Newborn with suctioning and umbilical cord

Childbirth (also called labour, birth, or parturition) is the culmination of pregnancy, the emergence of a child from its mother's uterus. It is considered by many to be the beginning of a person's life, and hence the opposite of death. Age is defined relative to this event in most cultures. A woman is considered to be in labour when she develops regular painful uterine contractions, which are accompanied by changes of her cervix, these primarily being effacement and dilation. While childbirth is widely experienced as painful, some women do report painless labours. Download high resolution version (1200x1025, 934 KB)Newborn with suctioning and umbilical cord Taken 1:08 a. ... Download high resolution version (1200x1025, 934 KB)Newborn with suctioning and umbilical cord Taken 1:08 a. ... Newborn at 45 seconds. ... Birth is the process in mammals by which a fetus is expelled from the body of its mother. ... A pregnant woman Pregnancy is the process by which a mammalian female carries a live offspring from conception until it develops to the point where the offspring is capable of living outside the womb. ... A male Caucasian toddler child A child (plural: children) is a young human. ... Mother with her child (Sculpture) A mother is typically the biological or social female parent of a child or offspring while the male parent is the father. ... Female internal reproductive anatomy The uterus or womb is the major female reproductive organ of most mammals, including humans. ... Life is a multi-faceted concept. ... Death is either the cessation of life in a living organism or the state of the organism after that event. ...

The normal birth

Introduction

Midwives are experts in normal birth and perceive childbirth as a normal life event for most women, one which is best handled by as few interventions or interference as possible. Midwives are trained to assist at births either through direct-entry or nurse-midwifery programs. Lay midwives are trained through being apprenticed to an experienced midwife. Midwifery is a blanket term used to describe a number of different types of health practitioners, other than doctors, who provide prenatal care to expecting mothers, attend the birth of the infant and provide postnatal care to the mother and infant. ...

The medical science of childbirth is termed obstetrics and a doctor who specializes in managing birth is termed an obstetrician. Obstetricians are surgeons, who are trained to recognize childbirth as potentially dangerous event that sometimes requires intervention to ensure a safe outcome for the mother and the baby. Obstetrics (from the Latin obstare, to stand by) is the surgical specialty dealing with the care of a woman and her offspring during pregnancy, childbirth and the puerperium (the period shortly after birth). ... This article needs cleanup. ... Surgery Surgery (from the Greek cheirourgia - lit. ...

First stage: contractions

A typical human childbirth will begin with the onset of contractions of the uterus. The frequency and duration of these contractions varies with the individual. The onset of labour may be sudden or gradual. A gradual onset with slow cervical change towards 3 cm (just over 1 inch) dilation is referred to as the "latent phase". A woman is said to be in "active labour" when contractions have become regular in frequency (3-4 in 10 minutes) and about 60 seconds in duration. The now powerful contractions are accompanied by cervical effacement and dilation greater than 3cm. The labour may begin with a rupture of the amniotic sac, the paired amnion and chorion ("breaking of the water"). The contractions will accelerate in frequency and strengthen. In the "transition phase" from 8cm-10cm (3 or 4 inches) of dilation, the contractions often come every two minutes are typically lasting 70 - 90 seconds. Transition is often regarded as the most challenging and intense for the mother. Some mothers say things like "I give up, I want to stop now. Forget this!" It is also the shortest phase. Binomial name Homo sapiens Linnaeus, 1758 Subspecies Homo sapiens idaltu (extinct) Homo sapiens sapiens Human beings define themselves in biological, social, and spiritual terms. ... The amniotic sac is a tough but thin transparent pair of membranes, which hold a developing embryo (and later fetus) until shortly before birth. ... The amniotic sac is a tough but thin transparent pair of membranes which holds a developing embryo (and later fetus) until shortly before birth. ... Chorion can refer to the following things: Chorion is the outer membrane of the amniotic sac. ...

During a contraction the long muscles of the uterus contract, starting at the top of the uterus and working their way down to the bottom. At the end of the contraction, the muscles relax to a state shorter than at the beginning of the contraction. This draws the cervix up over the baby's head. Each contraction dilates the cervix until it becomes completely dilated, often referred to as 10+ centimetres (4") in diameter. Female internal reproductive anatomy The uterus or womb is the major female reproductive organ of most mammals, including humans. ... Categories: Anatomy stubs | Reproductive system | Gynecology ... Cervical dilation is the dilation (widening) of the cervix during childbirth. ... (Redirected from 1 E 1 m) To help compare different orders of magnitude this page lists lengths between 10 m and 100 m. ...

