That ended the last week of waiting. Fights begin. The culmination moment of the whole pregnancy comes – a few more hours, and you will see your baby. Of course, you will worry and worry about the outcome of childbirth, but if you are well prepared and understand what to expect, what happens at each stage of labor, it means that courage will also return. Give life to a child! After all, this is happiness! Prepare yourself, learn in advance the techniques and methods of relaxation and breath control – they will help you maintain composure and cope with pain. And do not be alarmed if during the bouts something is not quite as you expected.
HOW TO DETERMINE THE BEGINNING OF CROSSINGS
YOUR ALARM that you miss the onset of bouts is absolutely groundless. Although the false cuts that occur in the last weeks of pregnancy can sometimes be mistaken for the onset of labor, you will not confuse real contractions with anything.
Appearing Ajar, the cervix pushes out the blood-stained mucus plug that blocked it during pregnancy. What to do This can happen a couple of days before the onset of labor, so before you call the midwife or the maternity hospital, wait until the pain in the abdomen or back becomes constant or the amniotic fluid recedes.
The discharge of amniotic fluid rupture of the amniotic bubble is possible at any moment. Waters can flow away, but more often they ooze out a little – they are held by the head of a child. What to do Immediately call a midwife or ambulance. Hospitalization is safer, even if there are no cuts yet, as infection is possible. In the meantime, put a towel in order to absorb moisture.
Contractions of the uterus First, they make themselves felt as dull pains in the back or thighs. After a while, contractions begin, similar to the sensations during a painful menstruation. What to do When cuts become regular, fix the intervals between them. If it seems to you that the contractions have begun, call the midwife. While they are not very frequent (up to 5 minutes) or painful, it makes no sense to rush to the hospital. The first birth usually continues for quite a long time, 12-14 hours, and part of this time is best spent at home. Walk slowly, stopping to rest. If the waters have not yet moved, you can take a warm shower or lightly refresh yourself. In the maternity hospital you may be advised not to come before the contractions increase and begin to repeat every 5 minutes.
SEATED AGENTS Weak uterine contractions occur throughout pregnancy. In the past few weeks, they become more frequent and more intense, so sometimes they can be taken as the beginning of contractions. If you feel such cuts, stand up, walk around and listen, whether they are continuing, whether the pauses between them are becoming shorter. Harbingers of contractions are usually irregular.
TRAINING PERIODICES Trace the dynamics of contractions over the course of an hour: the beginning and the end, the gain, the increase in frequency. When contractions stabilize, their duration must be at least 40 seconds.
At this stage, the muscles of the uterus contract to open the cervix and skip the fetus. At first birth, the contraction continues on average 10-12 hours. It is possible that at some point you will panic. No matter how well prepared you are, the feeling that something unconscious is going on with your body can be frightening. Keep calm and try not to interfere with your body, do what it tells. Right now you will really appreciate the presence of a husband or girlfriend, especially if they know what a fight is.
BREATH IN THE FIRST PERIOD OF DELIVERY At the beginning and at the end of the contraction, breathe deeply and evenly, inhaling with the nose and exhaling with the mouth. When the contraction reaches its peak, resort to shallow breathing, but now inhale and exhale through the mouth. Do not breathe so too long – you may feel dizzy.
ARRIVAL IN RHODOM
In the emergency room you will be met by a midwife sister who will complete all the formalities and preparatory procedures. The husband may be near you at this time. If you give birth at home, you will be prepared for childbirth in a similar way.
Questions of the midwife A midwife will check the records and your exchange card, as well as check if the water has withdrawn and there is a traffic jam. Also, ask a series of questions about contractions: when did they start? how often do they occur? what do you feel? What is the duration of the attacks?
Examination When you change clothes, your blood pressure, temperature and pulse will be measured. The doctor will conduct an internal examination to determine how the cervix has opened.
Examination of the fetus The midwife probes your abdomen to determine the position of the child, and listens to his heart with a special stethoscope. It is possible that for 20 minutes she will record the fetal’s heartbeat through a microphone – this recording will help establish whether enough baby receives oxygen during uterine contractions.
