Hospitals 

What is used to induce labor? Contraindications for artificial stimulation. How is the labor induction gel administered?

The maternity bag has been packed for a long time, and you are still "two in one". You don't sleep well and can't rest properly. Your stomach is like a balloon, your legs are swollen, and the due date is marked on the calendar behind. You have not been afraid of childbirth for a long time, on the contrary, you listen to yourself every minute in the hope of further developments ... But be careful, mother nature is smarter and she knows what she is doing! After all, the impulse to birth is given not by the mother, but by the child. That's why you need to be patient and not get depressed. In this article, we will talk about post-term pregnancy, its features and ways to stimulate it.

Why is a post-term pregnancy dangerous?

According to studies, post-term pregnancy lasts from 41 weeks to 41 weeks and 6 days, as well as 42 weeks or more. With such a pregnancy, your baby may be at increased risk of health problems. Thus, the size of the fetus can be significantly larger than average at birth (fetal macrosomia), which can increase the risk of surgical vaginal intervention, it is possible that the child’s shoulder will get stuck behind the pelvic bone during childbirth, which will lead to shoulder dystocia.

Another negative syndrome can be associated with a decrease in fat under the skin, a lack of cheese-like lubrication on the body of the fetus, a decrease in the primary hairline in the child, and staining of the amniotic fluid, skin and umbilical cord in green, due to meconium - the contents of your child's intestines. There may also be a low volume of amniotic fluid, which can interfere with your baby's heart rate and compress the umbilical cord during labor.

A post-term pregnancy can also present the following complications during childbirth:

  • increased vaginal discharge;
  • more painful contractions with shorter intervals;
  • infection;
  • postpartum hemorrhage, etc.

Indications for labor induction

Unfortunately, the body is not always capable of naturally stimulating the onset of labor, and it is not always possible to wait for this moment. Sometimes it may happen that the child must be born as soon as possible in order to save his life. Other indications include:

  • Pregnancy more than 41 weeks - the most common reason for the use of stimulants. This procedure is done to reduce the risk of a caesarean section.
  • The appearance of symptoms of any disorders dangerous to the health and life of the fetus. For example, a decrease in the heart rate detected on CTG.
  • Multiple pregnancy. With multiple pregnancies, when babies simply cannot appear in the usual way, stimulation is also prescribed.
  • Descent of water and the absence of more than 10-12 hours of the onset of contractions. Stimulation is carried out taking into account the high risk of infection through the cervix.
  • Detection of pathological changes in the placenta.
  • Hormonal or endocrine disorders, at which the production of oxytocin will be small or will be missing .
  • In case the uterus is stretched too much due to the presence of increased amount of amniotic fluid (polyhydramnios).
  • Chronic and other diseases of the pregnant woman. If the mother has kidney disease, thyroid disease, gestational diabetes, high blood pressure, then the gynecologist may prescribe stimulation.
  • Umbilical cord prolapse or placental abruption. Doctors use the stimulation method to avoid complications during and after the birth process.
  • In some cases, the indication for stimulation is the late age of the expectant mother.
  • Weak labor activity . In the case of a slow opening of the cervix (by 2-3 cm) with contractions for more than 6 hours in a row, doctors may resort to stimulation.

What concerns the decision to stimulate labor activity is made only by a doctor and only after a full examination, which will establish that the continuation of pregnancy can harm the child or mother.

Contraindications for labor induction

But, as for any medical intervention, there are contraindications for inducing labor. Medical stimulation is not performed if:

  • The size of the woman's small pelvis is smaller than the size of the head of the fetus. Since there is a possibility that the baby will get stuck in the birth canal.
  • The presence of scars on the uterus. Labor induction is not carried out, as this can lead to a rupture along the old scar.
  • The location of the fetus. In lateral (transverse) presentation, in general, if the fetus is not in head presentation, stimulation is not performed.
  • Unsatisfactory condition of the fetus and contraindications to the stimulation of labor by the pregnant woman. If natural delivery is not possible, caesarean section is performed.

As a rule, induction of labor is used in exceptional cases, after a balanced medical decision, since any interference with the natural physiological process is not desirable. However, if doctors insist on stimulation, if you have no contraindications to it, you should still trust your doctor or resort to safe, natural methods of labor induction.

Methods of artificial stimulation of labor

It should be noted that the methods of artificial stimulation of labor are conventionally divided into medicinal and non-medicinal. How do birth control drugs work?

To prepare the uterus for disclosure, analogues of natural hormones are used, which trigger labor and increase the contractile activity of the uterus. When using the drug method of stimulating labor, the hormones oxytocin or prostaglandins are administered to the pregnant woman.

Oxytocin is a synthesized analogue of a hormone produced by the pituitary gland. Oxytocin is administered in the main form of intramuscular or subcutaneous injections.

Oxytocin causes non-physiological contractions, in which there is severe labor pain, so it is used in combination with pain medications. Contraindications to the use of oxytocin include incorrect placenta previa, non-head position of the fetus, a scar on the uterus after surgery in previous pregnancies or the inability to have a baby through the natural birth canal (large fetus, narrow pelvis of a pregnant woman, etc.)

