Youth and beauty 

How to deliver at home? The biomechanism of labor, or how to understand that labor has begun? The right approach to pushing

Today, childbirth is positioned as a normal process of the body for the expulsion of the fetus, the membranes of the fetus and the placenta from the uterus through the birth canal. During the primary care phase, the rescuer may be confronted with different periods of labor in which different types of benefits need to be provided.

Every health worker should be able to diagnose the period of labor and the birth itself, and every doctor must be able to choose the correct management tactics.

When does out-of-hospital labor occur?

Most often, such childbirth occurs with premature pregnancy, in women who have multiparous.

Classification of childbirth

Distinguish between genera:

  1. Premature. The pregnancy was terminated between 22 and 37 weeks. As a result of such childbirth, premature babies are born. These children are characterized by low body weight (500 g - 2500 g), body length from 19 to 46 cm, immaturity of all organs and systems;
  2. Urgent ( routine childbirth). This labor begins at 38 to 42 weeks of gestation. As a result, a child is born with a body weight of 3200 g and a height of 46 cm;
  3. Post-worn. Pregnancy ended in more than 42 weeks. In this case, the child has signs of postmaturity, and these are fontanelles and sutures are narrow, the skin is dry, dense bones of the skull. With such births, the baby is often born with injuries;
  4. Physiological;
  5. Pathological.

Management of out-of-hospital labor

  1. It is necessary to resolve the issue of transporting the woman in labor to the hospital;
  2. Collect anamnesis: how many pregnancies and childbirth were previously, the course and complications with them;
  3. Determine the position of a real pregnancy, that is, a general increase in body weight, the possibility of a threat of interruption, changes in urine and blood tests, changes in blood pressure over time. These data must be noted on the exchange card;
  4. Conduct an objective study and assess the condition;
  5. Determine what stage of labor is in progress at the moment;
  6. 6. Investigate the position of the fetus in the uterus using four methods of external examination;
  7. Listen to the fetal heartbeat;
  8. Assess the nature of the discharge from the genital tract of the woman in labor;
  9. If it is necessary to carry out a vaginal examination;
  10. Establish a diagnosis of childbirth;
  11. Hospitalized in a specialized obstetric and gynecological hospital. If there is no possibility of transportation, delivery is on the spot.

Home delivery

Before giving birth, a woman is given a cleansing enema, the hair in the perineum is shaved off, the external genitals are washed with clean warm water and soap. Then bed and underwear is changed. Oilcloth is placed under the sheet. A homemade pillow wrapped in sheets is also used, which is also placed under the mother's pelvis. This pillow is called a polster. Polster is necessary to open free access to the perineum.

Biomechanism of childbirth, or how to understand that childbirth has begun?

This term means a complex of rotational and translational movements of the fetus passing through the birth canal.

The first stage is the cutting of the head into the small pelvis with its oblique size.

The second stage is the internal rotation of the head. The head passes a wide part of the pelvic cavity with moderate flexion in one of the oblique dimensions. The inner turn itself ends in the pelvis. Thus, the head goes from an oblique dimension to a straight one.

The third stage of labor is head extension. A fixation point is formed between the pubic joint and the suboccipital fossa of the baby's head. Extension occurs around this point. The crown of the head is born first, then the forehead, face and, finally, the chin.

The fourth stage is the inner turn of the shoulders, as well as the outer turn of the head. When the head is born, it turns with the back of the head to the mother's left thigh, and to face the right thigh. Gradually, the child bends and the back shoulder is born, after which the rest of the torso and legs are born.

A newborn baby inhales the atmospheric air for the first time, screams and actively moves his legs and arms, turns pink.

Further observation

During this period of labor, the woman in labor is closely monitored. The newborn is also examined, his vital functions and physical activity are assessed.

Childbirth actions

Before giving birth, a person washes his hands and carries out treatment with any skin antiseptic that is at hand. The task of the delivery person is the obstetric benefit. It is necessary to help in childbirth, but the main thing is not to interfere with the physiological process.

When the head begins to erupt, the midwife wraps her hand around the perineum with a clean, and preferably sterile, napkin and tries to restrain the premature extension of the baby's head during the contraction. This movement promotes the emergence of the baby's head from under the pubic symphysis.

Removal of the head begins only at the moment when the suboccipital fossa passes under the pubic articulation.

At this moment, the woman in labor does not need to push and she is informed about this. The released head is wrapped around with a hand, while the other hand is wrapped around the crotch, and slowly remove it from the head, gradually freeing the entire head. Removal of the head is carried out until then. Until the crotch comes off the baby's chin. Of course, all these manipulations are performed only in between contractions.

In addition, after the birth of the head, it is necessary to remove all mucus and fluid from the baby's mouth, so as not to lead to aspiration of the masses into the lungs during the first breath.

When the head is born, check for the presence of an umbilical cord entanglement around the neck. If the umbilical cord entanglement takes place, carefully remove it through the head.

Actions after the birth of the head

Do not rush to give birth to the rest of the body in the absence of any indications, for example, intrauterine fetal asphyxia or bleeding. You should wait for the baby to turn around in the birth canal on its own. For this, the woman is asked to push.

After both shoulders are born, the baby is lifted up and carefully, without sudden movements, pulled out of the birth canal.

In order to preserve the perineum, you should not release the head until the back of the baby's head is connected to the pubic joint, since otherwise there are frequent perineal rupture injuries, which heal very difficult and cause a lot of inconvenience to the woman.

When erupting the head, the obstetrician's allowance should not be forced. On the contrary, the manual is carried out very carefully and accurately. The newborn is placed between the mother's legs and covered to prevent hypothermia.

Assessment of the baby's condition according to the Apgar scale

The assessment is carried out at 1 and 5 minutes. This method includes the definition:

  • palpitations;
  • breathing;
  • skin color;
  • muscle tone.

The assessment of the child's condition is carried out in points:

  • 7-10 points - no resuscitation is required;
  • 4-6 points - children have cyanotic skin, weak muscle tone, heart rate over 100 per minute, increased reflex excitability. These children have a high chance of survival and life without consequences;
  • From 3 to 0 points. These children are in a deep asphyxia and need resuscitation. At the same time, 0 points indicates a stillbirth.

Actions after the baby's first breath

When the child cried out, it is necessary to separate him from the mother, that is, to bandage and cut the umbilical cord. The umbilical cord is treated with alcohol at a distance of 8-10 cm from the baby's umbilical ring, tied with a sterile thread from the baby's side and from the mother's side. Between the dressings, the umbilical cord is cut with sterile scissors and then treated with 5% iodine solution.

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 fashion trend, 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, should always be in touch, in the event of the onset of childbirth, come to the rescue, for this you must 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 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.

