How long does labor last in nulliparous at different stages? Attempts - the process of the birth of your baby into the world

01.08.2019

Today we will talk about what attempts and contractions are. How to distinguish them? Do they cause pain? In addition, we will pay attention to breathing techniques during various periods of labor, which will help girls who are in the delivery room for the first time.

The first pregnancy for every woman is an exciting event. Everyone, without exception, is trying to prepare as much as possible for the upcoming stay in the hospital. Expectant mothers are interested in questions: what are attempts, contractions, what you need to take with you, what complications can arise during childbirth, and so on. But now there is a large amount of information that can prepare a woman - these are special books, manuals and videos. In addition, doctors recommend that pregnant women attend courses for expectant mothers, which are held at schools for pregnant women, without fail. There they will help you overcome the fear of the upcoming birth, teach you how to breathe properly during childbirth, help you choose the right diet, and the courses end with child care. There, experienced specialists will show you how to hold the baby, wash, swaddle, and so on.

How to distinguish contractions from attempts?

Let's start by considering the most common question: contractions and attempts, how to distinguish them? Here the process of childbirth is approaching, then the expectant mother begins to think about how she will pass the test prepared for her by nature. What are contractions - for the expectant mother is more or less clear, but with attempts not always. What are pushes?

If you don’t delve too deeply into medical terminology, then the whole period of childbirth can be divided into the following periods:

contractions;
attempts;
postpartum period.

Now let's delve a little into the terminology to try to explain the difference between the first two concepts. Contractions are signs of cervical dilation, which is necessary for the baby to be born. But with attempts there is an "expulsion" of the crumbs from the uterus. Based on this, the expectant mother will not only feel painful changes in her body, but she herself will understand the difference in her behavior during these periods.

Breathing during contractions

If attempts began, and the doctor said to restrain them, then breathing “like a dog” will help. This must be done frequently and superficially. During contractions, you can behave in a way that is easier for you (lie down, walk, and so on).

What sensations does a woman experience during attempts?

We figured out the question of what is attempts during childbirth. This is the process that helps "expel" the fetus from the uterine cavity. Now let's talk a little about how a woman feels at this moment.

How to understand that attempts have begun? The feeling at this moment is as if you want to empty your intestines. At this stage, the water must definitely break. What is the reason for this feeling? The pushing period is characterized by the fact that the baby's head begins to move along the birth canal and presses on the rectum. Attempts are a signal that it is necessary to give birth. At this moment, women act instinctively, because nature has taken care to turn off the consciousness of a woman. Of course, the doctor controls all the movements of the woman in labor. During the period of attempts, the muscles of the press and diaphragm begin to work actively.

The duration of the pushing period depends on how many births the woman has had. As a rule, in a primiparous woman, the child is in her arms two hours after the water breaks. If the attempts last longer than this time, then this is a clear signal that something is going wrong.

Pain during contractions, as well as attempts

Now we will try to deal with the question of what hurts more: contractions or attempts? This question interests many women who are about to become a mother for the first time. We will immediately give the answer - contractions.

What are contractions and contractions? What happens to the female body at this moment? The pain that women experience during childbirth is associated only with the active work of the muscles. Contractions are more painful as the muscles are actively working to open the cervix. During attempts, as a rule, there is no pain.

Do not be afraid that you will not understand when the attempts begin. Do not forget: childbirth is a natural physiological process, women act instinctively. You yourself will understand everything, and an experienced doctor will help you.

Importance of pushing during childbirth

What is it we figured out, but why are they needed? Attempts are understood as spontaneous contraction of the muscles of the press and diaphragm, which leads to the pushing of the fetus out. In medical circles, this process is also commonly referred to as "fetal expulsion."

The doctor must tell you that during contractions you must save your strength. Rest in between. No matter how paradoxical it may sound, a woman can even sleep between contractions. This is necessary, because during the period of attempts you will have to work hard. As mentioned earlier, the time of attempts is different for everyone. They can last from thirty minutes to five hours. It all depends on the readiness of the woman, the number of births. But the average duration is only two hours.