Prostaglandins unlike oxytocin, they cause more tolerable contractions. Another plus is that the drug does not penetrate the amniotic sac and does not restrict the movement of a woman during childbirth. Preparations based on prostaglandins help the maturation of the cervix - it softens, the elasticity of its muscle structures increases. In order for the drug to take effect, gynecologists inject prostaglandins in the form of a special gel or suppositories deep into the vagina and cervical canal. The disadvantages of using prostaglandins include: slowing down the active stage of labor, vomiting and headaches.

TO non-drug methods, medical methods of labor induction include: amniotomy and expansion of the cervical canal.

Amniotomy - this is a puncture of the fetal bladder, which is done during a post-term pregnancy, with a deterioration in the condition of the placenta and, as a result, a high risk of developing hypoxia in a child. How does this happen? A special hook is inserted into the vagina, which captures the fetal bladder and opens it, which causes the outflow of amniotic fluid. This method is safe for a child, and painless for a pregnant woman. This procedure should be carried out only by an experienced obstetrician and only if indicated.

Expansion of the cervical canal. In this case, a catheter with a balloon filled with water is used, which is inserted through the cervix into the uterus. The irritated uterus pushes the balloon through the cervix, thereby making an opening from 2 cm to 4 cm.

Another way to expand the neck is to use P alochek from kelp.

The sticks are inserted into the cervical canal, one end of the rod should reach its cavity, and the other should be controlled by the doctor, protruding into the vaginal cavity. The sticks thicken significantly due to the absorption of vaginal and cervical secretions, expanding the cervical canal, preparing the cervix for the upcoming birth.

Natural Ways to Induce Labor

Nipple massage

One of the most effective ways to stimulate labor is to massage the nipples. A pregnant woman can massage her nipples with her thumb and forefinger for several minutes every day. The body releases oxytocin, a natural hormone that causes the uterus to contract. Massage can be prescribed for pregnant women from the 39th week of pregnancy. Massage can help increase the strength of contractions already during childbirth.

sexual contact

Sex shortly before birth is one of the common tips on how to induce labor. This advice makes sense, since male sperm contains prostaglandins, but their content is relatively low. Prostaglandins have a very beneficial effect on the maturation of the cervix, softening it and changing its condition. Therefore, gynecologists often recommend making love from the 38th week of pregnancy up to 2 times a day, which, of course, is very welcome by future dads. You just need a more comfortable and safe position. At the same time, unprotected contact can be dangerous in some cases. Before having sexual contact with a partner, consult with your doctor, as sex has its pros and cons when inducing labor. An example is the disease of the genital organs of the spouses.

Physical exercise

In order to give birth sooner, a pregnant woman can work in the same pre-pregnancy mode: wash the floors, wipe the dust, iron the clothes (provided that you feel good and the doctor does not advise physical rest!) This method of stimulation will come in handy, because Many mothers experience the so-called "nesting period". However, be careful with certain types of work, such as washing windows and hanging curtains: you can lose your balance and fall! Do not lift heavy loads - just measure the degree of physical activity appropriate for your condition. Physical exercise to induce labor is recommended after 38 weeks of pregnancy.

Use spices

Make yourself some spiced tea. It is usually consumed within two days to induce labor. You will need one small ginger, 12 cloves, 1 piece of cinnamon. The ingredients are mixed with a liter of boiled water and allowed to infuse for 30 minutes, then the drink is poured into a thermos. You can drink tea all day long.

Massage of the lower abdomen

It is recommended to increase blood circulation in the muscles of the uterus, in order to pass the baby's head during childbirth and is a partial prevention of rupture (however, this will not always be a 100% guarantee). Some experts claim that massage helps to give birth to a child at the peak stages of pregnancy. Massage oil can be made from olive oil. You can use other massage oils that contain lavender, mustard sage, and rose essential oils. Such oils act as an antiseptic, preventing any possible infection. Also, during massage, you can use a special gel to stimulate childbirth.

Alternative ways to induce labor

Dance and music

Dance for pregnant women is highly recommended for many reasons. Perform it daily, preferably without tight clothing, with a scarf around your hips. Dance alone in your room to any tune that pleases you and your child for at least 30-40 minutes. Music should not be rough and hard, you should try to avoid sudden movements and jumps.

Craniosacral therapy improves the circulation of cerebral vessels, relieves headaches, restores the mobility of the pelvic bones, sacrum and joints of the spine, reduces tension in the brain membranes, normalizes nerve function, etc. This therapeutic method is ideal for pregnant women. This method can and should be used when the birth of a child begins to be late.

CranioSacral Therapy is often used as a means of transporting the energy that triggers the birth process. Rapid natural childbirth often occurs after CranioSacral Therapy.

Homeopathy

If you know a good homeopath, you should consult him, because homeopathy can prepare a woman for childbirth and overcome the difficulties of the natural process of childbirth. But don't go to the first homeopath you come across that you don't know.

Walking

During a long walk, the baby presses on the cervix, which causes it to begin to open. This method only works if the cervix has already begun to flatten in anticipation of labor.

Acupuncture (acupuncture)

We don't know much about acupuncture, but this effective method of traditional Chinese medicine is suitable for post-term pregnancies and is often recommended by specialists. Acupuncture should always be performed by a specialist, such as a traditional Chinese medicine center. If the baby is ready to be born, labor will begin within 24 hours.

