Types of labor and stages of labor - important information for moms

Every pregnant woman, closer to childbirth, has more and more questions to which she would like to get answers. The meeting with the long-awaited baby is getting closer, so we will try to cover the main aspects that every expectant mother has to face:

• - a question especially worrisome for women who have to give birth for the first time. Most women are worried that they will miss the beginning of the labor process and will not make it to the hospital in time. Do not worry too much about this, you will not confuse true contractions with anything!
• - this question worries both primiparous women and experienced mothers.
• How to make childbirth painless pain threshold for each woman is purely individual, however, the expectant mother is able to minimize labor pains as much as possible. For this, whole techniques, massages, and postures have been developed. If a woman cannot stand the painful sensation at all, then in order to preserve her strength for the strenuous period, the doctor can give an epidural anesthesia;
• Natural childbirth go - before, the method of delivery was chosen at the request of a woman, but in recent years, natural childbirth has been more and more practiced, which has a much more favorable effect on both the health of the child and the postpartum period;
• - you need to take care of this in advance, so as not to face later the closure of the hospital for washing or other amenities. At 39-40 weeks of pregnancy, the expectant mother in the antenatal clinic is given a referral to the maternity hospital, where it is written in which institution she is expected and at what time.

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Childbirth is a short-term period that characterizes the completion of pregnancy with the birth of a child. Nobody can predict the outcome of any pregnancy, as well as make an accurate forecast of childbirth - according to which scenario they will go. But we are accustomed to always tune in to the positive - after all, humanity has not died out and is not dying out even in the absence of high-quality medical care, therefore we perceive childbirth as a natural physiological process and we always hope that the pregnancy will end well for both the mother and the baby.

Many complications of childbirth can indeed be prevented, but you should not rely only on the help of the medical staff. A woman should not be passive, but an active participant in her own childbirth. as well as pregnancy in general. It depends on her interest and participation whether the child is born alive or dead, healthy or sick, whether she will survive (survive) this difficult period or not, remain healthy or suffer from birth complications in the future.

Nobody is immune to the bad. However, I suggest that you adopt a few rules that can increase the chances of a successful pregnancy outcome.

Rule number 1. Know the exact gestational age and expected due date (PDD).

This will help to avoid mistakes in pregnancy management tactics and prevent its unjustified termination.

The gestational age is always set on the first day of the last menstrual period, adjusted for the duration of the menstrual cycle, or according to ultrasound data at 8.5-13 weeks of pregnancy, when the error in determining the period is 1-3 days. The longer the gestation period, the more errors in its determination.

PDD is not an accurate due date.. This is just an estimated day when the deadline reaches 40 weeks. Therefore, of course, no one requires delivery of a normal pregnancy on this very day, adjusting to the interests of someone, especially a doctor (in a hurry to go on vacation, for example).

Additional Information:
EARLY PREGNANCY DIAGNOSTICS
5.1. From what day should the pregnancy be counted?
5.4. Correct diagnosis of early pregnancy
5.9. Estimated due date

Rule # 2. Know what a full-term pregnancy is. This will allow not to make hasty conclusions and not go against the natural termination of pregnancy if there are no indications for premature artificial delivery.

Modern classification of delivery on time:

• early in term (or early term) - from 37 to 38 weeks and 6 days;
• at full term (full term) - from 39 to 40 weeks and 6 days;
• late on time (late full-term) - from 41 to 41 weeks and 6 days;
• post-term - 42 weeks or more.

If labor begins after 34 weeks of pregnancy, it does not require the administration of drugs in order to stop labor, because this can lead to the loss of the child and complications from the mother's body.

Additional Information:
New classification of term delivery

Rule number 3. Planning for labor and the choice of methods of delivery should be carried out in the third trimester (after 28 weeks).

Too early interest in the topic of childbirth can lead to a stressful situation, unnecessary worries and interventions in the process of carrying a pregnancy.

• You don't have to think about childbirth until 20 weeks.
• From 20 to 36 weeks, a woman should be well aware of the topic of preterm labor.
• From 36 weeks, it is important to know how labor is going on, what normal and pathological labor is, what periods of labor exist, what methods of delivery exist, methods of pain relief, etc. During this period, it is necessary to discuss with the doctor the topic of childbirth, a number of possible scenarios for their course, taking into account the height / weight of the woman, the size of the fetus, the presence of complications from both the female body and the fetus, the advantages and disadvantages of certain types of delivery offered to a woman ...

