shed its lining in the weeks after birth, and while similar to menstruation, this release of the lining sustained throughout pregnancy is called “lochia.”

support your uterus, support yourself

Consider how you can help encourage, rather than inhibit, the natural processes of labor! Practice the following throughout pregnancy, and prepare a labor environment that supports these goals as well:

• being relaxed

• minimizing fear

• releasing tension in the body

• keeping a loose jaw (rather than clenched)

• promoting the flow of oxytocin

Learn more about the physiology of labor here.

Hire a doula who will support you and your family throughout your perinatal journey! Continuous support from a doula is known to decrease the use of medical intervention and increase the likelihood of reporting a positive birth experience. Especially if you do not have control over who attends your birth (as in large hospital settings where various nurse-midwives or obstetricians are on call at various times), having a person on your birth team you can count on to directly support you and your birth wishes is invaluable. Quality doulas will offer informational support, physical support, and emotional support — and they’ll connect you with resources they recommend in your community.

Photograph by Brianna Trammell

Ensure that your birth team is one you can trust to support and acknowledge your feelings, concerns, and needs all throughout pregnancy, labor, birth, and postpartum. A quality birth team will encourage you to embrace informed choice, and they’ll be receptive and responsive to your expressions throughout all of the perinatal phases. They’ll also know when to take steps to further support where your body and baby are at in the labor process, manage any hiccups with interventions (such as managing after-birth hemorrhaging with Pitocin), and ensure you feel emotionally, physically, and mentally cared for throughout and after birth.

Photograph by Annica Quakenbush

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