The question of “how childbirth goes” worries not only expectant mothers, but also their husbands: both those who decided to support their spouse in a difficult process, and those who are waiting for the appearance of heirs outside the maternity hospital.

Doctors divide the complex process of the birth of a baby into several periods, each of which has its own tasks, and the coordinated actions of the woman in labor, the child, the midwife and the doctor are aimed at solving them. In some cases, the intervention of an anesthesiologist, surgeon, neonatologist, and resuscitation team is required.

Mothers who are not going through childbirth for the first time are often interested in this issue, and most importantly, they want to make the birth go smoothly, because they are familiar with the sensations. We'll talk about how a baby is born, how the woman in labor feels, and how to make the process easier and painless.

Pregnancy is a natural state for women of childbearing age; during this period, the body is aimed at bearing a child, therefore, the work of all organs and systems is activated, hormonal and physiological loads are sometimes too great.

Often during this important period, pregnant women get tired of the “burden” of the new life developing in them and dream of childbirth as a way of getting rid of it.

But childbirth, like any natural process, does not occur spontaneously. Some time before they begin, the woman begins to feel a set of symptoms, which can suggest that delivery is close.

This is due to changes in hormonal levels, because progesterone, the hormone that maintains pregnancy, gives way to estrogen, the hormone that prepares the body for childbirth. It is he who is “responsible” for the process of “setting up” a woman for the successful birth of a baby. Expectant mothers rejoice at these moments, as these are harbingers of soon meeting the long-awaited baby.

Conventionally, we can divide the signs into those that can be determined independently and those that can only be seen by an obstetrician-gynecologist during an examination.

Here are the signs that a woman can feel on her own:

• short-term uterine contractions, the so-called. Their task is to train the smooth muscles of the uterus, just as athletes train muscles, in order to minimize stress on the body and prepare the woman’s body for the birth of a child. That's why these contractions are called "training" contractions.
• reduction in abdominal size. This sign is due to the fact that the baby’s head, when presented correctly, descends into the small pelvis, preparing for childbirth. At the same time, the uterus descends, freeing the diaphragm and lungs, breathing becomes easier, and heartburn is less common.
• discharge from the genital tract. This sign is often confused with leakage of amniotic fluid in which the baby develops, and this worries expectant mothers. In order not to worry in vain, you can buy special tests at the pharmacy, similar to those that detect pregnancy, and at home determine whether there is amniotic fluid in the discharge.
• weight loss by 1-2 kg and reduction in visible swelling of the limbs. If previously the elastic band from socks left a visible mark, now it becomes almost invisible.
• changes in the posture and gait of a pregnant woman: this sign is associated with a shift in the center of gravity and fatigue from a prolonged state of pregnancy. The head is slightly thrown back, and it is more convenient for a woman to walk in small steps, with a slight spring: this gait is called a “duck walk.”
• an increase in the frequency of the urge to go to the toilet, loosening of stools (associated with the release of the birth canal so that the baby’s head can freely squeeze through).
• nagging pain in the lower back and abdomen. Ligaments stretch, and this is a natural process during childbirth. Many women, answering the question of how the second birth went, miss this sign because they did not feel it: their ligaments were already prepared by the birth of their first child.

There are only two symptoms by which only a doctor can determine the proximity of labor: a decrease in the volume of the abdomen during the next measurement (performed in a supine position), as well as softening and partial opening of the cervix, a change in its structure from elastic to looser.

The harbingers of childbirth are not of the same type: for each woman this process can occur in its own way, depending on hormonal levels, physical fitness, moral and psychological state and other factors. It is also important whether a woman is giving birth for the first time or whether she already has children.

For first-time mothers, the process of preparing for childbirth goes smoothly, gradually, and takes from two to three weeks. In addition, in most cases, the warning signs of labor go unnoticed.

In multiparous women, Braxton-Hicks contractions come earlier, and the time after the mucus plug leaves before birth is reduced, so it is especially important to listen to yourself and your feelings if this is not the first time you are going to the hospital.

How is childbirth? Step by step process

The harbingers of labor are becoming more noticeable, training contractions are becoming more disturbing, and the time is rapidly approaching the 40th obstetric week of pregnancy. All this suggests that labor will begin soon.