Home Birth Benefits

Annual statistics show an increase in the number of people willing to give birth at home. Apart 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 ease the load by taking any position, which cannot be said about the hospital ward. Connected to the sensors, often with a dropper, a woman 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 giving birth 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 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 the occurrence of unforeseen circumstances (suddenly opened bleeding, entanglement with the umbilical cord, rapid birth), 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 point, 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 such, 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 labor. 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 child. 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 bowel function;
  • 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:

  • craniocerebral trauma 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.

To begin with, the maternity hospital, which is across the street from us, was closed for the car wash just on my PDD (estimated date of birth), and I wanted to give birth under a contract. We talked with the maternity hospital, they sent us, saying: "Suddenly you will not be in time before closing." And I was firmly convinced that we would be in time. Not in time in the end, women's instinct is not always reliable.

At the 38th week, they sent me to be saved from the LCD to our maternity hospital. Low water. They did not confirm, but said that the child is very small for this period. And, perhaps, it is necessary to deliver and feed outside the mother ... Barely fought back. I asked to do an ultrasound scan again - and - oh, a miracle! - the child “grew up” by 500 g. Girls, always double-check the analyzes, if suddenly something! They let me go for a walk.

Then we went to another hospital, consulted with a good doctor. She looked again at the ultrasound scan, did CTG and let her go until April 2. She said to drink vitamins and increase the mass of the child. On April 2, they were sent to KTG, released until April 9, if it does not start earlier. To celebrate, April 2 was celebrated in a cafe. I feed the child. There were no special harbingers. Although sometimes it caught, and the baby sat very low at the end.

Childbirth story: here it is ...

On April 5, I wake up at 8:30 am and understand that “this is it”: I can feel the contractions directly. But at first I don't understand what the gap is. Well, maybe about 5-7 minutes. I woke up my husband, began to get ready and cook porridge for my daughter, called the doctor and parents to come. Already started to really grab so that it hooked right in the fight.

I decided to go to the shower to wash. This was the wrong decision. Since in the shower it became very strong to grasp in a minute. I realized that I had to go to the hospital urgently. I shout to my husband to call an ambulance. He called an obstetric ambulance. I also scream for him to get me out of the bath - I myself can no longer. And at this moment I understand that now there will be childbirth itself! I started pushing straight, and the contractions are very strong, and I can't even breathe them ... Then I was very scared. My husband somehow pulled me “ashore” - into the room on the bed in which my mother gave birth (that is, in a towel). The elder child is spinning around us, does not understand what the matter is ...

Subconsciously, I already realized that I was giving birth at home, but what should I do in this situation? We did not prepare for home birth. And most importantly, I was afraid that the bubble might not burst - the first time it was pierced to me. You don't worry too much about yourself, but yes about your child. I ask the ambulance to arrive as early as possible.

Home birth: on-site assistance

The doorbell rings, a young paramedic stands on the threshold. Asks why I don’t dress.

- I can not! - I say through the blanket, which I clenched between my teeth, and lie on the bed. She looked and realized that the bubble was already coming!

- Oh, don’t push, don’t push!

Hands are shaking, the midwife is dialing the phone from the usual ambulance. Consults on how to give birth ... Sent her husband downstairs for a delivery package. My husband runs in shock, as he realized that I was already giving birth. And I relaxed a little that at least some kind of doctor is already there. After a couple of contractions, I realized that I could not help pushing, and literally in one push the head came out, then the body.

Time 9:50 - less than 1.5 hours from the beginning of the contractions ... They put the baby on her stomach, quacking. Ufff, everything seems to be nothing. Somehow the umbilical cord was cut. Then the mother-in-law came first, the eldest daughter took over, although she also needed water when she found out that another granddaughter had already been born.

Then the midwife arrived with an ambulance. We did procedures with the child, made me scream properly, and wrapped me in a diaper. I then tried to give a breast, but at first she did not really understand.

Late visit to the hospital

The afterbirth does not come out. I'm not so pushy anymore. In short, they dressed me, took the bags, they put me on a stretcher, they wrapped the baby with a blanket and went to the hospital. Not the one with whom the contract is (although also close). The contractions are still going on, the ambulance is driving over bumps - not a very pleasant sensation.

We arrived at the hospital, they are no longer in a hurry, they walk around, fill it up. The child is in her arms. While they were filling, the afterbirth came out, they pressed on the stomach on the contraction and everything is in order. And then I thought that they would clean.

Then everything is as it should be: they looked at the chair, made one seam - the edge of the seam left after the first birth was torn. We looked at the baby - 2930 g, 46 cm - so they were worried about the ultrasound scan about the low weight, they calculate the weight by height, as I understand it.

Now in the family we call baby Rocket.

I lay in the corridor almost until the evening, as there was some kind of influx of women in labor. Almost everyone is now given oxytocin after childbirth to contract the uterus - this is cruel, since the uterus is already contracting.

And the money for the contract was returned. Less procedures.

Drawing conclusions

Total: the second birth is much faster and much more painful. The first 5 hours in 2013 went on, but I fought the contractions almost all night and at first did not understand that it was them. And this time in the evening there was nothing foreshadowing, and in the morning it suddenly and swiftly began and went. It's pretty scary to give birth at home without full medical care. So, multiparous, remember that if the first birth is fast enough, then the second can be even faster.

Specialist comments

Elizaveta Novoselova, obstetrician-gynecologist, Moscow

Many of us have heard about childbirth, which took place in a few hours, as in the story of our heroine. For expectant mothers, such a story about childbirth is often perceived with enthusiasm and arouses poorly concealed envy: some lucky woman "was tortured" in just 1.5 hours! However, in fact, you should not be jealous: such a quickly passed childbirth often negatively affects the condition of the young mother and the health of the newborn. The result of "haste" can be severe ruptures of the birth canal, massive uterine bleeding and, worst of all, serious complications for the baby, sometimes remaining for life, and sometimes life-threatening. This is not surprising: after all, fast and impetuous labor is a complication that develops as a result of a violation of the normal regulation of labor. And although the story told by Ksenia has a happy ending, her worries were well founded.

The first labor, which proceeds without complications and medical stimulation, lasts on average about 11-12 hours. Of this time, about 8-9 hours is spent on the opening of the cervix, no more than 2 hours - for the period of expulsion of the fetus and no more than 30 minutes - for the birth of the placenta. Rebirths may be faster, especially if less than three years have passed since the first birth. However, even more intensive repeated labor usually lasts 5-7 hours.

Rapid labor is labor that lasts from 5 to 7 hours in a woman giving birth for the first time, or from 3 to 5 hours in a woman giving birth again. Rapid labor in primiparous lasts less than 5 hours, with repeated births - less than 3 hours. Such a high rate of the birth process is provided by excessively strong and frequent contractions of the uterus, significantly exceeding the natural resistance of the tissues of the birth canal. As a result of this "birth pressure", the fetus is literally pushed out of the mother's body, not having time to adapt to the abruptly changing environmental conditions and leaving significant destruction in the mother's birth canal.

