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Emergency care for a woman in labor: how to deliver outside the hospital. How to give birth - wikiHow

Childbirth is one of the most common reasons for calling an ambulance. An ambulance doctor can face any moment of the birth act - the period of disclosure, the period of expulsion, the subsequent and early postpartum periods. The labor act begins with a period of dilatation, which is determined by the appearance of regular contractions, which are periodic contractions of the myometrium - the smooth muscles of the uterus. They ensure the dilatation of the cervix and facilitate the expulsion of the fetus. Contractions occur involuntarily, continue at the beginning of labor 15 - 20 s, at the end - 80 - 90 s. The intervals between contractions at the beginning of labor are 10 - 12 minutes, then reduced to 2 - 3 minutes. Contractions help to pull the circular muscles of the cervix to the sides and upward, which leads to shortening, smoothing, opening of the cervix and the formation of the birth canal (birth canal). A certain value in the opening of the cervix belongs to the fetal bladder, which is understood as part of the membranes and amniotic fluid located in front of the presenting part of the fetus. During the contraction, the fetal bladder is poured and embedded in the cervical canal, contributing to its stretching from the inside.

In primiparous women, the process of cervical dilatation differs from that in multiparous women: in the first case, first there is a smoothing, and then the opening of the cervix, in the second, both of these processes occur simultaneously. The duration of the opening period in primiparous women is 16-18 hours, in multiparous women - 8-12 hours. The unleashing of labor is a complex physiological process that obeys the body's biorhythms. It was found that biorhythms of the onset of labor in their uncomplicated course are characterized by the highest intensity (acrophase) at 0-3 am. The circadian rhythm of the end of labor is less stable, in healthy women it has 3 rises - at 6, 11 and 16 hours with acrophase at 11 hours.

During the physiological course of the birth act, at the end of the opening period, the membranes rupture and amniotic fluid is poured out. However, in 30 - 40% of all births, rupture of the membranes is observed earlier - at the beginning and during the period of disclosure (early rupture of amniotic fluid) or even during pregnancy, before the onset of labor (premature rupture of amniotic fluid). In rare cases, rupture of the fetal bladder does not occur - during the period of expulsion, it is the first to be born from the genital slit. If you do not artificially open the bladder of the jaws of bullet forceps, a Kocher clamp, forceps, any other instrument, fingers, then the child will be born in membranes. This will disrupt the transition to extrauterine breathing and lead to asphyxiation of the newborn.

The second stage of labor - the period of exile, ends with the birth of the fetus. In this period, attempts are added to the contractions - reflex contractions of the striated muscles of the whole body, but first of all - of the abdominal press.

After the outflow of amniotic fluid, the myometrium adapts to the reduced volume of the uterus. It tightly covers the fetus and contributes to the formation of the most appropriate position of the fetus for passage through the birth canal (the spine unbends, the head bends as much as possible and is pressed against the body, the arms are also tightly pressed against the body, the shoulders rise). Under the influence of attempts, passing through the birth canal, the fetus makes translational and rotational movements: flexion of the head, internal rotation of the head, extension (birth) of the head, internal rotation and birth of the trunk.

As the head approaches the pelvic floor during pushing, the perineum protrudes, the anus gapes, and the front wall of the rectum is sometimes exposed. The hairy part of the head appears from the genital slit, which, after pushing, goes inward (cutting the head). In the future, an increasing part of the head appears (is born) from the genital fissure during the attempt, which does not disappear even outside the attempt. The birth process of the head begins from its occipital region (the region of the small fontanelle). Then the parietal tubercles, forehead and face of the fetus are born. At birth, the strongest stretching of the perineum occurs from the genital fissure of the parietal tubercles, which is associated with the passage of the largest size of the head at this moment. After the birth of the head, an internal rotation and birth of the shoulders takes place: the shoulders are set in the straight size of the pelvic outlet, while the head turns its face to the left (at the second position of the fetus) or right (at the first position) mother's thigh. The anterior shoulder of the fetus is fixed at the lower edge of the pubic syndesmosis, and the posterior shoulder is born. Then the rest of the shoulder girdle, torso and legs of the fetus are born. A healthy child screams loudly, is active, the skin is pink in color. The duration of the expulsion period in primiparous women is 1 - 2 hours, in multiparous women - up to 30 minutes, sometimes only 5 - 10 minutes.

The third - successive - period begins after the birth of the fetus and ends with the birth of the placenta (i.e., the placenta and membranes). The birth of the placenta is provided by successive contractions, during which contractions of the myometrium, including the placental region, lead to the separation (detachment) of the placenta from the uterine wall. Unlike the first two stages of labor, the successive period is accompanied by blood loss. Bleeding arises from the vessels of the placental site tearing during detachment and contributes to the formation of a retroplacental hematoma. The latter, in turn, accelerates the process of placental abruption: it protrudes the placenta into the uterine cavity and promotes its birth with the fruit side outward. Less often, the process of placental abruption begins from its edge. In this case, the placenta is born on the maternal side. As a rule, the process of placental abruption and the birth of the placenta is completed in 3 - 4 contractions and, therefore, lasts no more than 10-15 minutes. It should be remembered that an increase in the duration of the subsequent period reduces the likelihood of its spontaneous birth and significantly increases the risk of developing subsequent bleeding. Therefore, the maximum duration of the subsequent period should not exceed 30 minutes. Physiological blood loss in the successive and early postpartum periods is 200 - 250 ml.

With the beginning of the process of childbirth, a woman is called a parturient woman, at the end of the subsequent period and then within 8 weeks after childbirth - a parturient woman.

Maintaining a generic act requires a certain skill. It is necessary to establish the onset of labor - the beginning of regular contractions, evaluate their frequency and intensity. For this, the duration of contractions is counted using a stopwatch and the interval between them is measured. For a correct judgment about the nature of labor, you need to observe several contractions in a row. It is necessary to make an external obstetric examination, which allows you to determine the position of the fetus (longitudinal, transverse, oblique), the presenting part (head, breech presentation) and its relation to the entrance to the small pelvis (pressed against the entrance to the small pelvis, by a small, large segment at the entrance to pelvis, in the pelvic cavity).

