A report on Caesarean section

A team of 4 performing a caesarean section
A 7-week-old caesarean section scar and linea nigra visible on a 31-year-old mother: Longitudinal incisions are still sometimes used.
Transvaginal ultrasonography of a uterus years after a caesarean section, showing the characteristic scar formation in its anterior part
Suturing of the uterus after extraction
Closed incision for low transverse abdominal incision after stapling has been completed
Removal of the baby
Illustration depicting caesarean section
A baby being removed from its dying mother's womb
A caesarean section performed by indigenous healers in Kahura, Uganda. As observed by medical missionary Robert William Felkin in 1879.
Saint Caesarius of Terracina, invoked for the success of caesarean delivery
Fictional 15th-century depiction of the birth of Julius Caesar

Surgical procedure by which one or more babies are delivered through an incision in the mother's abdomen, often performed because vaginal delivery would put the baby or mother at risk.

- Caesarean section
A team of 4 performing a caesarean section

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Newborn baby and mother with vernix covering on the baby

Childbirth

17 links

Newborn baby and mother with vernix covering on the baby
A Luristan bronze fibula showing a woman giving birth between two antelopes, ornamented with flowers. From Iran, 1000 to 650 BC, at the Louvre museum.
Sequence of images showing the stages of ordinary childbirth
The hormones initiating labour
US births by time of day
Engagement of the fetal head
Stages in the birth of the baby's head
Newborn rests as caregiver checks breath sounds
Share of births attended by skilled health staff
Oxytocin facilitates labour and will follow a positive feedback loop.
Mechanical fetal injury may be caused by improper rotation of the fetus.
810 women die every day from preventable causes related to pregnancy and childbirth. 94% occur in low and lower middle-income countries.
Medieval woman, having given birth, enjoying her lying-in (postpartum confinement). France, 14th century
Cost of childbirth in several countries in 2012.
Model of pelvis used in the beginning of the 19th century to teach technical procedures for a successful childbirth. Museum of the History of Medicine, Porto Alegre, Brazil
Kangaroo care by father in Cameroon.
Disability-adjusted life year for maternal conditions per 100,000 inhabitants in 2004. 
no data
less than 100
100–400
400–800
800–1200
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1600–2000
2000–2400
2400–2800
2800–3200
3200–3600
3600–4000
more than 4000
Disability-adjusted life year for perinatal conditions per 100,000 inhabitants in 2004. 
no data
less than 100
100–400
400–800
800–1200
1200–1600
1600–2000
2000–2400
2400–2800
2800–3200
3200–3600
3600–4000
more than 4000
Disability-adjusted life year for neonatal infections and other (perinatal) conditions per 100,000 inhabitants in 2004. Excludes prematurity and low birth weight, birth asphyxia and birth trauma which have their own maps/data. 
no data
less than 150
150–300
300–450
450–600
600–750
750–900
900–1050
1050–1200
1200–1350
1350–1500
1500–1850
more than 1850

Childbirth, also known as labour and delivery, is the ending of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or Caesarean section.

A woman in the third trimester of pregnancy

Pregnancy

6 links

Time during which one or more offspring develops inside a woman's womb.

Time during which one or more offspring develops inside a woman's womb.

A woman in the third trimester of pregnancy
William Hunter, Anatomia uteri humani gravidi tabulis illustrata, 1774
Melasma: pigment changes to the face due to pregnancy
In the later part of pregnancy the uterus takes up much of the abdomen
Timeline of pregnancy, including (from top to bottom): Trimesters, embryo/fetus development, gestational age in weeks and months, viability and maturity stages
Distribution of gestational age at childbirth among singleton live births, given both when gestational age is estimated by first trimester ultrasound and directly by last menstrual period. Roughly 80% of births occur between 37 and 41 weeks of gestational age.
Fertilization and implantation in humans
The initial stages of human embryogenesis
Breast changes as seen during pregnancy. The areolae are larger and darker.
The uterus as it changes in size over the duration of the trimesters
By the end of the second trimester, the expanding uterus has created a visible "baby bump". Although the breasts have been developing internally since the beginning of the pregnancy, most of the visible changes appear after this point.
Pregnant woman in third trimester of pregnancy (last month)
The uterus expands making up a larger and larger portion of the woman's abdomen. At left anterior view with months labeled, at right lateral view labeling the last 4 weeks. During the final stages of gestation before childbirth the fetus and uterus will drop to a lower position.
Linea nigra in a woman at 22 weeks pregnant.
CT scanning (volume rendered in this case) confers a radiation dose to the developing fetus.
A pregnant woman undergoing an ultrasound. Ultrasound is used to check on the growth and development of the fetus.
Giotto di Bondone Visitation, circa 1305
Embryo at 4 weeks after fertilization (gestational age of 6 weeks)
Fetus at 8 weeks after fertilization (gestational age of 10 weeks)
Fetus at 18 weeks after fertilization (gestational age of 20 weeks)
Fetus at 38 weeks after fertilization (gestational age of 40 weeks)
Relative size in 1st month (simplified illustration)
Relative size in 3rd month (simplified illustration)
Relative size in 5th month (simplified illustration)
Relative size in 9th month (simplified illustration)
Anatomical model of a pregnant woman; Stephan Zick (1639–1715); 1700; Germanisches Nationalmuseum
Statue of a pregnant woman, Macedonia
Bronze figure of a pregnant naked woman by Danny Osborne, Merrion Square, Dublin, Ireland
Marcus Gheeraerts the Younger Portrait of Susanna Temple, second wife of Sir Martin Lister, 1620
Octave Tassaert, The Waif aka L'abandonnée 1852, Musée Fabre, Montpellier
The Visitation: Mary, pregnant with Jesus, visiting pregnant Elizabeth, depicted as a statue at the Church of the Visitation in Ein Karem, Israel.
Venus of Willendorf, c. 25,000 BC, Austria
Taweret ancient Egyptian goddess of pregnancy.
Pottery figure from ancient Mexico
Picture of the tragic and gory story about the life of a travelling actress called Okume.<ref name="British Museum">{{cite web | title=Collections Online | website=British Museum | url=https://www.britishmuseum.org/collection/term/BIOG177414 | access-date=2022-07-01}}</ref>
Gustav Klimt, 1903, Hoffnung I (Hope I)