Other procedures You will be asked to pass urine for sugar and protein tests. If you have not yet departed water, you can take a shower. You will be sent to the Prenatal ward.
INTERNAL EXAMINATIONS The doctor will, if necessary, conduct internal examinations, monitoring the position of the fetus and the degree of cervical dilatation. Ask him questions – you should also be aware of what is happening. Usually the opening of the uterus is uneven, as it were. pushes. The examination is carried out in the intervals between contractions, therefore, feeling the approach of the next contraction, you will have to inform the doctor about it. Most likely, you will be asked to lie back, surrounded by pillows, but if this situation is uncomfortable, you can lie on your side. Try to relax as much as possible.
TRACK The cervix is a ring of muscles that, in the normal state, are closed around the uterine mouth. The longitudinal muscles that form the walls of the uterus depart from it. During contractions, they contract, pulling the neck inward, and then stretching it so that the head of the child passes into the uterine mouth. 1. The cervix relaxes under the action of hormones. 2. Weak cuts smoothly smooth the cervix. 3. Strong contractions lead to cervical dilatation.
PROVISIONS FOR THE FIRST PERIOD OF PARENTS In the first period, try to try different body positions, finding the most convenient for each stage. These provisions must be mastered in advance, so that at the right moment you can quickly adopt a suitable posture. Perhaps you suddenly find it better to lie down. Lie down not on your back, but on your side. The head and the thigh should rest on the pillows.
Vertical position In the initial stage of contractions, use some kind of support – a wall, chair, or hospital bed. If you wish, you can kneel down.
Sitting Position Sit facing the back of the chair, leaning on the planted pillow. The head is lowered on the arms, the knees are apart. Another pillow can be put on the seat.
Relying on a husband In the first stage of labor, which you will probably carry on your feet, it is convenient to put your hands on your husband’s shoulders and rest during the fights. A husband can help you relax by massaging your back or stroking your shoulders.
Kneeling Position Kneel down, spread your legs and, relaxing all your muscles, lower your upper body onto the pillows. Keep your back as straight as possible. In between contractions, sit on your hip.
Four point support Kneel down, leaning on your arms. It is convenient to do on the mattress. Move the pelvis back and forth. Don’t hunch your back. Between contractions, relax, dropping forward and resting your head on your arms.
BIRTH PAIN IN THE BACK When the head is biased, the head of the child rests against your spine, causing back pain. To make it easier: during fights, lean forward, putting weight on your hands, and perform post-movement movements with your pelvis; in intervals go between the contractions let the husband massage your back.
Lumbar massage This procedure will ease back pain, and will soothe and rejuvenate you. Let the husband massage the base of the spine to you, pressing in a circular motion with the protrusion of the palm. Use talc.
HOW TO HELP YOURSELF
Move more, walk in the intervals between contractions – this will help to cope with the pain. During attacks, choose a comfortable posture. Keep as straight as possible: the head of the child will rest against the cervix, the cuts will be stronger and more efficient. Concentrate on breathing to calm down and divert your attention from contractions. Relax in the breaks to save strength until they are especially needed. Sing, even shout to ease the pain. Look at one point or at any subject to distract. React only to this fight, do not think about the following. Imagine each attack as a wave, "riding a saddle" which you "take it out" baby Urine more often – the bladder should not interfere with the progress of the fetus.
WHAT MAY HELP CAN
Praise and encourage your wife in every way. Do not get lost if she gets annoyed – your presence is still important. Remind about the method of relaxation and breathing, which she studied on courses. Wipe her face, hold her hand, massage her back, offer to change position. What touches and massage she likes, you need to know in advance. Be a mediator between your wife and the medical staff. Keep her side in everything: for example, if she asks for a painkiller.