It should be emphasized that the elastic abdominal wall in primiparous women makes it difficult to determine the presenting part (head, pelvic end of the fetus) and its relationship to the entrance to the small pelvis. Therefore, an external obstetric examination carried out without appropriate experience may give erroneous results. The symptom of its "ballot" helps in determining the position of the head - palpation of a dense and round part, easily shifting to the side in the fundus of the uterus (with breech presentation) or above the entrance to the pelvis (with cephalic presentation).

After determining the position and presentation of the fetus, it is necessary to listen to its heartbeat, which is normally 130-140 beats / min. An obstetric stethoscope is used to auscultate fetal heart sounds.

In an ambulance car, it is desirable to have a portable device "Kid" or other portable equipment for listening to the fetal heartbeat.

The fetal heartbeat is better heard from the back - on the left in the first position (the back is facing the left), on the right - in the second position (the back is facing the right). With a cephalic presentation, it is better heard below the navel, with a pelvic presentation - above the navel.

An essential diagnostic moment in the management of childbirth is to determine the integrity of the fetal bladder. To judge this, use the woman's instructions for the outpouring of amniotic fluid, observation of the leakage of water from the genital tract during external examination and internal (vaginal) examination. The latter most reliably answers this question, and also allows you to determine the stage of the birth act (the degree of cervical dilatation), to clarify the presenting part (head, buttocks, fetal legs), the position and type of the fetus (by the location of the sagittal suture and small fontanelle), pathological forms of presentation and insertion of the head, to assess the state of the soft birth canal (presence of scars, vaginal septum, etc.) and the bone pelvis (shape of the pelvis, degree of narrowing). Vaginal examination is an extremely serious diagnostic technique that requires a lot of experience and, in addition, is not indifferent for a woman in labor - it contributes to infection of the birth canal, in the presence of placenta previa, it can cause profuse bleeding. Therefore, it is produced in a special room of the maternity ward, according to indications - in the operating room, after thorough disinfection of the external genital organs of the woman in labor, the doctor's hands, always wearing sterile gloves. In the absence of these conditions (sterile gloves, disinfectants), lack of proper experience and special indications, vaginal examination at the prehospital stage cannot be performed.

The body of a woman in labor (her cardiovascular, respiratory, nervous and other systems) experiences a significant load during the period of exile. In this period of labor, the clinical manifestations of late toxicosis usually intensify, decompensation develops more often in cardiovascular diseases, respiratory diseases, etc. In connection with the frequent and intense contractions of the myometrium, intrauterine hypoxia of the fetus often develops. It is also facilitated by the collisions of the umbilical cord, especially manifested in this period: a short umbilical cord, entanglement of the umbilical cord around the body or neck of the fetus, true umbilical cord nodes, etc. Therefore, the second stage of labor requires especially careful monitoring of the state of the woman in labor, the nature of labor and the state of the fetus. The fetal heartbeat is heard after each attempt: a decrease in heart rate up to 120 beats / min and less or an increase in excess of 150 beats / min indicate the developed intrauterine hypoxia of the fetus. This is also evidenced by the appearance of meconium in the outflowing amniotic fluid with a cephalic presentation. If a woman in labor notes a long time ago of the amniotic fluid outflow (more than 6 -8 hours) or a pus-like discharge appears from the genital tract, or the body temperature rises (to subfebrile numbers and above), then one should think about the inflammatory process in the membranes, uterus (chorioamnionitis, metritis ).

If necessary, end the second stage of labor at the prehospital stage (at home, in public places, in ambulance transport), which may be in the case of violent labor, in a multiparous woman, the woman in labor is given a comfortable position - on the back, with knees bent and wide spread legs. The pelvic end is raised, a pillow is placed under it, a polster, a roller, the external genital organs of the woman in labor and the doctor's hands are disinfected with a disinfectant solution: the external genital organs of the woman in labor - a solution of potassium permanganate (0.02%) or iodonate (1% solution of free iodine), or gibitan (0.5% alcohol solution of chlorhexidine bigluconate), or alcohol solution of iodine (5 - 7% solution); doctor's hands - gibitan, pervomur (recipe C-4 from 30 - 33% hydrogen peroxide and 85-100% formic acid), in their absence - alcohol or iodine.

After the eruption of the head, they proceed to the obstetric benefit, which includes 2 main points:

  1. protection of the perineum from tearing,
  2. careful removal of the fetus from the birth canal.

Protection of the perineum is provided by restraining the rapid advancement of the head: its gradual eruption stretches the tissues better, prepares them for the birth of the greatest volume. At the same time, the delay in untimely extension of the head is carried out, which contributes to its passage through the birth canal in a smaller size (small oblique).

To provide obstetric benefits, the doctor stands to the right of the woman in labor and puts the palm of his right hand with divorced I and II fingers on the perineum, thus protecting it from rupture. The doctor places the terminal phalanges of the fingers of the left hand on the nape of the fetus, bending the head posteriorly towards the perineum and restraining its excessive advance during the push. In the intervals between attempts, the left hand is held on the head, and the right hand frees the soft tissues from it in the clitoris and labia minora and lowers them towards the perineum ("tissue borrowing").

The most crucial moment comes after the birth of the occiput and suboccipital fossa: the birth of the largest head size begins, which can contribute to perineal injury. In the physiological course of childbirth, this is a small oblique size with a circumference of 32 - 33 cm and a diameter of 9.5 cm. Therefore, the removal of the head should be carried out outside of pushing activity. The woman in labor is forbidden to push and is offered to breathe deeply through the mouth. At this time, the tissues of the vulvar ring are removed from the parietal tubercles of the head, the head is captured with the left hand and carefully unbend: the forehead and face of the fetus are born above the perineum. The right hand is held on the perineum, protecting it from rupture.