Delivery before 39 weeks by labor induction or caesarean section is not recommended unless required for other medical reasons.

Drawing of a frank breech from 1754 by William Smellie

Breech birth

4 links

When a baby is born bottom first instead of head first, as is normal.

When a baby is born bottom first instead of head first, as is normal.

Drawing of a frank breech from 1754 by William Smellie
Breech birth position seen on MRI
Twin breech (vertex and non-vertex twins)

Most babies in the breech position are delivered via caesarean section because it is seen as safer than being born vaginally.

A non-pneumatic anti-shock garment (NASG)

Postpartum bleeding

4 links

Often defined as the loss of more than 500 ml or 1,000 ml of blood within the first 24 hours following childbirth.

Often defined as the loss of more than 500 ml or 1,000 ml of blood within the first 24 hours following childbirth.

A non-pneumatic anti-shock garment (NASG)
Performing a uterine massage
Side view of a uterine massage with underlying anatomy

It also occurs more commonly following caesarean sections, those in whom medications are used to start labor, those requiring the use of a vacuum or forceps, and those who have an episiotomy.

Drawing of childbirth with use of forceps by Smellie

Obstetrical forceps

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Obstetrical forceps are a medical instrument used in childbirth.

Obstetrical forceps are a medical instrument used in childbirth.

Drawing of childbirth with use of forceps by Smellie
Obstetrical forceps, by William Smellie (1792)
Wooden forceps c.1800, Hunterian Museum, Glasgow
James Young Simpson's Caesarian forceps, Hunterian Museum, Glasgow
Chamberlen forceps (Maldon)
Palfijn "hands" in different versions
Dussee French forceps (circa 1725) with two different locks
French forceps, Levret-Baudelocque type (1760–1860) with perforator and hook at the end of the handles
Tarnier forceps with tractor handle (1877) and USA Dewey model (1900)
Hodge "Eclectic" forceps – USA (1833)
Elliott forceps with "pressure regulating" screw at the end of handles – USA (1860)

In general, a forceps birth is likely to be safer for both the mother and baby than the alternatives – either a ventouse birth or a caesarean section – although caveats such as operator skill apply.

Sequence of images showing the stages of a normal vaginal delivery (NVD)

Vaginal delivery

3 links

Birth of offspring in mammals through the vagina (also called the "birth canal").

Birth of offspring in mammals through the vagina (also called the "birth canal").

Sequence of images showing the stages of a normal vaginal delivery (NVD)
Sequence of images showing stages of an instrumental vaginal delivery.

It is considered the preferred method of delivery, with lower morbidity and mortality than Caesarean sections (C-sections).

Drawing of internal and external bleeding from placental abruption

Placental abruption

4 links

When the placenta separates early from the uterus, in other words separates before childbirth.

When the placenta separates early from the uterus, in other words separates before childbirth.

Drawing of internal and external bleeding from placental abruption
Ultrasound showing placental abruption.
Gross pathology of a uterus which has been opened to show a placental abruption, with a hematoma separating the placenta from the uterus.

Risk factors include smoking, pre-eclampsia, prior abruption (most important and predictive risk factor), trauma during pregnancy, cocaine use, and previous cesarean section.

Labor induction

4 links

Process or treatment that stimulates childbirth and delivery.

Process or treatment that stimulates childbirth and delivery.

Induction of labor in those who are either at or after term improves outcomes for newborns and decreases the number of C-sections performed.

A gross anatomy image of a placenta that has been cut after delivery

Eclampsia

3 links

Onset of seizures in a woman with pre-eclampsia.

Onset of seizures in a woman with pre-eclampsia.

A gross anatomy image of a placenta that has been cut after delivery
Diagram of the regions (or quadrants) of the abdomen, to assist in locating the right upper quadrant or the epigastric region, where eclampsia-associated pain may occur
Diagram of the placenta and its position in the uterus during pregnancy

Other treatments may include blood pressure medications such as hydralazine and emergency delivery of the baby either vaginally or by cesarean section.

Types of placenta accreta

Placenta accreta spectrum

3 links

Associated with an increased risk of heavy bleeding at the time of attempted vaginal delivery.

Associated with an increased risk of heavy bleeding at the time of attempted vaginal delivery.

Types of placenta accreta

The condition is increased in incidence by the presence of scar tissue i.e. Asherman's syndrome usually from past uterine surgery, especially from a past dilation and curettage, (which is used for many indications including miscarriage, termination, and postpartum hemorrhage), myomectomy, or caesarean section.