When the contractions began to intensify, Ksenia decided to go to the shower, but soon realized that this was the wrong decision. Warm water not only reduces pain from a contraction, but also stimulates blood circulation, which, with a tendency towards a rapid course of labor, can only speed up the process. The threat of too rapid development of labor can be suspected when, in the first 20-30 minutes, the frequency of contractions obviously increases. For example, with normal dynamics of labor activity, the first contractions last about 10 seconds, interspersed with an interval of at least 20 minutes, and the pause will shorten to 15 minutes after 1–1.5 hours. With the "accelerated version", within half an hour from the moment of the first contraction, the interval will be reduced to 4–5 minutes, while the intensity of the contractions themselves will noticeably increase. It is this version of the change in sensations that Ksenia describes.

The narrator was misled by the absence of pain during labor: she involuntarily compared her feelings with the beginning of the first birth and thought that it was too early to leave for the hospital. The absence of pain during labor can be explained by the good extensibility of the tissues of the cervix and the birth canal, the high threshold of pain sensitivity and the good psycho-emotional readiness for childbirth of our heroine. In addition, during the entire process, Xenia had a whole fetal bladder - this is also a powerful factor in protecting against pain, both for the woman in labor and for the fetus. During contractions, the elastic fetal bladder, filled with water, acts as a universal shock absorber, protecting the fetus from excessive pressure from the walls of the uterus, the cervix from the direct pressure of the fetal head, and the woman in labor from pain.

After taking a shower, Oksana realized that she would have to give birth at home, and did not know what to do, since she was not preparing for a “home” birth. What about the expectant mother herself and her loved ones if childbirth takes place outside the walls of a medical facility - in an apartment, on vacation, or even on the road?

If the period of contractions was short, you did not have time to understand that it was childbirth, or to get to the hospital, you had a desire to push, the "finest hour" of the future dad or another person who is at this moment next to the woman in labor is coming. And the first thing to do is call an ambulance! At the same time, when making a call, you should tell in detail everything about the woman in labor, using your own knowledge and an exchange card. Be sure to clarify how old she is, how long she is, what kind of pregnancy / childbirth it is for a woman, how this pregnancy proceeded (if there were serious complications, you should mention this), when and how labor activity began (water departed, contractions began) ... You should also calmly and sensibly explain how to get to the place where you are. While the medics get to you, you can receive the necessary advice and guidance from them by phone.

Then you need to help the woman in labor to take a comfortable position. It will be better if the woman lies on her side or half-sitting half-sitting with her back against the wall, high headboard, car seat, a roll of blankets. You can undress completely or take off your clothes below the waist. Place the cleanest cloth or piece of clothing you have underneath your lower body. While the contractions are going on, effectively massage the back in the sacrum area, the inner thighs, the protrusions of the pelvic bones in the right and left iliac region - these techniques are distracting and help to better endure pain. Watch your breathing: during a fight, you should breathe shallowly with your mouth wide open, and between contractions it is better to breathe as calmly and relaxed as possible. You can moisten your face, rinse your mouth (you should not drink with the rapid development of childbirth). Call specialists and consult how and how you can help the woman in labor, depending on her feelings.

As soon as the paramedic arrived in time looked at the woman in labor, she realized that a bubble was already coming. Ksenia mentions that she was very worried about the fetal bladder that did not burst in time, because she remembered that in the first birth in a similar situation, doctors pierced it. It should be noted that during childbirth, the fetal bladder performs important functions. At the beginning of labor, for most of the first period, the fetal bladder, filled with amniotic fluid, presses on the cervix. During the contraction, due to its elasticity, it bulges into the lumen of the hole in the neck, increasing its opening. In the physiological (normal, natural) course of labor, the fetal bladder ruptures with full or almost complete (5-6 cm) dilatation of the cervix. With such a timely rupture of the membranes, the baby is without water a little longer than the period of perspiration lasts. Timely rupture of the membranes not only contributes to the normal smoothing and dilation of the cervix, but also preserves the most favorable conditions for the fetus during labor. In the presence of amniotic fluid and a whole fetal bladder, the baby feels comfortable, he is protected from infection and excessive pressure from the contracting uterus, the blood flow in the vessels of the uterus, placenta and umbilical cord does not suffer, and the process of cervical dilatation proceeds safely. However, if at the beginning of the attempts the fetal bladder still remains intact, it is invariably "pierced" (an amniotomy is performed) so that the dense wall of the bladder and the fetal waters do not prevent the baby from taking the first independent breath.

Ksenia writes that she was pushing “wrong”, so the afterbirth did not come out for a long time. We are talking about the successive period - this is how obstetrics is called the third stage of labor, when everything that remains in the uterus after the fetus is born - the afterbirth. The concept of the placenta includes a child's place (placenta), the remnants of the membranes (walls of the fetal bladder) and the umbilical cord. This period is the shortest and most imperceptible for a woman in labor. It usually lasts several minutes and is accompanied by one contraction. However, after a rapid birth, the separation of the placenta is sometimes delayed, since the entire supply of oxytocin, a hormone that controls the contraction of the uterus, is spent on the rapid birth of a baby. This is exactly what happened in the case of our heroine. A delay in the placenta in the uterus or birth canal can cause postpartum hemorrhage, so the ambulance team promptly delivered Ksenia to the nearest maternity hospital to provide qualified obstetric care. Fortunately, she was not needed: soon upon arrival at the maternity hospital, the afterbirth safely separated itself.

At the end of the story, Ksenia warns her readers: if the first birth was fast enough, the second birth can be even faster. And she's absolutely right; moreover, the very fact of repeated childbirth with a short interval may be a predisposing factor for the rapid or even rapid development of labor. How not to miss the signs of "acceleration"? Rapid labor is characterized by a “stormy start”. In this case, the very first contractions are painful, prolonged and too frequent. If contractions immediately cause a high degree of discomfort and are separated from each other by a pause of 10 minutes or less, you should go to the nearest maternity hospital immediately! The sooner the expectant mother and baby are under the supervision of doctors, the more chances there are to correct labor and avoid complications.

In the case of the development of rapid and rapid labor, therapeutic measures are aimed at reducing the intensity of labor, that is, reducing and reducing contractions. In the admission department, the expectant mother is put on a gurney; getting up and walking is forbidden. A cleansing enema is not done when diagnosing rapid labor, since this procedure has a rhodostimulating effect. The woman in labor on a gurney is taken to the maternity ward and transferred to the bed, placing it on the side opposite to the position of the baby's back. This position of the woman in labor lengthens the time of childbirth as much as possible. Childbirth is also accepted in this position.