If, after the birth of the fetal head, an entanglement of the umbilical cord around the neck is found, the loops of the umbilical cord are carefully pulled and released through the head. When the umbilical cord is pulled very tightly, it is cut between two clamps.

After the birth of the head, the woman in labor is asked to push: during the pushing, an internal rotation of the shoulders is carried out, which are set in the straight size of the pelvic outlet. The head is gripped with two hands in such a way that the palms are placed on the ears of the fetus, the fingertips are facing the face, and pulled downward until the anterior shoulder is fixed at the lower edge of the pubic symphysis (Fig. 68). Then the head is raised up, thereby helping to give birth to the back shoulder. If the shoulder is not born at the same time, then other techniques are used:

  1. the head is grasped with the left hand and pulled up, and the crotch is removed from the back shoulder with the right hand;
  2. the second finger of the hand is inserted into the armpit of the front shoulder from the side of the back, with which the shoulder is pulled during the push until it is born.

The back shoulder is also released. It should be remembered that the birth of the fetal shoulder girdle, in turn, contributes to strong stretching and trauma to the perineal tissue (shoulder size 12 cm, shoulder girdle circumference 35 cm). Therefore, the obstetric allowance for the removal of the hanger should be provided with great care. Following the birth of the shoulders, the birth of the fetal body occurs, which usually takes place without difficulty. The obstetric allowance for the birth of the trunk is as follows: with both hands, they cover the chest of the fetus and direct it up; the upper body is born first, then the rest of the body.

After the birth of the fetus, the third, successive, period begins. He is led, carefully observing the condition of the woman in labor, the color of the skin and visible mucous membranes, complaints, the pulse is counted, blood pressure is measured, etc. A container is placed under the woman's pelvis to collect and record the lost blood (vessel, kidney basin, etc.). It is necessary to empty the bladder, the filling of which interferes with the process of placental abruption and the birth of the placenta. Attempts to speed up the separation of the placenta by using external massage of the uterus, stretching the umbilical cord, etc., are unacceptable - they can lead to a disruption in the process of placental abruption and bleeding.

The separation of the placenta from the uterine wall is evidenced by a number of signs, of which the most informative are the following:

  1. a change in the shape of the uterus and the height of its bottom - immediately after childbirth, the uterus has a rounded shape and is located at the level of the navel; after placental abruption, the bottom of the uterus rises 2-4 fingers above the navel, it deviates to the right, becomes narrower in diameter;
  2. sign of Chukalov - Kustner - pressure on the uterus with the edge of the palm in the suprapubic region leads to retraction of the umbilical cord if the placenta has not separated from the uterus; if the umbilical cord does not retract, this indicates the separation of the placenta;
  3. a sign of Mikulich - a detached placenta, being born in the vagina, contributes to the urge to push.

In some cases, the spontaneous birth of the placenta is delayed, despite its detachment from the uterine wall. This is due to changes in intra-abdominal pressure, insufficiency of the abdominal press, which is not able to provide the release of the placenta, and other reasons. Therefore, making sure that the process of placental abruption is completed (according to one of the above signs), it is necessary to highlight the latter with external methods. There are several of them, but the most accepted method of Krede - Lazarevich: the bladder is emptied, the uterus is brought to the middle position, it is gently massaged to induce a contraction, the bottom of the uterus is grasped with the right hand so that 4 fingers of the palm lie on its back surface, and I finger - on the front wall of the uterus (the doctor stands to the right of the woman in labor); the uterus is compressed in the anteroposterior size and pressure on its bottom - forward and downward, which contributes to the birth of the placenta.

The born afterbirth must necessarily be taken to the obstetric hospital, since a thorough assessment of its integrity by the obstetrician is necessary. To determine the integrity of the shells, the placenta is turned with the mother's side down, while the shells are turned inside out and hang down, which allows them to be well examined. To examine the maternal part of the placental tissue, the placenta is laid out on a large smooth plane (tray) and the presence of each lobule in the center and along the edges of the placenta is examined - a break in the vessel, a bleeding dent indicate the absence of a part of the placenta.

For delivery, it is advisable to use a sterile disposable obstetric kit. In addition, the ambulance must have a bix with sterile bags for the initial treatment of the newborn. The packs contain a catheter for sucking mucus from the upper respiratory tract (which can be done by connecting the catheter with a rubber balloon), cotton swabs, a pipette for prophylaxis of ophthalmorrhea, 3 Kocher clamps, anatomical forceps, scissors.

The ambulance must have the following medicines required for childbirth and primary treatment of a newborn: ethyl alcohol 95%, iodonate, 1% solution (or 5% alcohol solution of iodine), sodium sulfacyl solution 30%, potassium permanganate solution 0.02% ...

To carry out the resuscitation of newborns in the delivery set, you must have the "Ambu" apparatus (DP-10).

At the end of childbirth, the postpartum woman requires careful monitoring and care. Produce a toilet of the external genitalia, their disinfection and examination (including examination of the cervix and vagina). If there are gaps, cuts, they are sutured. It should be emphasized that examination of the soft birth canal and suturing are operations that should be performed only in a hospital setting.

In the presence of bleeding from soft tissues, the suture operation is carried out immediately after the end of the labor act. If it is necessary to transport such a postpartum woman, she should apply a pressure bandage (in case of bleeding from a perineal rupture, clitoris region) or tamponade the vagina with sterile gauze napkins. At the same time, all efforts should be directed to the urgent delivery of the postpartum woman to the obstetric hospital.

At the same time, general monitoring of the state of the postpartum woman, skin color, hemodynamic parameters - blood pressure, heart rate is carried out.

Ed. V. Mikhailovich

"Childbirth. Taking childbirth outside the maternity hospital" and other articles from the section

A hundred years ago, women gave birth at home. Most often, midwives or neighbors came to the rescue, whose knowledge about the peculiarities of the course of pregnancy and childbirth was mainly limited only by their own life experience.

It was customary in families to have many children, and the death of a baby or mother was perceived with the philosophical humility of believers in God and the afterlife of people.

