Childbirth
Overview
Childbirth (분만) is the physiological process in late pregnancy in which the fetus, placenta, and amniotic membranes are expelled from the mother's uterus. It usually begins spontaneously between 37 and 42 weeks of gestation, and continuous care and monitoring by medical staff are required to ensure the safety of the mother and newborn. Childbirth is one of the most central medical procedures in obstetrics and gynecology, and outcomes vary greatly depending on the level of prenatal care and the delivery environment.
Main Content
Definition and Classification
Normal childbirth refers to labor beginning after 37 weeks and before 42 weeks of gestation, with the fetus being delivered through the vagina. Birth before 37 weeks is classified as preterm birth, and after 42 weeks as post-term birth. Depending on how labor progresses, childbirth is divided into spontaneous vaginal delivery, induced labor, and augmented labor; depending on the route of delivery, it is divided into vaginal delivery and cesarean section.
Stages of Childbirth
Childbirth is generally divided into four stages. The first stage (dilation stage) lasts from the onset of regular uterine contractions until the cervix is fully dilated; for nulliparous women it takes about 12–18 hours, and for multiparous women about 6–8 hours. The second stage (expulsion stage) lasts from full cervical dilation until the fetus is delivered, and is the period when the mother pushes. The third stage (placental stage) is the stage in which the placenta is expelled after delivery of the fetus, usually taking 5–30 minutes. The fourth stage (recovery stage) is the 1–2 hours after childbirth, a period of intensive observation for complications such as postpartum hemorrhage.
Delivery Methods
Spontaneous vaginal delivery is the most common method; recovery is fast and initiating breastfeeding is easier. Painless delivery (epidural analgesia) relieves labor pain through epidural anesthesia and is widely performed in Korea as well. Cesarean section is performed when there is fetal distress, placenta previa, breech presentation, obstructed labor, etc., and is divided into emergency and scheduled. Other methods include water birth, forceps delivery, vacuum extraction, and uninduced natural childbirth.
Pain Management
Epidural anesthesia is a representative method that reduces lower-body pain by injecting a local anesthetic into the epidural space of the spine. In addition, spinal anesthesia, intravenous analgesics, electrical stimulation, breathing and relaxation methods (Lamaze method), massage, and heat therapy are used together. Pain control has a positive effect on maintaining the mother's strength and on the progress of labor.
Fetal Monitoring
Electronic fetal monitoring (EFM) is key equipment that simultaneously records uterine contractions and fetal heart rate to detect fetal distress early. Intermittent Doppler auscultation and fetal scalp blood sampling are used as adjuncts.
Major Complications
These include premature rupture of membranes, placental abruption, placenta previa, uterine atony, postpartum hemorrhage, perineal laceration, fetal distress, shoulder dystocia, and amniotic fluid embolism. Postpartum hemorrhage is one of the leading causes of maternal death worldwide, and early recognition and administration of uterotonics are important.
Postpartum Care
After childbirth, uterine involution, lochia discharge, perineal wound care, and breast care are carried out. Early breastfeeding and kangaroo care help newborn health and mother-infant attachment. Postpartum depression screening and psychological support are also essential.
Recent Trends
As of 2024–2025, in Korea, the number of obstetrics and gynecology clinics and delivery rooms capable of childbirth has continued to decrease due to the low birth rate, deepening the so-called 'childbirth-vulnerable area' problem. In response, the government is promoting support projects for obstetric clinics providing delivery services, reform of the emergency delivery transport system, and expansion of integrated maternal-newborn care. In clinical practice, there is active work on expanding access to epidural painless delivery, introducing remote fetal monitoring and wearable devices, and AI-based research on predicting labor progress and complications. In addition, biomarkers for predicting preterm birth, regenerative medicine approaches such as placental transplantation, and discussions on naturalistic and home birth are also taking place. The WHO continues to update guidelines emphasizing mother-centered respectful maternity care and reducing unnecessary medical interventions.
Related Topics
- [[Pregnancy]]
- [[Cesarean section]]
- [[Painless delivery]]
- [[Obstetrics and gynecology]]
- [[Newborn]]
- [[Postpartum care]]