For most pregnant women, especially those giving birth for the first time, labor and birth are the most frightening parts of pregnancy. Future young mothers on this topic are bombarded with a stream of terrifying information from friends, acquaintances and neighbors.

However, you cannot prepare for childbirth using other people's experiences and memories. A pregnant woman's anxiety will be greatly reduced if she knows and clearly understands the entire process of childbirth. A woman has 9 months to prepare for childbirth and subsequently take an active part in choosing the conditions for the birth of her child.

Doctors conditionally divide the entire process of childbirth into three phases. In the first phase, the cervix dilates and smoothes out so that the fetus passing through it does not damage it. The second phase represents the immediate birth of the child, and in the third, final phase, the placenta comes out.

1. First phase: dilation and smoothing of the cervix

In order for labor to begin and the baby to pass through the cervix, it must change its shape: when the upper part of the uterus contracts, the cervix and lower part are pulled upward towards the baby’s head. For women giving birth for the first time, this process takes about 8 hours; for women who have already given birth, it takes 4-5 hours. By the time the uterus finally changes its shape, contractions last about 40 - 90 seconds and occur every 3-5 minutes.

The mucus plug, which had been covering the opening in the cervix throughout pregnancy, falls out, and the cervix begins to open so that the baby can freely pass through: the baby’s head appears at the exit. At this time, the amnion around the fetal head is ruptured by the head itself, or by the intervention of a doctor, and a little amniotic fluid flows out. The baby's head is approximately 10cm in diameter and the cervix should dilate to this size. More frequent and intense contractions occur precisely at the moment of dilatation of the cervix and by the time of full dilatation, contractions last 60-90 seconds, every 2-3 minutes. For women giving birth for the first time, the process of dilation of the cervix may take 3-5 hours, for others - much less.

Position of the woman in labor for the first phase: at this stage, the woman does not yet have anything to actively participate in. It is recommended to sit, supported by pillows, and lie on your side. When moving to the second phase of labor, you can take any position that will make it easier, but you do not need to lie flat on your back.

Breathing exercises. At the very beginning of contractions, deep belly breathing helps to relax. As soon as contractions begin to intensify and the abdomen hardens, the woman in labor can use deep chest breathing and breathe in the usual way between contractions:

- at the early stage of contractions - deep breathing with the whole chest during contractions;
- for the middle stage of contractions - shallow and rapid breathing during contractions.

2. Second phase: childbirth

The transition and beginning of the second phase is characterized by the moment when a feeling of pressure arises in the lower pelvic area, back pain, dizziness and leg cramps may appear. At such moments, tension increases, and it is extremely important for a woman to remember the learned breathing exercises.

At this stage of the immediate transition to labor, the woman in labor should use shallow, rapid breathing during the contraction, holding her breath during its peak.

Contractions continue, their frequency and intensity increase, and the time between them has decreased significantly. A woman in labor may have a desire to bend over and begin to push, as if she were constipated. However, it is not safe to do this until the cervix is ​​fully dilated, otherwise it can be damaged.

When the cervix is ​​completely dilated (the doctor will inform you about this), you can begin to push the baby out of you. Here, it is important for a woman in labor to remember about pushing breathing: the woman breathes often, quickly and shallowly, and only at the moment of contraction she bends down, pushing out the baby, and pushes, holding her breath.

Within 5–40 minutes, the baby moves from the uterus to the vagina and is born. If there is a danger that the child may tear the perineum, the doctor may make an episiotomy: an incision from the vagina to the anus, which is sutured after birth. After an episiotomy, a woman should not sit for a while, experience physical strain, or carry heavy objects.

The child begins to emerge on his side and first (if the position is correct), the head appears rotationally, then the shoulders and the rest of the body. Contractions of the uterus force the baby to move forward.

The birth of the baby ends the second phase of labor. For women who have not given birth before, it lasts about an hour; for women who have children, it lasts much less, sometimes a few minutes.

When the baby is born, the nose and mouth are cleared of mucus and held upside down so that the mucus comes out of the lungs. When oxygen circulates in the lungs, the baby’s body turns from bluish to pink. Immediately, or a little later, the umbilical cord is clamped and cut.
The woman can choose her body position during childbirth and change it during the process. Many find it convenient to push while holding their legs and pulling them towards their stomach.

3. Third phase: delivery of the placenta

The placenta comes out within 30 minutes after the baby is born: the uterus contracts and expands during childbirth, but the placenta is incapable of this and therefore easily tears away from the uterus. After the placenta is delivered, the doctor checks it, preventing tissue particles from remaining inside the uterus and causing bleeding and the development of infection.

After childbirth, for about 10 days, bloody fluid is constantly released from the vagina: the uterus and the place where the placenta was cleansed. When breastfeeding, menstruation resumes after approximately 24 weeks, and ovulation begins in the 20th week. If a woman does not breastfeed, menstruation resumes after 6-10 weeks. 6 weeks after birth, the uterus and genitals return to their previous size.

The success of any event depends directly on how carefully all the processes of the preparatory period were carried out and how prepared the participants are. Childbirth, which requires maximum mobilization of all the physical and psycho-emotional resources of a pregnant woman, is no exception. Therefore, already in the first months of an excellent situation, you need to start studying everything related to pregnancy and childbirth.

After all, the main character in the maternity room is the woman in labor, who must fulfill her main task as clearly and adequately as possible - to help the baby be born. This is what every woman is waiting for Before your miracle, you simply must familiarize yourself with how to prepare for childbirth. It is important not only to know what awaits you and at what moment; in this matter, psychological preparation for childbirth is very important.

