Childbirth

The process by which an infant leaves the uterus and enters the outside world. Childbirth ( labour) normally takes place between 38 and 42 weeks of pregnancy and occurs in 3 stages. The onset of the 1st stage of labour is marked by regular contractions which become progressively more painful, and occur at shorter intervals. The cervix becomes thinned and softened and then begins to dilate with each contraction. During this time, there may be a “show’’, the mucous plug that blocks the cervical canal during pregnancy is expelled as a bloody discharge. “Breaking of the waters’’, the rupture of the amniotic sac, may occur as a slow trickle of fluid or a sudden gush. The cervix is fully dilated when the opening has widened to about 10 cm in diameter. This may take 12 hours or more for a first baby, but only a few hours for subsequent babies. In the 2nd stage of labour, the woman feels the urge to push with each strong contraction. As the baby’s head descends into the vagina, it rotates to face the mother’s back. The perineum is stretched thin at this stage, and an episiotomy may be performed to prevent it from tearing. Once the baby’s head is delivered, the rest of the body follows with the next contractions. After delivery, the umbilical cord is clamped and cut. In the 3rd stage of labour, the delivery of the placenta takes place. The various forms of pain relief available during normal labour and delivery include opioid analgesic drugs, epidural anaesthesia, and pudendal block.