THE MOST DIFFICULT TIME OF LABOR – the end of the first period. The contractions become strong and long, and the intervals are reduced to a minute. This phase is called transitional. Having suffered, you, probably, at this stage will be either depressed or overly excited and tearful. You may even lose the sense of time and between fights you will fall asleep. This may be accompanied by nausea, vomiting and chills. In the end, you will have a great desire, straining to push the fruit. But if you do it ahead of time, cervical edema is possible. Therefore, ask the midwife to check if the neck is fully open.
BREATH IN TRANSITION PHASE If premature attempts begin, take two short breaths and one long breath: "phew, phew". When the urge to quit, stop slowly, exhale.
How to stop attempts If the cervix has not yet opened, in this position do a double sigh and a long exhale: "phew, phew" (see top right). You may need pain relief. Stand on your knees and, leaning forward, lower your head on your hands; the pelvic floor should hang in the air. This will reduce the urge to attempt and make it difficult to push the fetus.
WHAT MAY HELP CAN
Try to calm the wife, cheer, wipe the sweat; if she does not want it – do not insist. Breathe with her during the bouts. Wear her socks if chills start. If attempts begin, call the midwife immediately.
WHAT HAPPENS WITH THE CERVICAL UTERUS The cervix, palpable at a depth of 7 cm, is already sufficiently stretched around the head of the fetus. If the cervix is not palpable, it means that its expansion has ended.
SECOND PERIOD AS ONLY the cervix has opened and you are ready for the attempts, the second stage of labor begins – the period of the expulsion of the fetus. Now to involuntary contractions of the uterus, you add your own efforts, helping to push the fetus. Contractions have become stronger, but they are less painful. Attempts are hard work, but the midwife will help you find the most comfortable position and will guide you, telling you when to push. Do not rush things, try to do everything right. During the first birth, the second period usually lasts more than an hour.
BREATHING IN THE SECOND PERIOD OF DELIVERY Feeling the urge to attempt, inhale deeply and leaning forward, hold your breath. Take deep, calming breaths between attempts. Slowly relax when the contraction subsides.
POSES FOR EXILEING THE FRUIT When trying, try to keep yourself straighter – then gravity will work for you.
Squatting This is the ideal position: the lumen of the pelvis opens, and the fetus emerges under the action of gravity. But if you did not prepare yourself for this position in advance, you will soon feel tired. Resort to the lightweight version: if the husband sits on the edge of the chair, his knees apart, you can sit between them, leaning his hands on his hips.
On the knees This position is less tiring, moreover, it facilitates the attempts. If you are supported from two sides, it will give your body more stability. You can simply lean on your hands; back should be straight.
Sitting You can give birth sitting on a bed with pillows over it. As soon as the attempts begin, lower the chin and clasp the legs with your hands. In the intervals between attempts, rest, leaning back.
HOW TO HELP YOURSELF At the time of contraction, strain yourself gradually, smoothly. Try to relax the pelvic floor so that you feel how it falls. Relax your facial muscles. Do not try to control the intestines and bladder. Rest between contractions, take care of strength for the attempts.
WHAT MAY HELP CAN HELP Try somehow to distract your wife between attempts, continue to calm and cheer her. Tell her about what you see, for example, the appearance of the head, but do not be surprised if she does not pay attention to you.
PIC PARENTS come. The baby is about to be born. You can touch the head of your baby, and soon pick it up. At first, perhaps, you will be overwhelmed by a feeling of tremendous relief, but followed by surprise, tears of joy, and, of course, a feeling of immense tenderness for the child.
1. The head of the fetus approaches the vaginal opening, pressing down on the pelvic floor. Soon there will be a crown: with each push it will move forward, then, perhaps, roll back a little while loosening cuts. Do not worry, this is completely normal.
2. As soon as the top appears, you will be asked not to push anymore – if the head comes out too quickly, perineal tears are possible. Relax, take a little breath. In the event of a threat of serious tears or any irregularities in the child, an episiotomy can be done. As the head expands the vaginal opening, there is a burning sensation, but it does not last long, alternating with numbness, which is caused by a strong stretching of the tissues.