We draw your attention to the fact that proper breathing will help reduce the load on the body, relax and eliminate pain. For these purposes, experts have developed a technique that should be learned in advance (bring it to automatism).

Proper breathing while pushing

It is very important to learn how to breathe properly during childbirth. How to behave during fights, we have described below. Now let's move on to the breathing technique during attempts.

It is very important to breathe often and deeply. Make sure you breathe into your belly with your mouth. Hold your breath a little and exhale calmly, but quickly. Please note that if you exhale sharply, this can push the baby back along the birth canal.
Under no circumstances should you breathe heavily. Now let's answer why. During such breathing, the muscles of the perineum tense up, a woman can simply suffocate the child.
It's not worth shouting. After all, there is no reason for that. In addition, screaming during an attempt stops the child, so this attempt is no longer as effective. Instead of screaming, focus on your breathing, because calmness and confidence will help you cuddle the baby to your chest faster.
Listen to the medical staff. Obstetricians try to alleviate your condition, suggest when and how to act. Coordinated work will help to give birth to a baby in two or three attempts.

Actions of women

During attempts, completely trust the obstetrician. He should tell you how to behave correctly so that the birth goes without complications and as quickly as possible. One push lasts an average of a minute, so don't waste it. At the very beginning, take a deep breath and push. Make sure that the air is pressed against the uterus, and not into the head. In the latter case, it will not do without ruptures of blood vessels on the face and eyes.

Don't worry if you can't get enough air in, exhale and take in some more. As a rule, for one attempt you can get air up to three times. When the baby's head appears, the obstetrician gives the command to stop pushing. If it is not possible to maintain calm breathing, then you can apply the “dog-like” breathing technique.

If you breathe correctly and listen to the medical staff, then the birth occurs quickly enough. If the doctor sees that you already have no strength at all, then he will give you time to rest.

How to push properly?

At courses for pregnant women, expectant mothers must be told about breathing techniques and behavior in the delivery room. In addition, attention is paid to the correct technique of attempts.

There is nothing special about this. You will feel a strong urge to have a bowel movement. Pushing is the same as on the toilet with constipation. The muscles of the press and diaphragm are involved in this process.

During attempts, you need to take a deep breath, raise your head so that you look at your navel. Wrap your arms around your knees and pull them towards you. Hold your breath and push. Please note that there are about three attempts per contraction.

Lack of attempts

Although childbirth is a physiological process, many women may not feel the period of attempts at all. It should be noted right away that the absence of attempts is not a violation. They simply don't exist. This is all due to the physiological characteristics of some women.

Although this is not a deviation, the absence of attempts to significantly complicate the process of childbirth. In such situations, a woman has to completely rely on an obstetrician-gynecologist, which is not always easy. On the other hand, you will not be distracted by any sensations, your task is to listen carefully and follow all the requirements of your doctor. But in fact, it's not as easy as it seems at first glance. But such is nature, attempts are not for everyone.

Final push

We have already said before how long the attempts last, but we did not say a word about the final attempt. After the birth of the baby, the placenta should also be born (in other words, the placenta). You will feel another urge, but less strong. One more little effort and the process is complete.

Do not be afraid of the description of attempts, in fact they are not so scary. Try to emotionally adjust yourself to the fact that an attempt is a tool that helps the baby to be born. Make the best use of this powerful and efficient tool.

Important points in breathing technique

Courses for pregnant women actively work out the correct breathing technique. Do this as often as possible, not only in class, but also at home on your own. If you feel dizzy, and your condition will be like fainting, then you should resort to the following points:

take a deep breath and hold your breath;
join two palms and breathe into them.

These are symptoms of hyperventilation, nothing to worry about. But, training should be postponed. Practicing the technique, you often have to breathe through your mouth, resulting in dry mouth. In this case, touch the tip of the tongue to the sky or simply rinse your mouth with water.

During childbirth, the baby has a much harder time than you. Don't forget about it. Arbitrary breathing can greatly delay the process of childbirth. Concentrate your attention on proper breathing, do not be distracted by extraneous matters.

