How long does labor last in nulliparous at different stages? Pain during contractions, as well as attempts. What to do during an attempt

19.05.2019

Despite the fact that childbirth is a process that has long been regulated by both nature and doctors, a lot of it also depends on the future mother herself. In particular - in the tight period, when the baby is already actively moving "to the exit." And here just mommy has to make sure that he passes this hard way hurry up. And for this, she must know how to push properly during childbirth.

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What are attempts and why are they needed

Attempts can be considered the most milestone labor activity, because it is thanks to these strong muscle contractions that the mother helps her baby to go through the birth canal faster and be born. Yes, here, unlike contractions, a woman in labor can already actively participate in the process, additionally straining different groups muscles during pushing.

This period of childbirth begins when the cervix has opened and is ready to miss the baby. Reflexively arising at the same time, attempts are layered on contractions, which by this time become even more frequent, strong and painful. However, many women in labor note that when it was time to push during childbirth, the consciousness seemed to switch to attempts and the pain was no longer felt so much.

A woman can feel the onset of this period herself, since the mechanism of attempts causes a feeling similar to when you really want to go to the toilet “in a big way”. Thanks to this "idea" of nature, the woman in labor has an irresistible desire to free her intestines. As a result, she pushes and thus helps the baby move faster.

How long is the push period

The duration of the pushing period is very variable and depends not only on how you push during childbirth. Several factors can come into play here.:

. future mother's condition(both physical and moral);

. physiological aspects(the ratio of the size of the pelvis of the mother and the head of the child, the presence of deviations or pathologies);

. presentation and size of the baby;

. what is this pregnancy;

. intensity and coordination of labor activity.

For example, in most primiparous mothers, the straining period is longer than in multiparous ones. Yes, and for the birth of a medium-sized baby, you do not have to push during childbirth as much as when giving birth to a strong man. That's why the stage of attempts can last from 10 minutes to 1-2 hours.

The most important thing at this stage of labor activity is not to be self-willed, but to clearly follow the doctor's commands. Since he knows better (in the literal sense of the word) when to help the attempt, and when to relax. At the same time, you need to breathe in such a way that the maximum of forces, of which there are not so many left, can be spent on straining. But let's get back to how to properly push during childbirth.

For this we We've put together a list of the most helpful tips:

1. On the eve of attempts, try to follow these tips:

Breathe calmly and as deeply as possible - both on the inhale and on the exhale. At the same time, try to inhale air deeply into the stomach;

In anticipation of the next attempt, hold your exhalation a little, leaning forward and pressing your chin to your chest. At the same time, tightly clasp your knees with your hands, spread them as far as you can, press them to your armpits and expect the maximum height of the attempt;

2. while pushing, do the following:

Start pushing during childbirth gradually, focusing on your feelings, that is, during the peak of the urge;

At the next attempt, give maximum effort, helping the baby move. At the same time, you need to push down, using the diaphragm and everything below it, and not in the face and eyes. And you need to do this until you feel that you are sorely lacking oxygen and you urgently need to inhale;

Try with the advent of each new attempt not to reduce your efforts to push the baby forward. The resulting pain and burning sensation in the perineal region should, if possible, be ignored. Moreover, if you push correctly in childbirth, these discomfort should increase, signaling that the baby is already very close to the exit;

Control your breathing - it should be smooth, even and rhythmic. And no sharp exhalations and sketchy breaths - they can reduce all your efforts and the efforts of your baby to zero;

There is another essential point in how to push during childbirth - do not scream. Crying is a significant expenditure of energy that could hasten the birth of a baby and reduce your anguish;

Remember such a simple standard for women in labor, which you must fulfill: at least 3 attempts for 1 contraction - without rest and breaks.

3. In between contractions, try to relax and rest as much as possible. And once again we will repeat - listen to the medical staff taking delivery from you.

It is the doctor or midwife who is your coordinator of how and when to push during labor. Otherwise, when forcing the process, you may suffer (due to tissue ruptures or divergence of the pelvic bones), and when tightening, the baby may suffer (due to hypoxia). At the same time, of course, listen to yourself: childbirth is a mechanism inherent in a woman by nature. Therefore, the body itself will give you clues both at the level of sensations and at the level of the subconscious. But most importantly - do not be afraid and tune in to the fact that soon everything will end, and your baby will be placed on your chest. You just need to try hard and be patient.

How to push during childbirth, video

Today we will talk about what attempts and contractions are. How to distinguish them? Do they cause pain? In addition, we will pay attention to the breathing technique in different periods labor activity, which will help the girls who first appeared in the delivery room.

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

How to distinguish contractions from attempts?

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

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

contractions;
attempts;
postpartum period.

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

Breathing during contractions

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

What sensations does a woman experience during attempts?

