Childbirth

The term Childbirth describes the process of childbirth that occurs at the end of a pregnancy. After an average of 266 days, the fetus leaves the maternal body. The natural birth process can be divided into four phases.

What is the delivery?

A birth can take several hours and shows a phasic course. A first-time woman is expected to take about thirteen hours. In women who are already mothers, birth takes an average of eight hours.

The birth begins with the opening phase, followed by the transition and expulsion phase and finally the afterbirth phase. Most deliveries in Germany take place in the delivery room in a hospital. It is also possible to give birth in a birthing center or at home.

In most cases, childbirth will take place without complications. Medical intervention, for example with medication, imperial or perineal incisions, is rarely required.

Function & task

Human birth starts with the opening phase. Irregular contractions appear. These initial contractions, which occur about two to three times every half hour, shorten the cervix and widen the cervix. If the amniotic sac has not yet cracked before the opening phase, it will do so now.

The frequency of contractions increases over time, until about two to three contractions occur within 10 minutes, with each contraction lasting about one minute. As early as the opening phase, the child is pressed down towards the pelvis.

The last third of the opening phase is called the transition phase. The contractions now come more and more often and are accompanied by more severe pain. In the transition phase, the child also turns so that his face is directed towards the tailbone.

When the cervix is ​​sufficiently opened, about eight to ten centimeters, the actual birth begins, i.e. the expulsion phase - as it is called somewhat insensitive. The contractions are now very strong and irregular.

The so-called urge to press is now triggered in the woman. This is caused by the pressure of the child's head on the maternal intestine. The woman supports the birth process with her uterine and abdominal muscles due to this urge to press.

Labor may be accompanied by nausea. After a few pressure pains, the head pushes through the birth canal and finally emerges. Now the child turns 90 ° C again so that the rest of the body can easily follow.

In the postpartum phase, the placenta and amniotic sac are born. This is followed by an examination of the completeness of the afterbirth, because placental remnants remaining in the uterus could lead to rebleeding or infections. If parts of the afterbirth are missing, a scraping is therefore carried out.

After the afterbirth, the child is cared for and can usually contact the mother immediately for the first time. This is important for what is known as bonding, i.e. the bond between mother and child. Any tears in the perineum that may have occurred during the birth are then treated or, if necessary, sewn.

Illnesses & ailments

Even if delivery usually takes place naturally without any problems, complications can arise. Risk factors that may make natural birth impossible include miscarriages or stillbirths in previous pregnancies, twin and multiple pregnancies, diabetes in the pregnant woman, Rhesus intolerance, and premature (under 18 years of age) or late births (over 35 years of age). The use of drugs, alcohol and cigarettes can also lead to complications before and during childbirth.

The most common life-threatening complication during childbirth is thrombosis with subsequent embolism. Overweight women and women with high blood pressure are particularly at risk here: If the blood clot formed in the leg veins during the thrombosis migrates into the lungs, heart failure can occur.

An embolism can not only result from a blood clot, amniotic fluid can also get into the woman's bloodstream and then lead to a so-called amniotic fluid embolism in the lungs. After a surgical birth, the risk of an amniotic fluid embolism increases.

Bleeding is also a danger during delivery. In rare cases, heavy bleeding occurs when the placenta is detached. The risk of bleeding increases if you have twins or if you have very older children. With prolonged bleeding there is a risk of circulatory failure. In severe cases, the uterus may even have to be removed.

If the blood pressure was already high during pregnancy, a blood pressure crisis with greatly increased blood pressure values ​​can occur during delivery. One then speaks of a gestosis. This is accompanied by nausea, vomiting or even seizures. The gestosis becomes life-threatening through complications such as a stroke, a heart attack or a rupture of the skin artery with the risk of bleeding.

If bacteria or other pathogens enter the mother's body after or during the birth process, puerperal fever (also puerperal or puerperal fever) can develop. It is sepsis, i.e. blood poisoning, with type A streptococci. Postpartum fever shows rather unspecific symptoms such as high fever, aching limbs and fatigue. If left untreated, the infection leads to shock and thus death.

A dangerous complication for the child is a loop of the umbilical cord. The umbilical cord is placed around the child's neck during the birth process. There is a threat of strangulation with insufficient supply of the brain. The result can be severe physical and / or mental disabilities for the child.

Incorrect or missing rotation of the child can also lead to difficulties during delivery. The wrong position can lead to delays in the birth process or even to a birth arrest. In the event of a birth arrest, a caesarean section is required in order to give the child a healthy birth.