Natural stimulation of labor. Preparations for stimulation in the hospital. method of stimulating labor in the hospital

27.04.2019

Stimulation of labor is a measure to speed up the onset of labor. It happens medical, that is, it is carried out in a maternity hospital, and independent. The latter represents the actions that the expectant mother herself takes to speed up the process. Natural stimulation of labor is possible if the doctor gives the go-ahead and the pregnancy is full-term. In the maternity hospital, doctors will only carry out any actions if the pregnancy is post-term and there are no contraindications for natural delivery.

Why Women Decide on Natural Methods of Stimulating Labor

We will only give a few reasons.

1. Protein in urine and periodic increase in blood pressure. These are well-known symptoms of incipient gestosis - a severe pathology of pregnancy, dangerous for both the mother and the baby, the treatment of which is only childbirth. Meanwhile, true gestosis is a contraindication to some types of stimulation. For example, administration of oxytocin is contraindicated in high blood pressure. And self-induced labor is also not safe. Untimely, too early separation of the placenta can be provoked.

2. They are afraid of giving birth to too large a child, more precisely, birth trauma, perineal and cervical ruptures. In this case, there are indications for stimulating labor activity only if the mother has a narrow pelvis. It happens that doctors say that you will give birth to a child with such a weight, but with such a weight you will not. Although in this case, not even the weight plays a role, but the head circumference. If it is 36 cm or more, problems may arise. However, if at 32-34 weeks they set a tendency for a large fetus, this does not mean at all that this tendency will continue for childbirth. It often happens that a woman has a large belly, and a large fetus was placed earlier, and an ordinary, average baby weighing 3300-3500 grams is born. That is, at home, natural stimulation of labor at 40 weeks is not required at all.

3. Feel bad: there are problems with sleep, lower back hurts, leg cramps tortured, frequent going to the toilet, tachycardia, etc. But this is not a reason to speed up the onset of labor. It remains quite a bit to be patient. Then you will miss your pregnancy.

4. The expected due date has arrived. Not all women give birth on this particular day. Childbirth at 41, and even at 42 weeks is considered the norm if there are no signs of postmaturity of the fetus. They are detected by ultrasound and CTG.

5. False contractions often appear, but they in no way turn into true ones. Some women have Braxton Higgs contractions as early as 20 weeks ... This is not an indicator that labor is about to begin. But also not a reason to provoke childbirth itself.

6. There are no symptoms of impending labor. In fact, some women don't have any precursors before the contractions. For many, the mucous plug comes off only during contractions, then the stomach drops. Well, "cleaning" the body is generally a very subjective sign of an imminent birth.

7. I would like to give birth on a certain day, or, conversely, not to give birth, for example, on a holiday. Childbirth is started not so much by the mother's body as by the child himself, when he is ready for them. Many moms worry that it is not safe to give birth during the holidays. Allegedly, doctors and midwives will celebrate, drink, and they will not have time for women in labor. This is not true. The usual horror stories. A child born on a holiday will probably even be proud of his date of birth.

Natural ways to stimulate labor: an overview of techniques

1. Primrose oil and other remedies from naturopaths and herbalists. It is taken orally, in the form of capsules, a dietary supplement sold in a pharmacy, at a dosage of 500-2000 mg per day. Evening primrose oil is also used as a lubricant when massaging the perineum. Massage is recommended for all primiparous women, as it is a kind of prevention of perineal tears during childbirth, improvement of elasticity. It is necessary to pull it down with 2-3 fingers. There should be no pain, you need to do it very carefully.
Evening primrose oil is said to contain prostaglandins, which is why it is so effective.

2. Various "laxative" techniques. The most popular is castor oil. Recommended dosages from experienced mums and doctors vary. Someone says that you need to drink the whole bottle, and someone says that two tablespoons are enough. Read the instructions or ask your doctor.

Why bother provoking diarrhea at all? Of course, this is not the point, but in the activation of intestinal motility. The intestines, in turn, will tone the uterus.