3. When the head appears, the child’s face is facing down. The midwife checks if the umbilical cord is wrapped around the neck. If this happens, it can be removed when the whole body is released. Then the baby turns its head to the side, turning before full release. The midwife will rub his eyes, nose, mouth and, if necessary, remove mucus from the upper respiratory tract.
4. The last contraction of the uterus, and the baby’s body is released completely. Usually, the child is placed on the belly of the child, since the umbilical cord still holds it. Perhaps at first the baby will seem bluish to you. His body is covered with original lubricant, traces of blood remain on the skin. If he breathes normally, you can take him in your arms, press him against your chest. If breathing is difficult, they will release the airway, and if necessary, will give an oxygen mask.
THE THIRD PERIOD OF BIRTH At the end of the second stage of labor, you will probably receive an intravenous injection of a drug that strengthens the uterine contraction – then the placenta will disappear almost instantly. If you wait until it exfoliates naturally, you can lose a lot of blood. Discuss this point in advance with your doctor. To remove the placenta, the doctor places one hand on your stomach and the other gently pulls on the umbilical cord. After that, he must check that the placenta is completely removed.
SCALE APGAR Having taken the child, the midwife assesses his breathing, heart rate, skin color, muscle tone and reflexes, calculating the score on a 10-point scale Hangar. Usually in newborns, this indicator ranges from 7 to 10. After 5 minutes they recount: the initial score usually increases.
AFTER THE BIRTH, you will be washed and, if necessary, stitched. A neonatologist will examine the newborn, the midwife will weigh it and measure it. So that the infant does not have a rare disease associated with insufficient blood clotting, it can be given vitamin K. The umbilical cord is cut off immediately after birth.
Question and answer "I fear injuries during childbirth. Is there such a danger?" Do not worry, there is no such danger – the vaginal walls are elastic, their folds are able to stretch and let the fruit through. "Is it necessary immediately after birth to give the baby a breast?" You can give a breast, but if the baby does not take it – do not insist. In general, the sucking reflex in newborns is strong, and when they suck, they have a good mood.
BIRTH RARE is painless, but the pain has a special meaning: after all, each fight is a step towards the birth of a baby. You may need painkillers – it depends on the progress of the contractions and your ability to cope with the pain. You may be able to overcome it using the self-help technique, but if the aggravating pain becomes unbearable, ask the doctor for an anesthetic.
EPIDURAL ANESTHESIA This anesthesia relieves pain by blocking the nerves of the lower body. It is effective when contractions cause back pain. However, epidural anesthesia will not be offered in every hospital. The time of its use should be calculated so that the effect of the anesthetic is stopped by the 2nd period of labor, otherwise it is possible to slow down the labor activity and increase the risk of episiotomy and forceps.
How it happens Applying an epidural anesthesia takes approx. 20 minutes. You will be asked to curl up to your knees rested on the chin. The anesthetic will be inserted into the lower back with a syringe. The needle is not removed, which allows, if necessary, to introduce an additional dose. The action of the anesthetic is terminated after 2 hours. He may be accompanied by some difficulty in movements and trembling in his hands. These phenomena soon pass.
Action Pain will pass on you, clarity of consciousness will remain. Some women feel weakness and headache, as well as heaviness in the legs, which sometimes lasts for several hours. On the child None.
NITROGEN OXIDE WITH OXYGEN This gas mixture significantly reduces pain, without removing it completely, and causes euphoria. Apply at the end of the 1st period of labor.
How it happens The gas mixture enters through a mask connected by a hose to the device. The effect of the gas is manifested in half a minute, so at the beginning of the fight it is necessary to take several deep breaths.
Action On You Gas dulls the pain, but does not relieve it at all. When breathing in, you will feel dizzy or nauseated. On the child None.
PROMEDOL This medicine is used in the 1st period of labor, when the woman in labor is excited and it is difficult for her to relax.
How it happens Injection of promedol is injected into the buttock or thigh. Onset of action – after 20 minutes, the duration – 2-3 hours.