Medicinal herbs that cause contractions

The power of nature has been known for centuries, and even our grandmothers knew about the benefits of herbs. Instead of pharmaceutical drugs, they used the gifts of nature to stimulate childbirth. In general, medicinal herbs are well tolerated and in many cases are used both as teas and in massage oils. What is their purpose? Herbs trigger and support uterine smooth muscle contraction. The use of such herbs is allowed from the 37-38th week of pregnancy. With the help of the natural ingredients listed below, you can stimulate labor at home. So, after consulting with your doctor, you can try:

  • sage tincture: for natural stimulation of childbirth, you can use tincture of sage. The dose is 10 drops per glass of water. Take one sip in the morning, consume the drink for 3 days. If the baby is ready for birth, childbirth is just around the corner. If necessary, you can repeat the dose again after three days. During childbirth, sage tincture helps the effectiveness of contractions.
  • flax-seed. From the 35th week of pregnancy, you can also consume flaxseed, two tablespoons a day. The seed can either be eaten dry or left overnight in water to soften. If you don't like the taste of flaxseed, you can add it to soup, bread, yogurt, etc.

Important!

What is the danger of stimulating labor for mom and baby

Studies evaluating the possible effects of labor induction usually do not include: the impact on a woman's mental health, her perception of childbirth, the impact on the infant's psyche, and on breastfeeding. After active stimulation of labor, a delayed onset of lactation and other negative effects may occur.

Excessive uterine tension also reduces the mother's confidence in maternal competence or separates mother and infant if complications occur during delivery.

Some experts even point to an increased adverse risk to a child's future health if the child's labor has been induced. There is a risk of complications such as uterine hyperactivity, uterine ruptures, stress and fetal hypoglycemia with further interventions during childbirth. If the uterus is overactive, preparations containing beta mimetics may be used to suppress it.

Artificial stimulation of labor: is it really necessary?

As mentioned above, it is better to use stimulation in extreme cases, when this process does not occur physiologically normally, and the absence of labor activity can become dangerous for the health of the mother or the life of the fetus. However, there are cases when labor is stimulated in vain:

  • so, quite often, childbirth is stimulated prematurely with a poorly calculated date of birth. The most accurate method is to measure the fetus with ultrasound in the first trimester of pregnancy, later this measurement can be subject to significant error.
  • it is inappropriate to try to stimulate labor in the afternoon and evening, when the woman is tired and drowsiness sets in.
  • a woman in labor should not be forbidden to eat and drink.
  • if a woman has an irregular menstrual cycle, there is no reason to induce labor before the 42nd week of pregnancy (including women with diabetes). Up to 42 weeks, diabetics are advised to give birth only if diabetes manifests itself clearly, for example, there is clearly poor placental function.
  • Also, many premature births are caused by the wrong method of inducing labor by a woman.
  • a larger fetus should not be a signal to induce labor, but in some cases, induction of labor has been shown to reduce the risk of clavicle fractures in infants.

As a result of stimulation, there is a high level of stress for both the fetus and the mother, an unpleasant birth experience, and the likelihood of termination of pregnancy by caesarean section increases.

When will the birth come? All women who are waiting for the birth of their baby think about this question. In most cases, and this occurs after the 37th week of pregnancy. However, there are also medical indicators in which the appearance of a child should take place earlier than the line.

There are cases when childbirth begins spontaneously, and then progresses more slowly and more slowly, then stops altogether. This is called weak labor activity. Therefore, when the contractions stop or they are not intense enough for the baby to appear, doctors begin to induce labor.

Stimulation of labor in the maternity hospital

Stimulation or artificial induction of labor must be carried out very carefully. During the procedure, doctors try to make sure that one contraction and no more takes place in 3-5 minutes. If after 3-4 hours of stimulation there are still no results, and labor activity does not begin, then you need to do a caesarean section and take out the baby.

Doctors associate a decrease in labor activity with a constant violation of the menstrual cycle in a woman, with the occurrence of endocrine problems and with inflammation of some organs. There are several methods of modern stimulation of labor. An experienced doctor should choose the one that best suits the woman in labor.

If the cause of delayed labor is that the cervix is ​​not ready to open, then prostaglandins are used to “ripen” it. These are hormones that immediately begin to affect labor activity. The main advantage of this method of stimulation is that the side effects are minimal and the dilatation of the cervix is ​​quite significant.

When a woman in labor has a weak contractile activity of the uterus, doctors use the method of amniotomy - opening the fetal bladder. Thanks to this method, the outpouring of amniotic fluid is caused, after which the pressure inside the uterus begins to fall, the baby's head begins to put pressure on the pelvic bones, the cervix opens - and childbirth begins. The amniotomy method is also safe for the child and mother, complications can occur very rarely.

However, if even after opening the fetal bladder, contractions do not begin, then they need to be stimulated. For the procedure, doctors use - this is an analogue of the natural hormone that a woman's pituitary gland produces during childbirth. You can use oxytocin in the form of tablets or intravenously - this is the most common method. The disadvantage of using it is only that the woman will have to be limited in her movements, since she will need to lie under a dropper. Oxytocin is used along with antispasmodics - drugs that relax the muscles of the uterus. All doses must be selected individually. Among the contraindications for the use of oxytocin are the impossibility of having a child through the birth canal, the incorrect position of the fetus, and hypersensitivity to the drug.

