Childbirth. birth pains. the first period of childbirth

Childbirth. Birth pains. The first period of childbirth 0 2.7

Births from A to Z

Childbirth. Birth pains. The first period of childbirth

About the nature of labor and behavior during the first period of labor

What most often frightens a young woman, the first time preparing to become a mother (or what scare her more often)? The answer begs - fights.

Anna Koroleva Obstetrician-gynecologist, doctor of the association "Medicine 2000"

What most often frightens a young woman, the first time preparing to become a mother (or what scare her more often)? The answer begs - fights. Ожидание боли может вызвать большую панику, чем сама боль. И чем ближе заветный срок, тем навязчивее преследует этот страх. Самое верное средство избавиться от страха - перестать прятаться от него и прятать его от себя, встретить его лицом к лицу, «поговорить» с ним. Вы боитесь схваток? Так давайте разберемся, что это такое.

What are contractions?

In the medical language, birth pains are involuntary regular contractions of the uterus, along with attempts related to the clan-eating fetus forces. Contractions indicate the beginning of labor. (In addition to labor, at the onset of labor can indicate such symptoms as the outflow of amniotic fluid and the passage of the mucous plug that closes the lumen of the cervix 1; the mucous plug can go away and 2-3 days before the birth, so that its departure does not always mean that it's time to go to the hospital). A lot of works are written about what, in fact, provokes the beginning of childbirth. Disagreeing in particular, all researchers agree in the main: organisms of the mother and child, being in close interaction, sort of "agree", transmit the necessary impulses to each other. Shortly before the onset of the birth of the placenta, women and the pituitary gland of the baby begin to produce specific substances (in particular prostaglandins and hormone oxytocin), causing contractions in the muscles of the uterus, called contractions. During pregnancy, the cervix is ​​tightly closed. With the onset of labor clamps, its opening begins: the uterus yew is gradually expanding to 10-12 cm in diameter (full opening). Generic pathways are preparing to "release" the child from the mother's womb. Intrauterine pressure during contractions increases, as the uterus itself shrinks in volume. In the end, this leads to rupture of the bladder and the outflow of part of the amniotic fluid. If this coincides in time with the full opening of the uterine throat, talk about a timely outflow of water, and if the uterine pharyngeal is not sufficiently opened at the time of rupture of the fetal bladder, this outflow is called early. The first, preparatory, period of childbirth takes an average of 12 hours, if a woman gives birth for the first time, and 2-4 hours less for those who have not the first birth. At the beginning of the second period of labor (the period of the fetal expulsion), attempts are made to contractions-contractions of the muscles of the abdominal wall and the diaphragm. In addition to the fact that different muscle groups participate in fights and attempts, they have one more important difference: fights are an involuntary and uncontrolled phenomenon, neither their strength nor frequency is dependent on the mother, while attempts to a certain extent are subject to her will , it can delay or reinforce them.

What to expect from contractions?

Sensations during fights are individual. Sometimes the first shocks are felt in the lumbar region, then spread to the abdomen, become girdling. Drawing sensations can occur in the uterus itself, and not in the lumbar region. Pain in bouts (in case you can not relax or find a comfortable position), resembles the pain that often accompanies menstrual bleeding. However, do not panic fear of labor. It is often possible to hear from women giving birth that the fights have passed at them either completely painlessly, or the pain was quite bearable. Firstly, during labor, the body releases its own painkillers. In addition, from painful sensations help to get rid of the techniques of relaxation and proper breathing that were developed during pregnancy. And finally, there are medicinal methods of anesthesia, however, they are recommended to be used only in extreme cases, since all of them affect the baby in varying degrees. Real (and not false - see below) "expelling forces" approach with a regular periodicity. Initially, the intervals between contractions are about half an hour, and sometimes more, the contraction of the uterus itself lasts 5-10 seconds. Gradually, the frequency, intensity and duration of contractions increase. The most intense and lengthy (and sometimes - although not always painful) are the last bouts, preceding the attempts. When to go to the hospital? In the case of the first birth (and if the maternity hospital is not far), you can wait until the interval between contractions is reduced to 5-7 minutes. If a clear interval between contractions has not yet been established, but the pain intensifies and becomes more and more prolonged, it is time to go to the hospital. If childbirth is repeated, then with the onset of regular bouts, it is better to immediately go to the hospital (often repeated births are swift, so it's better not to hesitate) 2. With the onset of contractions, mucous discharges may appear with a slight admixture of blood - this is the same slimy plug that "clogged" the entrance to the uterus. Blood (in a small amount) gets into the mucus due to smoothing and opening the cervix. This is a natural process, which should not be frightened, but with heavy bleeding, an immediate examination is necessary.