Action On you Promedol manifests itself in different ways. It has a calming effect on someone, it relaxes, causing drowsiness, although the consciousness of what is happening is completely preserved. There are also complaints about the loss of self-control, intoxication. You may be nauseated and swayed. On a child, promedol may cause respiratory depression and drowsiness in a child. After birth, breathing is easy to stimulate, and drowsiness will disappear by itself.
ELECTRO-STIMULATION Electrostimulation device reduces pain and stimulates the internal mechanism to overcome pain. It works on weak electric pulses that affect the back area through the skin. A month before delivery, find out if there is such a device in the hospital, and learn how to use it.
How it happens Four electrodes are placed on the back at the concentration points of the nerves going to the uterus. The electrodes are wired to the remote control manual control. With it, you can adjust the strength of the current.
Action On You The device reduces pain in the initial stage of labor. If contractions are very painful, the effect of the device is ineffective. On the child None.
MONITORING FRUIT CONDITION
DURING the entire period of labor, doctors constantly record the heart rate of the fetus. This is done with a normal obstetric stethoscope or with an electronic monitor.
OBSTETRIC STETHOSKOP While you are in the delivery room, the midwife regularly listens to the fetal heartbeat through the abdominal wall.
ELECTRONIC FRUIT MONITORING This method requires sophisticated electronic equipment. In some hospitals, such monitoring (control) is used throughout labor, in others – occasionally or in the following cases: if labor is caused artificially if you have epidural anesthesia if you have complications that may threaten the fetus if abnormalities are found in the fetus. Electronic monitoring is completely harmless and painless, but it significantly restricts freedom of movement – thus you cannot control the contractions. If your doctor or midwife offered you ongoing monitoring, find out if this is really necessary.
As it happens, you will be asked to sit down or lie on the couch. The body will be fixed with pillows. On the stomach, sticky tapes with sensors that capture the fetal heartbeats and register uterine contractions will be attached. Instrument readings are printed on paper tape. After the discharge of amniotic fluid, the baby’s heart rate can be measured by bringing an electronic sensor to his head. This monitoring method is the most accurate, but not very convenient. Some maternity hospitals use radio-wave monitoring systems with remote control (telemetric monitoring). Their advantage is that you are not tied to bulky equipment and you can move freely during contractions.
SPECIAL METHODS OF BREEDING THE EPISIOTOMY This is the dissection of the entrance of the vagina to prevent rupture or to reduce the second period of labor while threatening the health of the fetus. To avoid episiotomy: learn to relax the muscles of the pelvic floor when expelling the fetus, hold straight.
Indications Episiotomy will be needed if: the fetus has a breech presentation, a large head, other abnormalities, premature delivery is used with forceps or a vacuum you do not control the attempts; the skin around the vaginal opening is not stretched enough.
How it happens At the climax of the contraction, an incision is made in the vagina – down and, usually, slightly to the side. Sometimes there is no time for an anesthetic injection, but you still will not feel pain, since the partial numbness of the tissues is due to the fact that they are stretched. The stitching after an episiotomy or rupture may be quite long and painful – a complicated procedure that requires special care. So insist that you have a good local anesthetic. Suture material dissolves itself after some time, it is not necessary to delete it.
Consequences Unpleasant sensations and inflammation after episiotomy in the order of things, but the pain can be severe, especially when infected. The incision heals in 10-14 days, but if something bothers you and then, consult a doctor.
FETAL EXTRACTION Sometimes, forceps or vacuum extraction are used to help the child to be born. The use of forceps is possible only with the full opening of the cervix, when the fetus’s head enters it. Vacuum extraction is also acceptable in case of incomplete disclosure – in the case of protracted labor.
Indications Forced extraction is performed: if you or the fetus showed some abnormalities in the case of buttock previa or premature births during labor.
