Childbirth

Childbirth
SynonymsLabour and delivery, partus, parturition, birth, confinement[1][2]
Postpartum baby2.jpg
Newborn baby and mother
SpecialtyObstetrics, midwifery
ComplicationsObstructed labour, postpartum bleeding, eclampsia, postpartum infection, birth asphyxia[3][4]
TypesVaginal delivery, C-section[5][6]
Frequency135 million (2015)[7]
Deaths500,000 maternal deaths a year

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.[6] In 2015, there were about 135 million births globally.[7] About 15 million were born before 37 weeks of gestation,[8] while between 3 and 12% were born after 42 weeks.[9] In the developed world most deliveries occur in hospital,[10][11] while in the developing world most births take place at home with the support of a traditional birth attendant.[12]

The most common way of childbirth is a vaginal delivery.[5] 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.[13] 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.[14] The first stage begins with crampy abdominal or back pains that last around half a minute and occur every ten to thirty minutes.[13] The crampy pains become stronger and closer together over time.[14] During the second stage pushing with contractions may occur.[14] In the third stage delayed clamping of the umbilical cord is generally recommended.[15] A number of methods can help with pain such as relaxation techniques, opioids, and spinal blocks.[14]

Most babies are born head first; however about 4% are born feet or buttock first, known as breech.[14][16] Typically the heads enter the pelvis facing to one side, and then rotate to face down.[17] 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.[18] While making a cut to the opening of the vagina, known as an episiotomy, is common, it is generally not needed.[14] In 2012, about 23 million deliveries occurred by a surgical procedure known as Caesarean section.[19] Caesarean sections may be recommended for twins, signs of distress in the baby, or breech position.[14] This method of delivery can take longer to heal from.[14]

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.[4] Most of these occur in the developing world.[4] Specific complications include obstructed labour, postpartum bleeding, eclampsia, and postpartum infection.[4] Complications in the baby may include lack of oxygen at birth, birth trauma, prematurity, and infections.[3][20]

Signs and symptoms

Luristan bronze, fibula showing a woman giving birth between 2 antelopes, ornamented with flowers, Iranian, 1000 to 650 BC) at the Louvre museum

The most prominent sign of labour is strong repetitive uterine contractions. The distress levels reported by labouring women vary widely. They appear to be influenced by fear and anxiety levels, experience with prior childbirth, cultural ideas of childbirth and pain,[21][22] mobility during labour, and the support received during labour. Personal expectations, the amount of support from caregivers, quality of the caregiver-patient relationship, and involvement in decision-making are more important in women's overall satisfaction with the experience of childbirth than are other factors such as age, socioeconomic status, ethnicity, preparation, physical environment, pain, immobility, or medical interventions.[23]

Descriptions

Pain in contractions has been described as feeling similar to very strong menstrual cramps. Women are often encouraged to refrain from screaming, but moaning and grunting may be encouraged to help lessen pain. Crowning may be experienced as an intense stretching and burning. Even women who show little reaction to labour pains, in comparison to other women, show a substantially severe reaction to crowning.

Back labour is a term for specific pain occurring in the lower back, just above the tailbone, during childbirth.[24]

Psychological

During the later stages of gestation there is an increase in abundance of oxytocin, a hormone that is known to evoke feelings of contentment, reductions in anxiety, and feelings of calmness and security around the mate.[25] Oxytocin is further released during labour when the fetus stimulates the cervix and vagina, and it is believed that it plays a major role in the bonding of a mother to her infant and in the establishment of maternal behavior. The act of nursing a child also causes a release of oxytocin.[26]

Between 70% and 80% of mothers in the United States report some feelings of sadness or "baby blues" after giving birth. The symptoms normally occur for a few minutes up to few hours each day and they should lessen and disappear within two weeks after delivery. Postpartum depression may develop in some women; about 10% of mothers in the United States are diagnosed with this condition. Preventive group therapy has proven effective as a prophylactic treatment for postpartum depression.[27][28]

Other Languages
Akan: Abawo
العربية: ولادة
asturianu: Partu
Avañe'ẽ: Membysẽ
বাংলা: প্রসব
Bân-lâm-gú: Seⁿ-kiáⁿ
башҡортса: Тыуым
беларуская: Роды ў чалавека
bosanski: Porođaj
brezhoneg: Gwilioud
čeština: Porod
Chi-Chewa: Kubereka mwana
chiShona: Kuponiwa
Deutsch: Geburt
eesti: Sünnitus
Ελληνικά: Τοκετός
español: Parto
Esperanto: Nasko
euskara: Erditze
فارسی: زایمان
français: Accouchement
Frysk: Befalling
galego: Parto
ગુજરાતી: બાળજન્મ
客家語/Hak-kâ-ngî: Kiung-chṳ́
한국어: 분만
hrvatski: Porođaj
Ido: Parturo
isiXhosa: Ukuzala
italiano: Parto
עברית: לידה
ಕನ್ನಡ: ಶಿಶುಜನನ
Кыргызча: Төрөт
Latina: Puerperium
latviešu: Dzemdības
lietuvių: Gimdymas
magyar: Szülés
മലയാളം: പ്രസവം
मराठी: प्रसूती
Mìng-dĕ̤ng-ngṳ̄: Săng-giāng
монгол: Төрөлт
မြန်မာဘာသာ: ကလေးမွေးခြင်း
Nederlands: Bevalling
日本語: 分娩
occitan: Jasilha
ଓଡ଼ିଆ: ପ୍ରସବ
ਪੰਜਾਬੀ: ਜਣੇਪਾ
پنجابی: چِھلا
português: Parto
Runa Simi: Paqariy
Scots: Bairnbirth
SiSwati: Kubeleka
slovenčina: Pôrod
slovenščina: Porod
کوردی: زان
српски / srpski: Порођај
srpskohrvatski / српскохрватски: Porođaj
Basa Sunda: Babar
suomi: Synnytys
svenska: Förlossning
Tagalog: Panganganak
తెలుగు: కానుపు
Türkçe: Çocuk doğurma
українська: Пологи
اردو: زچگی
Tiếng Việt: Sinh con
ייִדיש: געבורט
粵語: 蘇得
中文: 分娩