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Reproductive physical maturity and the capacity for human reproduction begin
during puberty, a period of rapid growth and change experienced by both males and females.
Puberty is not an isolated event, but a process which takes place over several years.
1. Internal Organs
a) Uterus
The uterus is a hollow organ about the size and shape of a pear. It serves two important
functions: it is the organ of menstruation and during pregnancy it receives the fertilized ovum,
retains and nourishes it until it expels the fetus during labor.
Each tube is about 4 inches long and extends medially from each ovary to empty into the superior
region of the uterus.
It transport ovum from the ovaries to the uterus. There is no contact of fallopian tubes with the
ovaries.
d) Ovaries
The ovaries are for oogenesis-the production of eggs (female sex cells) and for hormone production
(estrogen and progesterone).
2. External Female Organs.
a) Mons Pubis
This is the fatty rounded area overlying the symphysis pubis and covered with thick coarse hair.
b) Labia Majora
The labia majora run posteriorly from the mons pubis. They are the 2 elongated hair covered skin
folds. They enclose and protect other external reproductive organs.
c) Labia Minora
The labia minora are 2 smaller folds enclosed by the labia majora. They protect the opening of the
vagina and urethra.
d) Vestibule
The vestibule consists of the clitoris, urethral meatus, and the vaginal introitus.
The clitoris is a short erectile organ at the top of the vaginal vestibule whose function is sexual excitation.
e) Perineum
This is the skin covered muscular area between the vaginal opening (introitus) and the anus. It
aids in constricting the urinary, vaginal, and anal opening. It also helps support the pelvic
contents.
f) Bartholin’s Glands (Vulvovaginal or Vestibular Glands)
The Bartholin’s glands lie on either side of the vaginal opening. They produce a mucoid
substance, which provides lubrication for intercourse.
Meanwhile, the left-over of the ruptured follicle has become a corpus luteum which
secretes progesterone. Progesterone further stimulates uterine development making it a
nutritious bed for the embryo in the event of pregnancy. In the absence of pregnancy, the corpus
luteum atrophies and progesterone level falls. This leads to the breakdown of the endometrium,
menstruation begins and the cycle starts over.
PHASES OF MENSTRUAL CYCLE
The uterus sheds its inner lining of soft tissue and blood vessels which exits the body from
the vagina in the form of menstrual fluid.
Blood loss of 10 ml to 80 ml is considered normal.
You may experience abdominal cramps. These cramps are caused by the contraction of the
uterine and the abdominal muscles to expel the menstrual fluid.
The pituitary gland secretes a hormone that stimulates the egg cells in the ovaries to grow.
One of these egg cells begins to mature in a sac-like-structure called follicle. It takes 13 days
for the egg cell to reach maturity.
While the egg cell matures, its follicle secretes a hormone that stimulates the uterus to
develop a lining of blood vessels and soft tissue called endometrium.
The egg cell released during the ovulation phase stays in the fallopian tube for 24 hours.
If a sperm cell does not impregnate the egg cell within that time, the egg cell disintegrates.
The hormone that causes the uterus to retain its endometrium gets used up by the end of the
menstrual cycle. This causes the menstrual phase of the next cycle to begins.
(https://www.menstrupedia.com/articles/physiology/cycle-phases)
LABOR AND BIRTH PROCESS
Stages of Labor
Labor is traditionally divided into three stages:
Stage 1. The first stage of labor is divided into three phases: latent, active, and transition
phase.
Latent Phase
The latent or early phase begins at the onset of regularly perceived uterine contractions
and ends when rapid cervical dilatation begins. Contractions during this phase is mild and
short,lasting 20-40 seconds. Cervical effacement occurs and the cervix dilates from 0-3 cm. The
phase averages 6 hours in a nullipara and 4.5 hours in a multipara.a woman who enters labor
with a “nonripe” cervix will
probably have a longer than average
latent phase.
Active phase
Transition phase
During the transition phase, contractions reach their peak of intensity, occurring every 2-3
minutes with a duration of 60-70 seconds ,and a maximum cervical dilatation of 8-10 cm
occurs.If it has not previously occurred, show will occur as the last of the mucus plug from the
cervix is released. If the membranes have not previously ruptured ,they will usually rupture at
full dilatation (10cm). By the end of this phase, both full dilatation (10 cm) and complete
cervical effacement (obliteration of the cervix) have occurred.
Stage 2. The second stage of labor is the time span from full dilatation and cervical
effacement to birth of the infant. With uncompleted birth and without epidural anesthesia this
stage takes about 1 hour. Your pushing, along with the force of your contractions, will propel
your baby through the birth canal. The fontanels (soft spots) on your baby's head allow it to fit
through the narrow canal.
The fetus begins descent and, as the fetal head touches the internal perineum to begin
internal rotation, her perineum begins to bulge and appear tense. The anus may become everted ,
and stool maybe expelled. As the fetal head pushes against the vaginal introitus, this opens and
the fetal scalp appears at the opening of the vagina and enlarges from the sizes of a dime , to a
quarter , then a half-dollar. This is termed as crowning. As the fetal head is pushed out of the
birth canal , it extends , then rotates to bring the shoulders into the best line with the pelvis. The
body of the baby is then born.
Stage 3. The third stage of labor , the placental stage, begins with the birth of the infant and
ends with the delivery of the placenta. After the birthof the infant , the uterus can be palpated as
a firm, round mass just below the level of the umbilicus. After a few minutes of rest , uterine
contractions begin again, and the organ assumes a discoid shape. It retains this new shape until
the placenta has separated, approximately 5 minutes after the birth of the infant usually
Placental separation: the placenta has loosened and is ready to deliver when:
Placental Expulsion- once separation has occurred , the placenta delivers either by the natural
bearing-down effort of the mother or by gentle pressure on the contracted uterine fundus by the
primary health care maneuver ( a Crede Maneuver). If placenta does not deliver spontaneously it
can be removed manually.