Pregnancy - Delivery

As the pregnancy moves through the labor stage toward delivery, the woman is instructed to bear down and strain with each contraction. This moves the baby's head down through her pelvis and widens the opening of the vagina.

Once about three to four centimeters of the baby's head are visible during a contraction, the doctor may apply pressure to help the baby deliver slowly and safely.

If a mother is exhausted and not able to push enough on the baby, forceps may be used. They may also be needed when anesthesia prevents a mother from being able to push during delivery. Generally, forceps aren't necessary.

An episiotomy in which a surgical cut is made in the perineum (the area between the lower edge of the vagina and the rectum) is done only if the perineum does not stretch enough to allow delivery.

This procedure is usually only needed for first deliveries that are fully at term. Doing it prevents too much stretching and possible tearing of the tissues.

Once the baby's head has moved past the cervix, its body rotates so that its shoulders angle and move downward toward delivery. Gentle downward pressure on the baby's head causes the forward shoulder to pass under the pubic bone.

The doctor will check to make sure that the umbilical cord (which connects the baby and the mother during pregnancy) is not wrapped around the neck of the baby. If it is, the cord may need to be clamped and cut.

As the doctor then gently lifts the baby's head, the back shoulder slides out of the mother's body and the rest of the baby's body follows without difficulty.

After the birth, the baby's nose, mouth and throat are cleared of mucus and fluids to help get breathing started. The baby's umbilical cord should be cut and sealed with a plastic clip. The baby is then placed in a warmed bassinet or on its mother's stomach.

The fourth phase begins after the baby's delivery and ends about four hours after the delivery of the placenta.

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