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Birth

Birth is the act or process by which an produces and brings forth its . In placental mammals, including humans, this typically involves the expulsion of a from the after a full-term of approximately 40 weeks, culminating in the delivery of the newborn and the . This event, also known as or parturition, involves coordinated hormonal, muscular, and mechanical changes in the mother's body to facilitate the baby's transition from intrauterine to extrauterine life. Labor usually begins spontaneously between 37 and 42 weeks of , though it can be induced medically if necessary. This article discusses birth primarily in humans, with dedicated sections on other mammals and non-mammalian animals. The process of birth is divided into three main stages. The first stage, the longest and often most variable, begins with the onset of regular uterine contractions that cause the cervix to thin (efface) and dilate up to 10 centimeters; it is subdivided into early labor (up to 6 cm dilation) and active labor (6-10 cm), potentially lasting from hours to a day or more for first-time mothers. The second stage starts with full cervical dilation and involves the active pushing phase, during which the baby descends through the birth canal and is delivered vaginally, typically lasting 20 minutes to 2 hours. Finally, the third stage entails the delivery of the placenta, which is expelled from the uterus shortly after the baby's birth, usually within 30 minutes, accompanied by the cutting of the umbilical cord. Birth can occur through , the most common method for low-risk pregnancies, or cesarean section (C-section), a surgical procedure performed when vaginal birth poses risks to the mother or baby, such as in cases of fetal distress or breech presentation; C-sections accounted for 32.4% of births in the United States as of 2024. Pain management options during labor include , opioids, or non-pharmacological techniques like exercises and immersion. While most births proceed normally, complications such as preterm labor (before 37 weeks), , or postpartum hemorrhage can arise, necessitating medical intervention to ensure the health of both mother and infant.

Biological Foundations

Definition and Terminology

Birth is the by which are delivered from the reproductive tract of a parent following a period of or internal development. This event marks the transition of the young from dependent embryonic or fetal stages to independent existence outside the parent's body, typically involving the expulsion of the along with associated structures such as the or remnants. In most contexts, birth encompasses both live-bearing and egg-laying mechanisms, though it is often associated specifically with viviparous where young emerge fully formed. A fundamental distinction in lies between , , and . refers to the production of live young that develop inside the mother's body, nourished via a or similar structure until birth, as seen in most mammals. involves the laying of eggs that contain all necessary nutrients for embryonic development outside the parent, common in , reptiles, and many . , a form, entails retaining eggs within the mother's body until the young hatch internally and emerge live, without direct nutrient transfer, exemplified in some sharks and reptiles. These modes represent adaptive strategies for offspring survival in diverse environments. Key terminology in the study of birth includes several standardized terms with roots in Latin and Greek. Parturition denotes the act of giving birth, derived from the Latin "partus" meaning "to bring forth," and is used interchangeably with "labor" in mammalian contexts to describe the physiological process of expulsion. The is the duration from to birth, varying widely across ; for instance, it spans about 20 days in some but extends to over 600 days in elephants, reflecting evolutionary adaptations to developmental needs. A neonate is the newborn immediately post-birth, from the Greek "neo" (new) and Latin "natus" (born), emphasizing the vulnerable early stage requiring immediate care. These terms are employed consistently in biological literature to facilitate cross-species comparisons. The variability in birth timing underscores the diversity of reproductive strategies. Short periods, such as those under a month in certain small mammals, allow for rapid in unstable environments, while prolonged periods in large herbivores enable advanced fetal maturation for survival in open habitats. This range highlights how birth timing is tuned to ecological pressures, though the core process of remains a critical reproductive milestone across taxa.