Preparing for childbirth correctly

Just as a woman prepared her body for conception before pregnancy, during pregnancy, you need to prepare yourself to the final stage - childbirth. After all, this process requires a lot of effort and knowledge in this area, and the two concepts are absolutely inseparable.

It often happens that after learning about her pregnancy, a woman sharply limits herself from performing various types of physical exercises, as well as from active sports. Some people not only refuse to go to the gym, but also to perform a number of ordinary household tasks in general. Of course, in an interesting situation, you should be quite attentive to your body, but such drastic actions are fundamentally wrong.

Naturally, in the first twelve weeks, it is better to refrain from overly active exercises, but in general, in the absence of prescriptions and health restrictions, a pregnant woman can safely continue to engage in sports (if she has been involved in sports before). It is worth remembering that in this situation it is best to opt for special classes in groups for pregnant women. In such groups you can practice:

• gymnastics for pregnant women, which is based on yoga or Pilates exercises;
• swimming in the pool;
• breathing exercises.

All this will fully have a positive effect on the body, with the help of which a woman will be able to adequately prepare herself for the upcoming event.

Preparing the birth canal

Preparation for childbirth should also be accompanied by maximum readiness of the birth canal, because at this most important moment the muscles of the pelvis and perineum of the expectant mother experience an incredible, colossal load due to the pressure of the fetus. At the same time, very often situations arise when they cannot stand it and end up seriously injured. To avoid such a negative consequence, every pregnant woman can prepare herself, this can be done with the help of:

• daily massage of the perineum for several minutes using vegetable oils. After all, it is oils that have a beneficial effect on the development of tissue elasticity. This type of procedure can be performed as early as the twentieth week of pregnancy.
• special exercises (Kegel exercises), which are aimed at maximizing the strength of the vaginal muscles and preventing the possibility of ruptures during childbirth. It is these exercises that will help in a speedy return to shape and postpartum restoration of organs.

Before taking any action, you should first consult with your doctor whom you are seeing. Since these recommendations are general, therefore, it is necessary to clarify what is possible specifically for you during this wonderful period of life.

Preparing the mammary glands

Preparing for childbirth includes several important stages, one of which is preparing the breasts for subsequent feeding. You need to start addressing this issue directly during pregnancy. Of course, now you can increasingly hear that breastfeeding is not so healthy and can easily be replaced with artificial feeding. But this is fundamentally not true, and it is very good if you also decide for yourself that you will feed your baby breast milk.

After all, IV is most often resorted to by women who had an unpleasant experience of the first application and, most likely, developed painful cracks in the nipples, which caused an unpleasant sensation in the area during feeding. To avoid everything and enjoy the moments GW, you need to prepare in advance. The following procedures will help greatly:

• daily taking a contrast shower in the chest area, which ends with slightly cool water;
• using bra pads made of rough fabric;
• daily rubbing and massage of the nipples using a rough cloth.

It is also worth studying breastfeeding techniques in advance, watching videos teaching the correct positions of mother and baby during feeding.

As for the period after childbirth, it is recommended to use a quick healing cream if there are cracks from the first days of feeding. It would be useful to use special breast pads, especially if the nursing mother has retracted nipples.

It is worth remembering that then after gestation and the feeding period you need It will be necessary to resort to special exercises to restore your breasts to their former attractiveness and firmness.

Any expectant mother at a certain moment begins to think about how not to miss the birth, how it will go, how the baby will be born. At the same time, any person by nature always imagines not the most rosy events in his head. That is why a pregnant woman is often accompanied by fear and anxiety, which are only greatly reinforced after another “funny” story from a friend or a story of an unhappy birth read on the Internet.

Some expectant mothers They begin to worry so much that they really need psychological help and a high-quality positive attitude. But, most often, a pregnant woman can help herself in this matter. To do this, you definitely need to exclude all negative events from your life, stop reading bad news (good news, as a rule, is not posted in news feeds), you need to protect yourself from friends who like to gossip and cry for their lives.

Please yourself more often with positive emotions and events, go for a walk every day, smile at the world. Also remember that you won’t be pregnant forever., so enjoy your condition while you can. After all, the first movements, the first kicks, conversations with the baby who lives in the tummy are so wonderful.

Methods of preparation for childbirth

In the modern world, there are many methods for preparing for childbirth, but all of them must include such important aspects as: the ability to relax, proper breathing and positive thinking. Some will say that they are quite similar, others will find many differences . In any case, it is recommended for pregnant women try to test the technique that is closest to it and most suitable.

How to prepare for childbirth, which maternity hospital to choose

Today, with the advent of birth certificates, every pregnant woman has the right to go to any maternity ward, regardless of her place of residence. Therefore, if for some reason you are not satisfied with the maternity hospital to which you are assigned at your address, you need to take care in advance about choosing what you want.

After week 35, when most of the issues have been decided, you must collect packages (the so-called alarm bag) based on the list that you were given at the antenatal clinic or maternity hospital. Since the requirements in each institution may vary greatly, it is necessary to clarify such nuances in advance. If this does not work out, you can find the most complete lists of what may be useful during childbirth on the Internet.

At the same time, remember that it is best to prepare the basic things in bags, but the rest, if necessary, can always be delivered by relatives or husband.

Be sure to take all necessary documents with you and, if possible, make photocopies (since the maternity hospital most often asks for them), which it is better not to part with, even if you go out to take out the trash, starting from the thirtieth week of pregnancy.