According to a large-scale study that was conducted in the United States in 2000, maternal and child mortality during planned births at home in women of low obstetric risk in the presence of trained personnel does not exceed those for childbirth in maternity hospitals.

It would seem that Russian adherents of home childbirth can enthusiastically exclaim "We told you so!" However, the reality is not so straightforward.

This article is addressed, first of all, to those who have already heard many positive reviews about home birth and are ready to take this step. On the Internet, disputes between supporters and opponents of the birth of a new family member, not in the "state house", but in their own, do not subside. Consider a number of arguments from both discussion groups.

The first illusion. Conscious choice

In some courses on preparing for childbirth and motherhood, the idea of ​​giving birth at home is presented as the result of a "deliberate choice" of serious and educated people who feel responsible for the well-being of their unborn child. At the same time, they offer to realize and choose based on the information provided by the teachers of these courses. Friends, neighbors, and online acquaintances also love to share positive experiences of home delivery with parents-to-be.

It usually tells about the successful long-term practice of giving birth outside the hospital both by Western specialists and their Russian followers, about the safety of the natural process of childbirth for the mother and baby, especially with excellent preparation of the pregnant woman, about the senseless and harmful procedures that the mother and her child undergo in the maternity hospital ... All of the above sounds reasonable and quite similar to the truth. However, it is also necessary to provide a list of notes with which the expectant mother and her husband are usually forgotten. But, as you know, only a person who possesses the most complete information, preferably gleaned from several sources, can make a deliberate decision.

Subsequently, if something goes wrong in childbirth, the unhappy parents say: "We did not know that this happens." I suppose it is inappropriate to say that they "deliberately chose something themselves" in this case.

The second illusion. Absolute naturalness

There is no doubt that the act of birth is a remarkably well thought out physiological process by nature. A normally proceeding childbirth does not require outside intervention, anyone can accept them: even a psychologist, even a plumber.

Strictly speaking, they may not be accepted at all. Professional assistance in childbirth is, for the most part, required for the prevention, early recognition and treatment of complications. Even without the participation of a midwife and a doctor, the baby will still be born. Only the likelihood of giving birth to a child "without consequences" in the absence of people who understand this is less.

For 40,000 years of human existence on Earth, women have successfully coped with the task of maintaining and increasing the size of the human population. As a result of natural selection, the weak perished, while those more adapted to existence in our world survived and passed on their genes to their offspring. Evolution sifted out not only those who could not distinguish an edible root from a poisonous one, were unable to keep warm in the fierce winter or fight off a saber-toothed tiger. She also got rid of individuals in whose delivery process there were some failures. As a result, "bad" heredity was not passed on to descendants, and the human race as a whole became healthier.

This continued until people were concerned about reducing the number of unsuccessful childbirth outcomes and did not come up with obstetrics in its various versions. Much later, they managed to achieve noticeable success in the field of neonatal resuscitation. These achievements allowed those who would have been condemned to death by the cruel mechanism of natural selection - and now their genes are among ours.

Refusing adequate obstetric care, the woman in labor remains completely at the mercy of the laws of nature - both wise and ruthless. Many supporters of home childbirth argue that this is exactly what they want, this is the only way they can feel themselves as the Mother, the source of new life, the most important participant in the historical process of the generational change, the quintessence of the Creator's plan or someone else. Unfortunately, from time to time, childbirth is not at all ideal. And the consequences in this case are spoken of as a tragedy, and not as a natural outcome. Which is strange. The natural process is natural selection.

Illusion three. Spiritual and non-spiritual obstetrics

People who are ready to give birth at home can be divided into several groups.

1. Professional midwives. They can only have obstetric education (secondary); obstetric education and higher education in another specialty (for example, psychology); medical education and an international certificate giving the right to obstetric care outside the hospital; foreign midwife diploma. The listed specialists are probably the only people whose right to give birth at home in the conditions of Russian reality can be discussed. We can agree that they probably have the necessary knowledge and skills, are able to assess the risk of complications, they will not undertake a home birth in a woman, if the risk is high, they will be able to distinguish the normal course of labor from the pathological one in time, in a critical situation they will provide all the help that in principle they can. (Unfortunately, a real obstetric disaster "alone in an open field" cannot be dealt with.)

However, childbirth outside the maternity hospital in Russia for some reason is not allowed and not welcomed by the state, no licenses are issued to carry it out. Why so - more on that later.

2. The second group is either physicians without special obstetric education, or not physicians at all. They proclaim childbirth as a completely natural act, "not a disease", mockingly ask, "Will you conceive in the hospital too?" - and regularly successfully help women in labor. Everything goes great until idealistic ideas collide with real life: it is impossible to reliably predict how childbirth will go even in a perfectly healthy woman.

3. The "midwives of the 21st century" deserve special mention. They regard their activities as adherence to Orthodox traditions, a godly deed, almost asceticism; they say that sincere faith will protect a woman in labor and her child from danger. For those who agree with the statement "God gave - God took" home birth with them is ideal.

4. A fashionable phenomenon with the stylish name "Solo Childbirth"(that is, without the participation of a midwife at all), does not stand up to criticism at all. The woman in labor herself, her husband-engineer and mother-economist may not even understand that the safety of the mother and her child is at risk.

Why does anyone give birth at home at all? Because there is a demand for it.

Where does it come from?

A hospital stay imposes a number of restrictions on a woman that not everyone wants to put up with. In addition, the current maternity hospital is not ideal, obstetrics is not an exact science, and the obstetrician-gynecologist is not God.

Remembering the bad or unpleasant experience of interaction with official medicine, some are ready to completely abandon professional help and get in return ... even less professional. But all the fantasies about your own sofa, your favorite bath and an affectionate highly spiritual midwife next to you will be brought to life. Most. The minority will turn out to be the "weak link" and will be out of the game forever. But there is no need to talk about this, so as not to spoil the holiday for others.

Even today there are non-silver obstetricians, they sincerely believe that they are doing a good deed, and are ready to do this good for free. There are "psychologists" for whom it is important to provide a woman with an opportunity to choose, to provide her with mental comfort, if she claims that she would not feel confident and calm in the hospital; their material reward attracts less moral satisfaction. There are simply prudent people who know that, in principle, a healthy woman should have a good birth without any intervention. They say whatever they want and take a lot of ordinary paper money for their work.

Of all the listed options, no one's actions can be called professional or combined with the concept of "spirituality". No one is able to help their charges in case of real danger. Nobody is responsible for anything.

Home births do not officially exist, which means that no one accepts them, they are only "present". Feel the difference.