During this stage, the expectant mother typically goes through several emotional phases. At first, the mother may be excited and nervous. Then, as the contractions become stronger, demanding more energy from the mother, mothers generally become more serious and focused. However, as the cervix finishes its dilation, some mothers experience confusion or bouts of self-doubt or giving up.

The duration of labour varies wildly, but averages some 13 hours for women giving birth to their first child ("primiparae") and 8 hours for women who have already given birth.

If there is a significant medical risk to continuing the pregnancy, induction may be necessary. As this carries some risk, it is only done if the child or the mother are in danger from prolonged pregnancy. 42 weeks gestation without spontaneous labour is often said to be an indication for induction although evidence does not show improved outcomes when labour is induced for post-term pregnancies. Inducing labour increases the risk of cesarean section and uterine rupture in mothers that have had a previous cesarean section. Induction is a way of artificially bringing on labour in a woman. ...

Second stage

In the second stage of labour, the baby is expelled from the womb through the vagina by both the uterine contractions and by the additional maternal efforts of ("bearing down"). The imminence of this stage can be evaluated by the Malinas score. Female internal reproductive anatomy The uterus or womb is the major female reproductive organ of most mammals, including humans. ... Human female internal reproductive anatomy The vagina (from the Latin for sheath or scabbard ) is the tubular tract leading from the uterus to the exterior of the body in female mammals, or to the cloaca in female birds and some reptiles. ... The Malinas score is an evaluation that allows to determine whether a pregnant woman is about to give birth. ...

The baby is most commonly born head-first. In some cases the baby is breech meaning either the feet or buttocks are descending first. Babies in the "breech" position can be delivered vaginally. Though in some areas finding an experienced willing attendant can be difficult. Breech birth is a birth in which the fetuss bottom is facing toward the cervix and the vaginal opening, rather than its head. ... Breech birth is a birth in which the fetuss bottom is facing toward the cervix and the vaginal opening, rather than its head. ...

There are several types of breech presentations the most common is where the baby's buttocks are delivered first and the legs are folded onto the baby's body with the knees bent and feet near the buttocks (full or breech). Others include Frank breech, much like full breech but the babies legs are extended toward his ears, and footling or incomplete breech, in which one or both legs are extended and the foot or feet are the presenting part. Another rare presentation is a transverse lie. This is where the baby is sideways in the womb and a hand or elbow has entered the birth canal first. A vaginal birth should not be attempted, although in rare cases the arm can be pushed back up and the baby can be physically turned into the proper position.

The length of the second stage varies and is affected by whether a woman has given birth before, the position she is in and mobility. The length of the second stage should be guided by the condition of the foetus and health of the mother. Problems may be encountered at this stage due to reasons such as maternal exhaustion, the front of the baby's head is facing forwards instead of backwards (posterior baby), or extremely rarely, because the baby's head does not fit properly into the mother's pelvis (cephalo-pelvic disproportion), true CPD is typically seen in women with rickets and bone deforming illnesses or injuries, as well as arbitrary time limits placed on second stage by caregivers or medical facilities.

Immediately after birth, the child undergoes extensive physiological modifications as it acclimatizes to independent breathing. Several cardiovascular structures start regressing soon after birth, such as the ductus arteriosus and the foramen ovale. Physiology (in Greek physis = nature and logos = word) is the study of the mechanical, physical, and biochemical functions of living organisms. ... The circulatory system or cardiovascular system is the organ system which circulates blood around the body of most animals. ... In the developing fetus, the ductus arteriosus (DA) is a shunt connecting the pulmonary artery to the aortic arch that allows much of the blood from the right ventricle to bypass the fetus fluid-filled lungs. ... Two structures in the human body are called foramen ovale, meaning circular hole. ...

The medical condition of the child is assessed with the Apgar score, based on five parameters. The Apgar score was devised in 1952 by Virginia Apgar as a simple and repeatable method to quickly and summarily assess the health of newborn children immediately after childbirth. ...

Third stage: placenta

Childbirth in a hospital. Photo by Ana Nascimento/ABr.

In this stage, the uterus expels the placenta (afterbirth). Nursing the baby will help to cause this. The mother normally loses less than 500mL of blood. Blood loss will be greater if the umbilical cord is used to tug on the placenta. It is essential that the whole placenta is expelled, so someone should examine the placenta to ensure that it is intact. Remaining parts can cause postnatal bleeding or infection. From wiki pt. ... From wiki pt. ... Human placenta shown a few minutes after birth. ...

