Labor and Delivery

An even rarer occurrence is the shoulder presentation. This occurs in only 1 birth out of 200. The shoulder presentation is extremely dangerous because the baby must be forced by the attendants into a breech position. This forcing can rupture the uterus, which may cause the death of the infant and severe hemorrhaging in the mother.

Another dangerous problem that can occur during birth is anoxia. Anoxia can occur if the placenta detaches prematurely if the umbilical cord is pinched or tangled, if the infant's head is injured to the point of hemorrhaging, or if the mother has been too heavily sedated during labor. If there is a problem during birth, the child may be removed from the uterus by Cesarean section. Approximately 23% of all births in the United States are Cesarean sections. In this procedure, the mother's abdomen is opened surgically and the baby is removed without passing through the vaginal canal. The surgical incision is then closed as it would be after any other surgical procedure.

Whenever possible, obstetricians use special surgical incisions in the uterus so that a woman who has had one Cesarean section may later deliver babies vaginally With the old Cesarean technique (when a vertical incision was used), once the incision was made and the uterine wall weakened, it was necessary to have any future babies also delivered by Cesarean. It should be noted, however, that women giving birth vaginally for the first time should expect labor to last as long as a typical first-time labor, regardless of how many babies they may have previously had by Cesarean section.

In addition, some obstetricians have recommended that Cesarean sections not be used routinely if breech birth or labor problems begin. They argue that breech births for low-weight babies, especially if the obstetrician is skilled, may present no difficulty and that abnormal labor of and by itself is not sufficient cause for a Cesarean section. When it is necessary, however, Cesarean section can be a lifesaver for both infant and mother.

Third Stage
Following the birth of the infant, the third stage of labor occurs, during which the placenta is expelled. The placenta and other expelled materials are called the afterbirth.



Source: "CHAPTER 3 CONCEPTION, PRENATAL DEVELOPMENT, AND BIRTH," Introduction to Child Development, 6th ed., John Dworetzky, West Publishing Company, San Francisco, CA, 1996.