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Normal Delivery

Series of events that take place in different organs in an effort to expel a live baby out of uterus through the vagina into the outer world is called labour.
It may occur prior to 36 weeks of pregnancy and is called preterm labour.
The labour is divided into 3 stages - first, second & third.

First Stage :
It starts from the beginning of true labour pains and ends with full dilatation (opening) of cervix. The average duration is approximately 12 hours in first pregnancy & 6 hours in 2nd or more pregnancies. Initially pains are not strong and come at intervals of 15 to 30 minutes & last for 30 seconds. Gradually the interval shortens & intensity & duration increases. In late first stage the pains come at every 3-5 minutes & last for 45 seconds. Pains are usually felt shortly after uterine contraction begins and pass off before complete relaxation of uterus. Maternal & foetal condition remains unaffected except during contraction.
Management: 
Non interference with watchful expectancy so as to prepare the woman for a smooth delivery in 2nd stage.
The progress of labour, maternal condition & foetal behaviour is monitored so that any deviation from the normal is detected at the earliest possible moment.
Woman is admitted in hospital, allowed to be in a comfortable position, walk, sit or lie down, enema is given, asked to empty her bladder frequently, adequate fluid intake is adviced but should avoid solid food.
Relief of pain- Various pain killers can be given to help the woman tolerate the pain. Epidural injection can be given if required or opted by the patient.
Regular monitoring of blood pressure, foetal heart rate & progress of labour is done by the doctor.

Second Stage : 
Starts from full dilatation (opening) of cervix and ends with expulsion of the foetus. Its average duration is 2 hours in the first delivery & 30 minutes in 2nd or more deliveries. This stage concerns with coming down of foetus and delivery of the foetus through the birth canal. The intensity of pain increases. It comes at interval of 2-3 minutes & lasts for 1 - 1 1/2 minutes. It becomes successive & unbearable in terminal stage. The patient feels like pushing the baby down & out called "bearing down". The head comes out first followed by shoulders & rest of the body. Patient shows signs of exhaustion.
Management: 
Is to assist expulsion of foetus.
To prevent injury to perineum
Patient is better lying down under constant supervision of the doctor.
Nothing has to be taken by mouth except water or ice.
Patient is shifted to the labour table & given the position for delivery.
With help of the doctor the head of foetus slowly passes out of the vagina then the shoulder & rest of the body slips out.
The slow process prevents injuries to the perineum of the patient.
The umblical cord is clamped (tied) & cut.
If the paediatrician is present, baby is handed over to him.

Third Stage : 
It begins after the expulsion of foetus & ends with expulsion of placenta & membranes. Its average duration is 15 minutes. The pain stops for a short time. However, intermittent discomfort in the lower abdomen re-appears, corresponding with the uterine contractions. Placenta is expelled by "bearing down" efforts or manual manipulation. Slight bleeding may be present. The patient may have chills and shivering.
Management: 
This is a very crucial stage of labour. This can be done by.
Watchful expectancy or
Active management.
The placental descent into vagina is allowed to occur spontaneously. If this does not happen spontaneously it can be manually removed by the doctor

Normal Puerperium : 
Puerperium is the period following child birth during which the body & the organs involved in pregnancy & child birth, revert back to approximately the pre-pregnant state both anatomically & physiologically.
It starts with the expelling of placenta and lasts 6 weeks. It can be divided into
Immediate within 24 hours.
Early - up to seven days.
Remote - up to 6 weeks.
Lochia : 
It is the vaginal discharge for the first fortnight during puerparuim. It comes from uterus, cervix & vagina. It has a fishy smell. Depending up the colour its divided into-
Lochia rubra-red and lasts for 1-4 days.
Lochia serosa yellowish or pink and lasts for 4-10 days.
Lochia alba-pale white and lasts for 10-15 days.
It may be seen up to 3 weeks.
Clinical Importance: 
It's smell, colour, amount & duration give an idea of infection, retained bits, subinvolution or other lesions.
Menstruation: 
If the woman is not breast feeding it starts by 6 weeks. If breast feeding it may be delayed. But usually comes before stoppage of breast feeding.

 
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nayapalli near hotel crown ,Odisha,India
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Testimonials By Our Patients

"my painless delivery was conducted by Dr Harpreet kaur by epidural , it was a wonderful experience as I was expecting severe pain & wht I got was a cute baby born absolutely painless that too 3.8 kgs ! 
Also my recovery was faster ..
Mrs suman , siligudi ."


" I was very tensed & fearing the pain of delivering my baby , then I was offered painless delivery option by Dr Harpreet kaur . As my labor pains started I ws given that inj by an anesthesia doctor n after dat it ws vry cmfrtabl and painless ..I got a taste of how severe the pain could had been whn during shifting the inj got disconnected for a min ..
Thanks to Dr Harpreet kaur & her team I was able to deliver painlessly ! 
Mrs jyoti tanwar , ghaziabad , Delhi ncr "


" We had been married for 5 years but couldnt conceive , we consulted many doctors in Delhi & Mumbai ..and were planning for IVF , test tube baby .
Then we consulted Dr Harpreet kaur , she suggested some more investigations and then put both of us on medicines , I conceived ..n m a happy mother now ..
Thank you Dr Harpreet kaur .
Mrs kajal Sharma , Mumbai "


" we were desperate for a child even after 6 years of marriage ..had shown to many doctors , finally after we consulted Dr Harpreet kaur at Delhi ..after some months , my wife was pregnant & v r a happy family now .
Mrs & Mr shekhar Verma , Delhi ncr "


" my wife finally conceived & delivered under treatment of Dr Harpreet kaur. Thanks to her .
Mr Deepak ,marketing manager , rg hospitals , Delhi ncr "


"I was suffering from severe menstrual bleeding & pain for almost an year due to multiple large fibroids in my uterus .. I was taking medicines for many months but no benefit , was advised hysterectomy , but was afraid of large cut & pain n delayed recovery ..
Whn we consulted Dr Harpreet kaur she suggested laparoscopic surgery , n told that only small holes will be made n my uterus will be taken out through those small holes in pieces ..
I underwent surgery , & was discharged in 2 days and was back to normal work in a week ! 
Thanks to Dr  Harpreet & laparoscopic surgery otherwise I would never had got operated ..
Mrs meena , faridabad , Delhi ncr "


" I was diagnosed with my tubes blocked ,and was advised. Tubal recannulation surgery by open. .
Someone suggested me Dr Harpreet kaur , she explained & offered me hysteroscopic tubal cannulation without any cut ! 
Procedure was done in morning & I was discharged in the evening ! 
Now I have high chances of conception ..
Thanks Dr Harpreet kaur & team .
Mrs sunita , Delhi ncr "

and many more....
 
MEDICAL INFORMATION
Plan Your Pregnancy
Anaemia in Pregnancy
Ectopic Pregnancy
Heart Disease
Multiple Pregnancy
Vomiting in Pregnancy
Caesarean delivery
Labour
Confirming Pregnancy
Breech Delivery
Overdue Baby
Normal Delivery
Overdue Pregnancy
Pregnancy Counselling
Labour Analgesia
Normal Puerperium
Understanding Conception
IUI
Hysteroscopy
Laparoscopy
Myomectomies
Uterine Fibroids
Endometriosis
Cervical Cancer
Endometrial Cancer
Breast Cancer
Ovarian cyst
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