The process, stages and course of childbirth

The process, stages and course of childbirth

The stages of the previous stages.
What are the stages and what happens in each of them? Here are the details

birth stages

  • As we have seen previously, childbirth includes three stages:
  1. The first stage: It is the role of labor or dilation and effacement of the cervix.
  2. The second role: The role of ejection: that is, the exit of the child outside the womb, which is childbirth with all its meanings.
  3. The third stage: It is the stage of salvation: in which the mother presents the placenta and the membranes attached to the fetus (salvation).

The first role, which is the role of work (or the role of expansion and regression):

The work is the gradual opening of the cervix under the influence of uterine contractions to facilitate the passage and delivery of the baby.
The cervix is ​​initially shortened and then erased, i.e. its thickness decreases, and it connects directly with the uterus with the beginning of dilation, meaning that the opening of the cervix expands in diameter and gradually opens to the vagina, and this is what concerns the obstetrician

When the opening of the cervix becomes ten centimeters wide, meaning that we can easily insert five fingers into it, then the widening is complete and appropriate for the passage of the fetus. Birth (cephalic birth) and it may be breech, so it is called birth (breech birth).

This role is somewhat long and stressful for the mother, especially if the uterine contractions are severe, and the obstetric team in this role can only wait and observe without affecting its progress, and the midwife may give some pain medications to the pregnant woman according to the severity and pain of the contractions.

As for the medical monitoring in this role, its goal is to ensure that the opening of the cervical orifice progresses gradually and in proportion to the time specified for it.

We also monitor the newborn and verify that he is in good health and does not experience any suffering during childbirth, by listening to his heartbeat, or permanently recording, during all stages of birth, his heartbeat by echograph, in advanced centers (by placing special receptors for the device on the abdomen of the pregnant woman).

The second stage, which is the role of extrusion (real birth):

When the dilation is complete and the part of the newborn opposite the cervix (often the head) descends sufficiently and appropriately through the orifice of the neck, the role of ejection begins, where the pregnant woman feels the urge to press down (similar to the urge to defecate).

Uterine contractions (labor) become close, successive, and more intense, but nevertheless more tolerable, because each contraction is accompanied, as we mentioned, by the desire to press downwards. The mother voluntarily contracts her stomach muscles to help the child’s progress and birth (the obstetrician may ask her to press down if she does not do this automatically )

In order for this effort to be fruitful and more effective, it is necessary to follow the advice of the midwife that directs the pregnant woman to the right moment to reduce the abdomen and pressure downward, and the right moment to relax, breathe and rest necessary to receive the next contraction. And at the last moment of birth, when the urge to pressure is very intense,

on the contrary, you must stop pressing when the midwife asks her to do so in order for the fetus to come out (born) slowly and without tearing the mother’s tissues: the vagina and the perineum (which is the space between the vulva and the anus).

If the midwife fears this rupture, despite taking all necessary precautions, he may resort to making an appropriate surgical incision to widen the child’s exit orifice and avoid ruptures during his exit, which may be very harmful to the mother, especially if it is on the side of the perineum leading to the woman’s lack of control over her defecation.

Finally, when the head is born, the rest of the fetus’s body comes out easily automatically, so we place the newborn on his mother’s stomach, then cut the umbilical cord, and start bathing the newborn, medically examined by the hospital doctor or a pediatrician according to the capabilities of the hospital.

The third role (which is the role of salvation):

After the exit and birth of the child, the woman relaxes for several minutes, then the uterine contractions return and

But with less intensity, and the role of deliverance begins, the placenta (delivery) gradually separates from the uterine wall and descends into the vagina.

where the obstetrician extracts it and carefully examines it and its membranes (which were previously the membranes surrounding the fetus) to make sure that no lobe of the placenta or a large part of its membranes remains within the uterus (which causes uterine bleeding in the future)

The birth of the placenta is generally accompanied by the exit of a large amount of blood.
Thus, the birth has completed its three stages, and we must monitor the mother and child for at least two hours to avoid the main mixing of this stage, which is bleeding.

Arrangements for antenatal

A well-prepared birth, psychologically, physically and mentally, has all the luck to be an easy and successful birth and to be a happy experience, especially for the first birth, in contrast to giving birth without preparation and preparation. In some countries, there are special centers to prepare the pregnant woman for childbirth, with special lessons that explain the course of childbirth and all its stages and the matters required of the pregnant woman to facilitate her birth.