When pregnancy comes to its logical conclusion, every woman begins to worry about the upcoming birth. Even those women in labor who have already gone through this process and have children cannot avoid certain fears and questions. After all, every time childbirth takes place in its own way, and it is impossible to predict exactly how everything will be in this case. Therefore, from approximately the thirty-fourth week, you need to start attending courses for pregnant women, taking online seminars on this topic and studying other information posted on forums and various websites. In general, preparation for childbirth should take several weeks. This article describes what needs to be included in it.

Let's talk about the birth process

Preparing a pregnant woman for childbirth is not always given due attention. Most often, in various courses, women are told about the three stages of the birth process, taught breathing exercises and try to reduce the level of fear in first-time mothers. However, in fact, many pregnant women note that they did not have enough information about how to properly respond to everything that happens to the body and control this process. After all, it is known that those women who take an active part in childbirth go through it more painlessly and have every chance of avoiding ruptures.

Therefore, any process of preparing for childbirth should include several important points, which we will consider in the article:

• setting the due date;
• signs of contractions that have begun;
• list of things needed for ;
• need and possibility of pain relief;
• three stages of the birth process;
• pros and cons of partner childbirth;
• preparing the cervix for childbirth;
• selection of courses for pregnant women and maternity hospitals.

Of course, expectant mothers have a lot of questions regarding childbirth. They are embarrassed to ask many of them, and therefore experience nervousness and fear. This negatively affects their emotional state and affects the baby. Sometimes such problems even slow down the onset of labor or prevent the process from proceeding naturally. Therefore, every pregnant woman should take preparations for childbirth very seriously and be sure to set aside time for this, even if she works until the last days of bearing the baby.

Date of birth: we calculate the exact day the baby is born

In childbirth preparation courses, specialists only briefly touch on the estimated date when labor can be expected to begin. But in fact, this topic worries most pregnant women. As practice shows, the real and estimated date of birth often have significant differences. This causes a lot of fears in women; they worry that contractions may start unexpectedly, they will not have time to get to the maternity hospital and this will harm the baby. Therefore, expectant mothers begin to go to two extremes: they insist on hospitalization several weeks in advance, or they become so worried that they provoke premature birth in themselves with a similar condition. To avoid such problems, you need to clearly understand when to expect contractions.

So, first of all, the expectant mother should know that the diagnosis determined by the obstetrician and the ultrasound examination cannot be considered accurate. A very small percentage of women give birth at this time, but it allows you to navigate the weeks and be ready to go to the maternity hospital at the right time.

In modern obstetrics, pregnancy is considered full-term from the thirty-seventh to the forty-second week. Moreover, it is worth keeping in mind that this time interval is subject to a certain classification:

• Early term. This category includes babies born between the thirty-seventh and thirty-eighth weeks and six days. The babies are fully viable and ready to exist outside their mother. In terms of their condition, they are no different from children born later.
• Full term. Most newborns delight their mothers when they are born at thirty-nine to forty weeks and six days. This interval is considered classic and by this time the woman should be fully prepared for the upcoming process.
• Late term. If your baby decides to be born at forty-one weeks or forty-one weeks and six days, then there is no need to worry. The baby didn’t linger inside you at all, he was simply waiting in the wings, which is quite normal.
• Postmaturity. At forty-two weeks, doctors usually diagnose postmaturity. But for this diagnosis, they conduct a lot of additional examinations to eliminate errors in setting the estimated date of birth.

Based on the information received, preparations for childbirth should be completely completed by the thirty-sixth week. From this period, the pregnant woman should more often be at home or with close people who will help her if contractions begin. A woman should carry with her everything necessary for admission and a charged cell phone with enough money on her balance to contact relatives.

It is also necessary to have a clear understanding that preparation for childbirth consists of moral and informational preparation. In no course should you be given any pills or recommended infusions or decoctions for a speedy resolution of the burden. Such interference in natural processes is unacceptable and in almost one hundred percent of cases will lead to a tragic outcome.

What is the first step in preparing for childbirth? What do women need to know by the thirty-sixth week? We will discuss this topic in the section on choosing courses for pregnant women.

Let's go to the maternity hospital: let's discuss the harbingers

Information about how labor progresses usually reassures women. After all, by owning it, they know exactly what to expect and will be able to classify the problem if it arises.

So, you should expect labor to speed up if you notice that it has become easier for you to breathe. This is due to the fact that the baby’s head descends into the pelvic area and the stomach seems to be lower than usual. This can happen two to three weeks before birth. Sometimes expectant mothers notice that their belly has dropped just a couple of days before the baby is born. In any case, this fact is the first harbinger of the upcoming birth.

At the same time, vaginal discharge increases. They may have a brownish or pinkish tint, and are often white. In this way, the mucous plug comes away, which throughout pregnancy prevented any infections from entering the uterus from the vagina.

Often, a couple of weeks before giving birth, training contractions become more frequent. They differ from real ones in their lack of regularity and almost painlessness. When changing position, the pain usually goes away and does not occur again.

Harbingers of impending childbirth include nagging and dull pain in the lower back, slight weight loss of up to two kilograms and a feeling of pressure in the pubic area. All the symptoms listed above indicate that your family will soon be replenished with a baby. However, you should not go to the maternity hospital with such signs, but the following characteristics should make you call an ambulance or your husband to go with him to the birth.