It should also be borne in mind that the stimulation of labor is not always justified. Any method of this procedure has its contraindications. Stimulation is not carried out if:

  • the size of the child's head does not correspond to the size of the mother's pelvis;
  • the baby inside the mother feels bad, judging by the indications of the heart monitor;
  • the fetus is located incorrectly;
  • Mom has health problems.

The decision to induce labor is made by the doctor. At the same time, he must weigh the pros and cons of such a procedure. Labor induction is justified only if:

  • observed;
  • and no contractions after 38 weeks;
  • there are relevant medical indications;
  • there is a failure in the process of childbirth;
  • the cervix does not open;
  • contractions stop abruptly;
  • the woman is too tired from contractions.

Childbirth after stimulation

No one can accurately predict how your child will be born. And this does not depend on whether the stimulation of labor was used. Nevertheless, the “medical” acceleration of the development of events during childbirth leaves its mark on the process itself, which, according to the laws of nature, should take place without any interference and acceleration.

In particular, there is evidence (and the experience of women in labor who have gone through artificial stimulation confirms this) that labor with drug stimulation is more uncomfortable for the woman in labor, since the pain due to the use of drugs intensifies and is felt more acutely. However, practice also proves that the delay in the birth process, among other things, contributes to the woman's fear of pain. Therefore, it is necessary to calm down, learn to relax and cope with pain. Remember that during childbirth, a woman's pain threshold decreases, and she is able to withstand any pain without risk to life - this is provided by nature. Think about the child: he urgently needs your support and help now. Do not forget that childbirth is also a serious test for him, which he passes with dignity!

And do not be discouraged if childbirth has to be stimulated: this is done solely in the interests of the child. Although, of course, it is better to talk to your doctor in advance so that medical stimulation (if suddenly) is resorted to only in case of emergency according to strict indications (alas, recently childbirth has been stimulated more and more often).

However, if a woman truly prolongs her pregnancy, then she can try to induce contractions on her own - still at home, while time permits.

Natural induction of labor

Many women begin to stimulate labor without even setting themselves such a goal. They just go on with their normal lives, going about their daily activities, but some of these activities in late pregnancy hasten the opening of the cervix and cause the onset of labor. Such properties are possessed, in particular, by sex. Irritation of the cervix during intercourse leads to the beginning of its disclosure. In addition, male sperm contains substances that also affect the processes of labor. And active uterine contractions during orgasm further enhance the labor-stimulating effect. That is why there are many cases when women gave birth easily, quickly and simply the very next day after a quality night spent with her husband.

A good and safe provocation of labor is nipple stimulation, which can be performed not only by a partner during sex, but even by a woman on her own if she begins to prolong pregnancy. Irritation of the nipple area leads to the production of the hormone oxytocin, which is necessary for the process of childbirth.

Any physical activity can cause the onset of childbirth in a natural way: whether it is a long or intense walk, gymnastics, cleaning around the house. If a woman is already on demolition, then in any of the cases she can give birth within a few hours after such activity.

Some advise taking a warm enough bath to hasten the onset of labor. But you should be careful with this method, and if the waters have already departed, then you can’t use it at all.

There are other ways to lure the baby into the world. Among them there are even funny ones: for example, shine a flashlight in the lower abdomen, attracting the attention of the baby and directing him to the “exit”. Meanwhile, not all of them help.

Do not forget that the baby may linger in the tummy for a reason: perhaps the X-time has not yet come. Or maybe it's time to let the doctors act if the examinations confirm the baby's trouble in the womb. In any case, remember that a positive attitude is one of the most important factors in this business. Tune in to the best, and know that there are safe methods to help you have a healthy baby!

Especially for- Maryana Surma

Helpful information

Olga Kenton: Doctors have been studying the technology of stimulating labor and its effect on the body of the mother and child for a century. Today, there are many ways and drugs that can speed up and facilitate the process of childbirth. But no matter what cutting-edge medicines they give you, no matter how you are assured that the stimulation procedure is absolutely safe - remember that any intervention in the birth process can both positively and negatively affect childbirth.

Since the female body is designed by nature in such a way that a child can be born practically without outside help, groundless interference in childbirth can only do harm. True, today complications even in primiparous mothers are recorded more often. This is due to poor ecology, the late age of the birth of the first child and, accordingly, a greater number of chronic diseases in women giving birth.

In addition, doctors, having believed too much in miraculous devices and medicines, are now increasingly relying on average birth rates than on their own experience. According to statistics, in every Russian maternity hospital, labor induction is used in 7% of cases of childbirth, but this is only according to official data. And what is actually happening, one can only guess, because in many maternity hospitals this procedure is put on stream.

Most women who are offered induction of labor simply do not know, and doctors do not consider it necessary to inform them, that the introduction of medications can either speed up or slow down, or completely stop the natural process of childbirth. And this leads to additional medical intervention, and increasingly to caesarean section.