Additional Information:
BIRTH AND ALL ABOUT THEM
17.2. Normal childbirth
17.5. Premature birth
17.6. Postterm pregnancy

Rule number 4. Preparing for childbirth is just moral and informational preparation, and nothing more. There are no other types of preparation for childbirth in modern obstetrics.

Medication "treatment" such as pills in the vagina, herbal decoctions and infusions, insertion of fingers and other objects into the cervical canal and much more that is imposed on a pregnant woman allegedly to speed up the completion of her pregnancy "as soon as possible", "so as not to suffer", is rude, unjustified and often dangerous intervention, which can lead to a dramatic and even tragic outcome.

A woman with a normal pregnancy should not be in the hospital before childbirth in order to prepare for childbirth! The imposition of false diagnoses in order to meet the bed-day plan and receive rewards should be eradicated from obstetric practice and should not be encouraged by anyone.

Additional Information:
BIRTH AND ALL ABOUT THEM
17.1. Myths about preparing for childbirth

Rule number 5. Study information about childbirth, taken only from reliable sources.

Unfortunately, most pregnancy courses and schools do not teach women the practical knowledge and skills that can be useful in childbirth. Women are taught breathing exercises, which in fact does not improve the outcome of pregnancy, various myths are imposed on them (such as the prohibition of meat eating and sexual activity before childbirth), they are shown beautiful pictures depicting the progress of the head and the baby along the birth canal, etc., but they do not teach how to correctly assess their feelings, what to pay attention to, when to shout and call for help, and when to calmly wait for the next period of childbirth.

Additional Information:
Lectures for pregnant women in the residential complex. Causes of colic in children - mom's staphylococcus?
Table guide for pregnant women
About school for pregnant women

Rule number 6. Study the topic of childbirth during pregnancy with those people who will be present at your birth. Because "one head is good, and two are better" and "from the side it is always more visible."

During childbirth, many women lose their composure due to fear and pain, as well as control over the situation, so they may not assess what is happening adequately. It is advisable that a loved one who will be at the birth (husband, mother, sister, girlfriend, etc.), observe what is happening with knowledge of the matter and help the woman make informed decisions.

Additional Information:
BIRTH AND ALL ABOUT THEM

Rule # 7. Know when to go to a maternity hospital or hospital.

You should go to the hospital when you see:

• regular contractions with a frequency of 8-10 minutes, if you can get to the hospital within 1 hour;
• amniotic fluid in secretions in any quantity;
• spotting and bleeding;
• severe pain in the lower abdomen, not dependent on contractions;
• severe headache and / or severe nausea with vomiting, increased blood pressure;
• severe weakness and deterioration in general condition;
• a sharp increase or decrease in fetal movements.

There may be other signs that require your doctor's attention. Therefore, if there is any doubt about whether to go to the hospital or not, whether new sensations and signs are the norm or not, it is best not to guess, but to call an ambulance or go to the hospital accompanied by relatives or friends.

Additional Information:
COMPLICATIONS OF PREGNANCY IN 2, 3 TRIMESTER
10.1. Bleeding in the second half of pregnancy
DISEASES OF THE MOTHER AND PREGNANCY
11.1.1. Preeclampsia
PLACENTA, CABINETS, SHELLS, NEGOTIATED WATER
13.4.4 Premature rupture of membranes
BIRTH AND ALL ABOUT THEM
17.2. Normal childbirth

Rule number 8. Without exception, all pregnant women should know what periods of labor exist and what signs they are accompanied by.

The first period has two phases: latent (latent, inactive) and active, which usually begins with the opening of the cervix by 3-4 cm. In the active phase of the first stage of labor, it is advisable for a woman to be already in the hospital... It is far from always possible to determine the onset of labor, especially during repeated childbirth, and not all women experience contractions - childbirth can be completely painless.

Attempts (second stage of labor) are allowed when opening at 8-10 cm, and not necessarily during contractions.

The third period is a wait-and-see period, therefore it should not be accompanied by the forcible separation of the fertile place due to the haste of the medical staff. Any intervention in the uterine cavity should be combined with high-quality and adequate pain relief.

Additional Information:
BIRTH AND ALL ABOUT THEM
17.2.1. Periods of childbirth
17.2.2. Second stage of labor - attempts
17.2.4. Third stage of labor

Rule number 9. Normal childbirth does not require medical intervention, because it is physiological.

