gerprints of the mother and sometimes footprints of
the baby are taken.
At this time the neonate’s general state of health
is evaluated using the APGAR scoring system. At one,
five, and ten minutes after birth the baby is given a
score of 0, 1, or 2 on Activity (muscle), Pulse (or heart
rate), Grimace (or reflex action), Appearance (color),
and Respiration (breathing). This test provides very
general information on whether the baby’s life-
sustaining functions appear normal and what kinds of
potentially dangerous problems may be present. The
majority of children score between 5 and 10, and 90
percent have a score of 7 or better; there is no reason
for concern unless the score is below 5.
During the third or placental stage, the afterbirth
(the placenta and cord) is expelled from the uterus.
Labor is now completed.
The length of the entire process varies greatly, as
does the actual experience of labor. Fifteen hours is
an average figure for the duration of birth from the
first contraction to the expulsion of the afterbirth for
a first birth. But this average covers a spectrum of
labor as long as twenty-four hours and as short as
three hours or less. Labor is usually longer for first ba-
bies than for later ones, and longer for boys than girls.
Two reasons for a longer first labor might be the easi-
er adaptation of the woman’s body to the process and
the reduced amount of anxiety present in subsequent
births.
‘‘Gentle Birth’’ Techniques
One way that the process of labor can be made
easier for the expectant mother is the use of certain
techniques often referred to as gentle births, such as
the Lamaze and Dick-Read methods of childbirth.
Both of these became very popular in the early 1970s.
Grantly Dick-Read believed that pain during child-
birth is not inevitable but is the result of fear passed
on from mother to daughter over the generations.
Dick-Read stressed that by educating the woman
about the birth experience, the fear of the unknown
can be removed. In its place a more positive view
about delivery can be substituted. In 1967 a French
obstetrician, Fernand Lamaze, developed a method
for childbirth he called ‘‘childbirth without pain.’’
This popular technique usually begins in the third tri-
mester of pregnancy when the woman practices
breathing and other exercises with her ‘‘coach’’ (usu-
ally the father). These exercises are used during labor
to help a woman control her anxiety and be able to
relax and push at the appropriate time. By practicing
the exercises in advance, the command or suggestion
of the coach is quick in coming and easy to maintain
at the time of childbirth.
A doctor holding a newborn baby boy at a hospital in Moscow. The
birth was complicated because the infant’s umbilical cord was
wrapped around his neck. Doctors had to push on the mother’s belly
and use forceps to get him out. (David & Peter Turnley/Corbis)There are a substantial number of studies show-
ing that prepared childbirth enhances feelings of self-
esteem, increases the husband’s degree of participa-
tion, and even strengthens the marital relationship.
Whereas in the 1970s fathers were still marginally in-
cluded in the birth of their children, it is almost the
exception in the early twenty-first century when they
are not.
What are the baby’s first impressions of the world
he or she is being thrust into? One French obstetri-
cian, Frederick Leboyer, believes that the very act of
being born can be a terrifying experience. In Le-
boyer’s view, the violence of modern delivery tech-
niques contributes a good deal to this ‘‘hell and white
hot’’ experience.
The Leboyer technique involves a number of rad-
ical changes in the delivery procedure. As soon as the
infant begins to emerge, the physicians and nurses at-
tending the birth lower their voices, and the lights in
the delivery room are turned down. Everyone handlesBIRTH 53