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Labour and childbirth (Parturition)

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Childbirth
Labour basically is the series of processes or sequence of events that lead to the delivery or expulsion of the fetus, fetal tissues and placenta through the birth canal to the outside world. Childbirth which is also known as delivery, parturition or sometimes as labour is the process of delivering the baby (fetus) and the placenta from the uterus through the vagina to the outside world. Therefore, we can basically infer that, the series or sequence of events which leads to childbirth or child delivery is called labour. 

This generally includes uterine contractions which is initiated by the hormone oxytocin secreted by the posterior pituitary gland and prostaglandins produced by the uterus. Childbirth definitively marks the end of pregnancy. The hallmark of this is when one or more babies leaves the uterus through the vagina, that is, by vaginal birth or through Caesarean section (C-section).

Gestation period

This is the time interval or the period from conception through prenatal development to delivery. It is generally referred to as the time or period of pregnancy. Generally, in humans the average gestation period is about 266 days, or about 280 days counting from the beginning of the last menstrual period to delivery or childbirth. It is important to understand that most fetus are born within 10 To 15 days before or after the calculated delivery date.

Types of birth

Childbirth or delivery can proceed and/ or occur through either of two ways, which are:
  • Vaginal birth, and
  • Caesarean section (C-section).


Vaginal birth

This type of birth is the most common method of delivery globally. This method of delivery basically entails the expulsion of the fetus, fetal tissues and placenta from the uterus to the outside world through the cervix and vagina. Vaginal birth involves and/ or go through three major stages, which are:
  1. The softening, thininig, shortening and dilation of the cervix. This stage is marked by strong and regular contractions and is referred to as the dilation stage.
  2. The droping down and delivery of the baby and is characterized by the actual birth or expulsion of the baby. This stage is sometimes referred to as the "pushing stage".
  3. The delivery or expulsion of the placenta (afterbirth), the placental stage.

C-section

The C-section or Caesarean section is a surgical delivery or an abdominal delivery. This method involves the delivery of the baby by an incision made through the abdomen, above the pelvis into the uterus. This procedure is performed by a medical doctor in a theater or controlled environment and it is a major surgical operation.

Caesarean section may be performed either by desire that is  willingly, because of the mothers fear or inability to go through the trauma of vaginal delivery which could be as a result of tokophobia (the abnormal, persistent and intensive fear of childbirth). Fear of the pains that may arise from uterine contractions prior to childbirth or during labour. Or on the other hand, it may be planned consciously if the baby (fetus) is breech or lying in a transverse position. The onset of certain preexisting medical conditions in the mother can determine the choice for a Caesarean section. Some of such conditions are:
  • Diabetes,
  • Active herpes infection,
  • Hypertension,
  • Coronary heart disease, etc.
Caesarean section may be performed also if the placenta is incorrectly sited/ positioned as in the placental condition called placenta praevia. Some other conditions that could lead to the performance of C-section are:
  • The baby is too large to travel or pass through the birth canal,
  • There is a heavy infection of the uterus,
  • Rhesus incompatibility,
  • Drug addiction,
  • Sexually transmitted infections (STIs) in the mother, etc.
Outside these medical conditions listed above, an emergency Caesarean section may be performed if there are:
  • Weak uterine contractions,
  • Fetal distress,
  • Prolonged Labour,
  • Eclampsia or pre-eclampsia,
  • Abruptio placentae, or a combination of these factors.

Stages of labour

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Labour and childbirth
The initiation of labour in humans is more complex than it has been explained in various medical literatures. Some mechanisms and processes of Labour are actually not fully understood. However, researcher's believe that labour is timed, during the last part of the third trimester of pregnancy, there is a rise in estradiol secretion from the placenta. This could probably be as a result of the rise in the secretion of androgen (primary dehydroepiandrosterone or DHEA) from the fetal adrenal cortex.

It is believed that the secretion and rise in the levels of DHEA is the timer or trigger of labour. There are evidence that, the injection of DHEA into monkeys can elicit or provoke labour. This further buttress the fact that secretion of DHEA is the key event in timing Labour and birth in mammals and other primates.

However it is timed, the DHEA secreted by the fetal adrenal cortex is converted to estrogens by the placenta and the rising levels of estrogens secretion in late pregnancy promotes the myometrium of the uterine wall to contract. Estrogen does this by,
  • Increasing the amount of oxytocin produced by the mother's hypothalamus and stored in the posterior pituitary gland,
  • Increasing the production of oxytocin receptors in the myometrium, and
  • Stimulating the production of prostaglandins in the uterus.
The stages of labour which have been highlighted above is divided into three, which are:

Stage One

This stage of Labour is called the dilation stage. At this stage, the cervix softens, shortens and dilates or opens to a diameter of about 10cm. This is by far the longest stage of Labour. The contractions at this stage are regular and the amniotic sac ruptures and release the amniotic fluid (water broke). At the beginning of Labour, the cervix starts to softens, thin out and shortens to enable it to dilate enough for the passage of the baby, by the end of this stage, the cervix is about 10cm (3.9in) dilated and this point is called the transition phase. This stage of Labour generally last between 8 to 24 hours.

Stage two

This stage of labour is called the expulsion stage or the pushing stage. It is the moment of parturition, the stage of actual childbirth. This stage generally starts when the cervix is fully dilated and ends when the baby is delivered. This stage consists of forceful uterine contractions and abdominal compressions to expel the fetus from the uterus through the vagina. This stage may last for about 30 minutes to one hour in first pregnancy but lesser in subsequent once.

Stage three

This stage is called the placental stage. It generally begins about 10 to 15 minutes after delivery or parturition, that is after the baby is born. At this stage, the uterus or womb contracts and the placenta is severed from the uterine wall and is expelled as the afterbirth.

It is important to know that every pregnancy is different and unique and there is a wide variations in the sequences of labour of different pregnancies.

Reproductive health

The major aim of all pregnancies is to have a safe delivery. It is a thing of joy to meet the baby you have been carrying inside of you for the past nine months safe and healthy for the first time. Having a safe delivery is the hallmark of reproductive health. So as a pregnant and/ or expectant mother, visit your doctor for you prenatal care. It is important you get checked up at stipulated periods to eliminate any form of emergencies. Prepared your mind and your body will respond to it when the due date comes.

Further readings


2 comments:

  1. For any women Giving birth to a child is one of the happiest moments in her life. Each women wants to become mother. But out of 7 one lady is unluckily can't give birth to a child due to PCOS infertility issues. But now PCOS treatment is possible. The Cost of PCOS treatment in India is affordable and that is revolutionary change in medical sector.

    ReplyDelete
    Replies
    1. I completely agree with you Sumita Sofat, Polycystic ovary syndrome (PCOS) have deprived lots of women the opportunity to become mothers. Thanks for your update...!

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