Home 
Childbirth
Definition
Childbirth is the process during which the foetus, the placenta and the membranes are expelled from the mother's body. The birth itself ends a woman's pregnancy, when the mother pushes the child out of her body vaginally, or the child is delivered from her body by caesarean section. Birth also severs the connection between mother and child by cutting the umbilical cord.
The course of labour
Childbirth is accompanied by labour pains caused by contractions, in which the womb tightens, and also by retractions, which are the opposite of contractions. Because the whole labour is accompanied by about 110–150 contractions in first-time mothers and 60–80 contractions in women who have given birth before, a woman can use pain-relieving options such as epidural analgesia. The epidural is administered by anaesthetists and injected into the spine of the woman in labour between contractions.
Every woman, however, perceives and experiences these pains in her body differently. While some women can go through every contraction without the slightest tremor, clenching or other strong sensation (for example in hypnobirthing), there are also pregnant women among us who may experience contractions as very painful. It is a question what causes this different experience of labour pains, because, for example, there is no hereditary predisposition to a "calm" birth either, in the sense of: "My mum and my grandmother had an easy birth, so I will certainly have a calm birth too." It is important to realise that every birth is different, takes its own course and writes its own story. Of course, this also involves the voluntary choice to use the pain-relieving options mentioned above.
Preparing for the birth
Every expectant mother has the opportunity to prepare for the birth, just as her body, physiologically adapted for childbirth, prepares for it throughout the 40 weeks of pregnancy without the pregnant woman having to do anything. The mother's pelvis widens week by week, and the baby creates its own space in the womb, thereby preparing the mother's body for birth.
If a woman decides to help things along a little, however, she can choose from several aids and techniques that may contribute to a better birth.
Aids include:
- EPI-NO or ANYBAL, which relax and loosen the pelvic floor muscles
- manual perineal massage, thanks to which an episiotomy may not be needed during birth
- proper breathing through contractions, which can be learned at an antenatal class provided either by the maternity hospital itself or by another organisation
- hypnobirthing, an alternative in which the woman achieves a high degree of physical and mental relaxation, up to self-hypnosis
As the due date approaches, mothers can reach for linseed or raspberry leaf, which soften the birth canal and may bring on labour sooner. Home preparation also includes a properly packed bag for the maternity hospital, ideally according to a list of items.
The approaching due date can also make some pregnant women nervous and revive the fear of childbirth that some women experience at the beginning of pregnancy, as soon as they find out they are pregnant. With the birth itself, however, a feeling of looking forward to the baby usually arrives, and the fear itself is often gone. If it persists, it is always good to have someone to talk to, for example your husband, who can accompany you at the birth, a friend or your doctor.
Childbirth and its signs
The most common and most likely signs of labour are regular contractions and the leaking of amniotic fluid. One signal may also be the loss of the mucus plug, but this can come away even several weeks before the birth, so it does not necessarily indicate that labour is approaching.
The stages of labour
The birth itself, that is a vaginal birth, is divided into several parts, or stages:
- the first stage of labour
- the second stage of labour
- the third stage of labour
The first stage is the opening stage, when in many cases the pregnant woman's waters break and the first labour contractions begin. Throughout this stage, the expectant mother can use a number of aids and techniques that will help her cope better with the first stage. These include, for example, proper breathing, back massage, gym balls, pleasant favourite music, a shower and so on. If the pain is already strong at this stage, the woman in labour can ask for pain-relief medication. She can likewise decide between an enema, Yal gel or suppositories to empty the bowels. From the very first stage, a midwife or a chosen doula assists the mother with everything.
The second stage focuses on the actual expulsion, pushing the baby out of the mother's womb. The midwife or doula again assists the mother with correct breathing, pushing and, for example, choosing the position at birth that is most comfortable for her, which in some maternity hospitals the mother can choose herself.
The third stage is typified by the final separation of the placenta, which nourished the baby throughout. The umbilical cord is then cut, cord blood is collected for storage if desired, the cut perineum is stitched, and the mother and baby are checked over.
Childbirth, discharge from the maternity hospital and baby care
After the birth, the woman is usually left for another 2 hours with the baby in the delivery room, during which the baby should ideally be allowed, in completely natural skin-to-skin contact, so-called bonding, to latch on by itself and to breastfeed for the first time. There may be a difference here between a vaginal birth and a birth by caesarean section - usually, however, bonding is possible immediately and should be the preferred way of caring for the newborn. Unfortunately, in a number of maternity hospitals this does not happen and the baby is not placed on the mother's bare chest (or at least the father's) immediately, but only after several hours.
After the birth, the so-called six-week postpartum period begins, and the woman is advised to stay in the maternity hospital with the baby for at least 72 hours. During these 72 hours the woman can practise breastfeeding, baby care, self-care, contact with the baby and more. During this time, the necessary examinations are carried out on both the baby and the mother.
Childbirth - types of management
Besides a vaginal birth, it is also possible to have a baby by caesarean section. This can be planned or emergency, depending on how the birth develops. A planned caesarean section is performed by a doctor when obstacles to vaginal birth that would endanger the mother or the baby are known in advance. These may include, for example, the position of the foetus, placenta praevia, pre-eclampsia, a multiple pregnancy, previous births by caesarean section, certain developmental defects of the baby or health problems of the mother. If complications arise during a vaginal birth, the obstetrician may decide on an emergency caesarean section in the interest of protecting the mother and the baby.
Childbirth - types by length of pregnancy
- birth at term (partus maturus)
- premature birth
- post-term birth
Childbirth - other types
- alternative birth
- outpatient birth
- physiological birth
- instrumental birth
- actively managed birth - medically managed birth
- natural birth - birth without outside intervention
- hypnobirthing
- induced labour
- birth of twins
- precipitate labour
- health insurers and the birth of a child
For more information visit www.tehotenství.cz