After the birth

Immediate breastfeeding of the first milk termed colostrum is recommended to reduce postpartum bleeding/hemorrhage in the mother, and to pass immunities and other benefits to the baby. Colostrum (occasionally known as beestings) is a form of milk produced by the mammary glands in late pregnancy and the first hours after giving birth. ...

Usually soon after birth the parents assign the infant its given names. They may have two names in mind, one for if it is a boy, and one for if it is a girl. A name is a label for a thing, person, place, product (as in a brand name), and even an idea or concept, normally used to distinguish one from another. ...

Often people visit and bring a gift for the baby. This page is about gifts in the common English-language sense. ...

Many cultures feature initiation rites for newborns, such as naming ceremonies, baptism, and others. Initiation rites are formalized, ceremonial rites of passage as an individual moves from stage to stage within a social career or formally acquires such status. ... Baptism is a water purification ritual practiced in certain religions such as Christianity, Mandaeanism, Sikhism, and some historic sects of Judaism. ...

Mothers often are allowed a babymoon period where they are relieved of their normal duties to recover from childbirth and establish breastfeeding with their babies. Length of this period varies. In China this is 30 days and is referred to as "doing the month".

Variations

When the amniotic sac has not ruptured during labour or pushing, the infant can be born with the membranes intact. This is referred to as "being born in the caul." The caul is harmless and its membranes are easily broken and wiped away by the doctor or midwife assisting with the childbirth. In medieval times, and in some cultures still today, a caul was seen as a sign of good fortune for the baby, in some cultures was seen as protection against drowning, and the caul was often impressed onto paper and stored away as an heirloom for the child. With the advent of modern interventive obstetrics, premature artificial rupture of the membranes has become common and it is rare for infants to be born in the caul in Western births. A caul is a thin, filmy membrane, the remnants of the amniotic sac, that covers or partly covers the newborn mammal immediately after birth. ... The Middle Ages formed the middle period in a traditional schematic division of European history into three ages: the classical civilization of Antiquity, the Middle Ages, and modern times, beginning with the Renaissance. ... An heirloom in general is any old item or antique passed down from one generation to another. ...

Pain control

Non-medical pain control

For some women the perceived pain of labour is a large concern. There are many ways to try to reduce the pain of labour, including psychological preparation, education, hypnosis, use of water in a tub or shower, emotional support and comfort measures by a trained professional Doula. These have no risks to the mother or baby, and have been found by some to be effective. Many women find the reliance on analgesic medication unnecessarily unnatural (or worry that it may harm the child); many try using non-pharmacological measures to control the pain. A doula is a non-medical assistant in prenatal care, childbirth and during the postpartum period. ...

Medical pain control

In Europe, inhaled nitrous oxide gas is a commonly used measure of pain control; in the UK, midwives may use this without doctors' approval. Pethidine (with or without promethazine) may be used early in labour, as well as other opiates; if given too late, they may cause respiratory depression in the infant. World map showing location of Europe A satellite composite image of Europe Europe is geologically and geographically a peninsula, forming the westernmost part of Eurasia. ... Nitrous oxide, also known as dinitrogen oxide or dinitrogen monoxide, is a chemical compound with chemical formula N2O. Under room conditions it is a colourless non-flammable gas, with a pleasant slightly sweet odor. ... Pethidine (INN) or meperidine (USAN) (also referred to as: isonipecaine; lidol; operidine; pethanol; piridosal; Algil®; Alodan®; Centralgin®; Demerol®; Dispadol®; Dolantin®; Dolestine®; Dolosal®; Dolsin®; Mefedina®) is a fast-acting opioid analgesic drug. ... Promethazine is an antihistamine and anti-nausea medication available by prescription in the United States, and over-the-counter in the United Kingdom. ... The term opiate refers to the alkaloids found in opium, an extract from the unripe seeds of the opium poppy (). It has also traditionally referred to natural and semi-synthetic derivatives of morphine. ...