You can use an enema with water or glycerin suppositories for the same purpose. It is very good to eat foods with a laxative effect, such as cabbage, beets, cucumbers, prunes, vegetable oil, etc.

3. Physical activity. Usually it is advised to walk up and down the stairs, but walking on a flat surface will also do. The main thing is to be more upright, so that the fetus quickly sinks deeper into the pelvis and thereby stimulates the cervical dilatation.

4. Sex. Without a condom and with the obligatory strong arousal and orgasm. This will lead the uterus to hypertonicity, and the sperm will contribute to the rapid maturation of the cervix, since it contains prostaglandins - substances that are used even in maternity hospitals to stimulate labor. The effect of one sexual intercourse is unlikely to be. It will take more than one day of active sex life.

5. Conversation with an unborn child. Tell him how you and all his relatives are waiting for him, loves, how much you bought for him, how you prepared. Even doctors agree that such conversations are effective.

6. Meditation and taking sedatives (valerian tablets). Stop waiting for childbirth, pay attention to every little thing, and they will start faster. Relieve stress.

7. The so-called exercises that stimulate the onset of labor. The simplest is squatting or mopping the floors on all fours.

8. Midwife cocktail. There are various folk recipes, but they all boil down to the fact that a generic cocktail (not necessarily liquid, it can be a salad, for example) should contain substances that promote the ripening of the cervix and have a stimulating effect on intestinal motility. An American cafe even has a "labor-stimulating salad" on the menu.
Generic products include ginger, pineapple, licorice, eggplant, pepper, vinegar, and cinnamon.

9. Stimulation of the nipples with hands and breast pump. You can simply massage your breasts in a circle. But it is more effective to take a breast pump and try to "pump". This will lead to a very active production of oxytocin and tone the uterus. If you spot colostrum, it's okay. The mammary glands have long been prepared for breastfeeding.

Artificial labor stimulation

Doctors often observe two trends among women with term pregnancies:

simple, in terms of providing assistance and the effectiveness of manipulations - when there are all obstetric harbingers of the imminent birth of a child, but the uterus is calm, there is no hypertension;
more difficult - when the birth canal is not yet ready, that is, the cervical canal is tightly closed and has a length of more than 3-4 cm according to the results of a manual examination by a gynecologist and (or) an ultrasound scan using a vaginal probe.

In the first case, in order to provoke labor, doctors perform an amniotomy or puncture of the amniotic fluid. The water in the front leaves, the fetus sinks lower into the basin. Contractions appear within 1-2 hours. If there are no contractions, they put an oxytocin drip for the entire period of contractions and attempts. Oxytocin provokes active contractions.

If the cervix is not ready, the bladder will not be punctured, first, by injecting a special gel or medically, by means of mifepristone tablets, the cervix is prepared for opening. It should become shorter and softer. With a small opening, an amniotomy is performed and, if necessary, oxytocin is given.

Many women are very afraid of the puncture procedure and the so-called manual separation of the membranes. But this is not at all scary, does not cause pain and, of course, does not require anesthesia. Much more unpleasant is the frequent examinations of the cervix in the process of its gradual opening and other obstetric manipulations.

Stimulation can be artificial or natural, it is not so important what triggered the onset of labor. The most important thing is that they go quickly and that there are no injuries.

When pregnancy becomes post-term, it is required to hasten the birth of a child - stimulation of labor in a stationary setting is a safe and effective procedure. So that our readers have a rough idea of what awaits them in the maternity hospital, what manipulations and drugs, we have prepared this material.

How to understand that the body is ready for childbirth

A woman on her own will not understand this in any way. She may often have preparatory contractions - but this is not at all a sign of the readiness of the cervix for childbirth. The most important thing is that it is ripe enough. In this case, childbirth will be as safe, comfortable and natural as possible.

But in recent years, doctors have observed such a tendency that in women, especially primiparous and with various chronic diseases and obstetric pathologies, by the expected date of birth, the cervix is completely unprepared for disclosure. This is also due to hormonal imbalance, too high progesterone - a hormone that prolongs pregnancy. Doctors use this information for drug stimulation of labor, it is carried out exclusively in the maternity hospital, since the drugs for this are very serious drugs that are not sold freely in pharmacies.