In the case of a successful birth, the young mother and her family do not think about it, and in the case of unsuccessful ones, it is too late to think. When a child appeared after thirty hours of labor in deep hypoxia, they were "rescued" with two hands: without equipment, but with spells and prayers. If it didn’t work out, then my mother did not prepare well for childbirth, didn’t believe strongly in God, behaved incorrectly, didn’t think about the baby and didn’t want to give birth at home at all. You are the one to blame.

Overconfidence, naivety or greed of domestic midwives, frivolity and gullibility of future parents, going to extremes instead of looking for a compromise have repeatedly led to trouble. But there is no end in sight.

Illusion four. "Ambulance" at the entrance

When discussing the problems of home childbirth, the idea is constantly expressed to put on duty under the windows of the apartment where the woman in labor is located, an ambulance car with a team of obstetricians-gynecologists, resuscitators, neonatologists, an operating room, blood of the right group, an incubator for a newborn, a ventilator and other achievements civilization. It is assumed that, if necessary, this can save time for calling an ambulance and her arrival. The idea is sound, but, nevertheless, it is almost impossible to implement it.

First, the legal status of the doctors on duty is not clear. They are waiting for the midwife to come and say: "I can't do it, let’s you now"? That is, the emergency obstetric aid team is connected only in case of problems and does not participate in any earlier events. Then it is difficult to share legal responsibility. Who was wrong: The midwife asked for help late or the help was not provided quickly enough. Or do the midwife and a special ambulance team work together, pretending to be a maternity hospital at home? Then how is this different from a regular maternity hospital? All this, at the very least, would be prohibitively expensive, and in the case of an operating room on wheels, it would also not be very hygienic.

Secondly, in fact, there are no such super-equipped machines and multi-armed brigades. There are state and private ambulance teams of various profiles. To meet the needs of a critical obstetric situation, you will need at least two of them: adult and pediatric intensive care. Putting them on duty for many hours is again very expensive, and it is impossible to leave the city without them. At the same time, they still cannot solve the main problem - the extremely urgent delivery of a woman in labor to the operating room.

Obstetrics is unpredictable, complications develop rapidly and may require prompt surgery or the help of a resuscitator, including a neonatologist resuscitator - a specialist in newborns. Even from the delivery room, a woman may not be able to get to the operating room behind the wall in time. Premature can lead to the death of the fetus in a few minutes, massive uterine bleeding in the third stage of labor just as quickly leads to shock and death.

A midwife in Holland, which is so often mentioned by fans of home births, is confident that a woman who has confided in her will be on the operating table within 15 minutes (maximum!) In case of complications. The famous obstetrician-gynecologist Michel Auden says that for any, even a favorable birth, surgical assistance should be within 20 minutes. Domestic experts insist that in critical situations, minutes are counted and counting on 15-20 minutes of "time reserve" is an impermissible luxury.

In St. Petersburg and other cities of Russia, such efficiency is almost unbelievable. Count on it rashly. A domestic midwife in Russia can promise: “If something goes wrong, we will call an ambulance, and everything will be okay. She will even call her, but there is no reason to guarantee this okay. a real situation or an unscrupulous person will talk about the availability of really fast professional obstetric care in our country.

15 minutes is the norm for the St. Petersburg ambulance to arrive at the place of the call. But it is not always possible to meet this norm. Unlike Holland, other European countries, the USA and Canada, we have almost no separate lanes for cars with special signals. Car enthusiasts do not scatter in different directions when they hear a siren. How long it will take to get first to the patient and then to the nearest maternity hospital depends on the traffic situation. And even if the "ambulance" was at the entrance, this journey could easily turn out to be "a lifelong road".

The idea of ​​driving your own car is also not good: similar transport problems; on the way, no assistance is provided to the woman and the child (for example, when the mother has bleeding, intravenous administration of special solutions is indicated; in case of respiratory disorders in the child, a ventilator is needed); the staff of the maternity hospital does not know about your imminent arrival and does not prepare for it.

It turns out that either you still need to be able to deploy an operating room right under the door of your own apartment, or ... not play childbirth at home.

The fifth illusion. Dungeons of the Inquisition

It seems that trying to protect the expectant mother and her child from possible troubles as much as possible, the organizers of the traditional system of obstetric care overdid it a little. The prospect of being alone in a white-tile maternity ward was depressing for many, and for some it terrified. It is not surprising that alternative schools and teachings arose and multiplied; they talked about the birth of a new person as an infinitely joyful process that does not pose a threat and does not require precautions. Therefore, it can happen anywhere at the request of a pregnant woman and her family. "Problems happen only in the hospital," said the adherents of such teachings.

The truth, as usual, is somewhere in between. Many modern maternity hospitals are actively striving to reach this ideal middle, allowing the presence of any close people at childbirth, taking care of the fearless surroundings of the maternity ward, reducing the total number of obstetric manipulations. "Operating room delivery" is likely to gradually evolve into "suite delivery" or something similar. Optimally, a woman during pregnancy and in the postpartum period should be monitored by the same doctor and midwife who are giving birth to her. Now the terms of stay in the hospital are being revised: they want to reduce the recommended five days to three.

All these changes are not capable of bringing ardent supporters of obstetrics into the hospital. They sincerely believe that it is the maternity hospital that is the focus of evil, it is there that all perinatal problems arise. The corresponding Internet resources are full of similar statements. It is difficult to argue with a woman who suffered in the hospital or lost a child there, and then gave birth perfectly in her own bath. She won't listen. It's hard to talk to people who say it's safer to give birth at home because they did a great job. They do not want to know about other people's problems, rejoicing in the absence of their own. This is an amazing community of "not believers in bad". Unfortunately, denying the bad does not completely destroy it. And it is just as difficult to learn new stories of home births in which a mother or her child suffered.

Modernization of the way of ordinary maternity hospitals makes the statements "Don't go there, it's creepy there: the child will be taken out with forceps, then dropped on the floor, but you will still be given a caesarean!" The smaller the difference between the images of the home room and the hospital ward, the more people will listen not to the enthusiastic exclamations of fanatics, but to their own inner voice. The decision they will make on the basis of real information, rationally weighing the advantages and disadvantages of both types of childbirth, and will be as close as possible to the idea of ​​"informed choice".

By the way, why do many women give birth outside the hospital really well? Because they take them seriously and prepare diligently. The maternity hospital will accept everyone: the sick, the busy, the lazy. Home midwives still try to observe their potential women in labor, help them better prepare for childbirth, both physically and psychologically, support, set them up for a successful outcome. That is, they carry out the work of a doctor in an antenatal clinic, overloaded with a stream of suffering.

In general, a strange situation has developed in Russia: if in third world countries home birth is the lot of the poor who are unable to pay for their stay in a special medical institution, then in our country it is almost a sign of security, good education, and elite status.