If a woman in labor comes to the maternity hospital by ambulance or on her own, because she feels that labor has begun, then the birth is called urgent. True, in some cases it is necessary to go to the hospital in advance so as not to miss their onset and avoid complications.

Doctors conditionally divide the whole process into three periods:

• contractions;
• pushing;
• birth of the placenta.

For the first time, the entire process can take even more than 12 hours; the second, third and subsequent ones take much less time. Often, future dads wonder how women give birth in order to decide whether to take advantage of the opportunity to attend their son or daughter's first birthday. Many of them are afraid of pain and blood, they are afraid they will not be able to withstand their wife’s suffering and will faint if they see any medical manipulations.

In this case, it is important to determine the purpose of your stay during childbirth. No one asks the husband to intervene or observe the process itself “from the doctors’ side.” The main goal of a man should be moral and physical support for his wife, as well as a willingness to resolve some bureaucratic or technical issues (call a doctor or midwife, help fill out documents and make important decisions).

Let's talk about each stage of childbirth separately.

Contractions

The first contractions occur quite rarely, with large and uneven intervals of time, but gradually they become more pronounced and painful. During this period, the mucous plug that closes the entrance to the uterus may come off, if it has not separated earlier. Most often, contractions become regular after the amniotic fluid is released.

In a hospital setting, in order to stimulate or speed up labor, doctors resort to puncturing the amniotic sac. But wherever the water spills out, at home or in the hospital, pay attention to its quantity and quality.

If there are few of them, perhaps the outpouring is incomplete, and their greenish color with flakes and dark inclusions may mean that the baby is experiencing oxygen starvation, he is no longer comfortable in the womb and it’s time to get out with the help of professionals.

During a contraction, a woman in labor is required to endure pain, not panic, and breathe correctly. Frequent, rapid breathing will saturate the blood with oxygen, which means it will ensure a comfortable state for both mother and baby.

The contractions become increasingly stronger, and after a few hours, the doctor or midwife, upon examination, diagnoses a strong dilatation of the cervix: by 4 fingers, approximately 8-10 cm. This indicates that the period of pushing is approaching.

Attempts

Attempts are actually the expulsion of the fetus, in language official medicine. It is difficult to find a woman who does not know how the first birth goes: most often, expectant mothers read a lot on this topic, attend courses or practical classes for pregnant women. But even the most theoretically prepared can become confused before the period of pushing begins.

In this case, midwives or a doctor come to the rescue. They will show and tell you how to push to give birth to a baby quickly and with the least amount of problems. If everything goes as it should, the process of pushing the baby out will take about 25-30 minutes. It is important to direct muscle movements towards the pelvis, follow the advice of specialists and not give in to panic.

If the impressionable husband of the woman in labor is present at the birth, at the moment of pushing he can leave the labor room, because at this moment his presence is not so necessary.

Expulsion of the placenta

The placenta is a muscular sac, an organ that arises and develops during pregnancy and dies with its end. For a long 40 weeks, the placenta supplied the baby with oxygen, established his connection with the expectant mother, and after a period determined by nature, the “baby place” is rejected from the woman’s body.

Usually, the expulsion of the placenta occurs with the next contraction after the birth of the baby, but there are times when the organ does not separate on its own. In this case, the doctor can help the woman in labor get rid of it: usually the placenta is removed manually under general anesthesia, and this entails additional days of sick leave.

How is the first birth?

If a woman is pregnant for the first time, she is more attentive to her body and the changes occurring inside it. But, in the absence of experience, some processes are noticed later.

So, the first movement can be detected after 20 weeks. By the way, those who know first-hand how 3rd childbirth takes place sometimes assure doctors that they felt the first movements of the fetus between 12 and 15 weeks of pregnancy.

Most often, the first birth lasts longer than subsequent ones, so you don’t have to rush to the maternity hospital, because there you will have to tirelessly walk around the prenatal ward in anticipation of contractions becoming more frequent.

Important! If you are giving birth for the first time, but have previously had late miscarriages or premature births for medical reasons, then your body is already ready for the process of delivery, which will take much less time.

Otherwise, the first birth is the same as for those women who have given birth several times already, if everything goes without complications.

How to make the process easier?