But besides this kind of drug preparation, other methods are also used. We will describe them in our material. But back to our neck.

At 39-40 weeks, all women are waiting for a gynecological examination in an antenatal clinic or a maternity hospital in order to determine the degree of cervical maturity. If the cervix is not at all mature, you need to take measures to prepare it now, otherwise you will face great difficulties in childbirth, and possibly a cesarean section.

During the examination, the doctor pays attention to the length of the cervix (he can determine the length of its exclusively vaginal part, but this is quite enough), the degree of its openness, softness. If the neck is closed, tight and long, it's time to take action. Many women think that an examination to diagnose the condition of the cervix is unnecessary (after all, it is very painful), and that an ultrasound scan with a measurement of its length with a vaginal probe is quite enough. But this is not the case. For readiness for childbirth, it is important to feel the cervix. Yes, it's a little painful. But it will still be in labor ... Try to relax during the examination, and the pain will be minimal.

How to stimulate labor with antispasmodics

Experienced women know that in the third trimester of pregnancy, antispasmodics should be used as little as possible, since they, rather, will not prevent premature birth with frequent hypertension, but, on the contrary, will provoke them. The thing is that antispasmodics relax the muscles, reduce their tone, including this applies to a very dense cervix.

The most effective and well-known substance used for this purpose in Russia is Hyoscina butylbromide - a drug familiar to many under the name "Buscopan". It can be prescribed from 38-39 weeks in the form of rectal suppositories for prenatal preparation of the cervix. Many studies and statistics prove their effectiveness. The majority of expectant mothers who used "Buscopan" before childbirth, their first period was quick and easy, the cervix opened without problems. Also, "Buscopan" is sometimes prescribed in the form of intramuscular injections, but already in a hospital setting.

In second place in terms of effectiveness are rectal suppositories with belladonna. They have antispasmodic, analgesic and anti-inflammatory effects. They well reduce the tone of the abdominal organs. Assign 1-2 candles a day.

And, finally, "Papaverine Hydrochloride" (rectal suppositories) and "No-shpa" (droverin) - inside and intramuscularly. Weaker drugs for almost natural stimulation of labor, including having a blood pressure lowering effect.

If all this does not help or the time is already running out, more serious measures are taken in the hospital. Read about them below.

Stimulation of labor with a Foley catheter

Foley's catheter is a urological instrument, but it has long been "chosen" by obstetrician-gynecologists who use it to expand the cervix. Cheap and cheerful, as they say. And it can be carried out in any maternity hospital remote from civilization. This is a method for mechanical action on the cervix.

A catheter is inserted into the woman's cervical canal. The procedure is not painful, but it can be a little unpleasant. Further, it is filled with 30-60 grams of liquid. This causes the cervix to dilate. And if the effect is persistent, then within 12-24 hours the catheter falls out by itself, and the cervix, expanded by 3-4 cm, is mature enough for doctors to start actively stimulating labor. Unfortunately, contractions after such a mechanical effect on the neck do not always appear on their own. The amniotic fluid is pierced to the pregnant woman and, if necessary, a dropper is placed with "Oxytocin".

The Foley catheter is rarely used by modern maternity hospitals to stimulate labor, since after it there is a high risk of weak labor and caesarean section. In addition, there is almost always a need for other types of stimulation.

Preparation of the cervix with kelp

This is, as with the Foley catheter, a mechanical way to dilate the cervix. But it is preferred. Kelp is a common seaweed, or rather two of them used in obstetrics. The doctor injects these algae in the form of several sticks into the woman's cervical canal. There they are saturated with moisture and increase in volume during the day by about 3-5 times, thereby slowly expanding the cervix. The length of one stick is 6-7 cm, and the initial diameter is 2-3 mm. The length of the kelp does not change when exposed to moisture. Only the volume is growing.

