INTRODUCTION

Pregnancy is the state of carrying a developing embryo or fetus within the female body.
This condition can be indicated by positive results on an over-the-counter urine test, and confirmed
through a blood test, ultrasound, detection of fetal heartbeat, or an X-ray. Pregnancy lasts for about
nine months, measured from the date of the woman's last menstrual period (LMP). It is
conventionally divided into three trimesters, each roughly three months long.
When gestation has completed, it goes through a process called delivery, where the
developed fetus is expelled from the mother’s womb. There are two options of delivery: Cesarean
section and NSVD or normal spontaneous vaginal delivery. A cesarean section is a surgical
incision through the mother’s abdomen and uterus to deliver one or more fetuses. NSVD or normal
spontaneous vaginal delivery is the delivery of the baby through vaginal route. It can also be called
NSD or normal spontaneous delivery, or SVD or spontaneous vaginal delivery, where the mother
delivers the baby with effort and force exertion.
Vaginal delivery is the method of childbirth most health experts recommend for women
whose babies have reached full term. Compared to other methods of childbirth, such as a cesarean
delivery and induced labor, it’s the simplest kind of delivery process.
Most experts also recommend vaginal births for women with low-risk pregnancies. And
indeed research shows that vaginal births may have a positive impact on a child’s health and
particularly in developing the child’s immune system. In cases of high-risk pregnancies, however,
cesarean sections can have life-saving results.
A spontaneous vaginal delivery (SVD) occurs when a pregnant female goes into labor
without the use of drugs or techniques to induce labor, and delivers her baby in the normal manner,
without forceps, vacuum extraction, or a cesarean section. This occurs after a pregnant woman
goes through labor. Labor opens, or dilates, her cervix to at least 10 centimeters. Labor usually
begins with the passing of a woman’s mucous plug. This is a clot of mucous that protects the uterus
from bacteria during pregnancy. Soon after, a woman’s water may break. This is also called a
rupture of membranes. The water might not break until well after labor is established, even right
before delivery. As labor progresses, strong contractions help push the baby into the birth canal.
ANATOMY AND PHYSIOLOGY OF THE FEMALE REPRODUCTIVE SYSTEM

EXTERNAL FEMALE GENITALIA

The overview of the female reproductive system begins at the external genital area or also
knows as the Vulva which runs from the pubic area downward to the rectum. A rounded mound
of fatty tissue that covers the pubic bone in the external genitalia of women is called the “Mons
Pubis”. During puberty, it becomes covered with hair. The mons pubis contains oil-secreting
(sebaceous) glands that release substances that are involved in sexual attraction (pheromones).
The labia majora are relatively large, fleshy folds of tissue that enclose and protect the other
external genital organs. The labia majora is comparable to the scrotum in males. ---The labia
majora also contain sweat and sebaceous glands, which produce lubricating secretions
The labia minora can be very small or up to 2 inches wide which lie just inside the labia
majora and surround the openings to the vagina and urethra. A rich supply of blood vessels gives
the labia minora a pink color. During sexual stimulation, these blood vessels become engorged
with blood, causing the labia minora to swell and become more sensitive to stimulation. The area
between the opening of the vagina and the anus, below the labia majora, is called the perineum.
The perineum varies in length from almost 1 to more than 2 inches (2 to 5 centimeters). The labia
majora and the perineum are covered with skin similar to that on the rest of the body. In contrast,
the labia minora are lined with a mucous membrane, whose surface is kept moist by fluid secreted
by specialized cells. The opening to the vagina is called the introitus. The vaginal opening is the
entryway for the penis during sexual intercourse and the exit for blood during menstruation and
for the baby during birth.
When stimulated, the Bartholin glands located beside the vaginal opening, secretes a thick
fluid that supplies lubrication for intercourse. The opening to the urethra, which carries urine from
the bladder to the outside, is located above and in front of the vaginal opening. The clitoris, located
between the labia minora at their upper end, is a small protrusion that corresponds to the penis in
the male. The clitoris, like the penis, is very sensitive to sexual stimulation and can become erect.
Stimulating the clitoris can result in an orgasm.