First of all, pay attention to bloody vaginal discharge and discharge of amniotic fluid. They may go away immediately or flow out gradually, but it is difficult to confuse them with something else. The amniotic fluid should be transparent, small white lumps of vernix are acceptable. But the greenish or brown color of the liquid is a danger signal. It means that meconium has entered the amniotic fluid and the baby is risking his life every minute. In this case, it is important to get under the supervision of doctors as soon as possible, warning them by phone about your condition.

Regular contractions also become a reason to immediately go to the maternity hospital. They always progress, gradually reducing intervals to ten minutes. If you notice that the pain is getting stronger, then it’s time to go to the hospital. However, before this, be sure to have an intimate haircut and a cleansing enema. Of course, the last procedure is also done in the maternity hospital, but many women are embarrassed by strangers and prefer to carry out all the manipulations at home. It is noteworthy that in childbirth preparation courses, many experts say that you can refuse an enema. However, midwives always note that such a solution is fraught with problems during pushing. Since the baby puts pressure on the intestines while passing through the birth canal, all its contents may involuntarily come out during the process. Therefore, this delicate issue should be resolved in favor of an enema.

Packing your bag for the maternity hospital

Any woman who has attended childbirth preparation courses knows quite well what to take with her. However, it is worth considering that the list of things must be checked with the one posted in the maternity hospital where you plan to give birth. Each institution has the right to introduce certain restrictions, so in this section we will provide a fairly general list of things needed in a hospital.

Naturally, the most important documents for pregnant women are documents. They should be placed in a separate file and always carried with you. You will need a passport, exchange card, health insurance policy, pension insurance card, birth certificate and a service agreement concluded with a medical institution. The last papers are needed if you have agreed on a paid birth.

For yourself, you should put washable slippers, a comfortable robe, a pair of nightgowns or pajamas in your bag. After giving birth, women will need bra pads, highly absorbent pads, disposable panties and body care products. Don't forget shower accessories, toothbrush and toothpaste.

Place children's things in a separate bag. The baby will need diapers, several sets of clothes, cotton pads and swabs, powder (at the mother's discretion), socks, a hat and anti-scratch mittens for the hands.

Making decisions about pain management

All women dream of pain-free childbirth. But, unfortunately, this natural process cannot take place without pain. However, today there are a number of techniques that can reduce discomfort. They are divided into non-medicinal and pharmacological.

The former are always discussed in some detail in childbirth preparation schools. These include massage of certain points on the body, hypnosis, meditation, self-hypnosis, acupuncture and others. Depending on your preferences, you can choose the most effective pain relief method for you. However, keep in mind that you need to practice it for several months, otherwise in a stressful situation you will forget about everything you were taught in the courses.

There are quite a few pharmacological methods to relieve labor pain. But obstetricians and ordinary women often argue about them. Despite the fact that the effect of the drugs used on the body of the expectant mother and baby has been well studied, it is believed that the administration of drugs has a negative effect on labor. Doctors often write that the use of medications that reduce sensitivity causes various injuries and provokes numerous ruptures during pushing. Therefore, in any case, the decision always remains with the obstetricians who deliver the baby. Only they can administer this or that drug to you, but if you refuse, you still shouldn’t insist - the specialists are responsible for you and the health of the newborn.

How does childbirth proceed?

The expectant mother should be fully aware of what awaits her during the birth process. It is best for her to take an active part in everything that happens. This is the key to a successful resolution of the burden and successful cooperation with doctors. They claim that trained women behave more calmly and confidently. They listen carefully to midwives and follow all their recommendations. Therefore, we will look at all three stages of labor and talk about what will happen in each of them.

First stage

The contraction period is the first and longest. Women giving birth for the first time note that it lasts up to twelve hours. Next time this stage is reduced to seven to ten hours. During this time, the cervix opens and prepares to let the baby through. Preparing the cervix for childbirth occurs gradually to avoid ruptures and other injuries. The slower this happens, the more likely it is that the birth will be successful. Contractions at the first stage become more and more frequent. Initially they last no more than twenty seconds and occur after fifteen minutes. As the neck opens, they occur every minute and last up to sixty seconds.

Second phase

Pushing becomes the second stage of labor. Its duration depends on the physiological characteristics of the woman and how she will follow the recommendations of obstetricians. Keep in mind that the pushing period can last up to two hours. However, all this time the baby will experience a lack of oxygen, and therefore it is necessary to help him be born. Pushing is an involuntary muscle contraction that literally pushes the baby out. A woman can and should manage these contractions. At this stage, she needs to listen carefully to the doctors and push or hold back when necessary.

This period does not end with the birth of the baby, because the female body must still reject the placenta. This process usually lasts for thirty minutes, and the doctor carefully examines the released placenta so that not a single piece remains inside that could lead to an inflammatory process and bleeding in the future.

Third stage

At the third stage of labor, the woman is examined for ruptures, checked and manipulated with the baby. The mother spends about two hours after birth under the supervision of doctors and with an IV. If everything is in order, the woman will be transferred to another department, where in a few hours the baby will be brought to her.

The truth about partner birth

Their necessity can be debated endlessly, but if we are talking about preparation for childbirth, then it is better for the pregnant woman to go through it with some close person. It has been proven that in a stressful situation, which undoubtedly is childbirth, the presence of a loved one has a positive effect on a woman. In addition, the partner can not only help the woman in labor, but also partially control the actions of doctors. Unfortunately, they are not always professionals in their field, and the presence of an adequate person in the birthing room can turn out to be fateful.

However, I would like to note that you should not insist on partner childbirth with your husband if he does not want it. This decision must be voluntary and mutual, otherwise your man will experience serious stress and will not be able to help you. In such situations, you can take your mother, girlfriend or any other person in whom you are confident.