In the very idea of ​​a Russian birth at home, I am not depressed by the fact that there are such special people who want to see their child for the first time in the circle of the light of the hearth. This is their right - the right to life and the right to die. The "fashionable trend" scares me: giving birth at home is exclusive, non-standard, "for the elite." And the flocks of "others" living on forums and communities attract new members to their ranks. Consequently, the number of unsuccessful childbirth outcomes increases.

It is difficult for traditional medicine representatives to understand why seemingly reasonable people interested in having a healthy child are looking for a spiritual midwife. Why can't you find an intelligent, benevolent doctor who you want to trust in nine months of pregnancy and choose a good maternity hospital? Stop subconsciously tying yourself to the image of your apartment and prepare for childbirth in such a way as to concentrate not on the outside world, but on the inside? Why is the pursuit of personal comfort, bordering on whim, more valuable than the life and well-being of a little person? Because a group of "killers in white coats" will harm him, and one midwife will help?

Conclusion

So, what is the difference between home births in developed countries and Russian ones so radically?

Western researchers say childbirth at home is safe; but not just like that, but under the following conditions:

  1. surveyed pregnant women of low obstetric risk (assessed by persons with medical education and specialization in obstetrics);
  2. delivery on time,
  3. the child is not expected to have problems;
  4. trained medical personnel present;
  5. everything happens in developed countries, where the emergency medical service works perfectly, there are free teams and a free road - the time of delivery of a woman in labor to an obstetric hospital will not exceed 15 minutes.

In our country:

  1. any woman dissatisfied with official medicine can find an assistant for an alternative, "non-birthplace" delivery. Moreover, the more serious her obstetric and gynecological problems, the greater the measure of irresponsibility inherent in her soulless obstetrician;
  2. childbirth of any period. Although "normal time" is really a relative concept and varies in a number of countries;
  3. since "ultrasound is harmful to do", the condition of the fetus was assessed as best they could;
  4. about who is taken to deliver at home, mentioned earlier;
  5. if necessary, truly fast delivery of home birth participants to the maternity hospital is unlikely.

That is, home birth in Russia and in the West are two completely different phenomena. Even if we legalize them here, issue certificates and licenses to certified specialists, settle legal issues - this will not solve the problem of emergency teleportation to the hospital from an apartment, from a summer residence, from the seashore or the edge of a forest.

It won't solve it.

The inaccessibility of the necessary assistance in a reasonable time makes us perceive childbirth at home not as a successful economically profitable model, but as a game of Russian obstetric roulette. Under the current state of affairs, it is impossible to permit such activity at the state level: people would consider it safe - but this is not true.

Maria Maksimenkoambulance doctor

Discussion

I would not think about home birth if there were many factors present in maternity hospitals. Read about the natural physiology of childbirth and compare with how it happens in the hospital and then we will discuss those who decide to go home!
An alternative that suits everyone is to take with you a midwife whom you trust and / or a doula, a partner (husband or sister) for giving birth to the hospital. And to organize a "soft home birth" in a maternity hospital so that everyone and the public would be calmer and no one censured the mother. Great idea! But. Do you know that in this case you will have to pay for the contract in the RD yet? maybe they won't let anyone in and won't let anyone do anything! Otelnyts boxing for childbirth according to the Oms is not provided by anyone and the presence of outsiders is a violation of the rights of the giving birth neighbor. That is, for Moscow, in this case, the amount of the contract in an ordinary maternity hospital is 100-130 thousand for an ordinary hospital delivery only in a separate ward and whoever needs to be allowed to you
in fact, more often than not, the grandfather's team still accepts and no special attitude NO + services of a doula and a midwife. And it turns out for many an unbearable amount! 180 thousand for calm physiological childbirth. So that's it.
The article is one-sided and the author is completely unaware of the problems of traditional medical intervention in childbirth (as they do it more conveniently), services and their cost in maternity hospitals.
I have a familiar family there; my husband is an anesthesiologist. His wife gave birth to both children (after 30 years by the way) at home with a midwife. And everything went great. And this is a conscious HIM and her position

07/21/2018 10:15:21 AM, Ko_A

I support the author. Thank you for the article. However, I will note that in the hospital I personally really lacked the support of a person I trust. In the comments they wrote about a contracted midwife, I support this idea. Doctors are different, but I am inclined to believe that there are more good people than bad.

Girls, my husband did not let me give birth at home, he was scared for me. But, fortunately, we found a compromise, giving birth in a midwife from the CTA, that's how I would be in the hospital, but no one bothers me. And again, specialists in case of "suddenly" are all nearby. It seems to me optimal, I did not regret it at all, perhaps it was precisely this calmness that I lacked. Easy childbirth)

And so what we have - Maria, an ambulance doctor, like wrote an article while sitting in the kitchen! I pulled the boogers out of my nose and smeared them on the table. Marya, figures and facts, names and surnames, in the studio!

02/21/2013 09:34:41, Katya

In America, home births are officially safer than normal births for both mother and baby. True, statistics are not fair. Home births are of 2 types, planned (these are safer than a hospital), and according to the principle "it happened" (with an understandable outcome). Further, healthy women in labor are selected for the planned home birth, midwives will not take on difficult cases. It is clear that the overall statistics for such genera are positive. What does this have to do with Russia? Yes, no.

I am not calling for home birth in Russia. Home births can be very safe if organized correctly. And if you find crooked midwives or doctors ... then, of course, God forbid. Both at home and in the hospital ... it all depends on the doctor ... oddly enough.

04/18/2012 09:47:08, masha__usa

04/18/2012 09:43:35 AM, masha__usa

But it only seems to me that doctors have a "selfish" interest in prohibiting home birth? It's like asking a pill maker about herbal infusions ... will give you a lot of nightmares ... because his business is built on pills, not herbs.