INTERNAL FEMALE GENITALIA

The Vagina
The vagina is the female organ of copulation and receives the penis during intercourse. It
is a muscular, ridged sheath connecting the external genitals to the uterus, where the embryo grows
into a fetus during pregnancy.

The Cervix
The cervix is the narrower, inferior part of the uterus. After intercourse, sperm ejaculated
in the vagina pass through the cervix, and then proceed through the uterus to the fallopian tubes
where, if a sperm encounters an ovum (egg), conception occurs. The cervix is lined with mucus,
the quality and quantity of which is governed by monthly fluctuations in the levels of the two
principle sex hormones, estrogen and progesterone.
When estrogen levels are low, the mucus tends to be thick and sparse, which makes it
difficult for sperm to reach the fallopian tubes. But when an egg is ready for fertilization and
estrogen levels are high the mucus then becomes thin and slippery, offering a much friendlier
environment to sperm as they struggle towards their goal.

The Uterus
The uterus or womb is the major female reproductive organ of humans. One end, the cervix,
opens into the vagina; the other is connected on both sides to the fallopian tubes.
The uterine wall is composed of three layers: the Perimetrium, Myometrium, and Endometrium.
The Perimetrium is the outer serosa layer of the uterus, equivalent to peritoneum. The Myometrium
is the middle layer and is consists of a thick layer of smooth muscle. This part accounts for the
bulk of the uterine wall and is the thickest layer of the smooth muscle in the body. Its major
function is to accept a fertilized ovum which becomes implanted into the endometrium, and derives
nourishment from blood vessels which develop exclusively for this purpose. The fertilized ovum
becomes an embryo, develops into a fetus and gestates until childbirth. The Endometrium is the
mucous membrane or the innermost lining layer of the uterus which functions to prevent adhesions
between the opposed walls of the myometrium.

The Fallopian Tubes

The Fallopian tubes or oviducts are two very fine tubes leading from the ovaries of female
mammals into the uterus. On maturity of an ovum, the follicle and the ovary's wall rupture,
allowing the ovum to escape and enter the Fallopian tube. There it travels toward the uterus, pushed
along by movements of cilia on the inner lining of the tubes. This trip takes hours or days. If the
ovum is fertilized while in the Fallopian tube, then it normally implants in the endometrium when
it reaches the uterus, which signals the beginning of pregnancy.

The Ovaries
The ovaries are the place inside the female body where ova or eggs are produced. The
process by which the ovum is released is called ovulation. The speed of ovulation is periodic and
impacts directly to the length of a menstrual cycle. After ovulation, the ovum is captured by the
oviduct, where it travelled down the oviduct to the uterus, occasionally being fertilized on its way
by an incoming sperm, leading to pregnancy and the eventual birth of a new human being. The
Fallopian tubes or also known as oviducts have small hairs (cilia) to help the egg cell travel.
 PATHOPHYSIOLOGY (Normal Spontaneous Vaginal Delivery)

HOST AGENT ENVIRONMENT

Female Therapeutic environment
37 years Old Fertilization
(Union of sperm and ovum)

Zygote - Unicellular
(Intermingling of haploid paternal 23 X or Y and maternal 23 X chromosomes)

Series of Mitotic Cell division - Cleavage

(In 24 hours become two cell organism)

In 72 hours become 16 cell organism called Morula

Morula enters the uterus on the 3rd day through peristaltic movement
Separate into two parts by fluid from the uterus on the 4th day

The outer layer gave rise to the placenta The inner layer gave rise to the embryo
(Trophoblast) ( Embryoblast )

Blastocytes attaches to endometrium on the 6th day

Implantation

Embryonic development begins during second week continues through

the eighth week

3 Stages
1st stage – increase in cell number and with Fetal Development is from ninth week to birth
elaboration of cell products
2ndstage – morphogenesis / includes mass Newborn baby via Vaginal Delivery
cell movement
3rdstage – differentiation or maturation of
physiologic processes