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CHARACTERISTICS OF CHILDBIRTH
Labour may be defined as the period characterised by the presence of regular and painful uterine contractions accompanied by progressive cervical shortening and dilatation that culminates in childbirth.
Labour is comprised of four stages or periods that define its progress, from the beginning until the initial postnatal period:
- Stage 1 or dilation: interval between the beginning of childbirth and complete cervical dilation
- Stage 2 or expulsion: interval between full cervical dilation and the actual birth of the child.
- Stage 3 or birth: interval between the expulsion of the baby and the expulsion of the placenta
- Stage 4 or post-expulsion: interval between placental expulsion and definitive maternal stabilisation
The progress of childbirth, from beginning through to the expulsion of the child, is determined, in turn, by numerous factors, which include:
- Age - Parity - Anthropometric characteristics of the pregnant woman
- Premature membrane rupture
- Intensity, quality and coordination of uterine contractility
- Resistance offered by the cervix to stretching and dilation
- Ability to push (pushing reflex)
- Resistance offered by the pelvic floor to the distention caused by foetal descent
- Size and presentation
- Anatomical characteristics of the maternal pelvis
- Type of birth (spontaneous or induced)
- Obstetric and anaesthetic management
A normal delivery requires a good match between foetal size and the dimensions of the maternal pelvis, as well as a suitable ratio between uterine contractions and degree of uterine dilation.
In normal conditions, the foetus tends to present a longitudinal location, with cephalic presentation at the entrance of the superior pelvic strait with the back of the head as the leading point, adopting a generalised flexion that will adapt to the birth canal in the most suitable way.
Any abnormality in any of these foetal parameters will lead to a more complex obstetric birth, and is often accompanied by a more severe pain than that which occurs in normal condition. A C-section may even be required.