With the development of medical science, society came to the need to organize special maternity hospitals, where women were provided with qualified medical care at the stage of pregnancy and childbirth. Thanks to this, the death rate of newborns has decreased tenfold. Fewer and fewer families lost their desired children and their mothers.

The organization of the obstetric service has undergone global changes in recent years. Pregnancy management, childbirth and postpartum care, examination and treatment of women and newborns are becoming more and more high-tech. Due to the enormous high cost of modern medical equipment, the cost of maintaining effective intensive care units, maternity hospitals with a small number of beds are gradually being closed. In parallel, large specialized medical centers are being formed, in which pregnant women from the moment of conception to childbirth, as well as infants, are provided with the necessary volume of medical care at the highest level. Thanks to the concentration of the best medical personnel in these institutions, their constant training and the rapid introduction of new progressive technologies, it was possible to reduce infant and maternal mortality to the level of the most highly developed countries of Western Europe.

What is home birth

Home birth is understood as a situation in which their labor period and the birth of a fetus occurs outside the walls of a medical institution. It can be:

  • home birth, when a gynecologist or midwife invited in advance is next to the woman in labor. This is the most favorable option;
  • rapid childbirth, catching a woman anywhere(public transport, at home, in a shop, in a clinic). Often, the opening of the cervix occurs so quickly that they simply do not have time to seek qualified medical help. In such cases, both the mother and the baby are at high risk of trauma, infection, hypothermia, bleeding, and the baby often develops pneumonia due to aspiration of amniotic fluid.
  • home birth or having a baby on the way to the hospital when the obstetric allowance is provided by the specialists of the ambulance team. This happens with late treatment or when a woman does not want to give birth in a maternity facility. Such situations can be led by the belief that one should go to the hospital not with the onset of labor, but only with severe contractions, the time interval between which does not exceed 10 minutes, or after the amniotic fluid has left. There are individual characteristics of the course of labor, in which the dilatation of the cervix at the final stage of labor after a relatively slow onset can occur very quickly and be taken by surprise.

Benefits of home birth

In the 70s of the last century, a wave of purulent-septic diseases among newborn children and their mothers in the postpartum period swept through obstetric institutions of all developed countries of the World. Pyoderma, pemphigus, omphalitis, pneumonia, severe gastroenteritis, meningitis, osteomyelitis, mastitis and endometritis were recorded with alarming frequency, difficult to treat, leading in some cases to disability and even death of babies and women. Very soon it was found out that the culprit of the epidemic was the staphylococcus microbe, which lives in the walls of maternity hospitals and is resistant to the antibiotics and disinfectants used. It was then that they began to look for ways to prevent nosocomial infection. One of the methods proposed for consideration was home birth.

What are the benefits of having a home birth?

  1. The child is in contact with a sharply limited number of people, which significantly reduces the risk of transmitting disease-causing microbes to him.
  2. There is no threat of nosocomial infection.
  3. By transferring her microorganisms to the newborn baby during childbirth and subsequent contacts with him, the mother simultaneously protects him from them thanks to the immune factors contained in breast milk.
  4. A woman giving birth in her usual home conditions, with the support of family members, experiences less psychological stress.

Today, almost all obstetric medical institutions have adopted the useful features of home birth. Widely practiced partner childbirth, when the father is constantly next to the woman in labor, first picks up the baby and cuts his umbilical cord. Postpartum wards function on the principle of permanent joint stay of the baby with the mother. Early initiation of breastfeeding is actively promoted. A woman with a normal postpartum period is discharged with a healthy baby home for 3-6 days. In order to minimize the time of contact of the postpartum woman with the hospital microflora, even after the caesarean section, the length of stay in the hospital is increasingly reduced, and the stitches are removed in the clinic at the place of residence.

Dangers of Home Delivery

Even a childbirth organized in advance and carried out in the presence of invited medical workers is a great risk to the health, and sometimes the life of the mother and baby. Indeed, during this very serious and complex process, it is almost impossible to foresee everything.

What is the risk of a mother during childbirth at home:

  1. The emergence of discoordination of labor, complicated by the threat of rupture of the uterus or, conversely, a pronounced weakness of contractions up to their complete cessation.
  2. Dense increment of the placenta with massive early postpartum hemorrhage. Undiagnosed endometritis complicated by late bleeding.
  3. The development of a clinical discrepancy between the sizes of the pelvis and the head of the fetus, requiring the urgent use of various auxiliary aids (for example, the imposition of a vacuum aspirator or obstetric forceps), up to a cesarean section. In such cases, delay can be complicated by a discrepancy or rupture of the pubic bones in a woman, severe trauma to the skull or spinal cord in a child, or intrauterine fetal death.
  4. The threat of an unproductive period of fetal expulsion due to a very short umbilical cord or not diagnosed prenatally congenital malformations (for example, a dermoid cyst in the neck). Without an urgent caesarean section, a viable and healthy fetus will inevitably die before birth.

What is the risk of the child? In the presence of a severe intrauterine infection or birth trauma, anomalies in the development of the lungs or heart, during intrauterine aspiration (inhalation) of amniotic fluid, emergency resuscitation may be required, which can only be provided by specially trained qualified specialists using expensive diagnostic and medical equipment. Clamping of the umbilical cord loops during the opening of the cervix and the rotation of the fetus in the uterus is fraught with acute severe hypoxia, as a result of which, without emergency delivery, the brain is damaged or the fetus dies.

In the fiction of the 18-20 centuries, cases of the death of young women during childbirth or from postpartum fever, the suffering of mothers who gave birth to a still child or lost it in early infancy are often described. Even representatives of the upper strata of society and the wealthy estates were not immune from such a disaster. Even from school, we know about the death of the young wife of the aristocrat Andrei Bolkonsky from the novel by A. Tolstoy "War and Peace". Our generation is much more fortunate: we can use the latest achievements of modern medicine. This reliably insures us against unforeseen, hazardous to health and life, situations that may occur during pregnancy or childbirth. And after the death of the desired baby and the experience of birth pangs, it is very difficult to psychologically and physically recover and decide on a second pregnancy. So is it worth risking your future?

