BIRTH Labor: The Birthing Process It is not yet known what precipitates the triggering of the release of the hormone oxytocin from the pituitary gland in most pregnant women about 266 days after conception on average. What is understood, however, is that it is oxytocin which causes the uterus to begin the periodic contractions, which ultimately push the baby out of the uterus and through the cervix and birth canal into life on its own. The Three Stages of Labor: First Stage: Typically lasting 16-24 hours for first-born children, the first stage of labor is the longest. Contractions initially occur every 8-10 minutes and last 30 seconds. Toward the end of the first stage, contractions occur about every 2 minutes, and last for 2 minutes. The period when contractions are most frequent and strongest is known as transition. The end of this first stage is when the mother's cervix fully opens to allow the baby's head to pass through. Second Stage:The second stage begins when the baby's head starts to move through the cervix and birth canal, and ends about 90 minutes later, when the baby has completely left the mother's body. Third Stage:During the third stage of labor, the umbilical cord and placenta are expelled from the mother's body. This takes only a few minutes to happen in most normal deliveries. While there are physiological factors contributing to the mother's experience of pain during the birthing process, cultural and personal expectations of the mother also affect how much discomfort she experiences. From Fetus to Neonate Most babies spontaneously begin to breathe air into their lungs as soon as they emerge from their mothers' bodies. The initial cries associated with birth helps the newborns to clear their lungs and breathe on their own. The Apgar Scale Used by trained health care workers, the Apgar Scale is a standard measurement system that looks for a variety of indications of good health in the neonate. Named after Virginia Apgar, the physician who developed it in 1953, the scale focuses on five basic qualities: appearance (color), pulse (heart rate), grimace (reflex irritability), activity (muscle tone), and respiration (respiratory effort). Health care workers assign the newborn a score ranging from 0 to 2 on each of the five qualities, producing an overall score ranging from 0 to 10. The great majority of infants score 7 or above. The 10% of neonates who score under 7 require help to start breathing, and those who score below 4 need immediate, lifesaving aid. Some infants may score low due to anoxia, the deprivation of oxygen during the birth process, while others may do so because of existing problems or birth defects. Extended anoxia can cause serious harm to the infant, however, brief periods of restricted oxygen may have no lasting effects.
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