Any woman is afraid of the birth process. In particular, this fear is observed when they are expected. Only after learning about the pregnancy, the expectant mother is worried about how the birth of her first child will go.

Duration of labor

It is difficult to say, in primiparas, because the body of each woman individually copes with this process, so it is difficult to predict anything. It depends on several factors. In particular, the following indicators are of great importance:

how quickly the cervix will open;
will the size of the baby correspond to the size of the birth canal;
the mother's breath, because it depends on him how the process will go, with proper breathing, a woman can feel less pain;
the intensity of the fights.

In addition, the woman in labor must follow all the advice of the doctor. It is also very important to prepare for childbirth in advance. If the primiparous knows how to behave during this process, then it will last no more than 10 hours. Although it is difficult to say how long childbirth lasts in primiparas with any pathologies. In some cases, a caesarean section may even be required. It is also worth noting that you should not panic. If a woman in labor cannot pull herself together, then the birth of the first child can last twice as long. But this does not mean that all 20 hours will have to be spent in the delivery chair. After all, the process of childbirth is not only the birth of a baby, but also the opening of the cervix, contractions.

Why is the first birth the most difficult?

The complexity of childbirth in primiparas is due to two aspects: psychological and physiological. Childbirth is a process that cannot be imagined until you feel it for yourself. The future mother, who is to give birth to a child for the first time, does not yet know what she will have to experience. Because of this, fears may arise, which can lead to complications in the course of childbirth. In addition, women do not know the first time. Of course, it hurts, and it does not depend on which births are on the account. After all, it is very difficult to find a comfortable position during contractions, learn how to push properly in a few minutes. Therefore, it is recommended to attend special classes and courses in order to be ready for anything.

In addition, many women are unaware of primiparous. In this case, there is a significant difference. After all, the birth canal of a nulliparous woman is very narrow, unstretched. Therefore, it can be much slower. As a result, the first period can last much longer (instead of 5-8 hours, it takes 10-12). The second period also lasts longer. There is a lesser intensity of attempts. And after the first birth, the walls of the vagina stretch and never return to their original shape.

First stage of labor

How long does labor last in primiparas in the first period? It also depends on the characteristics of the woman's body. But it should be noted that this is the longest stage. Contractions may take up most of the time, but they will be short and infrequent. Here, for the first time, a woman will feel what prenatal pain is (if it wasn’t there). The cervix will slowly open, but the expectant mother will not feel any discomfort. That is, pain will appear only during labor. Therefore, if you feel something (after all, then , you still have no idea how labor begins in primiparous, you still can’t imagine), then urgently go to the maternity hospital, otherwise there is a chance to give birth right at home. The second part of the first period lasts less, but more intense contractions are already observed. Be sure to move around so that the uterus opens faster The third phase lasts no more than an hour.Now you need to move from contractions to attempts.

Second birth period

Next, consider how long childbirth lasts in primiparas in the second phase, which involves an increase in the woman's activity. Now she has to push. Usually this process does not last long (from 5 to 40 minutes). Mom should help the baby move faster through the birth canal. After all, the baby himself will not be able to do this. If the mother's body is somehow weakened and she cannot push, then doctors may resort to surgery. In the second birth period, you must follow all the doctor's advice, breathe correctly. At the same time, it is necessary to push only when they talk about it. It is important to relax as much as possible and not be afraid. Because of fear, the uterus will be tense, so the child will not be able to actively move. As a result, doctors will have to use special tools to extract it. And this can harm the baby, so it's better not to risk it. Only in this case everything will go well.

Third period

It would seem that everything: the baby has already been born, which means that the birth is over. But it's not. A woman will have to do something else - it almost does not hurt to give birth, and this stage lasts a couple of minutes. Of course, if a woman is too tired, then the process may be slightly delayed - for about 30 minutes. If she does not have the strength at all to give birth to an afterbirth, then the doctor will help her.

The expulsion of the fetus from the uterus, which is called childbirth, is divided into 3 stages, and controlled labor attempts occur only in the second - during the expulsion of the fetus from the uterus - the preparation of the cervix and the expulsion of the placenta provide labor and postpartum contractions.

