الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Normal vaginal delivery is defined as a low-risk pregnancy of spontaneous onset of labor taking place between 37 and 42 weeks’ gestation, and it is the safest way for the fetus and the mother.
Labor starts the beginning of regular effective contractions and ends when the cervix is 10 cm dilated and that is called the first stage of labor . Second stage of labor starts when the cervix is completely dilated and is concluded by the delivery fetus . Third stage of labor starts by expulsion of the fetus and delivery of the placenta ends it .
In the third trimester of pregnancy, cervical growth and remodeling is enhanced. This process occur under the influence of relaxin and placental hormones. Prostaglandin E2 (PGE2) acts together with these substances to promote cervical change.
The force caused by the contractile myometrial bundles during labor squeeze the vessels lying within causing reduction in blood flow with each contraction, as there is a reduction in the placental blood flow causing less efficient gas and nutrient exchange which is detected by the fetus stimulating an increase of heart rate as force getting stronger.
Serial per-vaginal examinations and cervical assessments are used to get a full picture regarding cervical dilation, effacement, and fetal station. Using Cardio-tocography to monitor the adequacy and contractions’ frequency and fetal heart activity to maintain fetal well-being is crucial . The mother’s vital signs are recorded at intervals regularly and at any time the clinical status of the mother changes.