After the operation is done, the doctors “calm down” the woman with the words that this was the only possible option, and that if it weren’t for her (the operation), the result could have been much sadder. The only thing they do not talk about is that the very stimulation of childbirth becomes the causative agent of surgical intervention. H Often women, not having full information about the pros and cons of stimulation, and with the tacit consent of doctors, very easily agree to “push” the birth process. They do not realize that childbirth may be faster, but the pain will not decrease from this, but will only increase, and the child will have an increased risk of developing oxygen starvation, and, as a result of this, blood pressure may decrease (and this is already an indicator that that the baby is suffering in utero and you need surgery).

Of course, doctors must be trusted, and there are times when stimulation is really necessary and justified. But do not forget that any actions that the obstetrician decides on must be agreed with you or your authorized representative. Therefore, if you have such an opportunity, let your husband or one of the relatives whom you trust be present at the birth with you. And even if you are not able to make an adequate decision, they will be able to assess the situation more calmly.

Why is it necessary to induce labor?

In cases where childbirth does not begin naturally or does not progress, when there are medical indications for the birth of a child before the due date, doctors resort to induction of labor to open the cervix.

Stimulation of labor activity is necessary:

    in case of post-term pregnancy (more than 42 weeks);

    to reduce the risk of caesarean section in multiple pregnancies or large babies;

    to avoid birth complications in cases where there are medical indications for the health of the mother or fetus: kidney disease, thyroid disease, high blood pressure, gestational diabetes, umbilical cord prolapse.

The main disadvantages of labor stimulation:

    the main disadvantage of stimulation is too strong an effect of drugs on the body of the mother and child. Hence the very painful contractions, the suffering of the fetus and, as a result, a caesarean section;

    when a dropper is used in childbirth, a woman is forced to be in the most uncomfortable and ineffective position for the birth of a child - lying on her back. This increases the pain of contractions and interferes with progress in childbirth;

    stimulation can cause the development of oxygen starvation of the fetus, and in some cases lead to disruption of the functioning of the child's cardiac system;

    stimulation of labor can cause too long, very intense and painful contractions that require the introduction of an additional portion of painkillers;

    the likelihood of uterine rupture along the scar, in the case of repeated vaginal delivery after caesarean section;

    fetal distress. It is believed that childbirth occurs after the child secretes a special hormone into the mother's body, which starts the birth process. If the birth is stimulated artificially, then the child is not yet ready to be born;

    stimulation increases the risk of premature placental abruption, as well as the use of forceps or a vacuum extractor.

Types of artificial stimulation

The following methods are most often used to stimulate labor:

The introduction of analogues of natural hormones that trigger labor and enhance the contractile activity of the uterus

To prepare the uterus for disclosure, a drug such as is used.

Oxytocin- refers to the synthesized analogues of the hormone produced by the pituitary gland. Oxytocin is administered in the main form of intramuscular or subcutaneous injections. This drug has more minuses than pluses, and, in addition, there is a high probability of its overdose:

    oxytocin causes non-physiological contractions and increases labor pain (therefore, it should be used in combination with painkillers);

    the drug may increase the suffering of the fetus. Too long and intense contractions cause a decrease in the amount of oxygen supplied to the child. And babies born with the help of stimulation are less adaptable and more likely to have infantile jaundice;

    the dose of the drug should be selected individually due to the identified increased sensitivity to it in many patients;

    oxytocin should not be used if there is a scar on the uterus, placenta previa, an abnormal position of the fetus, or the inability to have a baby through the birth canal.

The use of prostaglandins

Studies show that it is much safer to use prostaglandins (prosten, enzaprost, dinoprostone, prostiv) to prepare the uterus for dilatation, causing milder contractions. Often the reason for the lack of progress in childbirth is the immaturity of the cervix. In order to "soften" it and cause contractions, doctors inject prostaglandins in the form of a special gel or suppositories deep into the vagina and cervical canal. Benefits of Using a Prostaglandin consist in the fact that this drug does not penetrate the amniotic sac and does not restrict the movement of a woman during childbirth. At the same time, prostaglandins can slow down the transition to the active stage of labor. In some women in labor, the use of these drugs causes the development of headaches or vomiting.

Amniotomy

Amniotomy- this is an opening of the fetal bladder with a special hook that is inserted into the vagina, the fetal bladder is captured and opened, which causes the outflow of amniotic fluid. This operation should be performed by an experienced obstetrician and only if indicated.

To avoid possible complications, an amniotomy is usually performed after the baby's head has passed into the small pelvis, squeezing the fetal bladder and the vessels on its surface, which prevents the risk of bleeding and prolapse of the umbilical cord.

The main indications for amniotomy, according to gynecologists and obstetricians, are pregnancy overdose, and as a result, deterioration of the placenta, as well as the risk of oxygen starvation of the fetus.

Another important reason for using amniotomy can be preeclampsia.

Preeclampsia- this is a complication during pregnancy, the main symptom of which is the appearance of edema ("dropsy of pregnancy"), as well as, in more severe cases, high blood pressure and the presence of protein in the urine. Opening the fetal bladder during preeclampsia can help a woman in labor and prevent complications during childbirth.

Another indicator for this operation, which is much less common, is the Rhesus conflict.