Mostly women, when talking about their second or subsequent births, note that the longest and most painful period is the first: contractions. That is why those who have experienced the birth of a child, when entering the maternity hospital for the second and third time, ask for pain relief during labor.

But the process can be facilitated without resorting to drug anesthesia. Let's talk about several ways.

1. Massaging your lower back during contractions will help relieve pain. On your own or with the help of your husband, massage the sacrum with soft, wide movements of your palms. This helps relax the muscles, distracts and therefore reduces discomfort.
2. Singing, reciting poems, or even dancing will help you distract yourself from pain. It relaxes the body, puts the woman in labor in a positive mood, and helps the baby go through a difficult process. By the way, in India, women traditionally dance a ritual dance called “belly dance” during childbirth.
3. Leaning slightly forward on the couch, wall, or husband's back is very helpful; it makes contractions much easier.
4. Do not panic, feel pain as a natural part of childbirth and experience it as a positive experience in your life: this is wise and will lead to a reduction in problems during childbirth.

The last and most important advice: you need to listen to your body and the baby inside, do not forget to pay attention to the words and tips of experienced specialists accompanying your birth, trust yourself, your feelings and sensations.

The presence of the child’s father at the birth will also be of considerable help: like the pregnancy process, this is an important stage of life together, and you can also live it together.

We must not forget that childbirth is a natural process, and a woman’s body is prepared for it by nature itself, so there is nothing scary or incomprehensible, it’s enough to get the necessary information in advance.

For a successful delivery, it is also important to regularly visit a gynecologist during pregnancy, follow doctors’ recommendations and take care of your health. And in this case, when asked how the third birth went, you will answer: “Easy and with pleasure!”

We wish you a safe birth and healthy children!

Useful video about childbirth

I like!

Attempts to describe the process of childbirth are made every day by thousands of women on hundreds of forums and blogs. But it is no longer clear. In any case, I caught myself thinking this way during my first pregnancy, re-reading the next revelations of another accomplished mother.

I offer my chaotic and not so chaotic notes, including recommendations for preparatory courses at the maternity hospital and personal observations. I don’t pretend to be the ultimate truth, but I hope that these notes will at least a little clarify the picture for those who are about to give birth for the first time in a Belarusian maternity hospital.

I also want to note that here we will talk about normal, safely completed births., and all observations and recommendations relate specifically to such childbirth and the postpartum period.

Before giving birth

In my case, labor was induced. Amniotomy (bladder puncture) was performed according to indications, at exactly 40 weeks and one day, since the gynecologist the day before did not like the “monotonous” CTG. I was quickly put into an ambulance and taken to the maternity hospital, where the exchange card had long been signed. From the moment the bladder was punctured until the baby was born, 6 hours passed.

Notes from the courses:

When to go to the maternity hospital:

1. If contractions last 15-20 seconds, every 7-10 minutes.
2. If your water breaks or leaks. It’s bad if the waters are yellow or green, good if they’re clear, with suspension. In case of leakage: wash, blot with cotton lining and push. If something drips, it’s childbirth, it’s time to go to the maternity hospital.

By the 38th week, you need to shave your external genitalia.

When admitted to the maternity hospital with contractions, a woman in labor goes through a registration process, where no one is in a particular hurry, then they look at the chair, give an enema, allow you to empty your bowels and escort you to the maternity ward.

At this stage, the level of comfort is reduced to a minimum, especially if several women are admitted and the examination-enema-emptying procedures take place in the same room with purely symbolic partitions.

In the case of a planned birth (that is, in my case, induced), the enema is given very early in the morning in the pathology department, then you have the opportunity to collect your thoughts in the toilet, after which the midwife on duty will escort you to the maternity ward, where you are assigned to wards.

Immediately after “checking in” - puncture the bladder on the chair. They also check the quality of the water, and if everything is in order (transparent, with suspension), you can go to the ward to prepare for contractions. We had a partner birth, so we were entitled to a separate room (if there was one, and there was one). My husband arrived at about 9 am, already dressed in all white (issued at the emergency room).

For admission you needed a certificate from a therapist, fluorography and a certificate of completed courses(cost about 600 thousand). We practice joint childbirth in all maternity hospitals, as far as I know, but in most cases, in order to give birth with a partner, you need to take a childbirth preparation course in this maternity hospital (the presence of a partner in some classes is mandatory).

