For most women, the birth of a newborn baby proceeds without problems. However, a number of problems can arise, including premature birth, breech birth, cesarean section delivery, and stillbirth.

Premature Birth: The Hazards of Early Delivery

The majority of babies are born late rather than early. Birth that takes place before the 37th week of pregnancy is considered premature birth. About 8% of births in the United States are premature. Prematurity increases the risk of birth-related defects and infant mortality (Palca, 1991). However, research into pediatrics has led to tremendous improvements in the survival rates of premature infants. Today infants born at 24 weeks’ gestation have a greater than 50% chance of survival (Welty, 2005). Unfortunately, more than half of these infants who survive develop complications and long-term effects of prematurity, such as developmental difficulties.

Подпись:Подпись:Подпись: ReviewQuestionПодпись:Подпись:Birth may occur prematurely for several reasons, including early labor or early rup­ture of the amniotic membranes or because of a maternal or fetal problem. It is common for women who have had one premature birth to have subsequent premature births. Approximately 50% of all twin births are premature, and delivery of multiple fetuses oc­curs about 3 weeks earlier, on average, than single births. In 2004 the world’s smallest surviving premature baby was born, weighing in at 8.6 ounces (her twin sister weighed 1 pound, 4 ounces; Huffstutter, 2004). These twins were delivered via caesarean section in the 26th week of pregnancy due to medical problems experienced by their mother. Other factors that may lead to premature birth include smoking during pregnancy, alco­hol or drug use, inadequate weight gain or nutrition, heavy physical labor during the pregnancy, infections, and teenage pregnancy.

G’K PROBLEMS DURING BIRTHINGFigure 12.5

G’K PROBLEMS DURING BIRTHING

Подпись:Подпись: sex byte In many mammals, it is common for the mothers to eat the placenta after delivery, a process known as placentophagia (pla-sen-tuh-FAY-gee- uh). Although this does not sound very appetizing to us, it does serve two very important purposes. The placenta is rich in progesterone, which, once digested, is quickly released into the bloodstream, causing progesterone levels to temporarily stabilize. This stabilization of progesterone has been hypothesized as a way to decrease the incidence of postpartum depression (R. Jones, 1984). In addition, in animals, eating the placenta also avoids attracting predators.

Подпись: Vagina
G’K PROBLEMS DURING BIRTHING
Подпись: Cesarean Section (C-Section) Delivery A cesarean section (c-section) involves the delivery of the fetus through an incision in the abdominal wall. From 1970 to 1988, the rate of cesarean sections increased from 5% to close to 25% (Stein, 2003) for several reasons: women were waiting longer to have children, which increased labor complications; the procedure became easier and safer to perform than it was several years before; and doctors performed cesarean sections to reduce the risks associated with vaginal delivery due to their fear of malpractice suits. One of the biggest concerns about cesarean section surgery has to do with possible pelvic floor injuries that can cause possible urinary or sexual problems later in life (Stein,

In 3% to 4% of births, the fetus is in the breech position, with feet and buttocks against the cervix.

2002) . Many hospitals are working with physicians to decrease the number of cesarean births; so far, these programs have been successful. In the United States today, approxi­mately 21% of babies are born by cesarean section.

C-sections are needed when the baby is too large for a woman to deliver vaginally, the woman is unable to push the baby out the birth canal, the placenta blocks the cervix (placenta previa), the cervix does not dilate to 10 centimeters, or the baby is in fetal dis­tress. If a doctor decides that a cesarean is necessary, the woman is moved to an operat­ing room and is given either a general anesthestic or an epidural. The operation usu­ally lasts between 20 and 90 minutes, and the woman will likely stay in the hospital longer than those who deliver vaginally. Women who have c-section births can get pregnant again and, although a woman may be able to deliver her next baby vaginally after a c-section (this referred to as a VBAC, or “vaginal birth after cesarean”), some choose to have another c-section for a variety of reasons, including to avoid the pain of vaginal labor or the risk of uterine rupture.