29. Childbirth and puerperium

Labour is a physiological process during which the foetus and placenta with membranes and umbilical cord, are expelled from the uterus. After the birth of the placenta and membranes, childbirth ends, and the postpartum period begins. The course and outcome of labour and birth is influenced by many factors, originating from mother and foetus but also from the attending care providers. Care during childbirth should strike a good balance between being too little, too late and too much too soon. Barrier-free collaboration of all care providers involved in maternity care is necessary in order to provide good-quality, woman-centred birth care. Adverse perinatal and/or maternal outcome, including a negative birth experience, may have lifelong consequences. In this chapter, the mechanisms of normal and abnormal labour, birth and puerperium are described, as well as the relevant factors contributing to a normal or abnormal course of childbirth and its consequences.