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Finally, we come to the very last stage of pregnancy; parturition. Also called; birth, delivery, labour, ….
The purpose of parturition is simple; the foetus leaves the uterus and moves to the outside world where this individual will finally stand on its own!
This process (called parturition, labour, delivery or childbirth) is usually initiated at the end of the 9-month pregnancy by increasing the number and strength of uterus contractions.
The contractions gradually become stronger, occur more frequently and become more painful (abdominal cramping) for the mother.
As labour advances, the cervix starts to open, allowing the foetus to start descending into the cervical canal. This will also lead to a break in the amniotic sac which will lead to the “water breaks”.
Usually, the foetus will go ‘down’ the cervix with its head first thereby gradually expanding the cervix during its passage.
If that is the case then the baby should be ‘repositioned’ by manipulating through the abdominal wall, but if that is not possible, then caesarean section should be considered.
As you can guess, labour is not simple. It is actually quite a difficult process, especially for the woman in labour.
Fortunately, in most cases, after delivery, both mother and child can start breathing and relax after this tremendous event.
Unfortunately, in some cases, delivery does not go well and complications arise which require additional resources and interventions.
The most common resource is the use of forceps to help extricate the child from the mother.
This is done when either the mother does not have enough strength to ‘push’ or when the condition of the foetus is deteriorating requiring a rapid delivery.
But for a delivery by forceps, it is necessary that the foetal head already protrudes somewhat from the vagina or else the forceps cannot be applied.
If forceps cannot be applied, sometimes a vacuum ‘extractor’ can be used. That is a cuplike device that can be attached to the foetal head (by ‘vacuum’) and then the foetus can be ‘pulled’ out of the cervix.
Another procedure is caesarean section (also called C-section) whereby the abdomen, under anaesthesia, and the uterus of the mother are opened and the child taken ‘out’ through that opening.
There are numerous reasons why caesarean section may be necessary such as a too small cervix/vagina, foetal distress, or maternal medical problems.
However, caesarean delivery has become so easy to perform that in some countries women resort to caesarean section instead of vaginal delivery to avoid to have to labour; in other words, ‘too posh to push!’
Another procedure is episiotomy. Here, a cut is made in the perineum to expand the size of the cervix thereby expanding the area through which the baby can pass through.
Once the child has born, another birth occurs; the placenta!
This usually occurs, automatically, about 15-30 minutes after the childbirth.
At the same time, the umbilical cord must be cut. Fortunately, for mother and child, the cutting is not painful, as there are no nerves in the cord.
The cutting of the cord used to be done immediately after birth but recently there are arguments leading to the postponement of cord cutting until after placenta delivery. This postponement would allow more blood to stream from the placenta to the new-born.
The remaining part of the cord that is attached to the born child (a stump) will gradually dry, shrink and fall off leaving a ‘belly button’ (= the navel!), visible for the rest of his or her life.
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