What does perinatal mean? What happens during the birth process? What are some things that can go wrong? You will find the answers to these questions and more in this lesson!
Carrie's unborn child is getting ready to be born. It's an exciting time for Carrie and her husband as she begins feeling contractions. She times them and discovers that they're coming more regularly and getting closer together! Soon, it's time to head to the hospital and enter the delivery room. Carrie and her unborn child will be monitored closely until the birth process is completed. Does it seem like there's a lot of activity going on during this time? This is because during the birth process many things happen in a relatively short amount of time.
The term 'perinatal' refers to the period immediately before and after birth. Depending on the definition, it can begin as early as the 20th week of gestation and end as late as 4 weeks after birth. However, in most cases, the perinatal environment simply refers to the medical and social environment surrounding the birth of a child. This lesson will discuss this process as well as any possible hazards that can occur.
Let's begin with the birth process. Labor is the term that refers to the process of giving birth. It can be difficult to tell when true labor begins, but there are some early signs that labor is approaching. This is called pre-labor. Pre-labor can occur a month or more before true labor begins, or it can appear only a few hours before true labor begins. Pre-labor consists of an increase in Braxton Hicks contractions, or contractions that do not progress. The cervix will also begin to thin and move forward in preparation for the big event.
During pre-labor, Carrie noticed things starting to feel differently. In addition to the increase in contractions, she noticed increasing pressure in the pelvic region and a vaginal discharge. Some women also experience mood changes or their water may break.
Stages of Labor
Pre-labor ends when contractions begin to progress (or become longer, stronger and closer together). Once pre-labor is over, the four stages of labor begin. Stage one of labor has three phases: early, active, and transition.
At the beginning of the first stage of labor, the contractions become regular and the cervix effaces (or thins) and dilates (or opens) to around four centimeters. This is usually the longest part of the first stage of labor. Carrie, like most mothers, is spending much of this time trying to decide if she's actually in labor yet. This is the early phase of stage one.
Next, Carrie begins to notice significant changes to her contractions. Her contractions become much more uncomfortable, even painful. Her contractions also become much more frequent and are about 2-5 minutes apart. This is when most women will go to the hospital to have the baby. This is the active phase of stage one.
Carrie's contractions begin to occur closer and closer together now. This is the most challenging part of the labor process for many mothers. The contractions do not necessarily become more painful, but they now last longer and are closer together. At the same time, a surge of stress hormones, such as adrenalin, surge into the bloodstream. It's a lot to deal with mentally as well as physically. Carrie is very focused on her labor at this time. Is it time to push or should we wait? How long does she have until she is hit by this next contraction? When is it going to end? This is the transition phase of stage one. At this point, the cervix fully opens and the baby's head moves through this opening into the birth canal.
The second stage of labor begins next. Carrie suddenly feels a strong urge to push. She also notices that the pain of her contractions has tapered off. She feels relieved and is able to focus more on what's going on around her. Carrie gains her second wind, and she's ready for the work of delivering her baby.
Carrie's husband encourages her to push as the time has come! She can feel a lot of stretching and pressure as the baby moves through the birth canal, but she can sense the progress as well! This stage can last as little as 15 minutes or as long as 3 hours. Finally, the baby passes from inside to outside the mother's body. The baby will typically emerge headfirst and then rotate sideways to allow the shoulders to fit through the birth canal. Carrie is relieved that her baby has arrived safe and sound and the labor process is almost over!
The third stage of labor is the shortest. This stage begins just after the baby is born and ends with the delivery of the placenta. It typically lasts from 10-30 minutes. Just after the birth of her baby, Carrie's contractions resume. These final contractions separate the placenta from the uterine wall. A few more small pushes are needed and then the placenta has left her body.
The period of time from after the placenta is delivered until a mother's condition is stable is called recovery. The mother is considered stable when her blood pressure is normal, vaginal discharge is at a normal rate and the uterus shrinks and regains its tone. This usually takes from 1-4 hours, but it can take longer if labor was difficult or any type of anesthesia was used. During this time, the caregiver monitors Carrie closely to make sure she has no lingering complications after giving birth. This is the fourth stage of labor.
Now you know the stages of labor, and I am sure that you're aware women have been having babies for a very long time. So, you may be wondering why so much medical attention is necessary? After all, isn't giving birth a very natural act?
We are all very happy for Carrie and her newborn. Unfortunately, not all births are as uneventful, and complications can occur. This is one reason why receiving proper care during the birth of a child is so important. The risk of injury from complications has been reduced significantly by careful monitoring of the mother and child during the delivery process.
Traumatic birth injuries are injuries caused during the birth process. These injuries to the newborn can range from minor scratches to paralysis or even death. The following are a few of the most common complications that can cause traumatic birth injuries:
- Prolonged labor
- Rapid labor
- Premature birth
- Low birth weight
- A large fetal head
- A breech birth or another unusual birth position
- A mother's pelvis that is too small or abnormally shaped
- An umbilical cord that becomes wrapped around the baby's neck
Fetal asphyxia, or a shortage of oxygen getting to the fetus, is one serious injury that can occur. There is a greater risk of fetal asphyxia when a baby enters the birth canal in the breech position (or feet first). The main cause of fetal asphyxia is the umbilical cord becoming wrapped around the baby's neck. Fetal asphyxia can cause brain damage, resulting in issues such as mental retardation or cerebral palsy, a neurological disability that inhibits muscle control.
The term 'perinatal environment' refers to the medical and social environment surrounding the birth of a child. A large part of the perinatal environment involves the process of giving birth. This is also known as labor. Determining when labor begins can be difficult, but there are some early signs that labor is approaching. These early signs occur in the period called pre-labor. Pre-labor is characterized by an increase in Braxton Hicks contractions, or contractions that do not progress.
Labor occurs when contractions start to become longer, stronger and closer together. Labor occurs in four stages, and stage one has four phases: early (when contractions begin), active (when contractions are more frequent and painful), and transition (when the baby moves into the birth canal to be born). Stage two is the birth of the baby, stage three is the delivery of the placenta, and stage four is the few hours after the birth, called recovery.
Traumatic birth injuries, or injuries caused during the birth process, range from minor scratches to severe complications or even death. One traumatic birth injury is fetal asphyxia, or a shortage of oxygen getting to the fetus. Receiving proper care during the birth of a child is important. The risk of injury from complications is reduced significantly by monitoring the mother and child in the perinatal environment.
Following this lesson, you will be able to:
- Describe the processes of pre-labor and the four stages of labor.
- List examples of traumatic birth injuries
- Explain why it is important to have proper medical care during the perinatal process
- Identify what happens during fetal asphyxia