In the second stage of labor, the contractions stop for a short time - the woman in labor during this period has time to rest a little, and her body prepares for labor - the contractions are replaced by attempts during childbirth, with the help of which the uterus expels the fetus. In order for attempts to occur, retraction of the muscles and the uterine wall must occur to adapt to a decrease in the volume of the fruit storage - the walls thicken, tightly cover the fetus, the birth canal must be fully formed, consisting of an open pharynx and vagina.

When retraction reaches the upper limit, intrauterine pressure increases, since the baby's head, which entered the pelvic organs as a separate segment, intensely irritates the nerve endings.

At this time, attempts appear - contractions of the striated abdominal muscles - arising reflexively.

Contractions and attempts occur arbitrarily - that is, their appearance is influenced by the processes occurring in the body: the production of certain hormones, a change in the state in the uterus, the readiness of the body for childbirth. But the woman herself cannot influence contractions - as soon as oxytocin begins to be produced - the hormone responsible for the contractile activity of the uterus - this is how they begin.

Attempts a woman can control herself. Of course, she cannot interrupt labor activity, but she systematizes them at her discretion. During an attempt, breathing is interrupted, the diaphragm drops, the abdominal muscles tighten, which causes an increase in intra-abdominal pressure. Attempts during childbirth help the baby prepare for the birth - his spine unbends and straightens, the arms are pressed tightly against the body, the shoulders rise to the head, protecting the fragile neck. A fetus that has already prepared for birth can be compared with a rocket prepared for launch - nature has allowed it to be given the most streamlined shape.

Due to contractions, intrauterine pressure increases, and intra-abdominal pressure increases, the fetus begins to make translational movements that are directed along the axis of the birth canal. The presenting part performs not only translational movements, but also rotational ones - it is thanks to such actions that the fetus successfully overcomes the birth canal.

Attempts help the fetus to overcome the resistance of the vulvar ring and pelvic floor muscles, as soon as the baby is born, they immediately stop, the abdominal muscles relax.

Contractions - painful contractions - a woman simply worries, attempts during childbirth cause constricting pain, and during them it is necessary to concentrate - by controlling them, a woman facilitates labor activity for herself and helps the baby to be born faster.

Feelings when attempts occur resemble the urge to defecate - usually obstetricians are advised to completely relax. The release of the intestines helps a woman to anesthetize labor, and an enema is made to facilitate the work of an obstetrician before childbirth.

Different medical directions suggest using 2 types of behavior during childbirth for a safe delivery - controlled and natural.

With a controlled type of behavior, the obstetrician leads the birth process, and the woman needs to follow his commands. The woman pushes, breathes and rests at the command of the obstetrician, who watches the movement of the fetus through the birth canal.

Natural process - when doctors monitor the process of childbirth, I completely rely on mother nature, hoping for a woman's instinctive behavior. But this does not mean that you can give birth at home or in "natural" conditions in nature - if something goes wrong, obstetricians provide the necessary assistance.

During attempts, it is necessary to control breathing - you need to breathe not only with your chest, but also with your stomach, be able to hold your breath on command.

As soon as the first attempts begin, the woman in labor needs to relax (as far as possible on the gynecological chair), and then tighten the abdominal muscles. During attempts, only the abdominal muscles work - the hips and buttocks should not be strained. After each attempt, you should try to at least give a few seconds of rest and restore breathing.

If labor activity slows down - contractions are not replaced by labor attempts, but completely subside, then doctors choose one of the strategies:

artificially stimulate labor activity;
surgery is performed - this operation is called a caesarean section.

A high risk of stopping labor occurs:

with overweight women;
if they went for natural childbirth after a cesarean section;
with a history of chronic diseases, including diabetes mellitus;
with diseases of the abdominal cavity;
after surgical operations on the abdomen and pelvic organs.

Doctors decide on obstetric care based on the clinical picture, controlling the intervals between the occurrence of attempts. In addition, fetal heart sounds are heard after each effort to exclude the occurrence of asphyxia.

