Vaginal Weights after Childbirth

 

Childbirth (also called labour, birth, partus or parturition) is the culmination of a human pregnancy or gestation period with the delivery of one or more newborn infants from a woman's uterus. The process of normal human childbirth is categorized in three stages of labour: the shortening and dilation of the cervix, descent and delivery of the infant, and delivery of the placenta. In some cases, childbirth is achieved through caesarean section, the removal of the neonate through the abdomen, rather than through vaginal delivery.

 

The stages of normal birth.

Latent
The latent phase of labour may last many days and the contractions are an intensification of the Braxton-Hicks contractions that start around 26 weeks gestation. Cervical effacement occurs during the closing weeks of pregnancy and is usually complete or near complete, by the end of latent phase. Cervical effacement is the thinning and stretching of the cervix. The degree of cervical effacement may be felt during a vaginal examination. A 'long' cervix implies that not much has been taken into the lower segment, and vice versa for a 'short' cervix. Latent phase ends with the onset of active first stage; when the cervix is about 3 cm dilated.

First stage:
The first stage of labor starts classically when the effaced (thinned) cervix is 3 cm dilated. There is variation in this point as some women may have active contractions prior to reaching this point, or they may reach this point without regular contractions. The onset of actual labor is defined when the cervix begins to progressively dilate. Rupture of the membranes, or a blood stained 'show' may or may not occur at around this stage.

Uterine muscles form opposing spirals from the top of the upper segment of the uterus to its junction with the lower segment. During effacement, the cervix becomes incorporated into the lower segment of the uterus. During a contraction, these muscles contract causing shortening of the upper segment and drawing upwards of the lower segment, in a gradual expulsive motion. This draws the cervix up over the baby's head. Full dilatation is reached when the cervix is the size of the baby's head; at around 10 cm dilation for a term baby.

The duration of labour varies widely, but active phase averages some 8 hours for women giving birth to their first child and 4 hours for women who have already given birth.

Second stage:
This stage begins when the cervix is fully dilated, and ends when the baby is finally delivered. At the beginning of the normal second stage, the head is fully engaged in the pelvis; the widest diameter of the head has successfully passed through the pelvic brim. Ideally it has successfully also passed below the interspinous diameter. This is the narrowest part of the pelvis. If these have been accomplished, all that will remain is for the fetal head to pass below the pubic arch and out through the introitus. This is assisted by the additional maternal efforts of "bearing down". The fetal head is seen to 'crown' as the labia part. At this point the woman may feel a burning or stinging sensation.

Delivery of the fetal head signals the successful completion of the fourth mechanism of labour (delivery by extension), and is followed by the fifth and sixth mechanisms (restitution and external rotation).

A newborn baby with umbilical cord ready to be clampedThe second stage of labour will vary to some extent, depending on how successfully the preceding tasks have been accomplished.

Third stage:
In this stage, the uterus expels the placenta (afterbirth). The placenta is usually delivered within 15-30 minutes of the baby being born. Maternal blood loss is limited by contraction of the uterus following delivery of the placenta. Normal blood loss is less than 600 mL.

Breastfeeding during and after the third stage, the placenta is visible in the bowl to the right.The third stage can be managed either expectantly or actively. Expectant management (also known as physiological management) allows the placenta to be expelled without medical assistance. Breastfeeding soon after birth and massaging of the top of the uterus (the fundus) causes uterine contractions that encourage delivery of the placenta. Active management utilizes oxytocic agents and controlled cord traction. The oxytocic agents augment uterine muscular contraction and the cord traction assists with rapid delivery of the placenta.

Medical professionals typically recommend breastfeeding of the first milk, colostrum, to assist with uterine contraction to reduce postpartum bleeding/hemorrhage in the mother, and to pass antibodies, immunities and other benefits to the baby [citation needed]. Many cultures feature initiation rites for newborns, such as naming ceremonies, baptism, and others.

Mothers are often allowed a period where they are relieved of their normal duties to recover from childbirth. The length of this period varies. In China it is 30 days and is referred to as "doing the month" or "sitting month". In some other countries, taking time off from work to care for a newborn is called "maternity leave" or "parental leave" and can vary from a few days to several months.