Preparing for childbirth: what to do

Childbirth is not only serious emotional stress, but also physical stress on the body. If you are well prepared for it, then there is a high probability that everything will go well, and the recovery process will not take much time. Preparation of the uterus for childbirth plays an important role in relieving pregnancy. You can learn about techniques and exercises that contribute to this in courses for pregnant women. Typically, a gymnastics routine combines yoga, Kegel exercises and stretching. However, you should not practice at home. Remember that such physical activity should be carried out under the supervision of specialists. Otherwise, you may experience premature labor. Preparing the cervix is ​​a long process. It takes at least three months.

If you are afraid of ruptures and care about the elasticity of tissues, then be sure to purchase oil to prepare for childbirth and massage the perineum with it. Starting from the thirty-sixth week, this is done daily. Typically the procedure involves dipping your fingers into the oil and slowly stretching the back wall of the vagina. The process may be accompanied by pressure and lasts about ten minutes. Judging by the reviews, women highly appreciate Weleda oil for preparing for childbirth. It is sterile, softens tissues and increases their elasticity. Weleda oil (for preparation for childbirth) does not cause allergies and can later be used as a regular care product.

Choosing courses and maternity hospital

Today, women can choose the institution in which they plan to give birth. Do not refuse this opportunity and read reviews on forums, visit the maternity hospital and find out about its rules, and also talk with doctors. It’s better if you have people you already know at the birth. This provides a special level of emotional stability and gives a feeling of peace.

There are also quite a lot of courses for pregnant women now. They have different directions and accents, so the choice is always up to the woman. However, please note that a good childbirth preparation school should include the following points in its program:

• breathing techniques;
• studying the stages of childbirth;
• pain relief techniques with massage and other methods;
• features of caring for a newborn;
• differences between normal and pathological childbirth.

It is important that information about the upcoming birth is as complete and useful as possible, then the pregnancy will end happily.

During the last 1-2 weeks before giving birth, several signs indicate that labor is approaching. For example:

— The uterus descends and it becomes easier for the pregnant woman to breathe;

— Sometimes she has sleep disorders, the woman is anxious;

- Urine leakage occurs more often, a feeling of pressure on the rectum occurs;

— The amount of mucous discharge from the vagina increases;

- Painless contractions of the uterus occur;

— The gelatin plug (bloody mucus that clogged the cervix) comes off. This happens 1-2 days before birth.

During fetal movements or when the abdomen is touched, (hardens). These contractions, and they are repeated at unequal intervals, but have the same intensity, “push out” the fetus, and it “goes” down to the cervix.

Start of labor

If before childbirth everything was prepared as expected, the pregnant woman had nothing to worry about. It is important that her family, and first of all her loved one, be attentive to her, try to make these days of waiting and tension easier for her, and convince her that everything will go well. A man should, more than ever, help with housework. And he also has the responsibility to prepare other children, if there are any according to their age, for such an important event in the life of the family.

Painful contractions of the uterus (contractions) mean that labor has begun. Contractions are repeated at first every 10-15 minutes, then this interval decreases. Often bloody mucus comes from the vagina of a pregnant woman. The contractions are becoming more and more painful.

As a result of these contractions, the cervix begins to open: labor has begun. With the onset of regular contractions, the pregnant woman is advised not to eat any more food.

A pregnant woman must be accompanied to the maternity hospital by one of her relatives. Regarding when to go there, you should take into account the following points:

Important points before childbirth

b) the first birth lasts longer, therefore, the pregnant woman may not be afraid that she will not be able to get there on time;

c) women with deviations in the position of the fetus or complications of pregnancy should arrive at the hospital earlier, before the first signs of labor appear, according to the recommendations of the Obstetrician who monitored the development of pregnancy;

d) rupture of the membranes and loss of amniotic fluid is a signal for immediate entry into the maternity hospital. The rupture of the fertile membrane and the release of the plug that clogged the cervix allows direct access to the external genitalia. This creates a risk of microbes entering the uterine cavity and infecting the fetus.

If labor pains do not occur within 24 hours, the doctor should use medication.

When going to the maternity hospital, do not forget to take your passport with you.

Normal birth

a) in 96% of cases, the child is born with (i.e., head down). The head of the fetus is the largest and densest part of its body, which is why nature assigns it such a responsible role: to pave the way, i.e. the opening of all organs must release the child into the world. The bones of the skull are not yet tightly fused, which allows them to move to a certain extent as they pass through the reproductive canal.

c) The reproductive (doctors say “genital”) canal of the mother consists of the bony walls of the small pelvis and muscle group: the cervix, vagina and perineum. The dimensions of a normal bony pelvis allow the fetal head to pass through; This is facilitated by the softening of the pubic fusion and the mobility of the coccyx. Muscle groups expand under the action of the fetus and are pushed out by strong uterine contractions. In women who give birth for the first time, the muscles have not yet been stretched, so their labor lasts longer than in those who give birth for the second and third time.

c) Uterine contractions (contractions) completely open the cervix. I must say that as the labor process progresses, the pain becomes more intense, but it can be withstood. This pain should not be quenched with medications, because after the baby is born, the woman does not even remember about it.

When the baby's way is open, uterine contractions change. Now they contract to expel the fetus. The woman in labor feels pressure on the rectum and has an uncontrollable need to push. A woman should know that it is her efforts, her active participation in childbirth that can be effective.

After the baby is born, the uterus contracts a little more to expel the placenta.

