Childbirth is a difficult process for every woman, especially if they are the first. Every expectant mother is looking forward to them and is a little afraid. We learn more about how childbirth occurs, as well as about the three birth periods.
Preliminary (preparatory) period of childbirth
The preliminary period of childbirth is not yet childbirth, but the preparatory period, lasting no more than a day. He does not cause discomfort to the future mother, the cervix is prepared for childbirth. She, slightly opening, softens. In this case, the woman feels small, almost not painful contractions, which over time begin to intensify.
If this stage proceeds pathologically, then it becomes of great importance – it is delayed in time with irregular painful contractions. To distinguish whether the preliminary period is correct, only a doctor can. The pathological course occurs mainly in excitable women who experience fear or uncertainty about childbirth. They have disturbed sleep, an increasing sense of anxiety and fatigue. Therefore, often there is a generic pathological activity.
However, the course of childbirth itself does not depend on how the preparatory period of labor takes place. As some mothers with many children say, childbirth is a lottery.
So, there are three periods of childbirth: disclosure (first), expulsion (second) and last (third). The process of giving birth to a baby is quite voluminous and complex. Therefore, childbirth is carried out by periods, we will consider them in more detail.
1 period of childbirth is the longest and most painful. It is characterized by regular contractions, with the help of which the cervix opens. The fetus during contractions along the birth canal hardly moves. During the latent phase, lasting up to 6 hours, labor pains are less painful and rare, but regular.
In the second phase of this phase, contractions intensify. They become more frequent, and the neck opens up to 10 centimeters. During this, there is an active contraction of the walls of the uterus, its longitudinal layer, and at the same time, relaxation of the circular.
Contraction of the uterus begins with muscles that are located closer to its bottom, and gradually spread throughout the organ. Muscle fibers slowly move to the bottom, and the thickness of the muscles there increases significantly, becoming, on the contrary, thinner in the lower parts of the uterus. The neck is smoothed and opens.
The main indicators of the first stage of childbirth are the strength of contractions, the regularity, frequency and speed of the opening of the uterus. The condition of the neck is determined by the doctor during a vaginal examination, the quality – with special devices that simultaneously record the heart contractions of the fetus.
In the absence of a monitor, contractions are counted by a stopwatch. This determines their duration and the interval between them. The strength of contractions is determined by the tension of the uterus, with the help of the palm, which is placed on the stomach giving birth.
Amniotic fluid helps maximize cervical dilatation. The fetal head is pressed against the small pelvis, and amniotic fluid is divided into posterior and anterior. With each fight, the bubble inflates more and more and begins to put pressure on the neck, which contributes to its more rapid opening. When it opens up to 5 centimeters, the bubble becomes no longer needed, and bursts. The water is leaving.
If they retreated to contractions, then their departure is called premature. An anhydrous period should not exceed 6 hours, their safe absence – 72 hours. But in any case, this is not considered normal during the first stage of childbirth, and the woman should be under the continuous supervision of doctors.
During the first stage of labor, the woman in labor can move freely and use methods of pain relief. If necessary, it is possible to use antispasmodics, narcotic and non-narcotic analgesics, epidural anesthesia is performed.
If during this period there is a breakdown, then the use of stimulation of activity is possible. If the amniotic fluid does not spontaneously burst in time, an amniotomy is performed.
The second period of childbirth
The second period is called the expulsion of the fetus. He got the second name, as potent. At its beginning, the contractions are already strong and long. The cervix opens sufficiently so that the fetal head descends into the small pelvis and, putting pressure on the nerve plexuses in the sacrum, begins to move towards the exit from the body.
Attempts begin (synchronous uterine contractions), in which the pressure in the peritoneal cavity increases, and the fetus moves freely along the birth canal. At the same time, the woman has a great desire to push, with which she is not able to fight. The sensations at the same time are very similar to the desire to “go big”, and inexperienced first-born women often confuse attempts with emptying.
Most often, attempts begin when the neck opens by 8 centimeters, and if at this time the woman begins to push, then she may get a neck injury. That is why at the very beginning the attempt is proposed to breathe by special techniques, but pushing is forbidden so far. The doctor examines the vagina, the midwife makes sure that the neck is open enough for the right birth.
