Childbirth and vaginal delivery
Childbirth (also called labor, birth, or parturition) is the culmination of pregnancy, the emergence of a child from its mother's uterus. It can be considered the opposite of death, as it is the beginning of a person's life. Age is defined relative to this event in most cultures.
The medical science of childbirth is obstetrics and a doctor who specializes in attending births is an obstetrician. A person who is not a doctor but who is specially trained to assist at births is a midwife.
First stage of labor
A typical human childbirth will begin the onset of the first stage of labor: contractions of the uterus, at first every 10-30 minutes and lasting about 40 seconds each. Occasionally the labor will begin with a rupture of the amniotic sac, the paired amnion and chorion ("breaking of the water"). The contractions will accelerate until they happen every two minutes. Each contraction dilates the cervix until it reaches 10 centimeters (4") in width.
The duration of labor 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.
Second stage of labor
In the second stage of labor, the baby is expelled from the womb
through the birth canal by both the uterine contractions and by
powerful abdominal contractions ("bearing down"). The baby is most
commonly born head-first. With difficulty, babies can be delivered in
the "breech" position where the baby's buttocks or feet are delivered
first and the legs are folded onto the baby's body. Babies in a
"footling breech" position should not be delivered via vaginal birth.
Immediately after birth, the child undergoes extensive physiological modifications as it acclimatizes to independent breathing. Several cardiac structures start regressing immediately after birth, such as the ductus arteriosus and the foramen ovale.
The medical condition of the child is assessed with the Apgar score, based on five parameters. A "good start" refers to higher scores, while a child doing poorly with have low scores that do not improve rapidly over time.
Third stage (placental)
The last stage of labor occurs about a quarter to a half-hour after the baby is born; in this stage, the placenta or afterbirth is expelled.
After the birth
Usually soon after birth the parents assign the infant its given names. Many cultures feature initiation rites for newborns, such as circumcision or baptism, amongst others.
When the amniotic sac has not ruptured during labor 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 easily wiped away by the doctor or person assisting with the childbirth. In medieval times, 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.
Due to the relatively-large size of the human skull and the shape of the human pelvis forced by the erect posture, childbirth is more difficult and painful for human mothers than other mammals. Many methods are available to reduce the pain of labor, including psycological preparation, emotional support, epidural analgesia, spinal anesthesia, nitrous oxide and opioids, the Lamaze Technique. Each method has its own advantages and disadvantages.
Complications occasionally arise during childbirth; these generally require management by an obstetrician.
Non-progression of labor (longterm contractions without adequate cervical dilation) is generally treated with cervical prostaglandin gel or 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 and Caesarian section.
In the past, a great many women died during or shortly after childbirth (see puerperal fever) but modern medical techniques available in industrialized countries have greatly reduced this total.
In modern times, participation of the father during childbirth is now the norm. However, before the 1960's, in most cultures the father was forbidden to enter childbirth area, as were other men with the exception of the doctor.
The exception to this rule were Poleshuks from Polesie. In this culture the wife gave birth sitting on her husband's knees.
In many legal systems, the place of childbirth decides nationality of a child. The birth certificate is the basic document, which proves that the individual is a human being.
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