Three phases of labor

— Period of expansion (dilatation),

— The period of expulsion of the fetus,

— The period of expulsion of the placenta.

The expansion period lasts from 8 to 12 hours in women giving birth for the first time, from 5 to 8 hours in women giving birth again. It is during this time that the shells rupture. After this, the woman in labor can no longer walk; if the rupture of the membranes occurred in the maternity hospital, then the woman should be brought there lying down. If the sac with amniotic fluid is intact, then with each contraction it sinks further into the cervix and thereby contributes to its expansion.

The doctor, of course, examines the patient, but he does not need to sit next to her. However, an experienced midwife should be with her at all times!

Psychological state of the mother before childbirth.

The woman in labor must completely trust the doctor and midwife leading the birth; do not be afraid, do not distract your attention, but listen to the doctor’s instructions: breathe deeply, tense or relax. Then the pain will not seem so strong and, as the American physician Rod assures, “when a pregnant woman is tense, the cervix is ​​compressed, and when a pregnant woman relaxes, the cervix relaxes too.” Breathing and relaxation should correspond to the different phases of expansion. At first, when the uterine contractions are weak, the woman breathes rarely and deeply. As contractions intensify and the time between them shortens, the woman in labor should take a deep breath if she feels a contraction approaching. If the contraction has already occurred, then you should breathe shallowly, relaxed (take quick and rhythmic inhalations and exhalations). When the contraction is over, the woman in labor should take a deep breath, slowly and deeply, and then exhale forcefully. Between contractions, the woman remains calm and breathes normally. Thanks to proper breathing, the oxygen demand (very increased) of the muscles of the uterus and fetus is ensured.

The expulsion period is a critical phase of labor for the fetus. It begins with the dilation of the cervix and ends with the birth of the child, the duration of this period is 25-45 minutes. It is extremely important that the mother in labor follows the instructions of the doctor or midwife and helps them, herself and the baby. When the contraction of expulsion occurs, the woman takes a deep breath, closes her mouth and pushes with all her might. Feeling that she did not have enough air, she exhales, takes 2-3 short breaths and exhales and pushes again. During the expulsion contraction, the woman in labor can make 3-4 attempts. If she starts early, without control, she quickly gets tired, her efforts were useless, and the birth is delayed.

When the fetal head stretches the vulva, the woman in labor feels sharp pain. The perineal muscles are very stretched. After 1-2 contractions, the baby's head comes out. The doctor and midwife leading the birth protect the perineum from rupture, perform rotational movements of the fetal head, then release the baby’s shoulders one by one and, finally, the entire body. Almost immediately after this, the newborn baby takes his first breath and “gives his voice” (cries).

Protecting the perineum before childbirth is an attempt to avoid its rupture if it is not dilated enough. This happens through uncontrolled, untimely attempts by the woman in labor or when the fetal head is very large and the perineal tissue is not elastic enough.

A quick birth is a risk for the mother and for the child: the blood vessels of the brain may not withstand the sharp decrease in pressure that the fetus experienced while passing through the pelvic-genital canal. In such cases, an incision is made into the vulva. After childbirth, the incision is, of course, sutured.

Immediately after birth, the newborn’s mouth and nose are cleared of mucus. The umbilical cord is then clamped, cut and tied. Then they show the child to the mother, and then apply a sterile bandage to the navel, make a toilet, and take the necessary measurements (body weight, height). The swaddlers bring the baby to the mother and tell her the number attached to the hand, the weight and length of the newborn.

The period of expulsion of the placenta ends the birth. The separation of the placenta (baby place) occurs within 10-20 minutes. After the birth of a child, the uterus immediately reduces its size. With barely perceptible contractions, it separates the placenta from its walls, but this separation is accompanied by bleeding. Yes, in fact, any normal birth is accompanied by blood loss (up to 400-500 ml).

A doctor or midwife monitors the separation of the placenta and helps expel it. In cases where the placenta does not come out on its own, a doctor or midwife should remove it.

After this, the muscles of the uterine walls contract and block the blood vessels. The bleeding stops. Doctors carefully examine the placenta. If there is a suspicion that it has not completely separated and this threatens the health of the woman in labor, the doctor manually checks the uterine cavity. It is also checked whether there are any ruptures in the vaginal wall or perineum; if necessary, sutures are applied to all ruptures. In addition to the pulse and temperature, the woman in labor is checked to see if uterine contractions continue. If she is relaxed, this may cause severe bleeding - meaning the medical staff should be on alert.

Induced labor

This term refers to a method of “artificially” inducing labor using certain medications. This method is used on the advice of a doctor to prevent complications for both the mother and the child (for example, post-term birth, incompatibility of Rh factors, diabetes in a pregnant woman, etc.).

The method of induced labor is quite safe if it is used in accordance with the situation and with skill. An obstetrician, as a rule, is guided by the following indications: age of pregnancy (at least 38 weeks) cranial presentation; the cervix is ​​soft, its opening is slightly open; a number of organizational measures and prerequisites for preparation for such births must certainly be provided.

A pregnant woman should be taken to the maternity hospital in the morning, after she has rested well at home and had a light dinner the day before. Childbirth is induced during the day, when medical personnel and support services (laboratory, blood transfusion center) are working.

Under normal conditions, childbirth proceeds safely. In exceptional cases, it becomes necessary to perform a caesarean section.

In order for the expectant mother to feel like a full participant in the process in the delivery room, she needs to prepare in advance for childbirth - both theoretically and practically. Modern medicine has developed methods by which a woman herself can contribute to the successful course of childbirth. So, what do you need to know about the birth process in order to feel confident, as well as relieve as much pain as possible, which mothers who give birth for the first time often fear?

