21. Delivery and puerperium

Labour is a physiological process during which the foetus, membranes, umbilical cord and placenta 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 delivery is influenced by many factors, originating from mother and foetus but also by the attending care provider(s). Care during childbirth should find a good balance between too little, too late and too much, too soon. Barrier-free collaboration of all care providers involved in maternity care is required 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, delivery and puerperium are described as well as the relevant factors contributing to a normal or abnormal course of delivery and its consequences.