Popular medical pain control in hospitals include regional anesthetics (epidural or spinal anaesthesia); these are often used for pain control, and are a necessity for Cesarean surgery (unless a general anesthetic is used). The epidural space is a part of the human spine which is very close to the spinal cord, lying just outside the dura mater. ... Spinal anaesthesia is a form of local, or more specifically regional, anaesthesia involving injection of a local anaesthetic into the cerebrospinal fluid (CSF), generally through a long fine needle. ... A general anaesthetic drug is an anaesthetic (or anesthetic AE) drug that brings about a reversible loss of consciousness. ...

The various measures for pain control have varying degrees of success and side effects to mother and baby. Timing of the administration is often a concern. For example an epidural given too early in labour can stop or slow labour increasing the risk of cesarean section, given too late in labour can hinder maternal efforts to push out the baby. These risks should be balanced against the fact that childbirth can be extremely painful, and anesthestics are an effective (and used properly, generally safe) way of treating that pain.

Complications of birth

Rarely, serious problems occur during childbirth. These problems are generally called "complications".

Infant deaths (neonatal deaths from birth to 28 days, or perinatal deaths if including fetal deaths at 28 weeks gestation and later) in modernized countries are generally under 1%. For example, a 1983-1989 study by the Texas Department of Health revealed that the death rate was 0.57% for doctor-attended births, and 0.19% for births attended by non-nurse midwives. Maternal deaths are generally under 1% even in the most war-torn and malnourished parts of the world, and generally around 100 per million in the more developed parts of the world. Conversely, there are some studies that demonstrate a higher perinatal mortality rate with assisted home births.^{[1] (http://en.wikipedia.org/wiki/Childbirth#endnote_WAustraliafoot)} Despite these, It is generally accepted that properly assisted home birth carries no greater risks than hospital birth for low-risk pregnancies.

Of course, not all complications lead to death. Some are merely painful, while others are disfiguring and disabling. A study done in the USA by Dr. Lewis Mehl matched 2,092 women according to risk factor, half giving birth at home, then analysed the outcomes. He found that there were 30 birth injuries (3.0%) for the hospital births, and none for the home births. Births at home had 173 lacerations (16.5%) and 103 episiotomies (9.8%), while those in the hospital had 223 lacerations (21.3%) and 914 episiotomies (87.4%).

Possible complications include:

• Non-progression of labour (longterm contractions without adequate cervical dilation) is generally treated with intravenous synthetic oxytocin preparations. If this is ineffective, Caesarean section may be necessary.
• Fetal distress is the development of signs of distress by the child. These may include rising or decreasing heartbeat (monitored on cardiotocography/CTG), shedding of meconium in the amniotic fluid, and other signs.
• Non-progression of expulsion (the head or presenting parts are not delivered despite adequate contractions): this can require interventions such as vacuum extraction, forceps extraction or Caesarean section.
• In the past, a large proportion of women died from infection puerperal fever, but since the introduction of basic hygiene during parturition by Ignaz Semmelweis, this number has fallen precipitously.
• Heavy bleeding during or after childbirth is a potentially lethal complication, particularly in places without access to emergency care. Heavy blood loss leads to hypovolemic shock, insufficient perfusion of vital organs and death if not rapidly treated by stemming the blood loss (medically with ergometrine and pitocin or surgically) and blood transfusion. Hypopituitarism after obstetric hypovolemic shock is termed Sheehan's syndrome.

An intravenous drip in a hospital Intravenous therapy or IV therapy is the administration of liquid substances directly into a vein. ... Oxytocin is a nine amino acid peptide hormone synthesized in magnocellular neurosecretory cells in the hypothalamus and released by the posterior lobe of the pituitary gland. ... A caesarean section (cesarean section AE), is a form of childbirth in which a surgical incision is made through a mothers abdomen (laparotomy) and uterus (hysterotomy) to deliver one or more fetuses. ... In medicine (obstetrics), fetal distress is the presence of signs in a pregnant woman - before or during childbirth - that the fetus is not well or is becoming excessively fatigued. ... In medicine, a persons pulse is the throbbing of their arteries as an effect of the heart beat. ... In medicine (obstetrics) cardiotocography (CTG) is a technical means of recording (-graphy) the fetal heartbeat (cardio-) and the uterine contractions (-toco-) during childbirth. ... Meconium aspiration syndrome (MAS) occurs when infants take meconium into their lungs during delivery. ... Puerperal fever is caused by infection of the genital tract shortly after giving birth, although any fever within two weeks of childbirth is dangerous since it can cause infertility or septicaemia. ... Ignaz Semmelweis on an old Austrian postage stamp Ignaz Philipp Semmelweis (originally Ignác Fülöp Semmelweis) (July 1, 1818 - August 13, 1865) was the Hungarian physician who demonstrated that puerperal fever (also known as childbed fever) was contagious and that its incidence could be drastically reduced by enforcing... In physiology and medicine, hypovolemia is a state of decreased blood volume. ... Pitocin is the synthetic version of the hormone oxytocin, which is produced by pregnant women to cause the uterine contractions that precipitate childbirth. ... Blood transfusion is the taking of blood or blood-based products from one individual and inserting them into the circulatory system of another. ... Hypopituitarism is a medical term describing deficiency (hypo) of one or more hormones of the pituitary gland. ... Sheehan syndrome, also known as Simmonds disease, postpartum hypopituitarism or postpartum pituitary necrosis is hypopituitarism (decreased functioning of the pituitary gland), caused by necrosis due to blood loss and hypovolemic shock during and after childbirth. ...