This means that when a pill is offered under the tongue, a cream in the vagina or an intravenous drip - supposedly to help speed up the process of childbirth, you need to understand that this is transfer / transition of normal natural childbirth to pathological because such an intervention is called induction (challenge) or stimulation (acceleration) of labor. This means that it is important to clearly know your diagnosis as a type of complication of childbirth, indications and contraindications for prescribing medications and other methods of accelerating delivery.

Labor progress is always assessed according to two criteria: cervical dilatation and child's progress along the birth canal, which is determined by manual examination. However, frequent manual inspections are strongly discouraged.

Additional Information:
BIRTH AND ALL ABOUT THEM
17.8. Induction and stimulation of labor

Rule # 10. The choice of pain relief during labor should be deliberate..

Childbirth can indeed be painless, although many women find it hard to believe.

The use of epidural anesthesia in many countries is often misdirected and even commercialized. The movement “every woman has the right to give birth without pain” may be accompanied by the imposition of drug pain relief without informing the woman about the side effects and complications of such pain relief.

Epidural anesthesia has only one plus - labor pain relief, and then if it is carried out on time and correctly, but there are many disadvantages. It lengthens the course of labor - both the first period and attempts, masks serious symptoms, for example, with a ruptured uterus, more often requires completion of labor by surgery (forceps, vacuum, cesarean section).

Additional Information:
BIRTH AND ALL ABOUT THEM
17.4. Pain relief during labor

Rule # 11. Supervise labor by playing the role of an active participant in the process. Among the people it sounds like a proverb “Trust in God, but don’t make a mistake yourself”.

It is necessary to keep a diary of childbirth, where to record the onset of labor, the frequency of contractions, the time of examination by the medical staff, what drugs were administered, what was carried out.

Whenever a midwife or doctor appears, do not be afraid to ask questions: what is the opening of the cervix (in centimeters, not fingers!), Where is the head or the advancing part of the fetus in relation to the birth canal (high, inserted into the small pelvis, halfway, at the exit ), whether the fetal heartbeat is heard and is it normal, etc. You can not understand the position of the sutures of the skull and fontanelles, understand nothing about the rotation of the head and the mechanism of labor, do not know by what criteria the progress of labor is assessed, but you need to ask explain to a doctor or midwife in an accessible form what is happening at a particular moment - is there progress or not, is everything good with the baby or there are some deviations from the normal course of childbirth.

Additional Information:
BIRTH AND ALL ABOUT THEM
How to ensure a successful outcome of childbirth? Is it possible to control the actions of doctors?
Using a fetal monitor during labor

Rule number 12. Monitor the actions of the medical staff.

No matter how difficult it may be, it is necessary to abandon our notions that a doctor is God and that one can completely “surrender” into his hands. Now you need to use the proven popular rule "Trust but verify."

All over the world, there is a degradation of medical education and, accordingly, a low quality of training for doctors. Moreover, such problems are typical not only for medicine, but also for other spheres of human activity. You don't have to go far for an example: evaluate the professionalism of those people with whom you work, study, live, and you will understand that there are not so many people who really know their business.

Another problem is the habit of living a lie. It is also typical for any society - both past and present. Any system, and the healthcare system is no exception, will make sure that the errors and errors of this system are justified, and that the consumer - the client (patient) - is the culprit. It is not customary to talk about medical (hospital) errors, it is not customary to discuss them - it is customary to hide them. Only a few win lawsuits against doctors and hospitals, because few succeed in proving the guilt of the system and its employees.

Relations with doctors and medical staff should not be built on complete, blind trust, but on constant monitoring of their actions. The doctor and midwife have no right to intimidate you - they are obliged to explain why and what is injected into a woman's body. Many procedures and drug administration require a woman's consent, often in writing, obtained only after a detailed explanation of the situation.

Additional Information:

Where to find the right doctor
How to choose a gynecologist
What to ask when concluding a labor contract?

Rule number 13. The postpartum period is not only breastfeeding, but also the time of significant physiological changes in a woman's body.

These changes begin with bloody discharge and a gradual decrease in the size of the uterus. Discharge (lochia) can last for 8-10 weeks. But ultrasound after childbirth is not carried out without strict indications, and curettage of the uterus - even more so.

The postpartum period can be accompanied by sharp jumps in body temperature, changeable emotionality, loss of strength, insomnia, lower abdominal pain, periodic bleeding, lack of menstruation, etc.

The child needs a healthy mother! If a woman does not understand what is happening to her and reacts negatively to normal physiological changes in her body, this also affects the health of the child.

Additional Information:
POSTNATAL PERIOD

Rule number 14. After a fight, don't wave your fists.

