Normal Delivery: Best A Woman can have

Vaginal delivery is the most natural and uncomplicated way of child birth. Till date it accounts for 70% of childbirth.

Pros:

• More positive birthing experience from a psychological stand point

  • Short recovery time

Cons:

• Stressful

• Unplanned baby's arrival

Normal delivery is divided into 3 stages.

• • In the first stage, the cervix dilates as a result of progressive rhythmic uterine contractions.

  • This is typically the longest stage of labor.

    • Cervical effacement, or thinning, occurs throughout the first stage of labor, and is graded 0-100%.

    • The first stage of labor is divided into the latent and active phases.

    • The latent phase can last for many hours. The cervix dilates, usually slowly, from closed to approximately 4-5 cm.

    • The active phase lasts from the end of the latent phase until delivery. It is characterized by rapid cervical dilation. The cervix usually dilates at a rate of 1.0 cm/h in nulliparous women and 1.2 cm/h in multiparous women during the active phase.

  • The second stage of labor is the time between complete cervical dilation and delivery of the neonate. This phase lasts minutes to hours. The maximum accepted time for the second stage depends on the patient's parity and whether the patient has an epidural or not.

    • • Six cardinal movements of labor occur during the second stage of labor.

        • Engagement of the head into the lower pelvis

        • Flexion of the head, putting the occiput in presenting position

        • Descent of the neonate through the pelvis

        • Internal rotation of the vertex to maneuver past the lateral ischial spines

        • Extension of the head to pass beneath the maternal symphysis

        • External rotation of the head after delivery to facilitate shoulder delivery

      • Several clinical parameters are followed.

        • The fetal presentation is determined by the first fetal body part that passes through the birth canal. Most commonly, this is the occiput or the vertex of the head.

        • The fetal station is the relation of the fetal head to the maternal ischial spines. The station is defined as -5 cm to +5 cm; 0 station is at the level of the ischial spines.

        • The fetal position is the orientation of the fetal vertex (the top of the head) in relation to the plane of the maternal ischial spines. The vertex normally rotates from a transverse position to an anterior or posterior position as the vertex internally rotates.

  • The delivery of the placenta is the third and final stage of labor; it normally occurs within 30 minutes of delivery of the newborn. As the uterus contracts, a plane of separation develops at the placenta-endometrium interface. As the uterus further contracts, the placenta is expelled.