What is a normal and natural childbirth?
Most pregnant women give birth without complications.
The onset of labor usually presents the start of periodic or regular and painful uterine contractions. They feel like jerks in the back, across the top of the uterus. Sometimes fluid bag baby breaks before the start of contractions or, more commonly, after labor has begun.
Often a mucous material is expelled from the vagina to the onset of labor (mucous plug) may contain traces of blood.
Some women may begin to expel the stopper days before you actually go
into labor and others do not expel, so it is not a reliable sign of
labor.
During a natural birth the uterine muscles contract and this contraction is what is known as labor pains.
Childbirth is a painful experience but breathing and relaxation
techniques learned in preparation classes can make this something less
stressful experience.
The contractions cause the baby's head is pressed down through the pelvis and against the inside of the cervix. Thus, the cervix is dilated, and allows the baby's head down into the vagina and the outside world.
The role of the midwife during natural childbirth is to guide, provide support and check that everything goes well. It is very important to ascertain that the mother feel safe and find the experience of giving birth as rewarding as possible.
The first stage of labor or expansion period
This phase begins when labor contractions begin to be as frequent, intense and long enough to cause the cervix to open.
At the onset of labor, usually externally examine women (abdominal
scan), to see how the baby is facing and to confirm that your head is
down.
The internal examination is conducted to check on the cervix (the cervix). Before labor begins, the cervix is about 3 cm long and is not dilated. When labor begins, the cervix is shortened (a process called effacement) and opens or expands. It is said that the cervix is fully dilated when open 10 cm. It is important that the mother begins to not push before you are fully dilated and the danger of tearing of the cervix.
When this expansion of 10 cm is reached is considered completed the first stage of labor is about to start the second.
The first stage usually lasts up to 12 hours in a first delivery and in
the following seven hours, but every birth is different.
In turn, this expansion phase or it characterized by different periods:
- Reach three centimeters dilated usually take most of time this period.
- From three to eight or nine centimeters usually fast (during acceleration).
- It becomes slow from eight or nine to reach full dilation (slowdown).
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The second stage of labor
See our 'section Pregnancy and Childbirth 'articles of interest:
- Childbirth: options
- Childbirth: what to bring to the hospital
- Am I in labor?
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The second stage begins when the cervix is fully open (dilated 10 cm). The woman usually has the feeling of fullness in the vagina or belly and want to push. Most women find the pain more bearable in this second phase as they can now relieve themselves by pushing.
The second stage of labor ends with the baby out into the world. It usually lasts 45 minutes to 2 hours in a first childbirth and 15-45 minutes in successive deliveries.
The third stage of labor
This phase ends with the expulsion of the placenta, umbilical cord and membranes, postpartum. Normally, the placenta is delivered between 5 and 15 minutes after birth.
The last phase of childbirth is a cooperation between the new mother
and the midwife or obstetrician, but little effort is required to
deliver the placenta.
Is a routine action administer an injection to the mother to stimulate
the contraction of the uterus after childbirth and before the expulsion
of the placenta.
By causing the uterus to contract, the risk of excessive blood loss is
reduced during placental delivery (post partum hemorrhage).
Sometimes the placental not done spontaneously obstetrician having to
proceed to extraction with one's hand and under analgesia and / or anesthesia .
What are the normal stages of a normal delivery? Who will be present during labor?
When childbirth takes place is usually sufficient assistance team which
midwives attending the mother at birth and later the newborn to apply
first-aid treatment.
When problems or risk to the child or the mother is present, the
medical team will consist of the obstetrician, midwife, anesthetist and
pediatrician.
Given a normal birth the medical staff will provide the couple or a
trusted family member accompanying the mother in the delivery room.
How the mother and baby are monitored during labor?
The mother's blood pressure, pulse and temperature are checked at regular intervals throughout labor and beyond. The baby monitor is normal hearing the beating of his heart.
It normally takes place listening to the heart with a special manual
recording amplifier and heart rate at regular intervals during labor.
In certain circumstances it is necessary to have a continuous record of the baby's heartbeat.
It can be obtained by a belt placed around the waist of the mother or
with a small electrode placed on the baby's scalp through the uterus and
vagina of the mother neck.
In analyzing the baby's heartbeat by these methods midwife or
obstetrician can detect if the baby is getting enough oxygen during
labor.
Sometimes the beat pattern shows abnormalities and may be necessary for
the obstetrician take a small blood sample from the baby's scalp to
analyze the oxygen content of the fetus (fetal making Ph).
Breech
In a breech baby it is placed in the uterus so that the head is near the mother's ribs and buttocks on the cervix. Because the baby's buttocks are slightly smaller than the head, it can be difficult to give birth safely.
An alternative is to gently turn the baby before labor begins (known as
external cephalic version), so it is head down when labor begins. This maneuver today is almost obsolete as they are not without risks and difficulties involved.