When childbirth ends dramatically or tragically, many go through psycho-emotional shock. Psychological trauma is characterized by the fact that it can take a long period, and when a woman or a married couple recovers and begins to think about what happened, trying to find out the reason for the loss of a child or the appearance of a sick child, the moment when it was possible to conduct research (karyotyping, a series of tests, etc. .) is often overlooked.

Every woman has the right to receive copies of all test results, without exception, and even the entire history of childbirth (this depends on the rules of the institution). But when the collection of this information begins, it suddenly turns out that the survey was not carried out correctly, the results of some studies are described in unprofessional stencil expressions, which are usually used to hide behind, and have no practical value. In most cases, it is impossible to find out the reason for the complication of childbirth and the negative outcome of pregnancy, and not because it is difficult to do “for technical reasons”, but because many facts will be distorted or distorted, fictitious or hidden. And then there will be only one thing left: to forget everything like a bad dream and start life from a new page, solving all emerging problems without losing common sense and the ability to think logically.

Easy and safe delivery for you!

Additional Information:
Obstetrics Navigator:
Positive stories about pregnancies and childbirth

Having a baby is hard and hard work not only for you, but also for your baby. To act correctly, remember how everything happens. The hour "X" is approaching, and, of course, you are worried. Let's face it, you are experiencing as never before in your life.

It's easy to understand! No matter how many literature about childbirth you read, no matter how many encouraging words you hear, it is not easy to get rid of fears (sometimes completely unfounded). Meanwhile, the main thing that you need now is calmness, only one calmness... While the baby is just preparing for the great journey, you have time to repeat everything that you learned from books and what you heard about in parenting courses.

Throw anxiety out of your head and once again mentally go through all the steps of an important path. You also need this in order to give birth to a strong, self-confident child. Indeed, many experts, led by the famous scientist Stanislav Grof, believe that at each stage of birth, a certain perinatal matrix is ​​laid, which is responsible for certain personal qualities of a person.

The first phase is preceded by nine long months of waiting. Already proven: a happy pregnancy is the key to the successful development of a child. But we also know that there is a lot you can do for your baby during childbirth! We are sure that you will go to the delivery room 100% prepared. In our "synopsis" - each stage of childbirth and something else!

It seems to have begun ...

The fact that childbirth has come is indicated by regular contractions of the uterus, lasting 10-20 seconds. The initial stage is the longest. In a woman giving birth for the first time, it can stretch for 6-12 hours. With repeated childbirth - for 4-8 hours. During this period, you feel contractions, thanks to which the baby will gradually move towards the "exit". They are weak at first and repeat after 10 minutes. Then they become more and more tangible and frequent: every 7-8 minutes. When they get stronger, they reach a peak, and then their intensity decreases.

Simultaneously with the contractions, the cervix begins to open. The first stage of labor will end with its full disclosure. Concentrate on correct breathing. You and your baby need plenty of oxygen to relieve the pain. It is also helpful to walk a little or sit on a special ball. Walking and vertical position of the body accelerate the movement of the baby through the birth canal, and the cervix opens faster... Your doctor and midwife will check you from time to time to check for disclosure. With the help of a cardiotocograph, the frequency of contractions is monitored: they become not only almost continuous, but also more painful.

A bath with warm water, a relaxing massage, and special birth positions help many women overcome discomfort.

Attention, attempts!

When the cervix opens up to its maximum (10 cm), the second stage of labor begins. It is shorter than the previous one and lasts about 2 hours.

Although, if a woman is not giving birth for the first time, it can be reduced to several minutes. The little one sank down and presses his head on the pelvis. Now hormones are intensively secreted in your body: endorphins (they have analgesic properties) and relaxins (under their influence, the pubic connection becomes more elastic, which makes it easier for the baby's task). The contractions are getting more intense each time. Gradually turn into attempts. But under no circumstances start pushing until the obstetrician gives you a sign... Failure to do so may result in injury to the birth canal. And besides, you will be wasting your energy. So try breathe slowly and calmly.

The birth drip is in the shape of a curve (in the form of the letter C), and it is not easy for the baby to pass it. The classic pushing posture is reclining. However, you can discuss a different position with your specialist in advance - squatting or on all fours. In these poses, thanks to the action of the force of gravity, it is easier for the baby to move. Blood passes through the placenta more easily and the baby receives more oxygen.

When the head appears concentrate and listen very carefully to the doctor and midwife. They'll tell you if it's time to push or not. Excessive force at the moment the head comes out can lead to ruptures.