Disadvantages of kelp labor stimulation are as follows:

severe pain that occurs in many women during the introduction of algae into the cervical canal;
unpleasant sensations during the entire time they were there;
sometimes the sticks are displaced into the vagina, making them useless;
it takes a lot of time to achieve the effect - about a day;
there is a risk of infection of the uterus and allergy to algae.

But all these complications are quite rare, so kelp is one of the most commonly used means of induction (stimulation) of labor by obstetricians.

Labor stimulation gel

The gel contains prostaglandins - substances that cause labor. Yes, exactly those contained in male sperm. After all, it is not for nothing that they say that sex during a long period of pregnancy often provokes childbirth.

However, prostaglandin in the form of a medicine should only be used in a maternity hospital, as it has a number of side effects. For example, visual impairment, drowsiness, tinnitus, changes in heart rate, dizziness, surges in blood pressure, etc. Prostaglandins have a lot of contraindications in the form of chronic heart disease, kidney disease, asthma, glaucoma, etc.

Prostaglandins are prescribed for immature cervix. It is administered intramuscularly or in the form of a gel. The second option is preferable, as it is effective at low doses. Usually, the gel begins to be injected one day before the expected birth. And the onset of labor is stimulated by amniotomy (puncture of the amniotic fluid) and oxytocin.

The gel is quite effective, but sometimes it does not work ... For example, it is ineffective when the gestation is less than 37 weeks (sometimes there is a need for stimulation at such an early stage), obesity in the expectant mother, over 30 years of age.

How labor is stimulated with pills in a maternity hospital

Mifepristone is a so-called antigestagen drug. It is used not only to induce childbirth, but also abortion in the first weeks of pregnancy, emergency contraception and in some countries for the treatment of uterine fibroids.

For stimulation in the maternity hospital, mifepristone (miropristone) tablets are given, which the woman takes exclusively in the presence of a doctor. This drug is strictly prescription and quite dangerous if you use it yourself in violation of the instructions. Since mifepristone is used for medical termination of pregnancy, all expectant mothers who want to keep their baby at least 40 weeks old should be kept away from it.

The scheme for taking the drug is as follows: 1 tablet of the drug with a dosage of 200 mg is taken on the first day and exactly 24 hours later another tablet is taken. How long after the second dose does mifepristone induce labor in women? Usually within 2 days, maximum within 3 days. If, after this time, the birth canal remains immature, the woman is given vaginal prostaglandins (gel). Although in this case, there are often failures and you have to do a cesarean section, as time is "running out", and the cervix does not ripen in any way.

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

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

Stimulation of labor in the hospital

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

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

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

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

However, if the contractions do not start even after opening the fetal bladder, then they need to be stimulated. For the procedure, doctors use - this is an analogue of a natural hormone that is produced by the pituitary gland of a woman during childbirth. Oxytocin can be used in the form of tablets or intravenously - this is the most common method. The disadvantage of using is only that the woman will have to be restricted in movements, since she will need to lie under a dropper. Oxytocin is used together with antispasmodics - drugs that relax the muscles of the uterus. All doses should be individually adjusted. Among the contraindications for the use of oxytocin are the impossibility of giving birth to a child through the birth canal, improper position of the fetus, increased sensitivity to the drug.

It should also be borne in mind that labor induction is not always justified. Any methods of this procedure have their own contraindications. Stimulation is not performed if:

the size of the baby's head does not match the size of the mother's pelvis;
the baby inside the mother feels bad, judging by the testimony of the heart monitor;
the fetus is not positioned correctly;
mom has health problems.

The decision to stimulate labor is made by the doctor. In doing so, he must weigh the pros and cons of such a procedure. Stimulation of labor is only justified if:

observed;
and no contractions after 38 weeks;
there is a corresponding medical indication;
there is a failure during childbirth;
the cervix does not open;
contractions stop abruptly;
the woman was too tired of the contractions.

Delivery after stimulation

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

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

And do not be discouraged if childbirth has to be stimulated: this is carried out solely in the interests of the child. Although, of course, it is better to talk to your doctor in advance so that drug stimulation (if suddenly) is resorted to only in case of emergency on strict indications (alas, in recent years, childbirth is being stimulated more and more often).