04/18/2012 09:34:09 am, masha__usa

To give birth at home or not at home is a secondary question. The main thing is the qualifications of the person taking birth, as well as the qualifications of specialists who assess the condition of a pregnant woman and her unborn child before childbirth. In Russia, both with those and with other specialists, in my opinion, there are HUGE problems, so the risk of getting into unskilled specialists, wherever you give birth, is huge. In my opinion, the most important thing for a successful pregnancy and childbirth is to find these very specialists (according to recommendations, articles, reviews, etc.) + in any case, find a maternity hospital that has everything you need in case of emergency to save both the mother and and a newborn. Personally, I would not give birth at home, although my experience of childbirth at the Central Pedagogical Service of Russia on a paid basis is not the most successful, but not terrifying either. I believe that the safest way of giving birth is in the maternity hospital, but this maternity hospital should be chosen in advance, the doctor should be chosen in advance, and most importantly, the presence of the husband (or any other relative / paid assistant) at the birth for help and safety net. as well as at least some general awareness of the mother on the topic of childbirth (including about + and - natural childbirth). All these measures reduce the percentage of risk and complications in both the child and the mother, but they, of course, do not guarantee anything 100%. Everyone already knows the disadvantages of Russian maternity hospitals. Therefore, a smart mother should take these disadvantages into account and deal with them at least somehow - be careful, not allow yourself to inject everything, find the strength to give up anesthesia, not allow doctors to tear the bubble with their hands, not allow to stimulate labor, not allow themselves to be left without attention alone and so on. etc. That is why the presence of a second loved one at childbirth, in my opinion, is simply necessary, because a woman in labor, due to her physical and mental state, simply cannot follow everything, and in Russia, unfortunately, you have to FOLLOW it! The worst thing is that our doctors do not have personal responsibility for mistakes, and therefore doctors, who make mistakes many times because of their immorality and because of their unskilledness, find themselves on an equal footing with moral and qualified doctors. Unfortunately, on their faces it is not written what they are - good or bad, so choosing a doctor is a very difficult matter. I personally see the only opportunity - to reduce risks by foreseeing everything. It is completely impossible to get rid of risks. The fact that in Russia the risks are higher than in the West is also a given, which so far we, ordinary people, cannot change in any way. Nevertheless, giving birth at home in Holland, in case of complications, you will be taken to the Dutch maternity hospital, and with us - to a completely random RUSSIAN attendant. I advise you to think about this brave mothers giving birth at home in Russia.

I have never been a fan of childbirth at home, but recently she has changed her views. A new employee-mother appeared at work, who gave birth to three children at home, and I gradually moved from skepticism and condemnation to understanding. And the children struck her. I just forgot when I saw such children at all. Neither I, nor my closest relatives and girlfriends have such. Calm, obedient children, absolutely healthy, both mentally and physically. They did not have childhood colic, no waking at night or regurgitation. I am silent about tiptoeing and Zpry, which is common for all the children I know. There is nothing of the kind - the consequences of hypoxia - that's what struck me. At first it seemed to me that this simply does not happen, but now I see that it is ...
I remember my childbirth, why was it caused when the doctors wanted it, then for a long time not healing episodes, why ??? only torn more .. and black hands from droppers, then the fight against staphylococcus rhd with varying success throughout the year, sleepless nights, increased ICP, endless visits to doctors ... a lot of wasted nerves, money, time ... Now there is still a lot problems. I see clearly that this is a consequence of what is called active management of labor or programmed-induced labor. I remember how the doctor in the last childbirth sweetly convinced me to agree to stimulation by the fact that the child suffers - with excellent health and analysis, with excellent CTG? just on ultrasound at 38 weeks - the old placenta. What is her old age? -Maybe you just needed to harvest me faster before washing and get your money? When I later asked the doctors I knew, I understood unequivocally that it was just a divorce for childbirth. The placenta does not age at 38 weeks, and at 42-43 weeks it does age in 0.5 percent of cases. I hate myself when I remember that after they smeared and after a while pierced the bubble, the child began to choke, as if he began to choke, and "ran on the ceiling" for almost an hour, then they began to save by connecting the system with oxytocin ... I felt that he felt bad. But everything was forgotten after birth, all the same hormones and maternal love for a newborn overlap everything and therefore mothers, forgetting about medical harm, dissolve in the child, and doctors continue their routine pipeline stimulation. These are not the dungeons of the Inquisition, these are often just strangers indifferent people for whom it is important to get a living fruit, or rather to extract the fruit, the honest words of a familiar doctor. Even good doctors who are well aware of the harms of interventions cannot violate the protocol. Honestly, looking back, I made an unambiguous conclusion for myself, if I still decide on pregnancy and it will be fine, as always, and there will be no contraindications, I will give birth only at home with a professional midwife who will not pin up and grease, but will simply insure me. I don’t believe that in expensive centers they DO NOT INTERFERE at all, friends at the highest level had mostly politeness and conditions, and they also routinely induced and stimulated, maybe only in smaller volumes.

I do not understand the article at all, assuming that the author is impartial and tries to consider the pros and cons. Everything becomes clear if we assume that the article is ordered.

“However, it is also necessary to provide a list of notes, with which the expectant mother and her husband are usually forgotten. But, as you know, only a person who has the most complete information, preferably gleaned from several sources, can make a deliberate decision.
Subsequently, if something goes wrong in childbirth, the unhappy parents say: "We did not know that this happens." I suppose it is inappropriate to say that they "deliberately chose something themselves".

And where did the author get the idea that all people who take such a step - giving birth at home - are misinformed?
:))))))))))))))))
Do they ALL live in the forest? They don't have a TV or internet? Do they have no one to communicate with on this topic? Why are they talking about adults here as about babies ?!

"And the consequences in this case are spoken of as a tragedy, and not as a natural outcome. Which is strange."

There is no need to generalize, to lump everyone together again. I am personally horrified at how many, too many lazy and stupid individuals, humanoid, who have not been personally touched by natural selection. Natural selection will still take its toll, walking with a heavy paw through a too inert and stupid community, since it was not possible to kill individual individuals.

"Remembering the bad or unpleasant experience of interaction with official medicine, some are ready to completely abandon professional help and get in return ... even less professional."

This is the fault of the "health care" system, officials. And I'm not going to let everyone into a purely personal process. Doctors often do not understand that they are not dealing with the removal of an inflamed appendix, but with childbirth, which all relatives think about, with which there are many hopes, plans, emotions, feelings. I WANT TO CHOOSE A DOCTOR, CHOOSE the most acceptable delivery option. THERE ARE NO OPTIONS in Erefia. This is the whole problem! Why should the brain be powdered with someone's ignorance, someone's illusions about the spirituality of midwives, intimidation by natural selection ??? You'd better tell me straight out that we don't want to do anything, we don't want to strain your brain. The leakage of money from families with the legalization of childbirth at home, as in Holland, is also not a reason to write such articles. The money will remain, the principle of work will change.

“It is assumed that, if necessary, it is possible to save time for calling an ambulance and its arrival. The idea is sound, but, nevertheless, it is practically impossible to implement it.
First, the legal status of the doctors on duty is not clear. They are waiting for the midwife to come and say: "I can't do it, let’s you now"? That is, the emergency obstetric aid team is connected only in case of problems and does not participate in any earlier events. Then it is difficult to share legal responsibility. "

So the legislators are to strain their convolutions and issue new correct laws. And these are not my problems. I don't have to think about it. An article about a stupid, intimidated man in the street who has never seen anything farther than his own yard.

"Even from the delivery room, a woman may not be able to get to the operating room behind the wall in time."

:)))))))))))))))))))))))))
Overdid it. We can, then let's stop giving birth altogether, since it is so unpredictable and dangerous.
And in the maternity hospital, if possible, they slow down, blunt with help. With all the capabilities of the maternity hospital, they commit medical errors and are not responsible for this. It is more difficult to punish them, to obtain compensation from a maternity hospital, than to punish a midwife without a license who delivered at home.