Try not to scream- this weakens the force of pushing and delays childbirth. The moment the head appears is the most difficult, since the circumference of this part of the body is the largest - about 32 cm. For comparison: the chest is 30-32 cm, the buttocks are only 27 cm. When the head comes out, it will be enough to try quite a bit - and the person will be born!

The last effort or labor is nearing the end

As soon as the umbilical cord stops throbbing, the doctor (or dad) will cut it. It remains to wait for the placenta to separate. It was precisely with this organ that the baby was connected by the umbilical cord during pregnancy and thanks to it received food and air. The exit of the placenta is warned by light contractions, but you may not even notice them. The doctor will ask you to push a little or to stimulate the nipples so that the uterus contracts. Then he will examine whether the placenta is intact. The pieces remaining in the uterus threaten with inflammation or bleeding. In this case, anesthesia is done and they are taken out.

Your way out baby

A few weeks before birth, the child enters the pelvis with his head. At the first stage of childbirth, he is calm, sometimes even asleep. But when the contractions intensify and the cervix begins to open, the pressure in the uterus increases. Then the baby pulls the legs to itself, and presses the chin to the chest. He turns sideways to enter the birth canal. On the way, the baby may turn a few more times.

Neck opening by 5 cm

Under the influence of contractions, the baby begins to squeeze through the opening of the pelvis. His chin is still tucked against his chest, which keeps his head to a minimum. The structure of the skull also contributes to the passage. The bones have not yet grown together and are moving. This makes the head even smaller.

Full disclosure and pushing

When opened by 10 cm, the head begins to enter the birth canal, then lingers above the pubic junction and rests on the muscles of the perineum. At the moment of attempts, the child moves forward, and in the breaks it returns slightly. So the head pushes the perineal tissue apart without damaging them. Under her pressure of the muscles of the perineum relax and disperse.

Head emergence

She is already visible and does not come back in between attempts. With a correct delivery, the back of the head, forehead, and then the face appear first. In some cases, when the mouth is already visible, the obstetrician with the help of a special catheter will begin to suck mucus from the child's mouth. it will make it easier for the little one to take his first breath.

Shoulders go out

As soon as the head appears, the baby deflects it and turns towards the mother's thigh. It is the same with the shoulders. When they show up, the rest will slide out easily.

Mom's watch

At the birth of a child, be sure to be present neonatologist. It is more important than this doctor in the first minutes, hours and days of the baby's life. And while he is examining him, you can feel your mood.

Many mothers said that immediately after giving birth, they experienced not fatigue, not pain, but euphoria. Yes, exactly euphoria! Several hours passed - and all the questions, fears, which haunted before the birth of the crumbs, left like some kind of unnecessary, unnecessary fantasies. Everything worked out by itself - without stress and excitement. We hope that it will be the same with you and your baby! Even if at first you get confused, and at some point you realize that you do not know anything about caring for a baby, trust your intuition and the child. He will tell you what he expects most from you.

In order for the expectant mother to feel like a full participant in the process in the birth ward, she needs to prepare in advance for childbirth - both theoretically and practically. Modern medicine has developed methods by which a woman herself can contribute to the successful course of childbirth. So, what you need to know about the birth process in order to feel confident, and also to ease the pain, which is often feared by mothers who give birth for the first time, if possible?

During pregnancy, there are many things that need to be done in a timely manner, for example, passing all the required tests, regularly visiting a doctor, getting an exchange card, preparing a nursery and a dowry. All these actions are absolutely correct and logical, they tune in to the upcoming decisive event - the birth of a child. But in order to pass this test with dignity and with the least losses for yourself and for your baby, first of all, you need to know and understand what awaits you at the "x" hour. The hope that doctors themselves know everything is fair - doctors really know everything, but without the assistance of the woman in labor and the meaningful implementation of all recommendations during childbirth, their focus on the successful outcome of childbirth will be inhibited, which sometimes, in critical cases, can be very important.

Estimated due date

This is one of the most essential questions, especially if you do not intend to go to the hospital in advance. It is important to arrive there on time, without harming yourself or your child by being late. What is needed for this?

First of all, to know the expected date of birth, taking into account the fact that it is absolutely impossible to determine it absolutely precisely, only with fluctuations of several days (weeks), therefore, you should not consider the date set by the doctor as the ultimate truth and wait for its exact implementation. What can be assumed based on objective data?

Pregnancy lasts an average of 280 days (40 weeks) from the first day of your last menstrual period. If you count three months ago from this date and then add seven days, this will be the approximate due date. For example: the last menstrual period was on December 10th, therefore, the birth can be expected on September 17th.