Evolutionary Origins

The transition from oviparity to viviparity in vertebrates represents a major evolutionary shift, with the earliest fossil evidence dating to the Devonian period approximately 380 million years ago. A remarkable specimen of the placoderm fish Materpiscis attenboroughi from the Gogo Formation in Australia preserves an embryo connected to the mother by an umbilical cord, indicating internal gestation and live birth. This discovery, along with embryos found in related species like Austroptyctodus gardneri, demonstrates that internal fertilization and viviparity originated early within placoderms, the dominant jawed fishes of the time, predating similar traits in modern chondrichthyans. These armored fishes, as basal gnathostomes, bridge aquatic origins to later terrestrial lineages, suggesting viviparity evolved as an adaptation for protected embryonic development in ancient aquatic environments that foreshadowed terrestrial challenges. Viviparity conferred adaptive advantages by enhancing offspring survival, particularly during environmental transitions such as the move to land in early tetrapod ancestors. In transitional species like Devonian placoderms and their descendants—early fish-amphibian forebears—live birth allowed mothers to shield embryos from aquatic predators and fluctuating conditions, reducing mortality compared to exposed eggs. This protection extended to emerging terrestrial habitats, where viviparous reproduction mitigated risks from desiccation, temperature extremes, and predation, enabling higher juvenile survival rates in variable ecosystems. For instance, maternal thermoregulation in viviparous lineages maintained optimal developmental temperatures, a benefit especially pronounced in cooler or unstable climates that oviparous species struggled to exploit. Key evolutionary milestones include the development of more sophisticated reproductive structures in later vertebrates. In mammals, placentation emerged around 160 million years ago, coinciding with the diversification of therian mammals during the Jurassic, transforming simple yolk-sac nourishment into nutrient exchange via chorioallantoic placentas for prolonged gestation. Concurrently, marsupials evolved pouch systems—folds of skin enclosing mammary glands—as an intermediate strategy, allowing underdeveloped young to complete development externally while protected, likely arising after the therian-placental split around 160 million years ago. These innovations diversified birth mechanisms across amniotes, with viviparity appearing independently in squamates and other reptiles by the Mesozoic. Natural selection played a pivotal role in refining birth timing and mechanisms to optimize the balance between and offspring viability. In viviparous species, selection favored delayed parturition to maximize maternal provisioning—such as through matrotrophy—while avoiding excessive costs or risks to the , as seen in the temporal spreading of investment over . Parent-offspring conflicts influenced this , with embryos extracting resources up to a point where maternal fitness benefits outweighed further , leading to adaptive trade-offs in length and litter size across lineages. This selective pressure ensured viable, independent young at birth, enhancing overall in diverse environments.

Human Childbirth

Physiology and Stages

Human childbirth, or parturition, involves coordinated physiological processes in the , primarily the , , and , regulated by hormones such as oxytocin and prostaglandins. The , a muscular organ, contracts rhythmically to expel the , while the dilates and effaces to allow passage through the birth canal; the , attached to the uterine wall, provides nourishment during but detaches post-delivery. Labor is initiated by rising levels of relative to progesterone, which sensitizes the to contractile stimuli, and involves prostaglandins produced in the and that promote cervical ripening and . Oxytocin, released from the , amplifies these contractions by binding to receptors on uterine , creating a that intensifies labor progression. The process unfolds in three distinct stages, each characterized by specific physiological changes. The first stage, dilation, begins with the onset of regular contractions and ends with full cervical dilation to approximately 10 cm; it typically lasts 12 to 20 hours in first-time births, divided into latent (early, slower dilation) and active (faster dilation) phases, during which the cervix thins (effaces) and opens under pressure from descending amniotic fluid and fetal head. Contractions in this stage start mild and irregular, increasing in frequency, duration (from 30-45 seconds to 60-90 seconds), and intensity (from 20-30 mmHg to 50-80 mmHg pressure), driven by oxytocin pulses that rise in amplitude and frequency. The second stage, expulsion, commences at full dilation and involves the delivery of the baby, lasting 20 minutes to 1 hour in nulliparous women; here, the fetus typically descends in vertex presentation—head flexed with the occiput leading—to navigate the pelvis, aided by maternal pushing triggered by the Ferguson reflex, a neuroendocrine response where cervical and vaginal distension stimulates further oxytocin release, enhancing the urge to bear down and fetal propulsion. The third stage, placental delivery, occurs 5 to 30 minutes after birth, marked by uterine contractions that shear the placenta from the endometrium, followed by its expulsion as the uterus contracts to reduce bleeding. Throughout labor, hormonal feedback loops maintain progression: facilitate formation in the for synchronized contractions, while oxytocin levels double during the latent and continue rising, peaking in the second stage to support expulsion via the . Fetal positioning is crucial; the optimal ( occurs in about 95% of term births, allowing the smallest head diameter to engage the first, but malpositions can contribute to dystocia—abnormally slow labor due to inadequate contractions, , or inefficient fetal descent—potentially prolonging stages without resolving underlying mismatches between maternal and fetal size. These mechanisms ensure efficient energy use, with the placenta's role shifting post-expulsion to , where continued oxytocin and action promotes uterine tone.