True or false?

It should be borne in mind that after the 20th week of pregnancy, some (not all) women have so-called false fights, or Braxton-Hicks contractions, and 2-3 weeks before the birth, women begin to feel precursory fights. Neither the one nor the other, unlike the true contractions, does not lead to the disclosure of the cervix. There are pulling sensations in the lower abdomen or in the lower back, the uterus is as if stony - if you put your hand to your stomach, you can clearly feel it. The same, in fact, occurs when clan battles, so "Braxton-Hicks" and harbingers often confuse women giving birth to the first time. How to understand whether childbirth really begins and it's time to go to the hospital, or is it just false bouts?

  • Braxton-Hicks contractions, in contrast to true birth labor, are rare and irregular. Abbreviations last up to a minute, can be repeated in 4-5 hours.
  • False contractions are painless. Walking or a warm bath often helps to completely remove discomfort. The role of false labor has not yet been fully clarified. Their appearance is associated with an increase in the excitability of the uterus, it is believed that shortly before birth, precursory fights promote softening and shortening of the cervix.

What to do in the bouts?

It is noticed that the more a pregnant woman is frightened, the less she knows about what is happening to her and what she has to do, the more difficult, longer and more painful it is for her to give birth. In the very recent past, the phrase "preparation for childbirth" seemed completely nonsense in Russia. Fortunately, over the last decade there have been qualitative changes in this area - many courses and schools have been opened to prepare for childbirth, where not only future mothers but also future dads are preparing for this important event. There are enough books published. And most importantly, psychology has changed. Now, if not all, most women understand that it is necessary to prepare for birth as any difficult and important work. And the main purpose of such training is to get rid of fear and pain. What do experts usually recommend in order for the bouts to pass as easily and painlessly as possible? As already mentioned, you can not control the frequency and force of fights, it does not depend on you. But you can quite help yourself and your child survive these bouts.

  • At first, when the contractions have just begun, it is better not to lie, but to move: this will speed up the process of opening the uterine throat, and, therefore, will shorten the time of birth.
  • Calmly concentrate and try to find the position of the body in which you are most comfortable.
  • Do not be shy if you want to stand on all fours, lie on a large inflatable ball or even ... dance. Believe me, no one will ever come to condemn you for extravagance.
  • Circular and shaking movements of the pelvis help relieve tension and reduce pain.
  • If possible, try between sleep contractions or at least "pretend to be asleep" (this will help to relax the body).
  • You can lie down for ten minutes in a bath with warm water - of course, if you are not alone in the apartment and if necessary will be able to help you.
  • The easy stroking of the lower abdomen with the pads of the fingers facilitates the contractions at the beginning of the path.
  • With the beginning of the bout, you need to inhale and direct the movement of the hands from the middle line to the sides, on the exhalation the hands move in the opposite direction.
  • With the intensification of the fights, it helps to relieve the pain with a strong and frequent pressing of the thumbs on the points in the anterior-superior region of the iliac bones (these are the most protruding parts of the pelvis).
  • Hands are comfortable to place their hands along the hips. Massage of the sacral zone of the spine is very useful. It is effective not only in the beginning of fights, but also all the time, while in your body expel forces act.
  • As the fights intensify, correct breathing becomes more important 3

But the most important thing is to tune in, listen to your own feelings and ... remember the child. You both have a hard work to do, but after all, the result will be a meeting!

Татьяна Кипринова

The first bout я распознала с трудом. Дело в том, что они были очень похожи на «тренировочные» схватки - так называемые «схватки Брекстона-Хикса», которые меня преследовали с 7-го месяца почти каждый вечер. И я сначала не могла понять - это по-прежнему они или уже начало родов. По ощущениям - как будто замирает живот внизу, потом «отпускает». Интервалы между схватками у меня были неравномерными: то через 20 минут, то через 5; но все-таки они шли регулярно (дольше двух часов) - это и повлияло на решение все-таки поехать в роддом. The first bout были вполне терпимы - просто ощущение небольшого дискомфорта. Между ними были значительные промежутки, которые давали возможность расслабиться, и я уже даже начала сомневаться в том, что действительно рожаю. По прибытии в роддом осмотр показал раскытие шейки матки 1 см. Когда прокололи пузырь (кстати, это оказалось совершенно не больно), схватки пошли уже эффективнее, боль стала вполне ощутима, интервалы были примерно в минут 5-10 (раскрытие 4 см). Раньше у меня были довольно болезненные месячные, и эта боль показалась мне похожей на менструальную. В течение следующих часов (ребенок продвигался к выходу) боль становилась все сильнее и сильнее. Было тяжело. Мне немного помогал массаж поясницы, который делал муж, и дыхание, про которое я читала в книгах (медперсонал тоже подсказывал, как лучше дышать). Когда боль стала просто нестерпимой, начались потуги (кстати говоря, я не раз слышала от других, что, когда ощущаешь, что настал предел и терпеть боль уже нет мочи, это значит, что скоро все закончится). Потуги распознать легко - непроизвольно начинаешь тужиться (этот процесс я могла бы сравнить с позывом в туалет). Потуги - вещь тоже болезненная, но кардиографический аппарат стал плохо прослушивать сердце ребенка, и мне надо было родить как можно быстрее. Поэтому примерно с пятой потуги я уже родила своего мальчика (не обошлось без эпизитомии). Весь процесс у нас занял 12 часов (это были мои первые parturition).