It is advisable to remember the day of the first movement of the fetus. Primiparous women feel it in the middle of pregnancy (20 weeks), and those giving birth a second and third time a little earlier (18 weeks).

It will be possible to speak most accurately about the date of birth if the gestational age is set. It can be determined by a doctor by the size of the uterus. With sufficient reliability, it is possible to determine the duration of pregnancy and, consequently, childbirth according to the data of an ultrasound examination of the fetus. Childbirth that occurs before 37 weeks of pregnancy is considered premature, and after 42 weeks - belated.

The duration of full-term pregnancy ranges from 37 full weeks (259 days) to 42 weeks (294 days). From the 38th week of pregnancy, birth can be expected every day.

By this time, it is worth forming your position regarding partner childbirth, so that, with mutual agreement, the partner also has time to prepare for the event.

When is it time to get ready for the hospital and what to take with you?

Each childbirth is unique in its own way: their onset may be different for different women, and the experience of girlfriends giving birth will only partially help. Therefore, it is necessary to know the harbingers of the onset of labor:

a pregnant woman feels that it has become easier for her to breathe; this is due to the fact that the fetal head sank lower and pressed tightly against the entrance to the pelvis; usually they say that the stomach has dropped;

the amount of vaginal discharge increases, they can turn brown or pink;

individual contractions of the uterus appear - "training" contractions, irregular, short and quickly passing;

weak, dull, quickly disappearing pains often occur in the lumbar region;

there is a slight loss of body weight.

When these precursors appear, you should prepare for a trip to the maternity hospital. It is possible that you will have to wait. The interval between the appearance of precursors and childbirth can be several days or 2-3 weeks.

The main thing that is characteristic of labor pains is their regularity, repetition first every 15-20 minutes, then more and more often, longer and stronger. In contrast, false contractions usually have an irregular rhythm, do not intensify, and may stop if the body position is changed.

If at least one of these signs of the onset of labor is present, this means that labor has begun and it is time to go to the hospital.

Before the trip, you can shave your crotch yourself and do an enema, or leave this procedure to the admission department of the maternity hospital.

By the time you leave for the maternity hospital, the collected bag should already be ready, taking into account what is allowed to be taken to that particular maternity hospital in which you are going to give birth (accordingly, this must be found out in advance). Otherwise, you run the risk of being left without the necessary things in the hospital.

Signs of the onset of labor, in which you need to urgently go to the hospital:

The appearance of spotting from the vagina.

Outpouring of amniotic fluid - they can be poured out drop by drop or about 200 ml at once. Normally, the waters are light or slightly pinkish, without an admixture of bright blood, white lumps of the primordial lubricant of the fetus can be seen in them. However, the waters can be green or brown, due to the ingress of the original feces - meconium. It is imperative to inform the doctor about this, since meconium in the waters indicates fetal hypoxia (lack of oxygen). After pouring out the waters, you must immediately go to the maternity hospital, since a long anhydrous interval is fraught with the danger of infection of the fetus and the mother's birth canal.

Regular labor pains.

Pain relief during labor

Those who are especially afraid of labor pain, which are legendary, should learn more about pain relief in advance.

Currently, all existing methods of pain relief in childbirth are conditionally divided into two groups:

Methods of non-drug exposure.

These include: psychoprophylactic preparation of pregnant women for childbirth, hypnosis and suggestion, acupuncture (using metal needles injections at specific points), transcutaneous electrical nerve stimulation, self-massage.

Methods of pharmacological action.

The effect of painkillers on the body of a woman and a child is well studied, as are the possible unwanted side effects. Anesthesia with pharmacological agents begins in the first stage of labor in the presence of regular strong contractions and the opening of the uterine pharynx by 3-4 cm. This also includes epidural anesthesia, which is carried out according to medical indications, in some cases - at the request of the woman. With this method of anesthesia, a special needle is inserted into the space above the dura mater covering the spinal cord, and the drug is injected there. With this method of anesthesia, the woman does not feel contractions, the lower extremities also lose pain sensitivity.

After examining the issue in detail and deciding on pain relief, be sure to discuss the chosen method with your doctor before the onset of labor. The decisive word in the choice of methods of pain relief should remain with the doctor - this is an axiom.

If you are a principled opponent of drug pain relief, you can, for example, agree with your doctor that you will give birth without pain relievers, but if you still feel that you need pain relief during childbirth, you can tell the doctor about it.

How is labor going?