Heart tones are not only heard, but also counted, the following symptoms indicate pathology: external edema of soft tissues and increased bleeding.

You also need to be able to push correctly, without wasting strength - the muscles should be strained at the peak of the effort, when the maximum urge is felt: it is very important to add visualization of the movement of the fetus, then the baby will quickly pass the birth canal.

During attempts, the baby's head can show up and hide back - this is how normal childbirth proceeds. There is no need to be afraid - everything goes naturally: this physiological process has been fully studied and tested many times in practice.

Attempts take only a few tens of minutes in the entire birth process, but are the most important. Depending on the physiological characteristics of your body, the presentation of the child and its size, the intensity of labor, and also on what the given pregnancy is, the duration of attempts may be different. Statistics show that, on average, in primiparous women, the second stage of labor lasts up to two hours, and in multiparous women - no more than an hour.

The value of attempts

The pushing period begins when the cervix is dilated enough to let the baby through. Actually, this is their role: to help the child to be born. An attempt is a contraction of the abdominal muscles and diaphragm, as a result of which intra-abdominal pressure is created, which helps to expel the fetus from the womb. Attempts join contractions at the stage when the latter become noticeably more frequent, longer and more painful.

Attempts during childbirth occur reflexively, regardless of the desire of the woman in labor, which is due to the increasing pressure of the presenting part of the fetus on the cervix. But unlike contractions, they can be controlled. And this is precisely the essence of childbirth: mother and child make mutual efforts to speed up the long-awaited moment.

Most women during an attempt experience a feeling similar to a bowel movement: it seems that the bowels are emptying, and therefore there is an irresistible and irresistible desire to push - it should not be restrained if it is not forbidden by obstetricians. Thus, nature helps a woman to survive the attempts most effectively and cope with her main task perfectly well.

Woman on the prowl

In the first stage of childbirth, when contractions are aimed at opening the cervix, a woman can only ease her well-being by taking comfortable postures and using the correct breathing technique during childbirth. Contractions are completely independent of the woman in labor, as is the course of childbirth in this period. But already with the onset of attempts, the mother turns from a passive participant in the birth process into a rather active one.

It is extremely important to feel the attempts during childbirth, so anesthesia is not used to anesthetize contractions. However, women in labor note that with the onset of attempts, the pain of contractions is not felt so strongly: all consciousness switches to effective straining.

Passing through the birth canal, the baby's body will compress the surrounding organs. With simultaneous straining of the woman in labor, this leads to the fact that the bladder and intestines can involuntarily empty during attempts. As a rule, a woman does not pay much attention to this during childbirth, but often worries about the likely "embarrassment" before childbirth. You should not worry about this at all: firstly, such phenomena are quite physiological, normal and familiar to medical staff, and secondly, all unwanted discharge from the mother's body is immediately removed by the midwife, so their contact with the child is excluded.

The only correct thing during the period of attempts will be to concentrate on your own feelings and the instructions of the doctor taking delivery. A lot will depend on you now. The better and more correctly you push, the easier the baby will be born. However, it should be understood that the rapid birth of a child is a great stress for him, so from time to time the doctor may give a “hang up” to straining.

Always remember that the baby tries no less than yours during attempts. In addition, he is now experiencing a lack of oxygen, so you should obey the doctor unquestioningly! It is necessary to restrain attempts if strong straining may be unsafe, and to give all the best on an attempt if the doctor has given such a command.

How to push properly during childbirth?

You will certainly feel that the attempts have begun. But pushing may be too early - listen to the doctor's instructions. If it is necessary to restrain or suspend the attempt (it cannot be eliminated, since it occurs reflexively regardless of your desire), then you should relax as much as possible, and take short, frequent shallow breaths (switch to "dog breathing").