Home birth is becoming very popular. What is needed in order for the outcome of such a natural delivery to be successful?

The question of where the birth will take place worries pregnant women for all nine months. However, it is not always a question of choosing a maternity hospital. Increasingly, expectant mothers are choosing between specialized medical institutions and a home environment, and many stop at the second option.

The benefits of home birth seem clear, but there are enormous risks that can lead to irreversible tragic consequences. Taking into account everything to the smallest detail is what the expectant mother needs to do before the final decision is made.

Why is it so popular to give birth at home?

Home births are chosen by women who want to provide themselves and their baby with maximum comfort and exclude medical intervention in the natural process. The "pluses" of home birth also include:

  • the presence of only those people whom the woman in labor wants to see at this moment
  • a woman feels like the mistress of the house and everything that happens there
  • no stimulation, no episiotomy, no forceps or pain relievers
  • intuitive selection of the most comfortable posture and type of delivery
  • the possibility of giving birth in water (this is how most home births are carried out)
  • no interference in the process of uterine contraction
  • positive emotions of a woman in labor from being in a familiar environment
  • joint stay of mother and child begins immediately after childbirth
  • the absence of "foreign" hospital microbes that can cause allergic reactions and infectious diseases in the mother and newborn baby
  • no one "puts pressure" on the woman in labor, does not force the child to be vaccinated

All this forces expectant mothers to refuse childbirth in the hospital and take risks, relying on their own strengths and the help of nature.



Which celebrity gave birth at home? The consequences of the home birth of stars

The popularity of home births is greatly facilitated by the fact that more and more celebrities are sharing their experiences of having children in the comfort of their homes online. And this experience is extremely positive.

So the children of Pamela Anderson, Meryl Streep, Cindy Crawford, Demi Moore, Gisele Bundchen, Joely Fisher, Jennifer Connelly, Miam Bialik and many other famous successful women were born at home.

It is noteworthy that Russian celebrities do not so often decide on a home birth. Most star mothers choose foreign maternity hospitals for the birth of their children.

However, a mother with many children Masha Makarova, the soloist of the once popular group "Masha and Bears", Sasha Zvereva("Demo"), Elena Selikhova("Balagan Limited") gave birth at home and were very pleased with their choice.

Masha Makarova gave birth to twin girls at home in 2005, and five years later her son was born in the same environment. Sasha Zvereva gave birth in the bathroom, with the help and support of close relatives. The whole process was filmed for the family archive. The sons of Selikhova were helped by their father, who prepared in advance for this event at special courses for future parents.

IMPORTANT: Abroad, home births are allowed by law and are carried out in the presence of qualified obstetricians and gynecologists. In Russia, childbirth at home is illegal. The responsibility for their implementation and successful outcome lies only with the parents-to-be.



How to prepare for a home birth?

Preparation for home birth begins from the moment of registration. The doctor who will observe the pregnant woman should be aware of the wishes of the expectant mother regarding childbirth at home.

The next important step in preparation is choosing a parenting school that specializes in home births. By attending classes, the couple has the opportunity to finally be convinced of the correctness of their decision and get to know better the obstetrician who will carry out the birth.

IMPORTANT: To be on the safe side, you need to choose a maternity hospital that will accept a woman in labor in case of complications. We must not forget about transport. During childbirth, a car must be on duty at the entrance, in which the woman in labor, if necessary, will go to the hospital.

What are the primary supplies needed to carry out childbirth at home?

By the time of the onset of strong contractions, future parents should prepare:

  • Bath or special pool. If childbirth will take place in a home bath, it should be thoroughly washed and disinfected. If an inflatable pool is being prepared for the birth of a baby, you need to lay out a hose and a pump in a prominent place
  • Large oilcloth
  • Sheets, diapers
  • Enema
  • A clay or crystal container for the placenta
  • Small bulb for suctioning mucus from the nose and mouth of the newborn
  • A hot water bottle with ice in the freezer, which is needed to contract the uterus
  • Umbilical cord scissors, silk thread
  • Hydrogen peroxide for perineal treatment
  • Cold water in case the child needs to be resuscitated
  • Frozen cubes of hemostatic and antiseptic herbal decoctions (nettle, water pepper, chamomile, calendula). Cubes are placed in the vagina after removal of the placenta, if bleeding occurs
  • Warm decoction of galangal root, nettle and water pepper, which must be drunk by a woman in labor in case of blood loss and severe weakness
  • Rosehip decoction, which will help restore strength after childbirth
  • A decoction of yarrow, chamomile and oak bark for washing



Physical preparation for home birth: Pilates, fitball

To feel confident in childbirth and avoid possible complications, the expectant mother needs to make the most of the preparation time. Exercise will help to gain additional physical strength, prepare for the upcoming stresses in childbirth, build confidence and increase the health of mom and baby.

IMPORTANT: Fitness for pregnant women should be regular. This means that at least three times a week, the expectant mother should perform a set of necessary exercises. The most effective types of fitness for pregnant women are Pilates (Aqua Pilates) and Fitball.

Classes pilates contribute to:

  • the acquisition of chest breathing skills
  • elimination of congestion in the limbs
  • relaxation training
  • development of hip joints
  • strengthening the back


Aqua Pilates allows you to combine the smooth movements of Pilates and the beneficial effects of water. Performing exercises in the water, the expectant mother:

  • relaxes and relieves muscle tension
  • improves blood supply to the uterus and blood circulation in general
  • protects the body from overheating (which is possible during physical exertion in the air)
  • gets rid of feelings of fatigue, stress and depression, gains peace of mind
  • learns to hold the breath correctly
  • helps the baby to take the correct position in the uterus with the help of special exercises

IMPORTANT: Pregnant women with any physical fitness and for a period of at least 12 weeks can practice aqua Pilates.

