Childbirth

• Stages of Birth

  • Stage 1: Dilation of the cervix
  • Stage 2: Descent and Emergence of the Baby
  • Stage 3: Expulsion of the placenta (and umbilical cord)
• Vaginal Delivery


  • Usual method of childbirth
  • Stimulates release of oxytocin (stimulates maternal behavior)
  • Surge of hormones from the delivery that benefit child
  • Stronger immune systems
  • Less likely to have allergies
• Stages of Birth: Stage 1

  1. Experience of regular and increasingly frequent contractions that cause the cervix to shorten and dilate

  2. Full dilation of the cervix: 10 cm allow the baby to descend into the birth canal
• Stages of Birth: Stage 2


  1. Begins when the baby’s head moves through the cervix into the vaginal canal (crowning) until they fully come out

  2. Umbilical cord is cut after the emergence of the baby
• Stages of Birth: Stage 3

  Expulsion of the placenta (and umbilical cord)
• Baby’s Adaptation to Labor and Delivery

  1. Healthy babies are equipped to withstand strong contractions (trauma) during labor and delivery

  2. Infant high cortisol levels during delivery is adaptive as they help the baby withstand oxygen deprivation by sending a rich supply of blood to the brain and heart
• Approaches to Childbirth

  • Natural or Prepared Childbirth
  • Home Delivery
  • Medical Interventions
• Natural or Prepared childbirth

  • Minimize or eliminate the use of drugs that may pose risks for babies and enable both parents to participate fully in a natural, empowering experience
  • Natural childbirth program attended by an expectant mother with a companion
  • Classes: learning about the anatomy and physiology of labor and delivery to reduce the mother’s fear
  • Relaxation and breathing techniques
  • Lamaze, Leboyer, Bradley and other methods
  • Labor coach (Doula)
• Cultural Practices in Childbirth

  • Mayan: gives birth in a hammock they sleep in every night and stays home for a week to evade evil spirits
  • East African (Ngoni): men are excluded from the birth experience
  • Thai: Resumption of normal activities within a few hours after birth
  • Sub-Saharan Africa and South Asia: home birth without skilled care
  • In the Philippines, there are lying in clinics (health care facility) for low-risk pregnancies, ran by midwives especially in rural areas
• In early times, childbirth is “a struggle with death” for both the mother and baby
• Before the 20th century, 1 of 10 women dies of childbirth, thousands are stillborn, and 1 of 4 babies born dies in their 1st year of life
• During the 20th century, professionalization of childbirth in hospitals started in the US, with a rise in childbirth hospitals from 5% to 65% from 1900 to 1920. Access to medicine, medical procedures, better sanitation, and prenatal assessment contributed to the dramatic reduction in risks of childbirth
• Natural childbirth program

  1. Attended by an expectant mother with a companion

  2. Classes: learning about the anatomy and physiology of labor and delivery to reduce the mother’s fear

  3. Relaxation and breathing techniques

  4. Lamaze, Leboyer, Bradley, and other methods

  5. Labor coach (Doula)
• Home delivery is safe for healthy women without pregnancy complications who are assisted by a well-trained doctor or midwife
• Medical Interventions

  • Fetal monitoring
  • Labor and Delivery Medication
  • Cesarean Delivery
• Fetal monitoring


  1. Mechanical monitoring of fetal heartbeat during labor and delivery

  2. Indicates how the fetal heart is responding to the stress of uterine contractions
• Labor and Delivery Medication

  1. Chosen to be used with natural methods, but with risks to the baby as medications pass through the placenta while the baby is inside the womb

  2. Pain-relieving drugs: Analgesic, Anesthetics, Pudendal block, Epidural analgesia
• Cesarean Delivery

  1. Surgical birth: delivery of a baby by surgical removal from the uterus

  2. Commonly performed when: Labor progresses slowly, Breech birth, Rh incompatibility, Placental abruption, Placenta previa, Serious maternal infection, Vaginal birth after Cesarean (VBAC)

  3. Not recommended for home births

  4. Increased rates of uterus rupture and infant death are observed
• Complications of Cesarean Delivery

  • Low birth weight, Postmaturity, Stillbirth
• Low Birth Weight (LBW) Risk Factors

  • Demographic and socioeconomic factors, Medical factors predating the pregnancy, Prenatal behavioral and environmental factors, Medical conditions associated with the pregnancy
• LBW Protective Factors

  • Babies’ resilience, Maternal education, Two-parent family structure, High SES, Parenting, Parent’s emotional stability
• Factors affecting babies' resilience

  • Maternal education
  • Two-parent family structure
  • High SES
  • Parenting
  • Parent's emotional stability
  • LBW
• Immediate outcomes

  • Compromised immune system leading to death
  • Stressful medical procedures eroding early coping capacities
• Long-term outcomes

  • Preterm infants at risk for high blood pressure, metabolic syndrome, adult-onset diabetes, and cognitive deficits
  • Small-for-date infants at risk for adult-onset diabetes and cardiovascular diseases
  • Risk for cognitive deficits, behavioral and mental health problems, motor development impairment
• LBW Treatment

  1. Immediate: Respiratory Distress Syndrome (RDS) treated with surfactant, preterm infants placed in an isolete (incubator) and fed through tubes, Kangaroo care (KC) involving skin-to-skin contact between newborn and mother

  2. Long-term: Training parents in caregiving skills, teaching parents how to recognize and respond to the baby's needs, SES influences the kind of intervention given in training parents and to the preterm infant
• Postmature birth refers to those not yet born 2 weeks after the due date or 42 weeks after the mother's last menstrual period
• Risks of postmature birth

  • Mother: Cesarean delivery, perineal tears, postpartum hemorrhage
  • Baby: shoulder dystocia, meconium aspiration, low Apgar scores, brain damage, death
• Infant Mortality reasons include preterm birth, childbirth complications, sepsis, birth defects, and genetic abnormalities
• Preventable causes of infant mortality include poverty, poor maternal health and nutrition, and inadequate medical care
• Sudden Infant Death Syndrome (SIDS) is crib death, sudden and unexplained death of a healthy infant
• Triple risk model for SIDS includes infant vulnerability, critical period of 2 to 4 months, and exogenous stressor
• Sleeping face down is a risk factor for SIDS
• Death from injuries can occur due to suffocation, traffic accidents, drowning, burns, and falls
• Immunization helps prevent diseases like measles, pertussis, and polio
• Concerns about vaccines causing autism or other neurodevelopmental disorders have been debunked
• Immunization schedule is important for preventing diseases