When everything with labor is normal, the physician or midwife should assist the woman in the delivery room with normal labor and make childbirth for her as natural as possible.
The purpose of labor is to deliver the baby. However, this is a process that can last many hours. In some native tribes it may only take 4 to 6 hours for a primigravida and 1 to 2 hours for a multigravida.
However, nutrition, personality and the fact that they deliver in the squatting position makes the circumstances in a primitive tribe quite different from conditions in the Western world.
The Lamaze childbirth (thanks to www.babycenter.com for this link) attempts to copy the conditions of natural child birth. However, if only the physical positions during the delivery are copied, attempts achieving similar easy deliveries will fail. Another method is the Bradley method (thanks to www.bradleybirth.com for this link) of natural childbirth.
Attention to the other factors such as a sensible diet (zone diet plan, see Ref. 2) should not be overlooked. There is evidence in the literature that difficult deliveries may just be another symptom of insulin resistance, so why not prevent and treat this with a sensible nutritional approach.
In industrialized countries a primigravida delivers her baby in a total of 12 to 18 hours on average. A multigravida may deliver the baby in much shorter time such as between 2 and 12 hours. However, there are a number of factors, which have an influence on this. With gestational diabetes the weight gain in pregnancy is exceeding 30 pounds and the baby is overweight by a few ounces or even 1 or 2 pounds heavier. This will slow down the delivery significantly or make it impossible for the head to fit through the pelvis. C. sections in this scenario are much higher. Faulty nutrition with too much starch and sugar is one of the main causes of gestational diabetes.
With a normal delivery most of the energy of the labor pains is directed at dilating the cervical canal to allow the baby’s head to fit through and descend into the small pelvis. With normal deliveries there is no problem (with abnormal ones there could be a head that is to big, necessitating an emergency Cesarean section).
This initial stage from the start of labor pains to the full dilatation of the cervix is called the first stage of labor. This is verified by an internal examination in a sterile gloved manner. The second stage is the dilatation of the vagina, where the vagina transforms from a long narrow structure to a wide and short structure. This second stage lasts about 45 to 60 minutes in “multiparas” (women that already have had several children), but can be rapid in a few multiparas who tend to have “fast deliveries” (very rapid ones, also called “precipitous deliveries”).
In a person like this sometimes the time from initial labor to the delivery of the baby may only be 30 to 60 minutes or two hours in total at the most.
On the other hand the second stage in a woman getting her first child (called “nullipara”, has not yet had a prior delivery) will often last 2 hours and is very exhausting. In this stage the woman needs to push down along with the labor pains. In the first stage the woman is not allowed to push. The delivery room nurse or a certified midwife are wonderful coaches in all of these stages and the father should be there as well to coach and support his wife.
The Baby is Born
One the baby’s head has passed through, the rest of the body is usually born very quickly (the third stage).
During the birth crowning (head is born) the soft tissue between the anal opening and the vagina can break. In order to turn this into a controlled tear, the physician or the midwife may help along by making a small cut with scissors, called an episiotomy. Usually this is done after some quick freezing with a local anesthetic, if it is determined that the soft tissue is a significant barrier and is impeding baby’s birth. Often though it is not necessary, and any spontaneous rupture can be fixed later with proper freezing and suturing when the delivery is done.
All attention turns to the baby now: Is it breathing, crying, healthy looking? There are whole books written on newborn resuscitation (reviving the baby). Suctioning of mucous from the back of the mouth may have to be done. If the baby is crying well it is briefly held upside down to allow gravity to remove some of the mucous from the trachea. The baby is wrapped into a soft cloth and put into a pre-warmed crib. Shortly after, if all is well, it is given to the mother and father for bonding. The baby may need a few minutes of oxygen to quickly recover from the stress of being born.
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