In all breech delivery should be represented by an obstetrician at the
time of the expulsion of the baby that may occur due to maternal or
fetal complications of obstetric practice maneuvers for removal or
necessitating having to use the forceps to remove the baby's head
remains trapped after the departure of the body.
In most obstetric services is common indicate cesarean in first whose baby is positioned buttocks; however, if not first-time and meet a number of conditions, vaginal delivery is normally permitted.
This approach is currently being revised, since in obstetric services
in the vaginal breech delivery in gilts is allowed, experience shows
that they are normal and no increased fetal risk births when cases are
selected. Many breech babies are born safely and mothers who have had a normal delivery will have less complications.
Delivery with forceps or vacuum (suction cup)
Between 5 and 20% of all births require the help of forceps or suction cup. This type of birth is known as instrumental birth. We carried out an obstetrician, who will use forceps or suction only in certain circumstances. The instrumental birth takes place only in the second stage of labor.
The most common reasons for the use of forceps or suction are:
When an instrumental birth is necessary, the doctor places the forceps
or suction cup on the baby's head and pulls with great care to
facilitate their departure.
Using forceps or suction cup, you may need to make a cut, also known as
episiotomy, in the perineum of the mother (the area between the vagina
and anus).
The first few days after birth, the baby will have the marks on the
places where forceps or suction cup is placed, but these disappear
quickly and are not of major importance.
If the use of forceps or vacuum is unsuccessful, it may be necessary to perform an emergency cesarean.
- The infant has a record of abnormal heart rate, suggesting lack of oxygen (fetal failure).
- The mother has spent much time pushing, it is exhausted and weak to continue doing so, being very engaged and head low.
- The baby's head is in a little normal position in the pelvis anticipating that the expulsion of the fetus is too slow.
- Avoid overexertion well women have scars from previous caesarean sections or other intervention on the uterus (the previous scar to have lower risk of rupture) or relief efforts that would aggravate certain maternal diseases ( heart failure, serious, etc.)
It can be used during labor and is particularly useful in the first phase. There are no major side effects for the mother or baby, and if the correct technique is still a good analgesia can be achieved.
Morphine or pethidine
These drugs are potent in relieving the pain administered by intramuscular injection. Serious side effects are rare. Mild side effects are that the mother may feel sleepy, develop itchy nose or feel nauseous. The drugs enter the baby's bloodstream and occasionally it can be a little slow to begin breathing at birth.
If this is the case, the midwife or doctor will administer an antidote
baby drug called naloxone to reverse the effects of the analgesic. These painkillers are administered once or twice during delivery and no risk of addiction for patients.
Epidural and spinal anesthesia
These techniques are administered by anesthesiologists. Both involve injecting an anesthetic through a needle near the spine in the lumbar region of the back. Usually they provide excellent pain relief without being very upset its inception.
Rarely it is contraindicated by severe spinal problems, infection in
the area concerned, severe maternal bleeding or suspected neurological
disease.
The epidural is durable and can be administered even early in labor. It will last all the time until birth. A spinal anesthesia is used for a short period of time, ie for a birth with forceps or a Caesarean.
Serious side effects are rare epidural or spinal, and both midwives and
anesthesiologists are specially trained to monitor their appearance.
Epidurals do not slow delivery but sometimes to make women more
effectively push hard in the second phase (to not feel the pain of
contraction), increasing the need for forceps or vacuum extraction to
baby.
Birth and pain relief medication (analgesia)
There are different types of pain relief that can be offered to women during childbirth. Some women decide in advance who do not want to use any analgesic method, but during labor can change their minds. Analgesia prescribes a doctor or midwife after a conversation with the woman. The most commonly used drugs are:
Tears in the vagina or perineum
To prevent serious tears that may incapacitate eventually produce usual
doing a cut or episiotomy near the line between anus and vagina. After birth the child proceeds practiced suturing the cut. Many women are worried thinking for cuts and lacerations heal after birth, but fortunately most do.
The majority of women are given local anesthesia in the perineum and vagina or some other anesthetic before receiving points. Absorption sutures (removes the body) so that no points have to be removed days after used.
What if the muscle of the anus (anal sphincter) tears?
Very few women suffer a torn anal sphincter during delivery. Usually this happens only if the baby in very large, and sometimes can desgarrase when the doctor uses forceps or suction cup.
The doctor can suture the sphincter and women usually done while under
the influence of a general spinal anesthesia, epidural or because it can
be very painful.
If women experience some form of incontinence after the birth, you should consult your doctor.
Why do some births end in an emergency cesarean?
Some births require an emergency cesarean is practiced if unexpected
complications arise and the baby shows signs of oxygen deprivation. If delivery takes place very slowly cesarean it will usually be necessary.
Every birth is different and every experience in those moments will be too.
However, most births are normal and natural and most women willingly
accept to go through it if its purpose is to have more children.
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