During the period of attempts, use the correct breathing technique, accumulating all the forces for straining. When it's time to help your baby, follow these steps:

In anticipation of the attempt, make a calm maximum exhalation, and then also calmly and deeply inhale into the stomach - exactly as deep as possible, and not as much as possible.
Hold your breath, lean forward slightly, pressing your chin to your chest, spread your knees to the sides, tucked into the muscle cavities, and clasp your hands.
Start pushing at the peak of the push, when you feel the urge to the maximum.
With the onset of attempts, push down, “pushing” the baby out of you - make maximum efforts. In no case should the face and eyes be strained - only the diaphragm and below.
Try to push the child forward, putting maximum effort on the attempt.
Direct the effort to the point of the most intense pain: the burning and pain in the cervix and vagina should intensify, which is proof of the correct effective effort.
Push until you feel the need to take another breath: in this case, slowly exhale the air, inhale deeply, hold your breath and repeat all over again.
Observe even and smooth breathing, without jerks and drops. A sharp exhalation will “pull” the baby back into the vagina.
Do not scream during an attempt - this will not help in any way, but it will waste a lot of strength. Try to remain silent, or at least groan.
During one fight, you should arrange 3 attempts in a row without interruptions.
In between contractions, try to relax and rest as much as possible, restoring strength for the next straining.
Do not force: there is hard work ahead, you need to concentrate and properly distribute your forces.

Another good tip: when you inhale before pushing, imagine that you are swallowing a ball - try to feel it in your stomach. Now, with the force of the abdominal press, push the "ball" to the perineum. In general, listen to your own feelings: they will not let you down.

On average, during one contraction, 3 attempts occur lasting 10-15 seconds. Many women try to make one long attempt, but this is a mistake: it is better to make 2-3 effective attempts during one contraction than one unproductive one, in which all oxygen supply, which is so necessary now for the baby, stops.

It is very important to push correctly, otherwise obstetricians will have to resort to extreme measures: squeezing the baby out of the abdomen and even using forceps, which is not very desirable. Therefore, it is necessary to calm down, objectively assess the situation and do everything in your power.

It is worth noting that they not only speed up and facilitate the process of birth, but also contribute to the correct straining, since the woman completely succumbs to her sensations, without thinking about where to direct the exhalation (the force of gravity acts). Ask about the most comfortable positions for childbirth in advance.

If there are no attempts at childbirth

Unfortunately, not all women experience labor during childbirth. In some cases, they are absent, which is not at all some kind of violation, but is due to the physiological characteristics of the woman in labor. However, the absence of attempts does not have the best effect on the course of childbirth. In such a situation, a woman has to rely entirely on the doctor, listen carefully and diligently follow his instructions. To be honest, it's very difficult. But what to do: such is nature - attempts come, as it turns out, not for everyone.

Final push

After the birth of the child, the placenta (or afterbirth, as it is also called) must also be born. You will again feel the urge to strain, but not as strong as in the second stage of labor. The last little effort - and the birth process is completed!

Don't let the description of attempts scare you. In fact, they are very helpful in childbirth and are not as scary as they are painted. The main thing is to perceive attempts as an effective tool for proper delivery and use it in the best possible way.

In the process of attempts, the head (or another part of the baby's body, if the presentation was not head presentation) will begin to appear from the vagina. The child makes progressive movements, and therefore for some time the head will show and hide back. Finally, when the reverse "swallowing" stops, you will be transferred to the delivery room or placed on the delivery table. And very soon you will not even remember how difficult it was for you.

Don’t worry about anything: childbirth is a natural process that has long been well studied and “worked out” in practice. Do not be afraid of them - everything will be fine!

Especially for Elena Kichak

Attempts from the point of view of physiology are arbitrary contractions of the muscle groups of the anterior abdominal wall, due to which the fetus is born.

Attempts appear in the second stage of labor - from the moment the cervix opens completely - up to 10 cm, and their end coincides with the moment the baby is born.

In the case of a complete opening of the cervix at the beginning of the second stage of labor, due to uterine contractions, the fetal head moves down, while "along the way" squeezing the walls of the rectum. The muscles of the diaphragm and the anterior abdominal wall, in response to irritation of the rectal receptors by the head of the fetus, begin a reflex contraction: this is typical for the onset of attempts. The head of the fetus presses on the muscles of the pelvic floor and on the rectum of the woman in labor, while causing her to desire to empty the intestines - and the urge to defecate. This phenomenon is an attempt.