Knowing what periods the childbirth process is divided into and how to behave at this time will help the mother to better cooperate with doctors, the result of which will be the birth of a healthy child and the absence of birth traumatism.

There are three stages of labor: dilatation of the cervix, expulsion of the fetus and the subsequent period.

The opening period is the longest in childbirth. It lasts about 9-10 hours in primiparous women and 6-7 hours in multiparous women. The duration of contractions during this period increases from 10-20 seconds to 1.5 minutes, and the interval between them decreases from 10-15 minutes to 1 minute.

The purpose of the first stage of labor is the gradual dilatation of the cervix. It occurs under the influence of regular contractions. When the cervix is ​​fully open, the fetal head can sink into the pelvic cavity.

What can mom do at this stage?

Learn to relieve pain by taking a comfortable position for yourself, and properly endure the contraction, relaxing after it. For this, there are special relaxation techniques that must be learned in advance.

You should definitely know about the main poses in which the contractions are easier to tolerate: an upright position, lying on your side, lying on your back, postures using a special ball. Both your husband and you can help by making an anesthetic massage (and having previously learned this). To relieve the pain of contractions at this stage, you also need to know how to breathe during contractions.

Expulsion of the fetus is the second stage of labor.

The duration of this period is on average 1-2 hours in primiparous women and less than an hour in multiparous women.

When the fetal head descends to the pelvic floor, attempts are made to join the contractions. Attempts are contractions of the abdominal muscles and the diaphragm (the muscle septum that separates the chest and abdominal cavities). The average duration of the push is about a minute. Thanks to pushing, intra-abdominal pressure increases, which, coupled with an increase in intrauterine pressure (due to contractions), allows the child to move along the birth canal. Attempts occur involuntarily, but, unlike contractions, a woman can control them, strengthening or restraining if necessary.

To avoid rupture of soft tissues as the baby passes through the birth canal, the doctor may make an incision in the perineum (episiotomy), which will then be sutured after the placenta is born (with pain relief). Episiotomy is a common operation during childbirth, you should be ready for it in advance. Moreover, evenly cut tissues grow together faster and better than uneven edges after tears.

The cry of a child immediately after birth is a good reaction to a new external environment for him. But labor is not over yet - the baby is still connected to the mother by the umbilical cord, and the placenta is in the uterine cavity.

What can mom do at this stage? Listen carefully to the doctor and midwife, as unauthorized actions can harm both the mother and the baby.

Correctly regulate attempts (having previously learned this). During the period of fetal expulsion, it is necessary to alternate muscle tension at the moment of an attempt and complete relaxation between attempts - this is taught by special techniques, the study of which must be devoted time in advance in order to bring the skill to automatism.

Correct breathing, necessary during the entire period of childbirth, does not lose its relevance during attempts. Firstly, at this moment, the fetus suffers from a lack of oxygen more than ever. Secondly, it helps to conserve strength and push more effectively. It must be said that correct breathing helps to avoid breaks, making it possible to stop the pushing, if it is not yet possible to push.

The third, successive, period lasts on average 5-10 minutes, but it can drag on up to 30 minutes.

At this time, the umbilical cord is crossed - today doctors often entrust this simple but symbolic manipulation to the father present at childbirth. When the umbilical cord is cut, neither the mother nor the child will feel pain, since there are no pain receptors in the umbilical cord.

After birth, the doctor and midwife will receive the baby and carry out all the necessary procedures: processing, weighing, measuring, examining.

On the handle, the child is put on a plate, which indicates the surname, name and patronymic of the mother, the year, day and hour of the child's birth, as well as his gender.

Weak contractions continue, which separate the placenta from the walls of the uterus, and then, with one or two light attempts, the afterbirth is born. Only after this can the childbirth be considered complete.

First contact with the baby and latching on to the breast

Today it is customary to do this even in the delivery room, immediately after the birth of the child. When exactly - it depends, firstly, on the traditions of the given maternity hospital, and secondly, on the condition of the newborn. The child can be placed on the mother's breast with the umbilical cord not yet cut, immediately after birth, or even after the birth of the placenta. Both options are normal. If the newborn or mom has health problems, this procedure may be postponed.

Where and with whom?

During the first stage of labor, the woman is in the prenatal ward. When the cervix is ​​open enough, the expectant mother is transferred to the delivery room, where she spends the second and third stages of labor on a chair or on a special bed.