Anna Goncharova

The contractions were like a very strong and painful menstruation. At first they were very weak, and I did not even feel uncomfortable. It was like a very light (not painful) spasm inside the abdomen. Painful contractions only began in about four hours. And it reminded me most of all of painful menstruation. But it was very painful only for about an hour. It was possible to endure, but with difficulty. My husband helped me a lot. Even at the most intense moment pain was not permanent. Everything was going about at a regularity of 5 minutes. At first the pain quickly grew, reached a maximum and then disappeared as quickly as possible. Each battle took about two minutes. For three minutes, there was absolutely no pain! Worst of all, I was at the beginning of a new fight - when it's not painful, but you understand that everything went first. Unpleasant, but tolerant. And only one hour. As soon as I was allowed to push, the pain stopped. No more pain, which sometimes write (in the lower back, or somewhere else), I did not have. By the beginning of the fights, I was already in the hospital, so I went straight to the doctor, and the doctor confirmed that parturition have begun. The doctor and midwife said when you can start pushing. It was not painful at all, and it does not hurt at all. Although they did the cut, I did not notice it at all. Generally speaking, I remember very well, but the pain is forgotten very quickly. I remember with pleasure - and first of all all sorts of funny moments. Feelings of horror and "nevermore" was not at all. Maybe because I was a good maternity hospital and I gave birth with my husband!

Elizaveta Samoletova

Unfortunately, childbirth я была психологически совершенно не готова. Поэтому, уже будучи в родзале (я лежала в роддоме на сохранении), почувствовала, что у меня очень сильно болит живот, и испугалась. Конечно, «теоретически» я знала, что мне предстоят схватки, но слабо представляла себе, что это такое. Конечно же, ни о каком подсчете интервалов между схватками (это предложила сделать акушерка, которая сидела рядом за столом и что-то писала) не могло быть и речи. Мне показалось, что я умираю, и слабеющим голосом я попросила сделать мне кесарево сечение. Акушерка почему-то весело рассмеялась. Я спрашиваю: «Вы что смеетесь?» А она мне: «По моим подсчетам, каждая вторая роженица просит сделать ей кесарево». Я мучилась около часа. Меня очень оскорбляло, что люди, которые были вокруг (медсестры, акушерки, зав. отделением и даже какие-то практиканты, которым меня показывали как пример «старой первородящей с несколько зауженным тазом») принимали мои страдания как должное и как ни в чем ни бывало пытались заговорить со мной на какие-то скучные бытовые темы (спрашивали, где я работаю, откуда у меня такая странная фамилия и как я назову своего будущего ребенка). А когда живот у меня начинал болеть особенно сильно, подходила акушерка и издевательски (как мне тогда казалось) рассказывала, как я должна дышать. Когда начались потуги, стало легче и даже, я бы сказала, интереснее, ведь «результат труда» должен был вот-вот появиться. Он и появился. В нем было 3 кг 600 г. Потом я извинилась перед врачами, но они снова засмеялись и сказали, что так, как я, ведут себя почти все. И я решила, что к следующим childbirth буду готовиться долго и серьезно.

1 Symptoms of the onset of labor, their periodization and course can be read in detail in No. 4/2001: L. Komissarova "A Great Miracle and Hard Work".2 We also recommend reading the article by N. Zaretskaya "When is it time to go to the hospital?" In No. 1/2001 of the magazine "9 MONTHS".3 On the technique of correct breathing during childbirth, which is recommended to master during pregnancy, see E. Pechnikova, "Easy breathing", No. 7-8 / 2001.