For classes fitball expectant mothers have no restrictions - the duration of pregnancy and the level of physical fitness do not matter. The load can easily change depending on the physical condition of the pregnant woman. The instability and constant fluctuations of the fitball allow:

  • improve coordination of movements
  • evenly distribute the load over all muscles
  • improve blood circulation and metabolism
  • roll over to a child in a rearward position
  • train vertical positions

IMPORTANT: Fitball for pregnant women is chosen by height, and inflated in such a way that it bends slightly when pressed.



Psychological preparation: correct morale and support from relatives

Psychological preparation for home birth is just as important as physical preparation. The course of childbirth directly depends on the state of the female psyche. The calmness and confidence of the woman in labor and her family members attending the birth helps to avoid the occurrence of many possible complications.

IMPORTANT: Future parents should be well aware of what will happen during the birth process. Nothing should confuse or frighten them. To understand all the nuances of home birth, you need to watch training videos, attend courses, talk with your doctor and midwife.


When preparing for home birth, expectant mothers are advised to engage in self-hypnosis. To do this, you need to repeat as often as possible:

  • "Childbirth will be easy and timely"
  • "The child grows and develops well"
  • "I trust nature and my body"
  • "We are safe with the baby"
  • "I am healthy and ready for childbirth at home"
  • "My home birth will be successful."
  • "We are looking forward to seeing our baby at home"

IMPORTANT: It will be good if future parents will communicate with other married couples who decide to give birth at home. You can discuss problems with like-minded people, share impressions and successes. It is better to tune in to the successful outcome of home births by communicating with women who already have a similar experience.

Relatives should be sympathetic to your choice and not interfere with its implementation. You should not neglect special courses that are conducted specifically for those close relatives of a pregnant woman who will be present at home births.

How to choose a leader for a home birth? Who should you contact for help?

For those who decide to give birth at home, it is very important to choose the right midwife (doula) who will lead the process. The presence of an experienced, specially trained person next to a woman during childbirth affects both the course of the process and the feelings of the expectant mother, as well as the health and well-being of the child.

When choosing a doula, you should be guided by several indicators:

  • she has the appropriate education and, at the request of future parents, will provide documents confirming it
  • the woman is experienced not only in helping other women in childbirth, but she herself gave birth at home
  • A midwife who adequately assesses the situation will ask the pregnant woman who applies to her to attend an antenatal clinic, will be interested in the test results, ask her general health and warn about possible risks
  • the midwife offers to discuss and draw up a plan for future childbirth, willingly answers questions about her skills and professional skills

IMPORTANT: The most important criterion for choosing a home birth leader is trust. If the woman in labor trusts the midwife, some misunderstandings, incidents and complications can be avoided during childbirth.

You can find a midwife by contacting a specialized home birth preparation center or courses for expectant mothers. Friends' advice and experience can also be helpful. It is important not to rush to the final choice and get to know several applicants better.



How is the home birth process going? Video

  • The first stage of any childbirth, including at home, begins with contractions. When they become noticeable, you need to do an enema and call your midwife. As long as the contractions are tolerable, you can complete all household chores and preparations for childbirth.
  • When the midwife arrives for labor, the expectant mother should provide information on the frequency and strength of contractions. During strong contractions, a woman chooses the most comfortable position for herself: you can sit, lie down, walk or even take a shower. To ease the pain of the contractions, you can accompany them with a voice. In this case, the midwife should help the woman not get lost and not go to cry
  • If the contractions are prolonged, the midwife can stimulate cervical dilatation with homeopathic or medication (at the request of the woman in labor). At all times, the birthing supervisor should listen to the fetal heartbeat and monitor the cervical dilatation.
  • The second stage of labor begins with pushing. They take place upright on the bed or in the bathroom, depending on the intended delivery site. While the midwife controls the process, the husband massages his shoulders and lower back.


  • When the head appears, the midwife helps the baby to move forward and after a few seconds he is completely out. If childbirth takes place in the bathroom, then after birth, the baby is in the water for some time, which provides him with a smooth transition from one environment to another. After that, the midwife takes the baby out of the water, frees his respiratory tract from mucus and gives it to mom
  • Mom puts the baby to the breast for the first time and waits for the placenta to exit. After removing the placenta, the umbilical cord is not cut immediately, but after a certain period of time, so that the blood from it has time to pass to the child. When the umbilical cord is cut, the midwife hands the newborn to the dad, and helps the woman who gave birth to get out of the bathroom, get dressed and move to the baby.

Video: Home birth with the family

If something went wrong: when should I go to the hospital?

Those who decide to give birth at home need to tune in only to a successful outcome. Also, do not think that something might go wrong or complications arise. However, it is impossible to completely exclude the possibility of occurrence of force majeure circumstances.


The home midwife cannot help in any way and the woman in labor will need urgent medical attention in a hospital setting if:

  • Childbirth dragged on. The waters have receded more than 10 hours ago, and the baby has not yet been born. This situation is dangerous with a high probability of infection of the child. Stimulation or emergency caesarean section may be required
  • Too narrow a woman's pelvis does not allow the baby to come out. If the home midwife cannot help, you need to urgently go to the hospital, where a cesarean section will be performed
  • During labor, there was a rupture of the umbilical cord veins, detachment or rupture of the placenta. The baby can only be saved by an emergency blood transfusion no later than 15 minutes after the complication occurs. In this situation, every second counts. If resuscitation is carried out later, irreversible changes will occur in the child's brain, which can lead to disability.
  • Delayed discharge of the placenta. Can occur completely unpredictably due to tight attachment or accretion. In order to save the life of the woman in labor, urgent surgical intervention is required.

IMPORTANT: It is not worth believing the comparative statistics of home and hospital births given, since in case of an unfavorable course, the woman in labor is sent to the hospital, when even doctors are not always able to eliminate the complications that have arisen.