During pregnancy, there are many things that need to be done in a timely manner, such as taking all required tests, visiting the doctor regularly, getting an exchange card, preparing the baby's room and dowry. All these actions are absolutely correct and natural, they set the stage for the upcoming decisive event - the birth of a child. But in order to pass this test with dignity and with the least loss for yourself and your baby, first of all you need to know and understand what awaits you at hour “x”. The hope that doctors themselves know everything is fair - doctors really know everything, but without the assistance of the woman in labor and the meaningful implementation of all recommendations during childbirth, their focus on a successful outcome of childbirth will be hampered, which sometimes, in critical cases, can be very important.

Estimated due date

This is one of the most significant questions, especially if you do not intend to go to the maternity hospital in advance. It is important to arrive there on time, without harming either yourself or your child by being late. What is needed for this?

First of all, know the expected due date, taking into account the fact that it cannot be determined absolutely precisely, only with fluctuations of several days (weeks), so you should not consider the date set by the doctor as the ultimate truth and wait for its exact implementation. What can be assumed based on objective data?

Pregnancy lasts on average 280 days (40 weeks), counting from the first day of the last menstrual period. If you count back three months from this date and then add seven days, this will be the approximate due date. For example: the last menstruation was on December 10, therefore, birth can be expected on September 17.

It is advisable to remember the day of the first fetal movement. First-time mothers feel it in the middle of pregnancy (20 weeks), and those giving birth for the second and third time a little earlier (18 weeks).

It will be possible to speak most accurately about the date of birth if the gestational age is established. It can be determined by a doctor based on the size of the uterus. With sufficient reliability, it is possible to determine the duration of pregnancy and, therefore, delivery based on ultrasound examination of the fetus. Childbirth occurring before 37 weeks of pregnancy is considered premature, and after 42 weeks - late.

The duration of full-term pregnancy varies from 37 completed weeks (259 days) to 42 weeks (294 days). From the 38th week of pregnancy you can expect to give birth every day.

By this time, it is worth forming your position regarding partner childbirth, so that, with mutual agreement, the partner also has time to prepare for the event.

When is it time to get ready for the maternity hospital and what to take with you?

Each birth is unique in its own way: its onset may be different for different women, and the experience of friends who gave birth will only partially help. Therefore, it is necessary to know the warning signs of the onset of labor:

a pregnant woman feels that she can breathe easier; this is due to the fact that the fetal head has dropped lower and pressed tightly against the entrance to the pelvis; usually they say that the stomach has dropped;

the amount of vaginal discharge increases, it may become brown or pink;

individual contractions of the uterus appear - “training” contractions, irregular, short and quickly passing;

weak, dull, quickly disappearing pain often occurs in the lumbar region;

there is a slight loss of body weight.

When these warning signs appear, you should prepare for a trip to the maternity hospital. It is quite possible that you will have to wait. The interval between the appearance of precursors and childbirth can be several days or 2-3 weeks.

The main thing that is characteristic of labor contractions is their regularity, repetition at first every 15-20 minutes, then more and more often, longer and stronger. In contrast, false contractions usually have an irregular rhythm, do not intensify, and can stop if you change the position of the body.

If at least one of these signs of the onset of labor is present, this means that labor has begun and it’s time to go to the maternity hospital.

Before the trip, you can shave your perineum and do an enema yourself, or leave this procedure until the emergency department of the maternity hospital.

By the time you leave for the maternity hospital, the collected bag should already be ready, taking into account what is allowed to be taken to the specific maternity hospital in which you are going to give birth (accordingly, this must be found out in advance). Otherwise, you risk being left without the things you need in the maternity hospital.

Signs of the onset of labor, in which you need to urgently go to the maternity hospital:

The appearance of bloody discharge from the vagina.

Outpouring of amniotic fluid - it can be poured out drop by drop or about 200 ml at a time. Normally, the waters are light or slightly pinkish, without any admixture of bright blood; in them you can see white lumps of vernix lubrication of the fetus. However, the waters may have a green or brown color, which is due to the ingress of original feces - meconium. You must inform your doctor about this, since meconium in the water indicates fetal hypoxia (lack of oxygen). After the discharge of water, you must immediately go to the maternity hospital, since a long period without water is fraught with the danger of infection of the fetus and the mother’s birth canal.

Regular labor pains.

Pain relief for childbirth

Those who are especially afraid of the legendary pain of labor should learn more about pain relief in advance.

Currently, all existing methods of pain relief during childbirth are divided into two groups:

Non-drug methods.

These include: psychoprophylactic preparation of pregnant women for childbirth, hypnosis and suggestion, acupuncture (using metal needle injections at special points), transcutaneous electrical nerve stimulation, self-massage.

Methods of pharmacological action.

The effect of painkillers on the body of a woman and child has been well studied, as have possible unwanted side effects. Pain relief with pharmacological agents begins in the first stage of labor in the presence of regular strong contractions and the opening of the uterine pharynx by 3-4 cm. This also includes epidural anesthesia, which is carried out for medical reasons, in some cases - at the request of the woman. With this method of anesthesia, a special needle is inserted into the space above the dura mater covering the spinal cord, and the drug is injected there. With this method of pain relief, the woman does not feel contractions, and the lower limbs also lose pain sensitivity.

Having studied the issue in detail and made a decision about pain relief, be sure to discuss the chosen method with your doctor before labor begins. The final word in choosing pain relief methods should remain with the doctor - this is an axiom.

