Delivery is the moment when the fetus, followed by the placenta, exits the mother's body.
Fathers or partners are encouraged to be actively involved in the process of childbirth by helping with relaxation methods and breathing exercises.
Positions for delivery may vary from squatting to sitting to semi-sitting positions (between lying down and sitting up).
With semi-sitting positions, gravity can help the mother push the baby through the birth canal.
The type of position for delivery depends on the preference of both the mother and the health care provider, as well as the health of the fetus.
During the delivery process, the medical team will continue to keep an eye on the mother's vital signs, like blood pressure and pulse, and the fetal heart rate.
The health care team will examine the cervical opening to determine the position of the fetus' head and will continue to support and guide the mother in her pushing efforts.
Types of Delivery
During a vaginal delivery, the health care provider will assist the fetus' head and chin out of the vagina when it becomes visible.
Once the head is delivered, the health care provider applies gentle downward traction on the head to deliver the shoulder, followed by the rest of the body. The baby turns itself as the last movement of labor.
In some cases, the vaginal opening does not stretch enough to accommodate the fetus.
It may be necessary to speed up delivery, for example, if the baby is in distress. In such cases, the health care provider may perform an episiotomy. This is a cut through the vaginal wall and the perineum. This area is between the thighs, extending from the anus to the vaginal opening.
An episiotomy is done to help deliver the fetus. Episiotomies are not needed for every delivery and are not routinely performed.
After the delivery of the baby, the mother is asked to continue to push during the next few uterine contractions to deliver the placenta. Once the placenta is delivered, any tear or episiotomy is repaired.
The mother is usually given oxytocin. This is a drug given either by an injection into the muscles or intravenously that is used to contract the uterus.
The uterus is then massaged to help it contract and to help prevent excessive bleeding.
Cesarean section (C-section)
For some women, the fetus may be delivered surgically by performing a Cesarean section.
Some Cesarean sections are planned and scheduled, while others may be performed as a result of complications that occur during labor.
Cesarean sections are performed in an operating room. Usually, local anesthesia is given to the woman prior to starting the C-section, though general anesthesia may be used if the surgical team feels it is best.
Once the mother is ready, a cut is made in the stomach, and an opening is made in the uterus. The amniotic sac is opened, and the baby is delivered through the opening. The woman may feel some pressure and/or a pulling sensation.
Following the delivery of the baby, the health care provider will stitch or staple the uterine incision and the cut that was made in the stomach.
Conditions for a cesarean section
There are several conditions that may make having a baby by cesarean section more likely. These include:
- Previous cesarean section
- Fetal distress (signs that the baby may not be doing well)
- Abnormal delivery presentation, like breech, shoulder, or face
- A labor that fails to progress or does not progress normally
- Placental complications. One example is placenta previa, in which the placenta blocks the cervix. This raises the risk that the placenta will become detached too soon from the uterus.
- Twins or other multiples