Time with attempts is of great importance and a great effort is required from the woman in labor to concentrate and follow all the instructions of the medical staff. In this case, the role of the midwife is very important, which helps the woman in labor remember how to breathe correctly. Since during this period a woman can simply forget everything that she studied in preparatory courses, if she attended them.
Next begins the second stage of this period, called generic. He is very responsible, as the child must make some of the most difficult internal coups for him, and at the same time he experiences great stress. Therefore, medical monitoring occurs almost every minute.
First, the fetal head is assembled to pass through the plane of the pelvis, then, repeating the shape of the birth canal, it turns, emerges from the genital gap and extends. After which there is a birth. Then the shoulders appear, making a preliminary internal coup, and after that the body and legs go out unhindered. If the child is very large, or the mother has a narrow basin, then birth is naturally impossible and a cesarean section is done.
In the 2nd period, labor activity may weaken, and attempts to become weaker. As a result, there is a risk of “stuck” of the fetus, leading to hypoxia, tipping over of parts of the body incorrectly, weakness of the woman in labor. As well as bleeding, which may indicate placental abruption, which is a serious complication. In this case, the heartbeat of the birth changes. It is heard not only during pregnancy, but also during childbirth with a stethoscope after each attempt.
After the head has appeared, mucus is removed from its mouth and nose to prevent it from entering the respiratory tract when the newborn begins to breathe on its own. The placenta, which is still in the womb, is separated by suppression with two clamps. And as soon as the baby makes the first cry, he is considered a newborn. This completes the 2nd period of labor.
The third period is called the next. After the baby is born, the volume of the uterus is greatly reduced, and it takes time for it to acquire a normal tone, since the placenta is separated and born also due to its contractions. As a rule, in first-born women, they begin 10 minutes after the end of the 2nd period. A little later – who is the second and subsequent, since the muscles of the uterus in them have a reduced tone due to stretching due to previous births. Usually the birth of the afterbirth occurs in 20 minutes.
If, under the influence of uterine contractions, the placenta does not separate from the wall and the birth does not occur within half an hour, then in this case it is separated or removed under anesthesia. Sometimes they squeeze, and the woman in labor has unpleasant short-term sensations. After the placenta is born, childbirth is considered completed.
At the end of the birth process, the woman remains in the delivery room for a couple more hours. This is to avoid unforeseen complications. During this period, the doctor regularly examines her birth canal and placenta.
Very often, the third period can be complicated by bleeding, which continues after childbirth. The reason may be the placenta, which has an abnormal attachment to the walls of the uterus. Perhaps bleeding and with a decrease in the ability of uterine contractions, or with trauma to the birth canal.
In this case, the necessary measures are taken :
- manual removal of the placenta occurs;
- through the abdominal front wall, the uterus is massaged;
- put ice on the lower abdomen (for about 20 minutes);
- injecting uterine contractions;
- sutured path damage.
Duration of labor
For many women in labor, the periods of childbirth and their duration are different. True, it changes slightly. The first birth is generally longer than the subsequent ones, and lasts from 9 to 11 hours. The longest duration is 18 hours.
For those who give birth the second and subsequent times in time, the process takes from 6 to 8, and a maximum of up to 14 hours. Long births are considered if they exceed the maximum duration, and completed earlier are called quick. Swift consider ending earlier than 4 hours in primiparas.
It begins with the birth of the placenta, 40 days its average duration. The early postpartum period is 2 hours after the successful resolution of the woman in labor. During this period, there is just a very high risk of hypotonic bleeding.
Then follows the recovery period. This is the time when a young mother is required to observe certain rules: adequate sleep and rest and restrictions on her sexual life. During this period, breastfeeding is established and health is restored. The discharge begins, lochia, which accompany the contraction of the uterus, and its size is gradually restored to its previous state.
During the postpartum period, a young mother should not be nervous. It is necessary to take vitamins, which are required not only to restore her health and tone, but also for a newborn baby. During this period, the love and care of relatives and close people, as well as their help and moral support, are very important to her.