If you are a principled opponent of drug pain relief, you can, for example, agree with your doctor that you will give birth without pain medications, but if during childbirth you still feel that you need pain relief, you can tell the doctor about it.

How is childbirth?

Knowing what periods the birth process is divided into and how to behave during this time will help the mother better cooperate with doctors, which will result in the birth of a healthy child and the absence of birth injuries.

There are three periods of labor: cervical dilatation, expulsion of the fetus and the afterbirth period.

The period of dilation is the longest during childbirth. It lasts about 9-10 hours in primiparous women and 6-7 hours in multiparous women. The duration of contractions during this period increases from 10-20 seconds to 1.5 minutes, and the interval between them decreases from 10-15 minutes to 1 minute.

The purpose of the first stage of labor is the gradual dilation of the cervix. It occurs under the influence of regular contractions. When the cervix opens completely, the fetal head can descend into the pelvic cavity.

What can mom do at this stage?

Learn to relieve pain by taking a position that is comfortable for you, and correctly endure the contraction, relaxing after it. For this, there are special relaxation techniques that must be learned in advance.

You should definitely know about the main positions in which contractions are easier to endure: vertical position, lying on your side, lying on your back, poses using a special ball. Both your husband and you yourself can help by doing a pain-relieving massage (and learning how to do it first). To relieve the pain of contractions at this stage, you also need to know how to breathe during contractions.

Expulsion of the fetus is the second stage of labor.

The duration of this period is on average 1-2 hours in primiparous women and less than an hour in multiparous women.

When the fetal head descends to the pelvic floor, contractions are joined by pushing. Pushing is a contraction of the abdominal muscles and the diaphragm (the muscular septum separating the chest and abdominal cavities). The average duration of an attempt is about a minute. Thanks to pushing, intra-abdominal pressure increases, which, coupled with increased intrauterine pressure (due to contractions), allows the baby to move through the birth canal. Attempts occur involuntarily, but, unlike contractions, a woman can control them, strengthening or restraining them if necessary.

To avoid tearing of soft tissues as the baby passes through the birth canal, the doctor may make an incision in the perineum (episiotomy), which will then be sutured with a surgical suture (with pain relief) after the placenta is born. Episiotomy is a common operation during childbirth, and you should be prepared for it in advance. Moreover, evenly cut tissues grow together faster and better than uneven edges after tears.

A baby's cry immediately after birth is a good reaction to a new external environment. But the birth is not over yet - the baby is still connected to the mother by the umbilical cord, and the placenta is in the uterine cavity.

What can mom do at this stage? Listen carefully to the doctor and midwife, as unauthorized actions can harm both mother and child.

Correctly regulate attempts (having previously learned how to do this). During the period of expulsion of the fetus, it is necessary to alternate muscle tension at the moment of pushing and complete relaxation between attempts - this is taught by special techniques, the study of which must be devoted time in advance in order to bring the skill to automatism.

Proper breathing, which is necessary during the entire period of childbirth, does not lose its relevance during pushing. Firstly, at this moment the fetus suffers more than ever from a lack of oxygen. Secondly, it helps to conserve strength and push more effectively. It must be said that proper breathing helps to avoid ruptures, making it possible to stop pushing if you cannot push yet.

The third, subsequent, period lasts on average 5-10 minutes, but can last up to 30 minutes.

At this time, the umbilical cord is crossed - today doctors often entrust this simple but symbolic manipulation to the father present at the birth. When the umbilical cord is cut, neither the mother nor the baby will feel pain because there are no pain receptors in the umbilical cord.

After birth, the doctor and midwife will receive the baby and carry out all the necessary procedures: processing, weighing, measuring, examining.

A sign is placed on the child’s arm indicating the mother’s last name, first name and patronymic, the year, day and hour of the child’s birth, as well as his gender.

Weak contractions continue, separating the placenta from the walls of the uterus, and then with one or two light attempts the placenta is born. Only after this the birth can be considered complete.

First contact with the baby and latching on to the breast

Today it is customary to do this in the delivery room, immediately after the birth of the child. When exactly - it depends, firstly, on the traditions of the given maternity hospital, and secondly, on the condition of the newborn. The baby can be placed on the mother's chest with the umbilical cord not yet cut, immediately after birth, or maybe after the birth of the placenta. Both options are normal. If the newborn or mother has health problems, this procedure may be delayed.

Where and with whom?

During the first stage of labor, the woman is in the prenatal ward. When the cervix is ​​sufficiently open, the expectant mother is transferred to the delivery room, where she spends the second and third stages of labor on a chair or on a special bed.

After giving birth, a woman (she is now called not a woman in labor, but a postpartum woman) remains in the maternity ward for another two hours under the careful supervision of medical personnel, who monitor her condition and the amount of bloody discharge from the genital tract. At this time, the soft birth canal is examined and, if there are ruptures, sutures are applied with preliminary anesthesia. Ice is placed on the abdomen for better contraction of the uterine muscles. After the examination, the woman is transferred to the postpartum ward.

Where can I get information about childbirth?

If a mother is taught how to care for a child in a maternity hospital, where they will also help establish breastfeeding, then the theory and practice of childbirth should be studied in advance, since the same breathing techniques or pain-relieving massage require the development of certain skills so as not to get confused in extreme conditions and to perform everything in the best possible way. . You can practice such skills in childbirth preparation courses. You can do this yourself, following the recommendations of magazines and books for expectant mothers and “rehearsing” at home with your husband or girlfriend.