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A typical pregnancy lasts about 40 weeks (9 months) from a woman's last menstrual period. During this time, the fetus develops inside the mother's uterus (womb). As the pregnancy approaches term, the uterus changes and begins to have contractions in the process of labor leading to childbirth. Obstetricians are doctors trained in the health care of pregnant women, including methods of delivery. Nurse midwives are registered nurses who specialize in the care of pregnant women, including labor and nonoperative methods of delivery. The May 4, 2005, issue of JAMA includes an article about episiotomy (an incision to widen the opening of the vagina) during the childbirth process.
Types of childbirth
Spontaneous vaginal birth—the baby is born through the vagina, usually with only guidance and assistance by the
doctor or midwife.
Vacuum-assisted vaginal birth—a suction (vacuum)
device is placed on the baby's head to help the baby's body transit
the birth canal.
Forceps-assisted vaginal birth—instruments
called forceps are placed around the presenting part (usually the baby's head),
allowing the doctor to complete a difficult delivery.
Cesarean birth (abdominal
delivery)—a major surgical procedure requiring anesthesia and a recovery
period. About 20% of births in the United States are accomplished using cesarean
birth. The cesarean rate in other parts of the world varies greatly.
Pain relief during childbirth
Because labor and childbirth can cause significant pain, it is important
to know your options about pain relief. Relaxation techniques and methods
of breathing are popular and useful ways to ease the pain of labor. Other
ways of managing labor pain are pain medications given through an intravenous
line, nerve blocks, and medications given through a catheter (tube) placed in the epidural space around
the covering of the spinal cord or as spinal anesthesia (injection into the spinal fluid). Epidural catheters placed to relieve
labor pain may also be used for epidural anesthesia if a cesarean birth becomes
necessary. Other types of anesthesia used for cesarean births include spinal
anesthesia and general anesthesia (being put to sleep),
which is usually used only for emergency cesarean deliveries or when medical
problems do not allow for spinal or epidural placement.
Preparing for labor and delivery
Seek early prenatal care if you suspect you are
Maintain a healthful diet and exercise plan approved
by your doctor.
Do not use tobacco, alcohol, or any illegal drugs.
Use the educational resources available through
your doctor to learn as much as possible about the process of pregnancy, labor,
and the methods of delivery.
Get plenty of rest as your due date approaches.
Labor and delivery may be lengthy and tiring.
For more information
National Women's Health Information Center 800/994-WOMANhttp://www.4woman.gov
American College of Obstetricians and Gynecologists 202/638-5577 http://www.acog.org
American Society of Anesthesiologistshttp://www.asahq.org
To find this and previous JAMA Patient Pages, go to the Patient Page
link on JAMA's Web site at http://www.jama.com. A Patient Page on birth labor was published in the September 18, 2002,
issue; and one on cesarean delivery was published in the May 22/29, 2002,
Sources: National Institute of Child Health and Human Development, American
Society of Anesthesiologists, March of Dimes, National Women's Health Information
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate
in most instances, but they are not a substitute for medical diagnosis. For
specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied
noncommercially by physicians and other health care professionals to share
with patients. Any other print or online reproduction is subject to AMA approval.
To purchase bulk reprints, call 718/946-7424.
TOPIC: WOMEN'S HEALTH
Torpy JM, Lynm C, Glass RM. Childbirth. JAMA. 2005;293(17):2180. doi:10.1001/jama.293.17.2180
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