Bibliography
Wolf, Theta. Alfred Binet. Chicago: University of Chicago Press,
1973.
Publications by Binet
Binet, Alfred, and Theophile Simon. A Method of Measuring the De-
velopment of the Intelligence of Young Children, 3rd edition. Chi-
cago: Chicago Medical Book, 1915.
Jennifer D. Wishner
BIRTH
Throughout the animal kingdom, birth is universally
recognized as a miracle of renewal where, once again,
a life begins. While humans are better than ever at
saving the lives of even the smallest newborn, the
whole process of birth is one of amazing change and
brings finality to nine months of preparation.
Labor
Labor is the beginning of the active birth process.
Many expectant mothers ask themselves the impor-
tant question ‘‘Is this it?’’ more than once in the late
weeks of pregnancy. Sometimes they feel a slight con-
traction and then nothing more. Such contractions,
known as Braxton-Hicks contractions, are relatively
painless and begin as early as the sixth month and
may continue throughout the pregnancy. Real labor
contractions cause more discomfort, occur with great-
er regularity, and are intensified by walking.
Other signs may or may not indicate that labor is
beginning, such as an ache in the small of the back,
abdominal cramps, diarrhea, indigestion, ‘‘show’’ (a
small amount of blood-tinged mucus emerging from
the vagina), and the ‘‘water breaking’’ (a discharge of
fluid from the vagina). The discharge of fluid, which
is caused by the rupture of membranes, can occur
some time before actual labor begins. The only cer-
tain signs of labor are the appearance of the show and
the onset of regular, rhythmic contractions that in-
crease in frequency and strength. When the fluid
from the amniotic sac is discharged, the first line of
defense against infection is broken. Often, if labor
does not begin after the water breaks, the physician
may induce labor.
Stages of Labor
Labor progresses through three stages: dilation,
or ‘‘the opening,’’ expulsion, and placental. The first
stage, dilation, can last anywhere from two hours to
sixteen hours or more. At first, each contraction is
thirty to forty-five seconds in duration and occurs
about every fifteen to twenty minutes. The contrac-
tions are involuntary and the woman cannot start
them or stop them at will or make them come faster
or slower. Their function is to dilate the cervix until
it is wide enough to let the baby through—usually
about four inches (ten centimeters). In the course of
the first stage of labor the contractions increase in fre-
quency until they are only a minute or two apart. Each
contraction itself also becomes longer and, toward the
end of the first stage, may last ninety seconds.At the end of the first stage there may be a series
of very intense contractions; during this time the cer-
vix has been stretched around the baby’s head. The
woman may feel ready to give up, but this phase,
known as transition, is soon over. It rarely lasts more
than half an hour and is often much shorter. In expul-
sion, the second stage of labor, the involuntary con-
tractions continue to be long in duration and closely
spaced, but now the woman has a strong urge to bear
down with her abdominal muscles. At each new con-
traction she pushes down with all her strength as the
baby’s scalp comes into view, only to disappear again
when the contraction ends. This is known as crown-
ing. With each contraction more and more of the
baby’s head can be seen. At this point in labor, some
obstetricians may perform an episiotomy (making a
small slit in the skin outside the vagina toward the
anus) to prevent this tissue from tearing. When the
baby’s head comes out as far as its widest diameter, it
stays out, and in a short time it is free. The head may
be molded (elongated in shape as a result of its pas-
sage through the cervix), but the soft skull bones that
have been squeezed together soon recover their nor-
mal shape.Some babies will give their first cry at this point.
With the next contractions the shoulders emerge, and
the rest of the body slips out easily. The feelings of
both parents at this time are almost impossible to put
into words: elation, exhaustion, and great feelings of
tenderness and caring.It was once the practice for the doctor to hold the
baby up by the feet immediately following delivery to
allow fluid and mucus to escape from the baby’s
mouth and nose, so that the infant could start breath-
ing, usually with a gasp and a cry. Today it is more
usual to aspirate the mucus from the baby’s mouth
and nose by suction as soon as the head is delivered.
This gives the baby a slight head start on independent
breathing.As soon as delivery is complete, the umbilical
cord is clamped and cut. The baby is then wrapped
in a receiving blanket, and someone performs a vari-
ety of procedures that vary from hospital to hospital.
Typically, drops of silver nitrate are placed in the
baby’s eyes to prevent infection, both mother and
baby are given plastic identification bracelets, and fin-52 BIRTH