Social aspects

In modern times, participation of the father during childbirth is now the norm. However, before the 1960s, in most cultures the father was forbidden to enter childbirth area, as were other men with the exception of the doctor. This is thought to be the origin of the midwife/mother/doctor requesting that the husband go boil water; the water is rarely used and actually is just a way of having the father leave the area but not feel as if he is doing so. Events and trends The 1960s was a turbulent decade of change around the world. ... A father is the male parent of a child. ...

The recent social development of increased education, requiring signed consent, permitting fathers into the birth area, and leaving the mother with less impairment from drugs and physical restraint, has led to a considerable increase in parental involvement in all aspects of the birth process.

Many families view the placenta as a special part of birth, since it has been the child's life support for so many months. Many parents like to see and touch this mysterious organ. In some cultures, there is a custom to dig a hole and plant a tree along with the placenta on the child's first birthday. The placenta may be eaten by the newborn's family, ceremonially or otherwise. A birthday is the date on which a person was born. ... Rat eating its offsprings placenta after birth Placentophagy is the term used to describe the act of mammals eating the placenta of their young after childbirth. ...

The oldest American woman known to give birth was Arceli Keh, aged 63. In November 2004 Aleta St. James, a 56 year old single mother gave birth to twins conceived through in vitro fertilization. In 2005, a 67 year old Romanian woman gave birth by cesarean to one surviving twin. November is the eleventh month of the year in the Gregorian Calendar and one of four Gregorian months with the length of 30 days. ... 2004 is a leap year starting on Thursday of the Gregorian calendar. ... 2005 is a common year starting on Saturday of the Gregorian calendar. ...

Legal aspects

In some legal jurisdictions, the place of childbirth decides the nationality of a child (under the doctrine of Jus soli) Nationality is, in English usage, a legal relationship existing between a person and a state. ... Jus soli (Latin for right of the territory) is a right by which nationality or citizenship can be recognised to any individual born in the territory of the related state. ...

Psychological aspects

Childbirth is a stressful event. Some women report symptoms compatible with post-traumatic stress disorder (PTSD) after birth. Postnatal depression and postpartum psychosis develop in some women. Post-traumatic stress disorder (PTSD) is a term for the psychological consequences of exposure to or confrontation with stressful experiences, which involve actual or threatened death, serious physical injury or a threat to physical integrity and which the person found highly traumatic. ... After giving birth, about 70-80% of women experience an episode of baby blues, feelings of depression, anger, anxiety and guilt lasting for several days. ... After giving birth, about 70-80% of women experience an episode of baby blues, feelings of depression, anger, anxiety and guilt lasting for several days. ...

References

1. ^  "Perinatal death associated with planned home birth in Australia: population based study (http://bmj.bmjjournals.com/cgi/content/short/317/7155/384)." BMJ. 317(7155):384-8. Accessed on May 28, 2005.

May 28 is the 148th day of the year in the Gregorian calendar (149th in leap years). ... 2005 is a common year starting on Saturday of the Gregorian calendar. ...

External links

• Emergency Child Birth (http://www.med-help.net/Emergency%2DChild%2DBirth.htm) - Provides video clip and colour photos (real) of child birth, and also emergency measures
• How you came into the world and grew inside a womb: from cells and embryo to baby (http://www.nvsh.nl/Website_Engels/Texts/Sexual_Information/Basics/FOL_1.htm) - Has colour photos (real) and explanations
• AP story on pregnancies in the elderly (http://www.cnn.com/2004/HEALTH/parenting/11/12/pregnant.59.ap/index.html)