Olya:“If they do not prepare for home birth on purpose, but hope“ at random, ”it is better to immediately abandon this venture. Such childbirth is unlikely to go without complications. Any doubts about their abilities should become a reason for going to the hospital "

Tatiana:“Husband and wife must fully trust each other and understand what they are doing. It is important that those present at home births are psychologically ready for the birth of a child in such conditions and are ready for any consequences or complications, because no one has canceled the laws of Nature, anything can happen. "

Raisa Semyonovna:“I gave birth to five children at home. Every time everything goes smoothly and without complications. I am sure that no doctors and hospitals will ever compare with the comfort of their home. "

Marina:“My friend decided to give birth at home, and it all ended sadly. The child could not be saved. But everything would have been different if she were in the hospital on time. Now she reproaches herself for not going to the hospital, because there is all the necessary equipment that could save the life of her child. And the midwife "washed her hands", explaining what happened with the wrong attitude and unwillingness of the parents "

Eve:“Until recently, I wanted to give birth at home, but still did not dare. I chose a maternity hospital where you can give birth with your husband and create a cozy, homely atmosphere for your own taste. When the contractions began, the husband dimmed the lights, turned on soft music. The doctor entered only at our invitation. Everything went well, we did not regret our choice "

Anya:“I don’t understand why voluntarily return to ancient times and risk the child’s life, and my own too. Yes, our great-grandmothers gave birth in fields and haystacks, but the infant mortality rate was about 50%. Even the statistics of the 1920s and 1930s have survived. In the old act records there are 2 columns: "the number of children" and "of them alive." That is, the death of a child used to be commonplace. Is it really that everyone who agrees to a home birth is ready to easily accept any possible complications? "


For those women who have decided to give birth at home, I would like to wish once again to sensibly weigh the pros and cons, to listen to their body and the voice of reason. After all, the negative previous "hospital" experience is not necessarily repeated again.

Perhaps, if you take a responsible approach to the choice of a maternity hospital and a doctor you can trust, you will be able to give birth to your baby in a comfortable, as close to home environment as possible, while minimizing the risks of home birth.

Video: Doctor Komarovsky about home childbirth

Health care cannot dictate its terms, it only helps those who have asked for help and advice. According to the Law, the expectant mother has the right to write a written refusal and give birth where she sees fit.

Preparing for home birth

For some it is a trend of fashion, for others it is a planned and prepared event. On the Internet, you can find a huge number of video tutorials on preparing for childbirth. However, one must understand that one video was shot by an obstetrician-gynecologist with many years of experience, and the other by an amateur mother who wants to tell her birth story.

  • a few weeks before the expected date of birth, pass all the necessary tests, make sure that the pregnancy is proceeding without deviations;
  • a medical worker, namely a midwife, must always be in touch, in the event of the onset of labor to come to the rescue, for this it is necessary to first conclude an agreement with the maternity hospital;

Gynecologist's advice. Do not give up a midwife for a home birth. This is the only guarantor of health if something goes wrong.

  • during pregnancy, attend special courses in preparation for childbirth, it is advisable to invite your husband for the company;
  • take care of all the necessary little things with which the birth wards are equipped, if there is an opportunity to rent a KGT apparatus for monitoring the heartbeat;
  • collect a first-aid kit in advance, it is better on the recommendation of a midwife. Most often, the list contains sea salt for baths, enemas, napkins, silk thread, blunt scissors, antiseptics for treating the perineum, disinfectants, etc.

It happens that after the next examination, the doctor reports on probable problems during childbirth or abnormalities that make childbirth at home impossible. Such information cannot be ignored, it is worth abandoning your idea. The consequences can be irreversible.

Benefits of home birth

Annual statistics indicate an increase in the number of people willing to give birth at home. Aside from the caveats, there are a number of favorable factors:

  • a woman in her "home walls" feels relaxed, it helps to concentrate on labor at the right time;
  • there is an opinion that natural childbirth without medical intervention takes place, without complications, therefore, only 3% of women are hospitalized after home birth;
  • an apartment or house has the necessary space for a woman in childbirth, she can relieve the load by taking any position, which cannot be said about the hospital ward. A woman connected to the sensors, often with a dropper, is forced to just lie down;
  • there is an opinion regarding the close relationship between the baby and the parents at the time of home birth.

Based on the above arguments, it becomes obvious why women choose this method. However, negative consequences also exist, they must be taken into account when making such a responsible decision as childbirth at home.

Disadvantages of giving birth at home

In case of refusal from planned hospitalization within the previously calculated period, everyone, from the gynecologist to the pediatrician, is obliged to convey to the woman what danger is fraught with independent labor. Today most of the information is contained on the Internet, home birth videos seem so easy and simple, but is it? What difficulties a future mother may face:

  • in the maternity hospital, a whole team of specialists monitors the health of the mother and baby. At home, at the time of unforeseen circumstances (suddenly opened bleeding, entanglement with the umbilical cord, rapid delivery), one midwife may simply not be able to cope;
    there are not isolated cases when an ambulance did not have time to take a woman in labor from home;
  • the hospital ward is equipped with expensive equipment that allows you to control the process, which is not available at home;
  • if the expectant mother psychologically cannot endure being in a medical institution, for a certain fee, you can give birth in medical centers, where the situation is more like a sanatorium;
  • a woman in a position blindly believes that at the moment of attempts, childbirth, her husband will help, will be strong moral support. But the truth is that most men who agree to be present at childbirth simply do not want to upset their half;
  • after the birth of the child, it is washed, the umbilical cord is processed, etc. At this moment, the doctors examine the mother and provide her with assistance, if necessary. There will be no one to do this at home;
  • all examinations of the baby in the first days of life, vaccinations are carried out on the spot in the hospital. While the mother is resting from labor, the baby is at the post under supervision. At home, there will be no one to do it.

Home birth is a huge family responsibility for the life of a mother and child. Agreeing to this, on the one hand, a "natural" step, and on the other "extreme" one should take into account all the nuances.

The main stages of this process

Every little thing in preparing for the birth of a baby at home should be thought out. Involving all family members, everyone will monitor the implementation of the assigned tasks. Previously, in addition to watching the video of the birth of children at home, familiarize yourself with the scientific medical literature.

Advice! Don't just rely on great reviews on the internet. According to statistics, 2 out of 10 children born at home die at birth or receive injuries incompatible with life.