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

Natural stimulation of labor

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

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

Any physical activity can cause the onset of childbirth in a natural way: whether it be a long or intense walking walk, gymnastics, housework. If a woman is already drifting, then in any case she can give birth within a few hours after such activity.

Some people advise taking a warm enough bath to speed up the onset of labor. But you should be more careful with this method, and if the waters have already departed, then it cannot be used at all.

There are other ways to lure your baby into the light. Some of them are quite amusing: for example, to shine a flashlight in the lower abdomen, attracting the child's attention and directing him to the "exit". Meanwhile, they do not help everyone.

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

Specially for- Maryana Surma

Stimulation of labor- This is the artificial induction of labor at any stage of pregnancy or its activation directly during childbirth to enhance contractions and attempts.

Of course, the best option is natural childbirth, when nature itself decides the moment of the birth of the child. However, there are situations when it is impossible to do without medical care and it is necessary to stimulate labor.

Indications for artificial induction of labor

Labor is stimulated for the following indications:

... It is carried out after 41 weeks or earlier if there are indirect signs of overdue;
Multiple pregnancy if it persists for more than 38 weeks;
Premature rupture of amniotic fluid in the absence of the development of labor;
Acute or chronic maternal illness preventing the further preservation of pregnancy;
Fetal condition that threaten his health and life with further prolongation of pregnancy;
Severe weakness of labor in the first and second stage of labor;
Immature cervix during full-term pregnancy;
Absence or delay in the first stage of labor.

Artificial stimulation methods

Today there are various methods for inducing labor in the hospital:

Amniotomy;
Detachment of membranes;
Use of prostaglandins;
Use of mifepristone;
Oxytocin administration;
Foley catheter insertion into the cervix;
The introduction of kelp into the cervix.

Amniotomy

Amniotomy is a procedure to artificially open the fetal bladder. The doctor, under the control of his fingers, inserts a special hook into the vagina and cervix, captures the fetal bladder and opens it.

As a result of the discharge of amniotic fluid, the pressure in the uterus drops sharply, the baby's head begins to press harder on the pelvic bones, and labor is stimulated.

information The procedure is absolutely painless for a woman and does not pose a danger to the baby, because the risk of developing any complications is minimal with proper manipulation.

Detachment of membranes

The procedure is performed on a gynecological chair. The doctor carefully exfoliates the amniotic membranes from the lower parts of the uterus in the area of the internal os. Manipulation is not always effective on the first try, sometimes you have to repeat it several times to activate labor.

The procedure is safe for the baby, but it can cause discomfort and pain for the expectant mother.

Prostaglandins

Prostaglandins are widely used for cervical maturation and stimulation. At the moment, there are various dosage forms of the drug release:

Vaginal forms(gel, vaginal tablets, uterine ring);
Oral tablets;
Solution for infusion(intravenous drip).

The use of dosage forms of prostaglandin

Method of administration	Dosage form	Multiplicity of introduction
Any form of the drug is used when the cervix is dilated no more than 4 cm.
Vaginal	Labor stimulation gel	Injected into the posterior vaginal fornix If necessary, repeat the procedure after 6 hours
Vaginal	Vaginal tablets
	Pessary	Inserted into the posterior fornix of the vagina (in most cases, once)
Oral	Labor stimulation pills	Tablets are taken orally with an initial dosage of 0.5 mg of the drug every hour If necessary, the dosage can be increased
Intravenous	Sterile solution	The initial dose is 0.25 mcg / min The subsequent dosage can be increased under constant control to eliminate side effects

The most widely used prostaglandins are for vaginal administration. while the risk of side effects is minimal. Tablets and solutions are used much less frequently.

Mifepristone

Mifepristone to stimulate labor is used according to the following scheme: 200 mg once a day, after 24 hours the drug can be taken again.

This drug is a synthetic drug that suppresses the action of progesterone and thereby stimulates the contractile activity of the uterus.

