Pregnancy

The birth

After 9 months of waiting, the day of the baby's birth finally arrives. Moment both long-awaited and feared. The contractions are regularized, they become close and painful. It's time to go to the maternity ward , having taken care before to take the mother and baby's suitcase .

If childbirth is a challenge for the mother, birth is also a problem for the baby. From the narrow space of the uterus, the newborn passes into the open air. In a few minutes, it changes environment from liquid to air, and must adapt quickly.

Birth: how is it?

The baby plays a vital role in triggering work. It is presented in 95% of cases upside down, it is said that it is a "cephalic" presentation, the most favorable to childbirth.

In 4% of cases, the fetus is seated in the belly of his mother is the presentation by the seat . The prognosis for vaginal delivery varies widely between schools, and a caesarean section can be discussed because it is a riskier delivery compared to a cephalic presentation.

Monitoring at the maternity ward

Once you arrive at the maternity ward, the midwife or the attending physician will take care of you. We set up a monitoring to appreciate the well-being of your baby by his heart rate, as well as the frequency of your contractions. You will have a vaginal touch to know where you are working. The characteristics of your uterine cervix (dilatation, length, consistency and position) and the height of your baby's head in relation to your pelvis will be evaluated.

Erasing and dilating the cervix

In late pregnancy, in general, the cervix is ​​closed, long, tonic and posterior. The contractions associated with the release of hormones and the support of your baby's head will act on the cervix. As work progresses, for a first baby, the cervix will start to shorten, it will become mid-long, short and then erased, this is called erasing the cervix . Once the cervix is ​​cleared, the expansion step begins. The neck will open gradually (on average 1 cm per hour) up to 10 cm, it is said that you are fully dilated .

If you have already given birth, the erasure and dilatation of your cervix are often done at the same time. The work is faster.

The engagement of the baby's head in the pelvis

During work, your baby will bend his head and orient it in one of the oblique diameters of your pelvis. This is the widest diameter. As and when, his head will go down. Head engagement is when the widest part of the baby 's head has crossed the narrowest part of your pelvis. Once her head is engaged, she will descend into the pelvis under the effect of uterine contractions.
Even if you are fully dilated, it is possible for the midwife to give herself some time to let your baby down as much as possible in your pelvis. Thus, the more his head is low and ready to go out, the less you push and the easier it will be.

expulsion

During the eviction, you will push with all your strength to bring out the head of your baby. The midwife will guide you and support you. Once your head was out, you did the hard part. The midwife will release one after the other the shoulders of your baby then the rest of his body. You can then reach out to pick up your child. Dad, if he wishes, can cut the umbilical cord. If your newborn is doing well, it can be left skin-to-skin against you and presented directly to the breast if you chose to feed it that way.

Sometimes the baby does not support the expelling efforts. The midwife can then be called to the doctor to help with the expulsion by a suction cup or spatulas.

The detachment of the placenta

Once your baby is against you, we wait until the placenta comes off (maximum 30 minutes after delivery). You will push once or twice to get him out.

The midwife will check the condition of your perineum and perform stitches if she finds a tear, or if an episiotomy was needed.

Read also :
> Preparation for birth and delivery in the water
> The birth project
> Share it with birth

Authors: Julie Martory and Clémentine Fitaire
Consultant: Bérengère André, midwifery school student.

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