The article is very bad in that it judges one-sidedly about those who want to give birth at home. For example, I do not consider the maternity hospital a focus of evil: "They sincerely believe that it is the maternity hospital that is the focus of evil, it is there that all perinatal problems arise."
Again. For those who do not understand the difficult position in any way: 1. Childbirth is a complex process, physiologically and psychologically. 2. I do not want to admit bad specialists to physiology and vile personalities to the psychological side. If you get to the hospital with appendicitis, then that's physiology and that's it. Childbirth is also a sensitive psychological side. I don't want to allow dirty personalities, envious, stupid, rude, lazy bitches here, just bitches suffering from under-fucking.

"In general, a strange situation has developed in Russia: if in third world countries home birth is the lot of the poor who are unable to pay for their stay in a special medical institution, then in our country it is almost a sign of security, good education, and elitism."

:)))))))))))))))))))))))))))
In Russia, maternity hospitals first appeared for women walking. “In the Russian Empire, the first maternity hospital was created by decree of Tsar Nicholas II in 1897,“ ... so that women of easy virtue do not give birth on the streets. ”In those days, giving birth in a maternity hospital was a sign of poverty and ignorance. Women gave birth at home under the supervision of midwives. ". Wikipedia.

I agree with Alexey, if the ambulance doctor writes - her motives are not clear - why? If there are so many emotions after work, where are the real cases?
A custom article for money? A pregnant, vulnerable woman is easy to scare, so who scares more? Childbirth is the same intimate activity as conceiving a child, and the way it proceeds depends very much on the emotional mood. And a woman giving birth at home should be aware that this is her job, and a woman giving birth in a maternity hospital, rather, relies more on doctors. For example, attempts (my experience) - you need to decide on them, despite the fact that it hurts, and in the hospital you may not dare - the doctors will help. Although now this dispute between home birth and childbirth in the hospital is not so relevant - home births arose not as a whim, but as an alternative, it seems, 15 years ago. Now the maternity hospitals have changed a lot - and the child is not taken away immediately after giving birth and give birth as you want, even vertically, even into the water, etc. If everything in the hospital was cloudless, then who would refuse medical insurance?

I am amazed at the statistics in the maternity hospital:
in the Netherlands, the mortality rate is 2.5 per 1000 births,
in Russia - 13-17 per 1000 births (I saw different numbers in different places).
Those. the difference is 5-7 times !!!

Dear doctors! WHY 5 times more newborns die in our country than in Europe ???
WHY we have more infections than in Europe, despite strict hygiene requirements: visits are prohibited. And where allowed - then changeable shoes and a dressing gown are required. And in Europe they go to the rod block in street shoes - and nothing.

There are no normal statistics on home births at all!
What I saw about home births (though the sample was less than 1000) was the same 13 (per 1000 births).

there would be more such articles and stories, and preferably cases from life, maybe mommies would have grown wiser!

I have never written on this site, but here it just got through! AUTHOR, YOU ARE A GOOD MAN! The article is super! I really hope it will be posted on all sites about motherhood! The adherents of home births shout about how our grandmothers gave birth in the field, but no one hesitates to look at the statistics of the mortality of mothers and babies 100 years ago! and also how many of these children later lived to be 2 and 4 years old! Let's move on: why cut out the appendicitis? Where better to put plantain - a well-known folk remedy. It is more natural and no interference! Let's rely on a natural process .... and selection!

05/17/2011 08:53:25, Olshik - irrigation

When a woman begins to give birth not in a maternity hospital (and this happens, as a rule, unexpectedly), the main thing is not to faint from what he saw or heard, but to help the woman in labor. Everyone needs to know how to give birth. After all, you never know what can happen!

Our task is to explain the basic provisions of how to properly deliver at home. Let's look at the question in stages:

  1. When there are no contractions, this is not a sign that labor will begin soon. First of all, you need to call an ambulance or deliver a woman to the nearest maternity ward. If this is not possible, call the emergency services, which will give you instructions on how to give birth.
  2. It is necessary, first of all, to place the woman in labor in the most comfortable place and pose (half-sitting-reclining with an emphasis on something, or put on her side). Provide all additional conditions: undress the woman from the bottom to the waist, put a clean cloth under her (sheet, fabric). It is also important to limit the intake of annoying and distracting sounds and noises.
  3. It is important to remember that the rules for how to give birth include boiled or (at least) purified water, a solution of cotton swabs, gauze and bandage, clean clothes and linen for the newborn. It is necessary to have tools for working with the umbilical cord: sterilized scissors and a pipette, about 60 cm (separated by 20 cm), also sterilized heavy-duty sutures.
  4. When the process of contractions begins, it is important to psychologically support the woman in labor, as well as wipe her face with a damp swab, massage the lower back. The question of how to give birth also includes control of breathlessness: during the break between contractions, a woman must breathe deeply (with her mouth open).
  5. When the head appears (with the correct presentation, it comes out first), you need to hold it with your left hand (or your right, if you are left-handed), and with the other hand, free the baby's nose and mouth from mucus that prevents him from breathing in and screaming (this can be done with the help pipettes or syringes). If the fetal bladder covers the head, which can also make breathing difficult, it must be carefully torn apart without damaging the head. When you are around your neck, immediately remove it, like a scarf. It is forbidden to pull the child by yourself! The spine can be injured!
  6. When the baby is born, it is important to make sure that there is no obstacle to the ease of breathing. You can lightly pat him on the back or heels. When there is no breathing at all, you need to help the child get rid of the mucus that interferes with this. It is recommended to do it (you need to hold the child in the palm of your hand, the stomach is directed downward, the head is slightly lower than the level of the body).
  7. When the baby was born, it is necessary to wait a few minutes until the pulsation of the umbilical cord completely stops and cut it: make 2 tight knots (one near the baby's tummy, the second after 10 cm near the first), after which you need to cut exactly in the middle. The ends of the umbilical cord should be disinfected with iodine solution or alcohol. Then wrap with a sterile bandage.
  8. After this process, the instruction on how to give birth to a woman does not end. After that, wrap the baby in prepared clean linen and give it to the mother. After that, you need to wait for the placenta to exit. You can massage the abdomen with a towel, previously dipped in cold water. Do not pull on the umbilical cord: bleeding may occur. After leaving the placenta, it is better to put it in a plastic bag and give it to the doctor. Mom is then recommended warm tea and a hot water bottle with ice on the lower abdomen. So far, you can only sleep on your back.

Remember that it is not enough to know how to deliver. It must be remembered that you need to quickly deliver the baby to the hospital in order to eliminate the risk of all kinds of infections. The same goes for the mother!