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Most babies are born following approximately nine calendar months of pregnancy. Delivery between 37–42 weeks of gestation is considered normal and full-term. A baby born prior to 37 weeks of gestation is considered premature, or preterm. After 42 weeks, it is considered postterm. Each of the latter circumstances is considered a higher risk delivery.
Labor occurs in three stages. The first is the dilation of the cervix, the second is the delivery of the baby, and
the third is the expulsion of the placenta. However, approximately 25% of babies born in the United States are surgically delivered by Caesarean section. This can be a necessary and even life-saving procedure, but this percentage is probably much larger than it could be with better management of labor and more informed birthing consumers.
A 2001 report showed that older pregnant women are more likely to deliver via Caesarean and also may more likely required induced labor. At one time, "once a Caesarean, always a Caesarean" meant a woman could not deliver vaginally after having a Caesarean, but that is no longer true for everyone. Women who have had previous surgical deliveries are increasingly choosing vaginal birth after Caesarean (VBAC). Having a sympathetic, informed caregiver and preparation helps achieve this goal.
The first stage of labor is the time that is required for the cervix to reach full dilation. It includes latent (early), active, and transition phases. The latent phase of labor, when the cervix progresses from being closed to 3 cm open, may last for days or longer. For some women, latent labor is not a distinguishable phase, and for others it leads immediately into active labor. The latent phase is often exciting for the mother, who wonders if her baby is finally going to be born. Contractions during this phase are not very painful. Active labor ensues around the time the cervix reaches 3 cm dilation, and continues until approximately 7 cm dilation. At this stage, labor contractions are powerful, and require the mother's concentration. The length of this stage is also variable, and is usually longer for first-time mothers than for those having subsequent babies. Active labor is followed by transition. This is the shortest and most intense stage of labor, when many women express feelings of despair, or "not being
able to do it anymore." At the end of transition, the cervix is fully dilated to 10 cm, and pushing can begin.
The second stage of labor is pushing the baby out through the vagina (birth canal). Contractions are generally less frequent than in the first stage of labor, but are very strong and long lasting. Many women find it a relief to be able to push. In the unmedicated mother, pushing is reflexive and instinctual. The pressure of the baby's head on stretch receptors in the maternal pelvis triggers the urge to push. Pushing is another phase where nature gives credit to the woman who has had a previous birth. First-time mothers generally push for about 60 minutes; subsequent births require an average of only 15 minutes.
The third stage of labor is the delivery of the placenta, which often goes unnoticed by the mother who is attending to her newborn. After the baby is delivered, the uterus should continue to contract in order to push out the placenta. This organ functioned to bring the baby nourishment from the mother throughout the pregnancy, and return the child's waste products to the mother to be excreted. If contractions become sluggish or stop before the placenta is delivered, breastfeeding the baby can trigger the release of the hormone oxytocin to stimulate the uterus to contract again. Alternatively, artificial oxytocin (pitocin) can be given by injection.
Author Info: Judith Turner, Teresa G. Odle, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Alternative Medicine, 2005
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