Parturition, also called childbirth, delivery, or labor, is a coordinated process of bringing forth an offspring and placenta from the uterus. It begins roughly nine months after conception. The exact events leading to parturition in humans are still unclear; however, initiation of childbirth is thought to be due to the various biochemical factors produced by the fetus and their interaction with placental and maternal biochemical substances.
STAGES OF PARTURITION
Parturition is divided into three stages. These are:-
1. DILATION– This is the first stage that begins with the onset of labor and continues until the cervix is completely dilated. This stage is divided into two phases:-
- Latent phase- This phase lasts for about 6hours for a primigravida and around 5hours for a woman who has delivered before. In this phase, the cervix is 0-4 cm dilated.
- Active phase- In this phase, the cervix is 4-10 cm dilated. This dilation occurs at a rate of 1cm per hour for a primigravida and 2 cm per hour for a woman who had a vaginal delivery before.
2. EXPULSION – This stage begins with full dilation and continues until birth. It is divided into two stages:-
- Passive phase- In this phase, the head of the baby moves down through the vagina.
- Active phase- In this phase, the mother actively pushes or contracts the abdominal muscles corresponding with uterine contractions. This phase lasts for 45minutes for a primigravida and 30minutes for a woman who had a vaginal delivery before. This stage ends when the baby is born, at what point the umbilical cord is clamped.
3. PLACENTAL STAGE – This stage begins after the birth of the child and ends with the delivery of the placenta and membranes. If assisted by the doctor, including gently pulling on the placenta, this stage takes around 5minutes. However, if unassisted, this stage can last around 30 minutes.
COMPLICATIONS DURING PARTURITION
Some of the common complications that are found to occur during the three stages of parturition are:-
- Fetal distress- It refers to a decrease in the heart rate of the baby. In this case, the doctor tries to speed up the delivery by using forceps or vacuum extractor. Even if that is not successful, cesarean delivery is done.
- Nuchal cord- This occurs when the umbilical cord wraps around the baby’s neck. This can become a problem if the mother can’t push the baby out and forceps or vacuum extractor is not successful. Cesarean section is often the best solution to this complication.
- Breech pregnancy- It is when the baby, instead of head positioned down, is found with feet down, bottom down, or sideways. Sometimes this can be corrected manually by the doctor or else cesarean delivery has to be performed.
- Lacerations- Vaginal lacerations are seen as profuse bleeding after delivery of the baby. This can often be avoided by making an incision in the external genital opening before delivery of the baby’s head.
MANAGEMENT OF PARTURITION
Pain experienced by a mother during the process of childbirth can be reduced by psychoprophylaxis, painkillers, local nerve blocks, or a combination of these methods. Psychoprophylaxis involves physically and mentally preparing a woman for delivery. Along with this, a comfortable environment, supportive friends and relatives and competent and encouraging birth attendants can greatly help to reduce or avoid the need for painkillers. Systemic drugs can be used to reduce labor pain. But they are often found to cause side effects in both the mother and newborn. These have led to a growing reliance on local anesthesia. The action of a local anesthetic agent is limited to the nerves close to the injection site and numbs only an isolated part of the body. This helps the woman to retain consciousness and control over the rest of the body.
HOMEOPATHY AND PARTURITION
Homeopathy has a vital role to play in facilitating easy parturition. Homeopathic medicines for easy delivery are not only effective and help to avoid the need for cesarean delivery in many cases, but also they don’t cause any side effects. In addition, in case of any complication related to parturition, there are many homeopathic medicines available to treat the condition effectively. Common homeopathic medicines for painless delivery and easy parturition are:-
Aconitum Napellus- It is indicated when the labor pains are frequent but irregular. The patient requiring this remedy is found to be very restless, anxious, frightened and convinced of dying during labor.
Arnica Montana- Arnica Montana is suitable when there has been a lot of bruising and bleeding during labor. It can also treat violent afterpains.
Caulophyllum– It is suitable when the labor pains are deficient and the patient is fretful and exhausted. It is the frequently used homeopathic remedy for easy delivery.
Chamomilla – It is suited when labor pains are spasmodic and press upward. The patient requiring this remedy gets very irritable, snappish and resents being examined due to being oversensitive to pain.
Cimicifuga Racemosa- It is suitable to treat afterpains, which are like electric shocks here and there and are accompanied by great intolerance to pain and irritability.