3rd June 2019

Childbirth

Childbirth, also known as labour and delivery, is the ending of a pregnancy by one or more babies leaving a woman’s uterus by vaginal passage or Caesarean section.[7] In 2015, there were about 135 million births globally.[8] About 15 million were born before 37 weeks of gestation,[9] while between 3 and 12% were born after 42 weeks.[10] In the developed world most deliveries occur in hospitals,[11][12] while in the developing world most births take place at home with the support of a traditional birth attendant.[13]

The most common way of childbirth is a vaginal delivery.[6] It involves three stages of labour: the shortening and opening of the cervix, descent and birth of the baby, and the delivery of the placenta.[14] The first stage typically lasts twelve to nineteen hours, the second stage twenty minutes to two hours, and the third stage five to thirty minutes.[15] The first stage begins with crampy abdominal or back pains that last around half a minute and occur every ten to thirty minutes.[14] The crampy pains become stronger and closer together over time.[15] During the second stage pushing with contractions may occur.[15] In the third stage delayed clamping of the umbilical cord is generally recommended.[16] A number of methods can help with pain such as relaxation techniques, opioids, and spinal blocks.[15]

Most babies are born head first; however about 4% are born feet or buttock first, known as breech.[15][17] Typically the heads enter the pelvis facing to one side, and then rotate to face down.[18] During labour a woman can generally eat and move around as she likes, but pushing is not recommended during the first stage or during delivery of the head, and enemas are not recommended.[19] While making a cut to the opening of the vagina, known as an episiotomy, is common, it is generally not needed.[15] In 2012, about 23 million deliveries occurred by a surgical procedure known as Caesarean section.[20] Caesarean sections may be recommended for twinssigns of distress in the baby, or breech position.[15] This method of delivery can take longer to heal from.[15]

Each year, complications from pregnancy and childbirth result in about 500,000 maternal deaths, 7 million women have serious long term problems, and 50 million women have negative health outcomes following delivery.[5] Most of these occur in the developing world.[5] Specific complications include obstructed labourpostpartum bleedingeclampsia, and postpartum infection.[5] Complications in the baby may include lack of oxygen at birthbirth traumaprematurity, and infections.[4][21]

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