When to start pushing

Before you start pushing, you need to call a doctor to determine the location of the baby's head. It is necessary to start attempts only in the situation when the head has passed almost the entire birth canal and lies on the pelvic floor with its parietal surface. The presence of premature attempts in a woman leads to a violation of the uterine - placental circulation, the rapid depletion of labor, the appearance of weakness of attempts and hypoxia - a lack of oxygen in the baby.

The desire to push in all women can occur at different times. In the event that it appears when the head is low, however, in the absence of a complete opening of the cervix to the end, then by moving the head with the help of force of attempts, the woman in labor may experience a rupture of the cervix. A woman in labor is recommended to use a special breathing pattern in order to curb the occurrence of premature attempts.

Step 1. Take a full deep breath in through your chest.
Step 2. Hold your breath, as if swallowing air, with a parallel tension of the abdominal muscles (the main muscle groups of the buttocks, thighs and face are in a state of relaxation). Then you need to gradually increase the pressure on the bottom, gradually tensing the abdominal muscles with more force to constantly help the child move through the birth canal.
Step 3. Make a smooth exhalation.
Step 4. If there is a feeling of lack of breath, you need to exhale smoothly, avoiding a sharp exhalation with a “jerk”. A sharp “jerk” exhalation can lead to a sharp decrease in intra-abdominal pressure and a quick “retreat” of the child’s head back, as a result - the appearance of a severe TBI - craniocerebral injury. Immediately after a smooth exhalation without rest and relaxation, you need to inhale and push.

All these actions must be repeated for three times during a full attempt.

After an attempt, you need to take a full breath and restore even, calm breathing with a state of complete relaxation. Thus, to perform the next attempt, you can quickly restore strength.

Attention! The midwife will ask you not to push at the moment the head is removed - then it is correct to breathe "dog".

What to do during an attempt

During the attempt, you need to press your chin tightly to your chest, grab your knees with your hands, then spread them apart and pull them to the armpit as much as possible. The main force of attempts should be directed to the point of development of maximum pain. The appearance of increased pain after an attempt testifies in favor of the correctness of your actions and the correct progress through the birth canal of the baby.

Average duration of pushing

This period in primiparous lasts an average of two hours, and in multiparous - for one hour. Its average duration can be influenced by various factors. For example, using such a pain relief technique as epidural analgesia, in nulliparous women, the second stage of labor can be extended on average up to three hours, in multiparous women, up to two hours.

The presence of a large fetus, weak labor, narrowed pelvis, overstretching of the muscles of the anterior abdominal wall can also increase the duration of this stage of labor. In contrast, women with well-developed abdominals have a shorter ejection period in labor.

Measures to prevent ruptures

It is necessary to start protecting the perineum from the moment the head erupts, that is, when the child's head does not “go away” between attempts in the opposite direction. With three fingers of the right hand, the midwife prevents the head from moving quickly during an attempt; as a result, the skin in the perineal area is gradually stretched and tears are thereby prevented. The fetal head normally passes through all the birth canals with its smallest diameter - that is, in a half-bent state (with the chin pressed against the breast). To prevent ruptures, with two fingers of the left hand, the midwife clasps the baby's head and carefully monitors its correct progress through all the birth canals.

The occipital region of the head is cut through first, then the crown of the head is cut through, then the baby's head is completely unbent and a face is born. From the moment when the fetal head begins to unbend, until the full birth of the face, the woman in labor should not push. The integrity of the perineum depends not so much on the correct actions of doctors, but on the behavior during childbirth of the woman herself.

With the help of breathing "dog" through the mouth, attempts can be weakened to a large extent. In 95 - 96 percent of cases, the born head is facing backwards; in the future, the child turns his face either to the right or to the left thigh of the mother. With the external rotation of the head, the internal rotation of the shoulders is simultaneously carried out, after which the anterior shoulder is born, which is located at the pubic joint, then the posterior shoulder, which is located at the sacrum. In the future, the birth of the legs of the child and the trunk occurs without much difficulty.