Pushing a human being out of your body involves so much more than a push. Giving birth vaginally is one of the most beautiful and natural processes that someone can experience. A process reserved for only women continues to amaze the world as they are put up against incredible amounts of pain that aren’t within a human’s normal threshold. The vaginal birth is a highly complex process that must undergo three main stages in order to complete a successful and healthy delivery. Three major stages that occur during a normal vaginal birth involve the dilation of the cervix, the period between full dilation and delivery, as well as the delivery of the placenta; however, many other delivery options are available that stray away from these common stages.
As the process of labor and delivery begins, a woman then enters the first stage of delivering vaginally. Due to progressive rhythmic uterine contractions, the cervix begins to dilate. The process that involves contractions and dilation is the longest stage of labor. Stage one is divided into latent and active phases. During the latent phase, the cervix dilates slowly from closed to about 4-5 centimeters (“Normal Delivery”). In this part it is common for the amniotic sac to rupture, or for the woman’s water to break (“Stages of Labor”). After a woman’s water breaks, she typically then goes to whatever destination she wishes to give birth at. This phase can last for many hours. After the latent phase, the active phase begins. The active phase then lasts until delivery. This phase is identified by its rapid cervical dilation. Here, the cervix usually dilates at a rate of 1.0 centimeters per hour in nulliparous women, new mothers, whereas a rate of 1.2 centimeters per hour occurs in multiparous women, experienced mothers (“Normal Delivery”). After full dilation is met, which is 10 centimeters, the woman can then enter the second stage of her vaginal delivery (“Stages of Labor”).
Next, the vaginal delivery proceeds and enters its second stage. Stage two involves the time between complete cervical dilation and delivery of the neonate, in other words, the newborn. This particular stage could last anywhere from minutes to hours. Depending on the length of this stage, the maximum accepted time allowed by the overseers of the mother-to-be depends on the patient’s parity, or gestation age, as well as whether the patient has an epidural (“Normal Delivery”). The second stage involves pushing. Up until now the body has been doing everything by itself, but now the woman must push to move the process along (“Stages of Labor”). A doctor is now fully involved in the birthing process by walking the woman through the final contractions as well as guiding the fetus out of the birth canal. As the labor progresses towards its ending stages the six cardinal movements of labor occur. The first cardinal movement is when the head of the fetus engages into the lower pelvis. The second movement involves the flexion of the head, putting the occiput in presenting position. Movement three is the descent of the neonate through the pelvis. Continuing to the fourth movement, the vertex, or position of the baby, is internally rotated in order to maneuver past the ischial spines. Step five involves the extension of the head to pass beneath the maternal symphysis, an area by the pubic bones. The sixth and final cardinal movement of labor is when the head is externally rotated after delivery in order the facilitate shoulder delivery (“Normal Delivery”). These cardinal movements are required for a successful delivery.
Continuing the second stage of vaginal birth, several clinical parameters are followed — all of which are determined by the doctor. In order to continue the delivery properly, the fetal presentation is determined. This is done by analyzing the first body part that passes through the birth canal. The most common fetal presentation is when the occiput or the vertex of the head passes first. Fetal station is the second clinical parameter identified. Station of the fetus is the relation of the head to the maternal ischial spines. A scale that defines this spans from -5 centimeters to +5 centimeters; zero is at the level of ischial spines. The final clinical parameter followed involves determining the fetal position. This is the orientation of the fetal vertex in relation to the plane of the maternal ischial spines. Normally, the vertex rotates from a transverse position to an anterior or posterior position as the vertex internally rotates. Stage two is then completed after the neonate is born and the umbilical cord is clamped and cut (“Normal Delivery”).
Then, the third and final stage of the vaginal delivery is initiated. This stage involves the delivery of the placenta. Typically within thirty minutes after the delivery of the newborn the placenta is delivered. The placenta delivery occurs as the uterus contracts. A plane of separation is then developed at the placenta-endometrium interface. After the interface is developed, further uterus contractions occur, thus expelling the placenta (“Normal Delivery”). If needed, pressure may be applied with massages and the umbilical cord may be pulled to deliver the afterbirth (“Stages of Labor”). After the placenta is delivered, the third and final stage of the vaginal delivery is complete.
However, as most know, not everything can fall under the perfect circumstance. This typical three stage process of a vaginal delivery is the most standard form of birth, but not the only option available. Alternative options are commonly a choice made by the mother, but can also be made at the discretion of the doctor. Some of the most common birth types aside from a vaginal birth includes: a natural birth, a scheduled cesarean, an unplanned cesarean, a vaginal birth after a cesarean, and a scheduled induction (“Types of Birth”). A natural birth is in fact a vaginal birth, but no medical intervention is allowed (“What is a Natural Birth”). Women who choose this tend to want to experience the birth in its most natural form as well as not wanting to harm their baby with any drugs that may be used. Another option is a scheduled cesarean, which is when a date is predetermined when the mother will undergo a surgical incision in the abdomen and uterus to deliver the baby. This option is usually used if the woman does not want to deliver vaginally or if there are predetermined medical concerns. An unscheduled cesarean section undergoes the same medical procedure, but typically occurs when there is a complication and the baby and/or the mother is in danger (“C-Sections”). Having a vaginal birth after a cesarean section, or VBAC, is another choice. This option pertains to women who are on their second or more child and previously had a c-section, but wish to deliver vaginally, which tends to be safer than a repeated cesarean (“VBAC”). The final common option that is available for women is a scheduled induction. Inducing labor is when the mother is given medicine or a health care provider breaks your water to commence labor. This option allows the process of delivering to be less spontaneous and more structured (“Scheduling Labor”). Overall, expecting mothers have a variety of options when dealing with the actual delivery of their child, but the most common option still involves the vaginally delivery.