Unassisted Vaginal Delivery
Normal vaginal labor is defined as progressive cervical dilation and effacement, with contractions of sufficient frequency and force.
Normal labor is defined by dividing it into four phases. Phase 1 is defined as the onset of labor and is divided into latent and active phases. The latent phase is the phase in which pain comes irregularly, contractions are not disturbing the pregnant woman and lasts until the cervix reaches a 3-4 cm opening. The latent phase lasts between 6-21 hours in women who have never given birth before and between 5-14 hours in women who have given birth before.
The active phase is the period from a 3-4 cm opening until the baby reaches a 10 cm opening. In the active phase, contractions are regular, their intensity increases, and the rate of baby descent increases with the contractions. The first stage of labor lasts on average between 10-25 hours in women who have never given birth (nulliparous) and between 8-19 hours in women who have given birth before (multiparous).
The stage is the time between the full opening of the cervix and the birth of the baby. The second stage of labor lasts on average 35-110 minutes in women who have given birth for the first time, i.e. nulliparous women, and 10-45 minutes in women who have given birth before (multiparous). If this period lasts longer than 2 hours in nulliparous women and 1 hour in multiparous women, we speak of prolonged labor. The exception is women who have had epidural analgesia. In them, it takes 3 hours in nulliparous women and 2 hours in multiparous women before we can say that labor is prolonged.
The stage is the time between the birth of the baby and the birth of the placenta, which we call the baby's partner. This phase lasts between 5 and 30 minutes on average.
The stage covers the 6-week period following the birth when the changes that occurred during pregnancy in the expectant mother recover.
Labor can start differently in every pregnant woman and pregnancy. Some women present to the hospital with contractions, while others present to the hospital with water breaking or bleeding.
The first examination at the hospital is to assess the well-being of the mother and baby. Subsequently, the condition of the cervix, the level of the baby in the mother's pelvis and the amniotic membranes (water sac) are evaluated. If labor is considered to have started, the pregnant woman is hospitalized.
Vaginal delivery is not allowed in the following cases;
- Vasa previa, placenta previa (the baby's partner is attached to the cervix)
- Abnormal posture of the fetus
- Active herpes infection
- HIV infection with high viral load
- Prolapsed umbilical cord
- Cervical cancer in advanced stages
To support labor;
- Epidural anesthesia
- Induction with oxytocin (artificial labor)
- Methods such as amniotomy (opening the water sac) can be used.
The fetal heart rate is also monitored regularly during labor.
What is Operative Vaginal Birth?
It is the realization of vaginal delivery with supportive tools such as vacuum and forceps as an alternative to cesarean section as a result of prolongation of the 2nd stage of labor in women who meet all the criteria for birth.