After giving birth, a woman (she is now called not a parturient woman, but a parturient woman) for another two hours is in the maternity ward under the close supervision of medical personnel, who monitors her condition and the amount of bloody discharge from the genital tract. At this time, the soft birth canal is examined and, if there are ruptures, sutures are applied with preliminary anesthesia. Ice is put on the abdomen - for better contraction of the muscles of the uterus. After the examination, the woman is transferred to the postpartum department.

Where can I get information about childbirth?

If the mother is taught how to take care of the baby in the maternity hospital, where they will also help to establish breastfeeding, then the theory and practice of childbirth should be studied in advance, since the same breathing techniques or anesthetic massage require the formation of certain skills in order not to get confused in extreme conditions and do everything in the best possible way ... You can practice these skills in preparatory courses for childbirth. You can do it yourself, guided by the recommendations of magazines and books for expectant mothers and "rehearsing" at home with your husband or girlfriend.

Pregnancy in the life of every woman is undoubtedly a great happiness. However, many expectant mothers are often worried about how the birth will go, especially the first. Proper preparation and knowledge of the birth process will help women in labor overcome fear and effectively cope with the difficult task that faces them on the day of birth.

As a rule, normal childbirth occurs according to the term (from 37 full weeks to 42). In nulliparous women, the average duration of labor is 13-16 hours. The next times everything goes faster: about 7-12 hours. However, in each case, this is an individual term.

In childbirth, there are 3 periods: disclosure (regular contractions), expulsion (attempts and birth of a baby), birth of the placenta.

A few days, and sometimes weeks before the baby is born, the expectant mother may notice changes in her health - the harbingers of childbirth. The reason for this is the hormones that are produced in her body during the entire period of gestation. A pregnant woman may experience "stretching" of the lower abdomen, frequent urge to urinate. Insomnia and some weight loss are possible. It is worth noting that such precursors may not be present.

The most common intrauterine position of the baby is head down (cephalic presentation), but the baby can also be positioned with the legs "forward" (breech presentation). Sometimes a cesarean section is performed with a breech presentation of the child, but there are exceptions. As a rule, the doctor decides this question in advance and warns the woman.

First stage of labor

Directly first stage of labor begins with regular contractions (lasting 5-10 minutes), the meaning of which is to open the cervix. Feelings with them are quite individual. Some women may experience "tremors" in the lower back, then in the abdomen. Also, the feeling of "stretching" can occur in the uterus, as well as in the lower abdomen.

The first period (opening) is quite long: 8-12 hours. In this period, the latent and active phases are distinguished. The first (latent phase) is characterized by short-term regular contractions at significant intervals. The opening of the cervix in this phase is slow: in 4-5 hours it opens by 4 cm. Further, the contractions become more intense, the uterus begins to open faster - the active phase of the 1st period starts. All this time, the doctor keeps under control the nature of the contractions, monitors the condition of the woman in labor.

Second stage of labor

In second period the cervix opens completely (10-12 cm). The amniotic fluid leaves painlessly. Intense contractions are supplemented with attempts (the muscles of the press and pelvic floor begin to contract, which causes an intolerable urge to push). Contractions during the period of pushing become shorter: 30-35 seconds.

As the cervix opens, nothing holds the baby's head, and the baby begins to slowly move along the birth canal. During the second period, the woman in labor should follow the instructions of the obstetrician and monitor her breathing. At this stage, breathing exercises are very important, which expectant mothers study during classes in preparation for childbirth.

The eruption of the child's head occurs (becomes visible during the attempt). After some time, the midwife retrieves the entire newborn. Usually the 2nd period lasts about an hour, but it may take a little longer. It all depends on the strength of the "expulsion", the size and location of the baby. When the baby, having been born, takes a breath for the first time and makes the first cry, the 2nd period ends.

Third stage of labor

Followed by third stage of labor(sequential) - the shortest. After birth, the baby is placed on the mother's chest, then the inflammation of the eye membrane is prevented, weighed, measured and put the first Apgar score.

The uterus contracts rapidly and the placenta is born. The sequential period lasts from 10 to 30 minutes. The doctor monitors the mother, her condition. If necessary, the woman is injected with a medicine to better contract the uterus. Next, the young mother is examined and transferred to the postpartum department together with the baby.

Preparation for childbirth in the medical center "Inspiration"

It is worth noting a few more points: as soon as the expectant mother assumed that childbirth had already begun, then she should not take food. The comfortable posture of the woman during the first and second periods is also important: it is allowed to squat, walk a little and kneel.

For more information on how you need to behave at one time or another of childbirth in order to facilitate their course, you can find out by going through