How does this happen
The forceps will be anesthetized – inhalation or intravenous anesthesia. The doctor places the forceps around the child’s head, and carefully squeezes it out. When applying forceps completely eliminate attempts. Then everything happens naturally. Vacuum extractor This is a small suction cup connected to a vacuum pump. Through the vagina it is fed to the head of the fetus. While you are pushing, the fetus is gently pulled through the birth canal.
Consequences Tongs can leave dents or bruises on the head of the fetus, but they are not dangerous. After a few days these traces disappear. A vacuum cup-sucker will leave a slight swelling, and then a bruise on the baby’s head. This, too, will gradually come down.
STIMULATION OF BIRTHS Stimulation means that contractions will have to be induced artificially. Sometimes methods are used to speed up contractions if they go too slowly. Physicians’ approaches to stimulation are often different; so try to find out what is the practice of artificially causing childbirth where you will give birth.
Indications Contractions are caused artificially: if during a delay of childbirth for a period of more than a week, there are signs of fetal impairment or a breakdown of the placenta function, if you have high blood pressure or some other complications dangerous to the fetus.
How it happens Artificially induced labor is planned in advance, and you will be asked to go to the hospital in advance. Three methods of stimulation of contractions are used: 1. The hormone preparation cerviprost is introduced into the cervical canal, which softens the cervix. The contractions can begin in about an hour. This method is not always effective at first birth. 2. Opening of the amniotic bubble. The doctor pierces a hole in the amniotic sac. Most women do not experience any pain. Soon, contractions of the uterus begin. 3. A hormonal drug is introduced through an IV line to reduce the uterus. Ask the dropper to be placed on your left hand (or on your right hand if you are left-handed).
Consequences The introduction of a hormonal drug is preferable – you can move freely during labor. When using a dropper, contractions will be more intense, and the intervals between them are shorter than during normal labor. Also have to lie.
BABY PREDING In 4 cases out of 100 the baby comes out of the lower body. Deliveries in this position of the fetus are longer and painful, so they should be held in the hospital. Since the head, the largest part of the baby’s body, will appear last at birth, it is measured in advance with an ultrasound scanner to make sure that it passes through the pelvis. An episiotomy will be required; Caesarean section is often used (it is mandatory in some clinics).
Gemini Gemini definitely need to give birth in a hospital, because forceps are often used to extract them. In addition, one of them may have buttocks presentation. Probably, you will be offered epidural anesthesia. The first stage of labor will be one. There are two second ones – two: first one child comes out, followed by the second. The interval between the birth of twins – 10-30 minutes.
When the cesarean section of the child is born through the open abdominal wall. You will be informed about the need for surgery in advance, but this measure may be caused by complications during childbirth. If a caesarean section is planned, epidural anesthesia will be applied, that is, you will be conscious and be able to see the baby immediately. If the need for surgery arises during contractions, then epidural anesthesia is possible, although general anesthesia is sometimes required. It is difficult to accept the fact that you can not give birth normally. But these experiences are surmountable if you prepare psychologically.
HOW THIS IS HAPPENING you will have your pubis cut off, a dropper is placed in your arm, and a catheter is inserted into your bladder. Make anesthesia. In the case of epidural anesthesia between you and the surgeon, probably install the screen. A horizontal incision is usually made, then the surgeon removes the amniotic fluid with a suction. The child is sometimes removed with forceps. After the rejection of the placenta you can pick it up. The operation itself takes about five minutes. Another 20 minutes takes suturing.
Section Section "bikini" It is done horizontally, above the upper pubis line, and after healing it is almost imperceptible.
AFTER THE OPERATION You will not be allowed to lie down for a long time without getting up. Walking and movement are completely harmless to you. The first days the incision will still be painful, so ask for a painkiller. Stand straight, supporting the seam with your hands. Two days later, start light exercises; another day or two, when they remove the bandage, you can swim. The stitches are removed on the 5th day. In a week you will feel quite well. The first 6 weeks, avoid heavy loads. After 3-6 months the scar will turn pale.
How to breastfeed Put the baby on the pillows so that it does not put pressure on the wound.