First and subsequent childbirth: The main differences

How long does the first and second birth begin?

Childbirth differences- 70% of primiparous women give birth at 41 and sometimes 42 weeks of gestation. Often, at 41 weeks, they are routinely hospitalized in the pregnancy pathology department and monitored: if labor does not begin before the 42nd, they are induced.

First and subsequent childbirth

With multiparous, the situation is exactly the opposite. 90% of women give birth before 41 weeks: depending on the individual characteristics of the body, this can occur at 38, 39 or 40 weeks. And only 10% give birth at 42 weeks. This is not considered a pathology, but is associated either with the psycho-emotional background of the pregnant woman, or with the physiological characteristics of the development of the fetus.

How long is the first and repeated births?

Repeated births are almost always faster than the first. If you turn to the medical literature, then it clearly states that the average duration of the first is 9-11 hours.  If it lasts less than 4 hours, it is a rapid labor. And if their duration does not exceed 6 hours, then we are talking about rapid childbirth.

*First birthSecond and subsequent childbirth
Delivery dateFrom week 41From week 38
Duration of labor9-11 hours6-8 hours
Cervical dilatation rate1 cm per hour1.5-2 cm per hour

* Average statistical data
The second time women give birth, as a rule, from 6 to 8 hours. A faster course is typical for all periods of repeated birth, including the second – the period of fetal expulsion.

However, theory is often at odds with practice. There are times when not only the second, but even the third or fourth births last longer than the first. There are many factors that affect speed. For example, the presence of tears in the cervix or perineum.
“The duration of labor is due to the rate of dilatation of the cervix in the active phase: 1 centimeter per hour for the first birth and 1.5-2 centimeters per hour for repeated ones.”

When is it necessary to go to the hospital for the first birth and when – for repeated ones?

In most of the capital’s maternity hospitals, a wait-and-see tactic is envisaged today.  That is, at the onset of the first stage of labor, the woman in labor is, of course, put in the birth box, but for 18-24 hours they try not to touch it, allowing the cervix to ripen and enter into labor without any outside intervention. Therefore, during the first birth, you should not rush to the hospital immediately after the water has left or the onset of labor, if you know that the road there will not exceed 2 hours.
With repeated childbirth, if the outflow of amniotic fluid is accompanied by contractions, you should hurry – so as not to give birth directly in the car or in the emergency room.

It is believed that with each birth, the weight of the child increases. This is true?

Overall, this is true. According to statistics, multiparous children are larger when comparing their weight with the first child. But do not be afraid: if a 4-kilogram baby was born during the first birth, it does not mean that with repeated birth his weight will necessarily reach 4.5-5 kilograms. A large fetus during the first pregnancy is often associated with a woman’s unhealthy diet.
With repeated pregnancy, women, as a rule, are more aware of their health and follow a diet, so they give birth to children with a smaller mass, and the birth itself is easier.

Which childbirth is more painful: the first or the second?

Based on my practice, most women describe their repeated births like this: they pass faster, but the contractions are more intense and painful. However, exceptions are possible: some women in labor literally do not have time to feel anything. It is worth noting that every year the number of expectant mothers is growing, who come to the second birth with the firm conviction of refusing any drug methods of pain relief. To this end, they use a fitball, a warm shower or a lower back massage, which is very effective, given that repeated births do not last long.

What is the risk of perineal tears in multiparous women?

If in the previous childbirth a woman had perineal tears or, for various reasons, she was cut, it does not mean that the subsequent childbirth will follow the same scenario. Even considering the fact that the child may be larger. The psychological factor plays an important role here: there is no need to tune in to the bad in advance and expect that there will certainly be a break!
“Whether or not there is a perineal tear does not depend on the number of births, but on the skill of the midwife and how closely the woman follows the doctor’s instructions.”

The first delivery ended with a caesarean section. What to expect on the next ones, if they go naturally?

It all depends on what caused the caesarean section the first time. If a woman explains to us that it was planned and happened at a stage when the necessary dilation of the cervix has not yet come, then the scenario of childbirth will be like that of a primiparous. And if a woman says that she was already in childbirth, but for some reason the baby’s head did not fall, then in this case the first period will pass, like a multiparous one.  But the attempts directly will proceed more slowly, since the head did not go down the last time and the body “does not remember” it.

What is the difference between the first cesarean section and the subsequent ones?

With the first operative delivery, everything is clear: if it is planned, then it takes place at the appointed time according to all surgical canons at a period of 39-40 weeks of pregnancy. Sometimes women ask to prolong pregnancy until the 41st week, and we meet them halfway if the baby feels good. As for the repeated cesarean section, it is carried out at an earlier date: 39-40 weeks, and not pulled until 41. Since there is already a scar on the uterus from a previous operation, we cannot allow it to become thinner to a life-threatening condition.

When can you plan your next baby after the first and subsequent births?

According to the WHO recommendations, after the birth of a child, a woman should feed him with breast milk for a year.  Against this background, lactational amenorrhea develops – that is, menstruation does not occur and there is no ovulation, which makes conception physically impossible.
During the next year, pregnancy is also not recommended: this time is necessary for the female body to prepare, to accumulate a supply of vitamins and minerals, which will later be useful for the normal development of the baby. Thus, 2 years is the optimal period after which you can plan your next pregnancy, if you adhere to the standards of the World Health Organization. Domestic medicine sets a broader framework: 3-5 years. However, if a woman has a pregnancy six months after giving birth, this is not a reason for panic. In this case, it is necessary to take vitamin complexes and other drugs as prescribed by a doctor on an individual basis.
“If pregnancy occurs 10 or more years after the previous one, the body perceives it as the first and the woman will give birth, like a primiparous.”

Are there differences in the postpartum period in primiparous and multiparous?

In multiparous women, when breastfeeding or lying on their stomach, contractions of the uterus are more painful in the first days after childbirth. Sometimes the pain syndrome is so pronounced that we resort to drug pain relief. While in primiparous, the process of uterine contraction is painless, and in most cases it is completely invisible to the woman, without causing her discomfort.

Dr. Ashwani Kumar is highly skilled and experienced in treating major and minor general medicine diseases.