Medical and Cultural Practices

The field of has evolved significantly from ancient practices centered on to contemporary surgical interventions. In around 1550 BCE, was a recognized practice documented in texts like the , where female practitioners assisted in deliveries using herbal remedies and manual techniques without formal obstetric training. This tradition persisted through various civilizations until the 18th and 19th centuries, when modern emerged with the development of and antisepsis. The first recorded successful cesarean section in the United States, where both mother and child survived, was performed by physician Jesse Bennett in 1794 on his wife in rural , marking a pivotal advancement in surgical . Common interventions in human childbirth include analgesia, of labor, , and fetal to manage risks during the stages of labor. Epidural analgesia, administered to block pain signals in the lower body, is used in approximately 70% of births to alleviate labor discomfort, though it can prolong the second stage and increase the need for assisted delivery. , often via synthetic oxytocin or prostaglandins, is employed when exceeds 41 weeks or for indications, affecting about 25% of births . , a to enlarge the vaginal opening, was once routine but is now recommended only selectively to prevent severe , with rates declining to under 15% in many settings. Continuous fetal heart rate tracks the baby's well-being during contractions, used in over 80% of U.S. births, though intermittent is preferred for low-risk cases to reduce unnecessary interventions. Cesarean sections, the most common major intervention, occur in 21% of global births as of 2021, with rates projected to increase to 28.5% by 2030, exceeding the World Health Organization's recommended 10-15% threshold in many regions due to factors like maternal request and provider practices. Cultural practices surrounding birth vary widely, influencing rituals and settings across societies. In some Indigenous communities, such as certain Native American tribes, water births are traditionally practiced for their perceived soothing effects, with immersion in warm water facilitating delivery in natural environments supported by community elders. Islamic postpartum care emphasizes rituals like the , a sacrificial offering on the seventh day after birth to express gratitude, alongside male and naming ceremonies, which reinforce communal and spiritual bonds during the nifas () period lasting up to 40 days. Modern trends show a resurgence in home births, which increased 77% in the U.S. from 2004 to 2017 and further rose post-pandemic, comprising nearly 2% of total births as of 2023, as individuals seek personalized, low-intervention experiences with certified midwives over hospital settings. Ethical considerations in prioritize , minimization of unnecessary interventions, and addressing disparities in maternal outcomes. Respect for patient requires providers to discuss risks, benefits, and alternatives for interventions like inductions or cesareans, ensuring decisions align with the woman's values rather than routine protocols. Efforts to reduce overmedicalization focus on evidence-based practices, such as avoiding elective episiotomies, to prevent harm from procedures lacking clear benefits. Maternal mortality disparities persist, with rates in low-income countries reaching 1 in 66 lifetime risk compared to 1 in 8,000 in high-income nations, largely due to limited access to emergency obstetric care in regions like .

Birth in Mammals

Placental Mammals

In placental mammals, the functions as a vital organ that facilitates the exchange of oxygen, nutrients, and waste products between the maternal bloodstream and the developing , allowing for prolonged internal periods that support advanced fetal maturation. This structure enables lengths that vary widely across , from approximately 19 to 21 days in house mice to about 22 months in African elephants, reflecting adaptations to body size, metabolic rates, and environmental demands. Unlike other mammals, this placental nourishment permits the fetus to remain fully enclosed within the until birth, minimizing external risks during development. The birth process, or parturition, in placental mammals typically unfolds in three stages akin to human : an initial phase of and lasting hours to a day, followed by active expulsion of the offspring, and finally the delivery of the . In producing litters, such as , adaptations include rapid successive births with intervals of 10 to 60 minutes between kittens, and placentas that may be expelled individually or in groups to expedite the process. These stages are hormonally regulated by progesterone withdrawal and oxytocin surges, ensuring coordinated labor tailored to species-specific needs. Representative examples highlight these variations. In , calving follows a of roughly 283 days, often requiring assistance in farming contexts to manage dystocia, which affects 13 to 15% of births and can lead to complications if not addressed promptly. undergo whelping after a 63-day , marked by the appearance of green discharge from placental separation as an early labor signal, with litters of 1 to 12 puppies delivered over several hours. Horses experience foaling after approximately 340 days, typically while standing, allowing the to drop to the ground and stand within minutes of birth to begin nursing. Placental mammals display a spectrum of offspring maturity at birth, influencing maternal investment. Precocial young, as in deer and , are born with eyes open, furred, and capable of standing and following the mother almost immediately, enhancing early predator evasion. In contrast, altricial young like those of rabbits emerge blind, hairless, and immobile, demanding prolonged nest confinement and intensive care. Following , maternal behaviors universally include licking the offspring to remove amniotic fluids and stimulate , consuming the to reduce scent cues for predators, and initiating to provide colostrum-rich , all of which foster bonding and in diverse ecological niches.