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

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

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

Pain during contractions, as well as attempts

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

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

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

Importance of pushing during childbirth

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

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

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

Proper breathing while pushing

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

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

Actions of women

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

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

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

How to push properly?

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

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

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

Lack of attempts

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

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

Final push

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

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

Important points in breathing technique

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

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

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

During childbirth, the baby has a much harder time than you. Don't forget about it. Arbitrary breathing can greatly delay the process of childbirth. Concentrate your attention on correct breathing Don't get distracted by other things.

Pushing during childbirth is a natural thing. They help the mother push the baby out and help her cuddle with her. Try to move this time as calmly and evenly as possible. Remember that the baby will help you in everything and with your support, both of you (or maybe three or four) will succeed.

What is pushing
Attempts are involuntary, undulating (offensive) contractions of the muscles of the vagina and pelvic organs, which help the muscles of the uterus and vagina to push the baby to the light.
The muscles of the uterus contract very strong force, it is necessary to control them with the help of a doctor. It will tell you when to push. Uncontrolled attempts can suffocate the baby or, by cutting off oxygen to him, “slow down” his development. Keep yourself in control and think only of the child.

Attempts are a reflex feeling, they occur when the baby is ready to be born. But, its weight can be very large, and the baby's head tries to push into the light during childbirth, and this all happens by reflex actions. The most important function of attempts is to help the baby be born into the world.

What happens when pushing
When the uterus is ready to "escort" the baby into the light of day, attempts begin. As I wrote above - contractions of the muscles of the small and large pelvis. They, straining, increase significantly, which presses all the organs of the large pelvis - the intestines, and the renal system. Therefore, during childbirth, absolutely involuntary urination and defecation occurs (feces come out). You should not worry too much, this is not a reason to be shy and worry, the birth of a baby comes first.

When trying, be sure to follow the advice and instructions of the doctor. Spontaneous attempts will not lead to anything good, the baby already suffers from a lack of oxygen during this process, and if the mother does not save him, he will not survive or be born healthy.

How to behave when pushing

breathe deeper and faster (dog breathing);
relax as much as possible before the attempt (inhale the air, exhale and look at the ceiling while relaxing);
do not speed up the process;
obey the doctor's instructions;
listen to your body;

Do not resist, do not try to stop the attempts.
It is not necessary to scream when trying, it will not help you in any way. Instead, concentrate on pushing the baby out as safely as possible. If you vote, it will save you morally, but will not help the baby in any way. Concentrate and take 10-20 short breaths to push yourself to the maximum level, then the same number of breaths and again attempts. Be sure to listen to your doctor. After all, giving birth, you do not know how the process takes place, and he, as a professional, will be able to advise and prompt you. Not listening to the doctor, you will only harm the child.

Placenta
When trying, there is such a thing as a "final attempt". It means pushing children's place- placenta and amniotic fluid. To push it out, it will no longer require such efforts as during childbirth, but, nevertheless, they must be applied and endured. After the baby comes out, the doctor will slap him on the pope, he will scream and the mother will understand that all her efforts were not in vain.

Every woman is afraid birth process. In particular, this fear is observed when they are expected. Only after learning about pregnancy, the expectant mother worries about how the birth will pass her firstborn.

Duration of labor

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

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

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

Why is the first birth the most difficult?

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

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

First stage of labor

How long does labor last in primiparas in the first period? It also depends on the characteristics of the woman's body. But it should be noted that this is the longest stage. Contractions may take up most of the time, but they will be short and infrequent. Here, for the first time, a woman will feel what it is prenatal pain(if not the cervix will dilate slowly, but future mother without feeling any discomfort. That is, the pain will appear only during contractions. Therefore, if you feel something (after all, you still have no idea how childbirth begins in primiparas), then urgently go to the hospital, otherwise there is a chance to give birth right at home. The second part of the first period lasts less, but more intense contractions are already observed. Be sure to move around so that the uterus opens faster. The third phase lasts no more than an hour. Now from fights you need to move on to attempts.

Second birth period

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

Third period

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

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

The value of attempts

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

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

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

Woman on the prowl

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

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

Passing through the birth canal, the baby's body will compress the surrounding organs. With simultaneous straining of the woman in labor, this leads to the fact that bladder and the intestines can be involuntarily emptied during attempts. As a rule, a woman does not pay attention to this. special attention during childbirth, but often worries because of the likely "embarrassment" before childbirth. Absolutely no need to worry this occasion: firstly, such phenomena are quite physiological, normal and familiar to medical staff, and secondly, all unwanted discharge from the mother's body is immediately removed by the midwife, so their contact with the child is excluded.

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

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

How to push properly during childbirth?

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

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

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

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

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

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

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

If there are no attempts at childbirth

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

Final push

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

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

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

Don't worry about anything: childbirth - natural process, which has long been well studied and "worked out" in practice. Do not be afraid of them - everything will be fine!

Especially for Elena Kichak