These centers are supervised by doctors and midwives, and pictures and films are used to explain and explain the course of childbirth. Also, the other goal of the center is to relieve the pain of childbirth as much as possible and to familiarize the pregnant woman with the unknown that awaits her, especially with regard to the first birth. Every unknown person contributes to the formation of some tension and fear, which increases the pain and reduces the mother’s cooperation with the birth team.

These centers also allow the pregnant woman sufficient time for dialogue with the doctor and to ask questions freely to inquire about the issues and problems that occupy a large part of her thinking, and it is another way to get rid of fear that leads to pain by knowing the unknown, and there are also practical lessons accompanying the theoretical lessons and then The pregnant woman exercises daily at home on the things she learned in the practical lessons.

In our current book, we will provide sufficient explanations for everything related to the course of childbirth, and we will now give a summary of the theoretical lessons and how to practice their application at home.

The course of childbirth and its signs: you will read it in the second chapter, and we mention here what is useful for us in this chapter.
There are three roles for birth:

First round:

In it, the uterus begins its regular contractions (talk) and at a rate of contraction (shot) every ten minutes to reach a contraction every minute at the end of this cycle, and this cycle takes 12 hours in the birth of the firstborn child (the first birth) and 7 hours in the subsequent deliveries.

The pain in it varies from one pregnant woman to another, and the role of the pregnant woman here is very simple. To relieve the pain, it is preferable to relax, not stress, and practice slow and deep inhalations at the beginning of each contraction, with a slow and long exhalation as well.

second floor:

It is the role that takes place in the labor room and under the supervision of the obstetrician, which is childbirth in all its meanings. The contractions here become more painful and appear 2-3 minutes apart and last for 1-1.5 minutes. This role lasts for one hour in the first pregnancy and twenty minutes in other pregnancies where These contractions push the newborn toward the woman’s vagina, and the job of the pregnant woman in this role is to make a deep and rapid inhale at the beginning of each contraction and stop breathing (holding the breath) while shrinking her stomach and pressing toward the anus with the intensification of the contraction, which helps her push the child toward the vulva and speeds up the course of childbirth.

Third round:

It begins shortly after the birth of the child, which is the role of the placenta (delivery), where the contractions return, but to a lesser degree, leading to the placenta separating and its migration down towards the vulva, where the generator pulls it. This role lasts from several minutes to fifteen minutes.

A pregnant woman should train at home to:

Relaxation and relieve tension and fear of childbirth (useful in the first round).
Training in breathing control by practicing deep and long breathing (useful in the first round) and slow exhalation, then training in rapid breathing and rapid inhalation, then stopping breathing voluntarily for as long as possible (helpful in the second round).

Training to reduce her abdominal muscles with downward pressure, similar to defecation (and useful in the second round). This training must be repeated several times a day in order to facilitate her delivery and reduce her pain. It is true that the obstetrician and his team of midwives and nurses will help the pregnant woman during childbirth, but they cannot perform the birth process for her.

Pain relievers used during childbirth:

It is common in our country to use topical analgesics:

The obstetrician injects a local anesthetic into the vulva and vagina to relieve pain when the baby is born and released.
The method common in France and Europe, which is epidural anesthesia, may also be used:
It consists of injecting an anesthetic substance into the lower spine. It is a safe method that relieves pain during childbirth and is harmless to the fetus and does not have any harmful effects on the mother (it is common for women to fear paralysis due to this method of anesthesia).

The method used in America:

Inhalation of anesthetic gas during uterine contractions (talk) and this gas is inhaled only during contraction (shot) through a mask located near the birth seat, from which the pregnant woman inhales the anesthetic gas during contractions and lifts it between them, and it is supposed to train and qualify the pregnant woman for this before giving birth.

Choosing a place of birth

Home birth:

It was common in the past, and some say that it is safe and sound, while others have experienced the painful moments of obstetric complications, which ranged from the loss of the newborn child to the threat to the life of the pregnant woman in some cases, or her death in the worst cases. It is true that this is rare and that nine out of ten births go through peacefully, but the complications may be painful and cannot be compensated, as we may have to transfer the pregnant woman to the hospital immediately to save the child or save her as well. Surgical operations as necessary.

Hospital birth:

We always advise pregnant women to give birth in the hospital, as we saw previously, and childbirth is inevitable and necessary in the hospital for the following cases:
The case of the first birth (the firstborn).
Late deliveries (older pregnant women).
Birth cases that require strict medical care, which we mentioned earlier.

Tags: Pregnancy, stages of pregnancy, symptoms of pregnancy

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