Marsupials and Monotremes

Marsupials and monotremes represent distinct reproductive strategies among mammals, diverging from the prolonged internal typical of placental mammals by emphasizing external development post-birth or . In marsupials, is brief, resulting in the birth of highly underdeveloped young that complete much of their growth in a maternal pouch, while monotremes retain the ancestral trait of , laying eggs that into altricial offspring nourished by milk. These approaches reflect evolutionary adaptations that prioritize mobility and energy efficiency in diverse habitats, such as arboreal or burrowing lifestyles. Marsupials exhibit short gestation periods, often lasting 12 to 36 days depending on the , after which the tiny, embryonic joey emerges and instinctively crawls from the birth canal to the mother's pouch to attach to a for continued nourishment and protection. For instance, in , gestation spans approximately 30 to 36 days, yielding a joey about the size of a jellybean that relies on the pouch for up to several months of development. Opossums demonstrate polyestrous breeding, with multiple litters per year and a gestation of only 12 to 14 days, producing 1 to 13 kits per litter that migrate to the pouch shortly after birth. Koalas, in contrast, typically produce offspring following a 35-day gestation, with the joey remaining in the pouch for around six months. This externalized development is facilitated by incomplete , where nutrient transfer via a yolk-sac is limited, supporting only early embryonic stages before birth. Monotremes, the egg-laying mammals including the and , further diverge by producing leathery-shelled after a brief internal , with embryos relying on for initial nutrition. In the , lasts about 21 days before 1 to 3 are laid and incubated for roughly 10 days in a , after which the hatchlings lap milk from specialized patches lacking nipples. Echidnas carry a single internally for 16 to 28 days before laying it into a temporary pouch for an additional 10 days of incubation, with the emerging to feed on milk secretions for several months. The ' provides essential and proteins during this phase, a holdover that underscores monotremes' basal position in mammalian . These birth strategies in marsupials and monotremes retain reptilian-like traits, such as minimal internal embryonic support and external nurturing, which enhance maternal mobility in challenging environments compared to the extended development of placental mammals. This evolutionary retention likely arose from the therian-mammal ancestor's adaptations around 160-170 million years ago, balancing endothermy and with ancestral oviparous elements.