But we must not forget that this manipulation can be unsafe. In Russian maternity hospitals, sometimes they do not even warn about amniotomy. And the consequences of such an operation can be very sad. Contractions may never come, which will require the use of other medications - oxytocin, and in rare cases, can lead to infection of the fetus or prolapse of the umbilical cord.

Despite the fact that the stimulation of labor is used everywhere today, in some cases it is forbidden to do it.

Contraindications for artificial stimulation:

    health problems in the mother (endocrine disorders, diabetes, suture on the uterus, etc.);

    incorrect position of the child;

    discrepancy between the size of the child's head and the size of the mother's pelvis;

    deterioration in the child's health (according to the indications of a heart monitor).

Along with medical methods of labor induction, there are natural ways that help speed up or start childbirth. The only thing to remember is that if you decide to use one of the methods of natural stimulation, first consult with your doctor. No matter how safe or pleasant this or that method seems to you, it is better to coordinate your actions with a specialist.

Natural methods of labor induction:

    Xclothes

During a long walk, the baby presses on the cervix, which causes it to begin to open. This method only works if the cervix has already begun to flatten in anticipation of labor.

    sexual intercourse

Semen contains the natural hormones prostaglandins, which soften the cervix and promote uterine contractions.

    Orgasm

Promotes muscle contractions of the uterus.

    Nipple massage

Increases the content of the hormone oxytocin in the blood. True, such a procedure requires more time than the use of artificial drugs. Massage should be done three times a day for ten to twenty minutes. Some doctors recommend performing this procedure only while in a hospital where it is possible to monitor the condition of the mother and child.

For example, a long walk and any active actions.

    Acupuncture

There are several points, the impact on which contributes to the natural stimulation of childbirth. These points are located between the index and thumb, in the upper part of the shoulder, in the sacrum, next to the ankle, on the outer part of the little finger at the base of the nail (information can be found in books on acupuncture) and, according to experts, are associated with the uterus. Their stimulation helps the woman relax, which relieves pain and starts the birth process.

Childbirth is a natural process due to human nature. However, no one is immune from pathologies and complications, so in some cases it is difficult to do without medical intervention. Often, doctors stimulate labor activity: what it is and how dangerous it is for the baby and the mother, all women in labor are interested.

This concept means the artificial induction of childbirth and their activation, if the natural process cannot, for some reason, go on its own.

The doctor may suggest this procedure if there are indications for induction of labor that pose a risk to the continuation of the pregnancy. These include:

  • prolongation: the gestational age exceeds 41 weeks;
  • no contractions within 24 hours after the water breaks;
  • chronic or acute diseases: kidney failure, diabetes, preeclampsia, heart problems;
  • multiple pregnancy (read about the features of such childbirth);

There are also unforeseen situations when a pregnant woman herself insists on giving birth with stimulation, but the decision in each such case remains only with the doctor. For the safety of the mother and child, the possibility of natural labor should be used, since drugs that stimulate it can lead to complications and side effects. Therefore, it is often said that this procedure is harmful. Is it so?

Why is stimulation dangerous?

Many women's fears are exaggerated, since few people know exactly what the induction of labor is dangerous and what consequences it can have for mother and baby. In most cases, it passes without complications and saves the situation. The negative points include:

  • painful contractions that are felt much more strongly by a woman than during natural childbirth - therefore, the question often arises about the use of epidural anesthesia ( full list of indications for it);
  • an uncomfortable position that complicates the process of childbirth: stimulant drugs are often administered through a drip, which forces the woman to lie mainly on her back, severely limiting her movements;
  • in rare cases, but still it sometimes happens, the procedure causes oxygen starvation of the fetus with all the ensuing consequences.

As for everything else, the right drugs to stimulate labor and the timely decision of the doctor to carry out the procedure most often save the lives of mothers and babies, and do not cripple their health. At the same time, all the pros and cons are weighed, which may be different in each individual case.

The answer to the question of whether labor induction is harmful is rhetorical. This is an artificial intervention in the natural process, and therefore it is undoubtedly harmful. But according to the available indications, this method is necessary. It happens that stimulation is useless, the mother's body does not respond to it. In such cases, the last chance is only a caesarean section.

Methods of stimulation of labor activity

For many women, this procedure is associated with painful and dangerous methods, again only because most do not know how labor is stimulated. It all depends on what stage the labor activity is at, whether it exists at all. After analyzing the state of the pregnant woman and the child, the question of which particular method of stimulation will be useful in a particular case is decided.

  • Detachment of amniotic membranes

The technique is used for post-pregnancy. The doctor peels off the amniotic membrane by hand, and this provokes the onset of contractions. The difficulty is that the procedure often does not work due to various reasons (inexperience of the doctor, thick walls of the shell, etc.). Therefore, it has to be done several times or resort to other methods. At the same time, the risk to the health of the mother and baby is minimal, and there are no pain sensations.

  • Prostaglandins

Prostaglandins are physiologically active substances that are independently produced by the human body. They cause the ripening and opening of the cervix. The drug is administered in the form of a gel or suppositories vaginally, and within half an hour labor usually begins. The procedure does not constrain movements, does not cause discomfort, has no side effects and contraindications, and does not have any effect on the fetus.