Childbirth can be divided into several stages:

  • preparatory;
  • the beginning of contractions;
  • discharge of water (at home, the bubble is not pierced);
  • stimulation of labor, if necessary;
  • childbirth;
  • cutting the umbilical cord;
  • attachment to the chest.

This is not an exact plan, but a normal delivery. We must prepare for any turn of events. Therefore, first study all aspects with a partner and decide whether you can handle it alone.

The opinion of a specialist: “Do not create the illusion that the midwife will solve all the issues during the birth of the baby. Who is a midwife? A person with a secondary medical education. "

Stimulation of labor

Home birth is an ongoing process, it is strictly forbidden to interfere with it. But stimulation by folk methods, some women in labor practice.

The most popular are:

  • sexual intercourse is the best natural stimulant;
  • throughout pregnancy, the gynecologist asks not to engage in nipple stimulation so as not to cause premature birth, in this case, this is just what you need;
  • domestic work;
  • warm bath;
  • enema and laxative as a provocateur of the intestines;
  • aromatherapy has recently been gaining popularity among other methods.

At the very beginning, it was mentioned, before giving birth at home, a woman should consult with doctors about her state of health, the readiness of the cervix. Only after this is it possible to resort to the above methods of stimulation.

Rapid labor

If you suddenly start giving birth at home, don't panic. Pull yourself together and take the following actions:

  • immediately call an ambulance team;
  • call neighbors and find out if there is a health worker among them;
  • create a calm atmosphere, loved ones are constantly with the woman in labor;
  • gather all the knowledge and prepare a place for receiving childbirth at home.

Obeying the circumstances is the only thing that can be done in such a situation. The main thing is to make a woman feel confident in the actions of others, and then the natural process will pass without complications.

Effects

All families choosing a home birth should know what to expect in case of unforeseen circumstances.

Most often these are:

  • traumatic brain injury of a child;
  • hemorrhage during labor;
  • internal breaks;
  • fetal death.

These are just a few irreversible consequences that are often incompatible with life. At such moments, a whole group of doctors is fighting for the existence of the mother and the baby in the maternity hospital. Every minute counts here. Before choosing such a tempting and comfortable option as home birth, consider whether the game is worth the candle.

This is a difficult and difficult process. Therefore, in most cases, pregnant women go to the hospital before the onset of labor, when their first symptoms appear. However, not everything goes according to plan in life; force majeure circumstances also happen. In such cases, you need to know how to act, what to do and when.

Who has rapid labor

There are several categories of expectant mothers who most often develop premature birth. Here they are:

  1. Pregnant women at a young age, under twenty.
  2. Mature women (over 30).
  3. Those carrying a second and subsequent pregnancies, if they have already had a preterm birth in the anamnesis.
  4. Those who, during the gestation period, had a threat of premature birth.
  5. Women with multiple pregnancies when delivery occurs between 36-37 weeks.

So, if you do not belong to any of the risk groups, it is still important after the 36 week period to exclude trips, long absences from home, keep a mobile phone with you all the time and prepare everything you need for the maternity hospital in advance. This will save you valuable time.

Symptoms of Impending Labor

The main signs of the onset of labor are:

  1. Discharge of amniotic fluid. They usually pour out in a stream. There are about 200 grams of them. But sometimes women confuse the outpouring of water with their leakage. The latter also requires urgent treatment for gynecological help. You should pay attention to the color of the water. If they are greenish, then this is evidence of fetal hypoxia.
  2. The appearance of contractions. These are severe pains that are contractions of the uterus. The intensity of the contractions increases, the gap between them decreases. Sometimes there may be no contractions. A woman sometimes feels aching pains in the abdomen, back, similar to menstrual pains. Together with them, chills, nausea are felt. And this is also a symptom of cervical dilatation.
  3. The beginning of attempts. They feel like an irresistible urge to defecate. The appearance of attempts is evidence that the baby will be born in a few minutes.

When a woman has felt the aforementioned precursors of childbirth and is at home alone, she should immediately call an ambulance, call her husband, and seek help from neighbors. In such cases, shyness is out of the question. If you are traveling by train - contact the conductor, they usually take first aid courses. When a woman, being on the road, visiting or in other conditions outside the house, feels that she will not have time to get to the hospital, then this does not need to be done. It's better to let the birth take place at home than on the road, in a traffic jam.

Labor has begun: what to do?

If two or three people are near the woman in labor at the time of childbirth, then one must take responsibility for helping the woman. First of all, you need to calm her down, give her confidence that everything will end happily, and the doctor is already on the way. If childbirth is rapid, then the second person can be in constant contact with the ambulance dispatcher and consult what to do at this or that stage of delivery.

It is necessary to prepare everything that may be required to help a woman. These are iodine, alcohol (vodka as a last resort), scissors, bandages, diapers, cotton wool, clean sheets, a rubber bulb. The woman should lie comfortably and should not be allowed to sit down to avoid crushing the fetal head. All of the above items should be within easy reach. You need to thoroughly wash your hands with soap and wipe them with alcohol. It is recommended to lubricate the phalanges of the fingers with iodine. Better to wear sterile gloves.

When you see that the head is born, the back of the head will appear first. Then she will turn around to face the mother's thigh. If the child is born in the fetal bladder, then it must be torn apart, freeing the head of the child. After the head turns, it is necessary to carefully suck the mucus from the mouth and nose with a pear. As a last resort, it can be squeezed out of the nostrils one by one, using napkins for this. Until the child is completely out of the mother's womb, it must be carefully held. If you see that the umbilical cord is wrapped around the neck of the crumbs, remove it carefully, without tension. Tie it two centimeters from your baby's skin right after the baby is fully born. Cut the umbilical cord in this area with pre-disinfected scissors. Treat the tip with iodine solution. The baby must be wrapped in a sheet, which is preheated. After that, you need to wait for the birth of the placenta. He is wrapped in a plastic bag and handed over to doctors who will come to the rescue. They hospitalize the child and mother in the hospital.