Mifepristone has a number of side effects and should only be taken under medical supervision.

Oxytocin

The most common route of administration of oxytocin is intravenous, in which the drug enters the bloodstream directly.

Women may respond differently to stimulation with oxytocin, so there is no standard dosage. The drug should be administered very slowly with constant monitoring of the onset of contractions to avoid uterine hyperstimulation and gradually adjust its dosage.

Foley catheter

A catheter is used to ripen the cervix during a full-term pregnancy. The balloon is inserted into the cervical canal and filled with saline solution to mechanically stretch the cervix and open it. The catheter is left in the canal for 12 hours or until it spontaneously falls out.

The procedure can be painful for the woman herself, but it will not harm the child.

Kelp

Kelp are dried stems that have been used to ripen the cervix for over a century.

The stems are inserted into the cervical canal, tamping tightly, where, under the influence of mucus, they swell and stretch the cervix.

Natural stimulation of labor

Natural stimulation of childbirth, of course, is more preferable: it may not always cause labor, but at the same time you can be sure that it will not bring harm to the woman and the child.

Natural stimulation techniques:

Long walks in the fresh air;
Walking stairs;
Having sex... Sperm must necessarily get into the female genital tract, because it contains prostaglandins, which enhance the contractile activity of the uterus;
Stimulation of the nipples;
Acupressure foot massage;
Taking a warm bath or shower.

Stimulating labor at home

important It should be noted right away that self-stimulation of childbirth at home not only can not always bring the desired effect, but also lead to a number of complications. Reception of any drugs, the use of various traditional methods should occur only after consultation with the attending physician.

Home stimulation of labor can be carried out using the natural methods described above, as well as using folk remedies.

Folk remedies for stimulating labor:

Vegetable oils... For example, castor oil has long been used to stimulate labor. The oil should be used on an empty stomach, 1 tablespoon 3 times a day, or it should be abundantly seasoned with salads and other foods;
Infusion of raspberry leaves... Take 2-3 times a day no earlier than from 37 weeks, because can cause premature birth;
Red currant juice(taken on an empty stomach in the morning);
Cleansing enema with the addition of sea salt(active intestinal peristalsis will increase the activity of the uterus).

Possible complications

Of course, artificial induction of labor should be carried out only on strict indications, because, despite rare complications, there is still a risk.

In addition, it should be borne in mind that there is contraindications for stimulating labor, both in the hospital and at home:

Wrong position and presentation of the fetus;
Large size of the child in combination with a narrow pelvis in the mother;
Diseases of the mother that prevent the natural birth of a child;
Fetal heartbeat disorders;
Uterine bleeding;
Prolapse of the umbilical cord or small parts of the fetus into the vagina.

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

To start normal labor, two basic conditions are needed: a mature cervix and sufficient strength and duration of contractions. Usually the cervix "matures" (ie becomes soft, shortens to 1 cm or less, and opens by more than 1 finger) by 38–39 weeks of gestation. With the onset of labor, the cervix continues to open and flatten. This is due to the contractions, as well as the pressure of the fetus on her. An important role is played by the fetal bladder, which "wedges" into the opening of the cervix, contributing to its opening. For the successful completion of the first stage of labor, uterine contractions must be strong enough, prolonged and occur at regular intervals.

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

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

What is the danger of weakness in labor?

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

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

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

Stimulation in labor: let's try it without medication

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

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

Drug stimulation during labor

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

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

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

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

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

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

With persistent weakness of labor, combined with other diseases, and if natural childbirth is impossible, a cesarean section is indicated.

The conditions for rodostimulation are:

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

Can stimulation during labor be avoided?

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

Such different concepts

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

The reasons for the weakness of labor:

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

When is labor stimulation not allowed?

Contraindications for rhodostimulation are the presence of a scar on the uterus, abnormal fetal positions, oxygen starvation, clinically narrow pelvis (a situation where the size of the fetal head does not match the size of the mother's pelvis), placenta previa (when the placenta blocks the exit from the uterus), severe gestosis, fatigue women in labor.