  • Puncture of the amniotic sac

A puncture of the amniotic sac is dangerous for infection. It is used when contractions are too long. An amino hook (a long plastic hook-like instrument) is inserted into the vagina, hooks the amniotic membrane through the cervix and pierces it, causing the amniotic fluid to flow out.

  • Oxytocin

Oxytocin is a synthetic drug, an analogue of a natural hormone that stimulates uterine contractions. It is used in case of attenuation of labor activity, decrease in the intensity of contractions. It is administered intravenously with a dropper. This method of stimulation is fraught with an overdose of the drug, which can lead to oxygen starvation of the child, as well as too painful contractions.

  • Pills

Modern medical stimulation of labor involves the use of special tablets that contain artificially synthesized antihistogens. They block the receptors of the uterus, accelerate the maturation and opening of its cervix. The advantage of tablets is that they do not have any effect on the condition of the woman and the baby.

In terms of ease of use, maximum efficiency and minimum number of side effects, this method of labor induction is considered the most preferable today. However, it has many contraindications: liver and kidney failure, diabetes, asthma, problems with blood clotting, individual intolerance.

  • Natural methods of stimulation

The most courageous women, realizing the need to accelerate labor and the inability to do this in the hospital, conduct stimulation at home. At the same time, a preliminary consultation with a doctor, at least by phone, is simply necessary. Natural stimulation methods include:

  1. sex, during which the uterus contracts, which becomes the starting point of natural childbirth;
  2. castor oil, taken orally, leads to increased bowel function, which provokes labor; the method is doubtful, as it causes diarrhea, nausea and dehydration;
  3. light physical activity will speed up the appearance of the baby;
  4. acupuncture also promotes the onset of labor.

Artificially induced labor with stimulation is a necessity, help for the female body and the child. Do not be afraid of this, because the doctors know what they are doing. Trust them. Moreover, without the consent of the woman in labor, no one has the right to interfere in the natural process of childbirth - even a doctor.

Childbirth is a complex physiological process of expulsion of the fetus from the uterine cavity. After the opening of the cervix in the first stage of labor, the baby begins to move through the birth canal due to uterine contractions - contractions. In the second period, contractions (contractions of the abdominal and diaphragm muscles) join the contractions, as a result of which the baby is born into the world. After that, the placenta quickly separates and the placenta comes out. Here it is, the happy ending!

To start normal labor, two basic conditions are needed: a mature cervix and sufficient strength and duration of contractions. Typically, the cervix "ripens" (i.e., becomes soft, shortens to 1 cm or less, and dilates by more than 1 finger) by the 38th to 39th week of pregnancy. With the onset of labor, the cervix continues to open and smooth out. This is due to contractions, as well as pressure on her fetus. An important role is played by the fetal bladder, which "weds" into the opening of the cervix, contributing to its opening. For the successful completion of the first stage of labor, uterine contractions must be sufficiently strong, long-lasting and occur at regular intervals.

In cases where the contractions are not intense enough, short or rare, they speak of the weakness of labor activity. This condition is also indicated by a low rate of cervical dilatation (normally 1 cm per hour). Also, this condition is diagnosed through observation, CTG (cardiotocography) and vaginal examination.

There are primary and secondary weakness of labor activity. Primary is manifested by contractions of weak strength, a violation of their rhythm and duration from the very beginning of childbirth. The second option is characterized by the appearance of the same changes, but not immediately, but after a certain period of time after the development of normal labor activity.

What is the danger of weakness of labor activity?

Many future mothers are perplexed - is labor stimulation really necessary? After all, you can often hear arguments about how they gave birth in the old days for several days, and nothing - everyone treated this normally. But it is important to understand that such a situation is not at all the norm and threatens the development of serious complications. For a baby, the danger of weak labor activity is to increase the risk of developing severe oxygen starvation, which is fraught with neurological disorders and cerebral circulation disorders in the newborn. In addition, during prolonged labor, amniotic fluid may enter the lungs of the fetus, leading to inflammation of the lungs and impaired breathing of the child after birth. These consequences often require long-term observation and treatment of the baby in the future.

On the part of the mother, there is a threat of birth injuries, and as a result of insufficient contraction of the uterus in the postpartum period, bleeding may begin.

Therefore, in all cases of development of weakness of labor activity, it is necessary to stimulate it - to increase the strength, duration and frequency of contractions.

Stimulation in childbirth: let's try without drugs

Most often, the concept of "rodostimulation" in expectant mothers is associated with the use of special medications, but, in addition to this, there are a number of non-drug ways to normalize labor activity:

  • The active behavior of the woman in labor contributes to the strengthening of labor activity.
  • Stimulation of the areolas (nipple circles) and nipples of the mammary glands leads to the release of the hormone oxytocin, which enhances uterine contractions.
  • Labor activity is enhanced when the position of the woman on her side, the same name as the position of the fetus.
  • Amniotomy (opening the membranes) is an effective measure to activate contractions. This is explained by the fact that after the discharge of amniotic fluid, the volume of the uterus decreases, which allows it to contract more efficiently. In addition, amniotomy activates the formation of prostaglandins - substances that are powerful stimulants of uterine contractions. This manipulation is painless, since there are no pain receptors on the surface of the membranes.