Birth in Non-Mammalian Animals

Birds and Reptiles

In birds, reproduction occurs via , during which is transferred from the male to the female through cloacal contact, enabling the development of within hard-shelled eggs laid by the female. These calcified shells, formed in the , protect the and provide a gaseous exchange barrier, with the nourished by reserves. periods vary by species but typically last 18–30 days; for example, the domestic ( gallus domesticus) requires approximately 21 days of constant warmth around 37.5–38°C for embryonic development to reach . Parental brooding is a key , where one or both parents use to maintain optimal temperatures, often turning eggs to ensure even development and prevent to the . A notable variation among birds is seen in megapodes (family Megapodiidae), which eschew direct parental brooding in favor of environmental heat sources for incubation. These precocial birds, including species like the malleefowl (Leipoa ocellata), construct large mound nests from decaying vegetation or use geothermal soils, where temperatures are regulated by the parents through mound adjustments rather than body contact, allowing embryos to develop over extended periods of 49–90 days without ongoing attendance. Hatchlings emerge fully feathered and independent, capable of immediate locomotion and foraging, highlighting an evolutionary divergence from typical avian parental investment. The hatching process in birds begins internally as the embryo absorbs remaining yolk and fluid, then uses an temporary egg tooth on its beak to pip through the shell, aided by enzymes secreted to weaken the inner chorioallantoic membrane and facilitate emergence. In precocial species like ducks (Anas spp.), young hatch with eyes open, downy feathers, and advanced motor skills, enabling them to leave the nest and follow parents within hours, often swimming and feeding independently shortly after. Eggs often exhibit camouflage adaptations, such as speckled or mottled patterns that blend with nest substrates like ground litter or bark, reducing predation risk during the unattended periods before or after laying. Reptiles, in contrast, predominantly employ oviparity with leathery, parchment-like eggs that lack the rigid calcification of avian shells, allowing flexibility and moisture retention in terrestrial environments. Fertilization is internal, similar to birds, via hemipenial insertion in males, but many species bury eggs in soil or sand for protection and natural incubation. However, viviparity has evolved independently in about 20% of squamate reptiles, including boas (Boa constrictor), where embryos develop within the mother's body, nourished via a simple placenta, leading to live birth of fully formed young after 5–7 months of gestation. In oviparous reptiles like sea turtles (family ), females undertake mass nesting events, known as arribadas in species such as the olive ridley (Lepidochelys olivacea), where thousands synchronize to lay clutches of 50–150 leathery eggs on beaches, minimizing individual predation risk through sheer numbers. lasts 45–75 days, depending on and depth, with embryos relying on geothermal and ; for loggerhead turtles (Caretta caretta), the average is around 60 days. involves enzymatic softening of the internal membranes and mechanical breaking of the shell using a caruncle (temporary ), resulting in precocial hatchlings that emerge en masse at night and instinctively orient toward the sea. Some reptiles exhibit unique reproductive strategies, such as in certain whiptail (Aspidoscelis spp., formerly Cnemidophorus), all-female where unfertilized eggs develop into genetic clones via automixis, producing 2–4 young per after 40–60 days of in buried nests. Adaptations like (TSD) are prevalent in many reptiles, including and crocodilians, where pivotal incubation temperatures (e.g., 28–32°C) during the middle third of development dictate sex; in many , cooler conditions yield males and warmer ones females, whereas in crocodilians, intermediate temperatures typically produce males and more extreme conditions produce females—providing a bet-hedging mechanism against environmental variability. Egg camouflage in reptiles often involves translucent or earth-toned shells that match burrow substrates, though burial provides primary protection, with some adding nests to deter predators.

Fish, Amphibians, and Invertebrates

In , the predominant reproductive mode is , in which females release large numbers of eggs that are externally fertilized and develop outside the body, a strategy seen in most bony species such as and . This approach maximizes offspring quantity but exposes eggs to high predation and environmental risks. , where fertilized eggs develop and hatch internally without maternal nourishment, occurs in various chondrichthyans like some and skates, providing embryonic protection within the . , characterized by live birth and direct maternal nutrient transfer to embryos, has arisen independently at least 22 times across lineages and is exemplified by poeciliids such as the ( reticulata), where a placental-like structure supports development, improving offspring viability in unstable habitats. Amphibians largely reproduce via , laying eggs in aquatic or humid settings where typically occurs, as in most frogs (Anura) and salamanders (Urodela) that deposit clutches in water to facilitate larval gill-breathing development. This ancestral mode suits their biphasic life cycle but limits distribution in arid regions. , though uncommon (affecting fewer than 1% of species), has evolved at least eight times, often involving internal retention and nourishment; for example, many (Gymnophiona) are viviparous, with embryos receiving glandular secretions from the , while the (Salamandra atra) gives birth to fully formed young after extended gestation. Reproduction in invertebrates varies widely across phyla, with oviparity prevailing in groups like arthropods and mollusks, where females lay eggs that hatch into dispersive larvae, as observed in insects such as the monarch butterfly (Danaus plexippus) depositing eggs on milkweed. This strategy supports high fecundity and adaptation to diverse environments. Viviparity, rarer but convergent in several lineages, involves internal embryonic development and live birth; all scorpions (Scorpiones) are viviparous, with mothers nourishing offspring via a specialized connection before releasing them on their back. The tsetse fly (Glossina spp.) exemplifies adenotrophic viviparity, retaining one larva per cycle and provisioning it with uterine "milk" proteins until it pupates externally post-larviposition. Similar modes appear in some cockroaches and ovoviviparous sea stars like Cryptasterina hystera, balancing protection against metabolic demands.

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