Childbirth

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Childbirth
Synonyms	Labor and delivery, parturition
Pronounce	N/A
Specialty	N/A
Symptoms	Uterine contraction, cervical dilation, rupture of membranes
Complications	Postpartum hemorrhage, infection, perineal tear
Onset	Typically around 40 weeks of gestation
Duration	A few hours to a few days
Types	Vaginal delivery, Cesarean section
Causes	Pregnancy
Risks	Preterm birth, breech birth, multiple birth
Diagnosis	Pelvic examination, ultrasound
Differential diagnosis	N/A
Prevention	Prenatal care, birth plan
Treatment	Pain management, episiotomy, induction of labor
Medication	Oxytocin, epidural anesthesia
Prognosis	Generally good with proper care
Frequency	Approximately 140 million births per year worldwide
Deaths	Approximately 295,000 maternal deaths per year worldwide

Childbirth during delivery

Labor and delivery refer to the physiological processes by which a baby is born. These involve the uterus contracting, changes in the cervix (the lower part of the uterus), the delivery of the newborn, and the expulsion of the placenta. Labor begins with uterine contractions and cervical dilation, preparing the body for the delivery of the baby. The process continues until the baby and placenta are delivered through the vagina (in a vaginal birth) or via a cesarean section.

Onset of Labor

Labor usually starts between 37 and 42 weeks of pregnancy. Signs of labor include:

• Regular uterine contractions
• "Lightening" – when the baby drops lower in the pelvis
• Increased vaginal discharge or "bloody show"
• Low back pain and pelvic pressure
• Water breaking – the rupture of amniotic sac

Stages of Labor

Stage 1: Early and Active Labor

• Early labor: The cervix begins to dilate and efface (thin out). Contractions become more regular.
• Active labor: Cervical dilation progresses more rapidly (up to 10 cm), and contractions intensify.

Stage 2: Delivery of the Baby

• Begins when the cervix is fully dilated.
• The woman pushes to help move the baby through the birth canal.
• Delivery occurs when the baby's head and body emerge.

Stage 3: Delivery of the Placenta

• The placenta separates from the uterus and is expelled.
• This stage typically occurs within 30 minutes after the baby's birth.

Pain Relief Options

There are both medical and non-medical options for pain relief:

Medical Pain Relief

• Analgesics: Provide partial pain relief (e.g., systemic opioids).
• Anesthetics: Block all sensation (e.g., epidural, spinal block, general anesthesia).

Natural Pain Management

• Relaxation techniques
• Breathing exercises
• Massage therapy
• Acupuncture
• Hydrotherapy
• Hypnobirthing

Induced Labor

Labor induction may be performed when medically necessary using:

• Prostaglandins to ripen the cervix
• Oxytocin (Pitocin) to stimulate contractions
• Amniotomy (artificial rupture of membranes)
• Cervical balloon catheter

Cesarean Delivery (C-section)

Cesarean delivery

A cesarean section involves surgically delivering the baby via incisions in the abdomen and uterus. It may be planned or emergency-based due to:

• Prolonged labor
• Fetal distress
• Breech or abnormal position
• Placental problems
• Infection risk

Vaginal Birth After Cesarean (VBAC)

VBAC is the process of delivering vaginally after a previous cesarean. With proper evaluation, many women are candidates for VBAC. Risks include uterine rupture, but benefits include shorter recovery and fewer surgical complications.

Complications During Labor

Complications may include:

• Prolonged labor
• Perineal tears
• Umbilical cord issues
• Fetal distress
• Premature rupture of membranes
• Shoulder dystocia
• Excessive postpartum hemorrhage

Birth Settings

Most women give birth in hospitals. Alternatives include:

• Birthing centers
• Home birth (with trained midwives)
• Water birth (not recommended for actual delivery)

Special Considerations

Multiple Births

Labor with twins or more increases the likelihood of preterm birth and cesarean delivery.

Older Mothers

Advanced maternal age increases the risk of complications such as gestational diabetes, preeclampsia, and stillbirth.

Newborn Assessment

After birth, the newborn receives an Apgar score based on:

• Heart rate
• Respiration
• Muscle tone
• Reflexes
• Skin color

Labor and Delivery FAQs

What is false labor?

Braxton Hicks contractions are irregular and usually painless contractions. Unlike true labor, they do not lead to cervical dilation.

Can you deliver vaginally after a C-section?

Yes, many women qualify for VBAC based on their medical history and pregnancy progression.

When should you go to the hospital?

When contractions are regular (every 5–10 minutes), your amniotic fluid has ruptured, or there is bleeding or reduced fetal movement.

See Also

• Pregnancy
• Childbirth
• Obstetrics
• Prenatal care
• Postpartum period
• Epidural anesthesia
• Induction of labor
• VBAC