Medical stimulation during childbirth

Before starting medical stimulation in childbirth, it is very important to assess the condition of the woman in labor. When she is tired, a drug sleep is prescribed, which lasts about 2 hours. The positive effect is due to the fact that during this period, childbirth does not stop, and the cervix continues to open. Often, after a rested woman in labor wakes up, labor activity returns to normal, and the need for labor stimulation may disappear. If this measure did not help, then, as a rule, the doctor decides on drug stimulation during childbirth.

To date, drugs of the prostaglandin group and oxytocin are used for this purpose.

Prostaglandins are biologically active substances that trigger regular labor activity. They contribute to the opening of the cervix and increase its contractions. Prostaglandins are used with the development of primary weakness of labor or with the development of secondary weakness of labor, if the cervical dilatation is not more than 6 cm. These drugs also have side effects - nausea, vomiting, increased blood pressure, increased heart rate, bronchospasm (difficulty respiration due to a decrease in the lumen of the bronchi). Given this, contraindications for the appointment of such drugs are bronchial asthma, increased blood and intraocular pressure (glaucoma), severe liver and kidney diseases. These drugs are administered intravenously.

Oxytocin (from the Greek oxys - fast, tokos - childbirth) is a synthetic analogue of the hormone oxytocin, which is responsible for the contractility of the uterus. Since the most common cause of the development of weakness in labor is the insufficient production of one's own oxytocin, the introduction of this substance helps to correct the situation and normalize the process of childbirth. Sensitivity to oxytocin increases towards the end of the first stage of labor, so it is most effective for secondary weakness of labor and weakness of attempts. It is also administered intravenously.

The introduction of these drugs requires constant supervision of an obstetrician-gynecologist and midwife. Careful monitoring of the contractile activity of the uterus and the condition of the fetus is necessary. It is important to prevent an overdose of prostaglandins and oxytocin, which causes uterine hypertonicity, which, in turn, leads to impaired uteroplacental circulation and intrauterine suffering of the baby, premature detachment of the placenta.

Along with the stimulation of labor, antispasmodic drugs are usually administered to relieve spasm of the cervix during contractions and soften it. Strengthening contractions with a dense cervix leads to its rupture. To prevent fetal oxygen starvation, drugs are prescribed that improve uteroplacental blood flow and increase the resistance of fetal brain cells to oxygen deficiency.

With persistent weakness of labor, combined with other diseases, and with the impossibility of natural childbirth, a caesarean section is indicated.

Conditions for labor stimulation are:

  • Correspondence of the size of the fetal head to the mother's pelvis, which shows the possibility of the fetus moving through the pelvic cavity during childbirth;
  • Satisfactory condition of the baby (according to cardiotocography, ultrasound, Doppler uteroplacental blood flow). With oxygen starvation of the fetus, it is impossible to perform rhodostimulation, as this can lead to vasospasm, disruption of the uteroplacental circulation and deterioration of the child's condition.
  • Absence of a fetal bladder. Rhodostimulation is not carried out with a whole fetal bladder. This threatens with a serious complication - placental abruption due to an excessive increase in intrauterine pressure. Usually, with the development of weakness in labor, an amniotomy is first performed (puncture of the fetal bladder), and then the woman in labor is observed for 2 hours. If during this time labor activity has not returned to normal, drug stimulation is prescribed.

Is it possible to avoid stimulation in childbirth?

Prevention of the development of weakness of labor activity is largely a normal pregnancy. For the expectant mother, a full-fledged sleep is necessary - at least 8 hours a day, a rational balanced diet, favorable conditions for psychological comfort. An important role is played by the absence of chronic foci of infection, good physical shape, training at school for pregnant women and support from relatives. Gymnastics for pregnant women, breathing exercises, swimming in the pool, yoga, outdoor walks are recommended. Also, the expectant mother needs to take vitamins (B6, ascorbic and folic acid), which have the ability to increase the energy potential of the uterus.

Such different concepts

It is important to understand that labor stimulation and labor induction are two completely different procedures. Rhodostimulation is always an intensification of already existing contractions, when labor activity began on its own, but then there was a failure in its normal development, and it began to weaken. Labor induction is carried out if it is necessary to induce labor, when there are no contractions yet.

Causes of weakness of labor activity:

  • previous abortions, miscarriages, curettage of the uterus, inflammatory diseases of the female genital organs, uterine fibroids, hormonal disorders and chronic diseases;
  • the age of the primipara is less than 18 and more than 35 years;
  • a large number of births (4 or more);
  • causes leading to overstretching of the uterus (large fetus, polyhydramnios, multiple pregnancy), preventing the full contraction of the myometrium - the muscles of the uterus;
  • hereditary predisposition, which can be traced through the female line;
  • complications of the course of pregnancy - postmaturity, fetoplacental insufficiency (i.e., the inability of the placenta to meet the needs of the developing fetus);
  • woman's fear of pain, lack of psychological attitude to childbirth.

When is it not possible to induce labor?

Contraindications for labor stimulation are the presence of a scar on the uterus, incorrect position of the fetus, its oxygen starvation, clinically narrow pelvis (a situation where the size of the fetal head does not correspond to the size of the mother's pelvis), placenta previa (when the placenta blocks the exit from the uterus), severe preeclampsia, fatigue women in labor.