There are rumors that the staff's attitude towards a woman in labor is much better when there is a partner nearby. Maybe this is so, because I had the most positive impressions from communicating with the medical staff: not a bit of rudeness, impatience, or inattention.

You are allowed and recommended to take the most necessary things with you to the maternity ward, in particular:

• Passport
• Exchange card
• Toilet paper
• Rubber slippers for yourself and your partner
• 0.5 liters of still water
• Mobile phone
• Socks (when lying on a gurney)
• To the partner: a certificate, a copy of the certificate of completion of the courses (according to the husband, no one even asked to show the latter at the reception desk).

Everything else is given to someone close to you after the birth; you will receive it 5-6 hours after the baby is born.

In the maternity hospital, all women in labor, like babies at birth, are equal: Each is given a white robe with or without insignia written in black marker, as well as a colorful robe. You can forget about underwear until you find yourself in the postpartum ward.

That is, forget about it altogether and don’t even try to carry and put on “contraband.” For all kinds of natural this process In case of secretions, there are linings, that is, fragments of dense sheet-like fabric that can (and should, because this is the only reasonable and possible option) be pressed between the legs.

How to move around, given that there is only one toilet per floor, and you need to go there as often as possible? Awkward. If necessary, you can ask for additional pads. Eating and drinking during childbirth is prohibited. Water can only be used to gargle.

This is done so that in the event of an emergency operation the person is already prepared for anesthesia. Of course, if you take a few sips and eat a couple of contraband cookies, the earth will not stop spinning, but I tried to follow the rules outlined in the courses.

The birth itself

Medical workers are superstitious people, so you will probably be asked to let your hair down for an easy and trouble-free delivery.

What does childbirth feel like? You take menstrual pain when the uterus contracts, getting rid of unnecessary endometrium, and multiply their intensity several times (each has its own multiplier).

The most painful contractions- the last hour or two, before that you can easily experience them without much change in facial expression, swaying on a fitball and chatting on abstract topics.

By the way, I’m not sure that in the general wards designed for three women in labor there are fitballs for everyone, so just in case it makes sense to ask permission to bring your own. The fitball became a real salvation for me when I no longer wanted to lie down and could not stand.

Is it painful to give birth? Of course it hurts. But it’s also painful to cut a finger... Or to break a leg... Apart from the presence of my husband, I was helped to experience the pain by a kind of mantra, words spoken by a midwife at a training course, which I liked so much that I wrote them down and remembered them forever: “Pain in childbirth is physiological, that is, normal."

And when I thought that this pain was normal, healthy, it really became easier. You can also reassure yourself that through pain during menstruation, nature has been preparing us for the upcoming birth for several years, so it’s nothing special, just a new level of sensations.

Another thing that kept my morale up was the thought of the divine snack already prepared in the bag for delivery to the postpartum ward: my favorite cookies, Alyonka chocolate bar, meat puree and birch sap. It's funny, but it's true... Childbirth is childbirth, but you want to eat.

At a certain moment, I was offered a pain-relieving injection with an aftertaste of glue. A moment to which I, without thinking twice, agreed. As the doctor said: “No one will give you a medal for refusing it.” I also remember exactly that there was a drip with saline solution. They also did CTG from time to time.

How to give birth?

Push and breathe in a certain way(table with breathing types below; most likely, all of them will be safely forgotten in the heat of childbirth, but, in as a last resort, the medical staff will advise). In case you suddenly forget everything, and the decisive moment of pushing has arrived, the doctor always has an apt and simple recommendation that everyone can understand: “Poop!” In principle, it quite accurately describes the essence of what is happening.

So, the moment comes when you can and should push. Pushing is a relief from pain, incredible relief, and movement forward. Now I will only be afraid (in terms of pain) of contractions in the last stage; pushing is a long-awaited release.

When you can officially push, each contraction is no longer a burst of powerless despair, but becomes a very real motor force.

I don’t remember any pain from the baby moving through the birth canal, it was only a little ticklish and even pleasant in places.

Unfortunately, in our maternity hospitals it is not customary to allow mother and newborn to be together for at least a few minutes after the birth of the latter. In the best case (in mine, for example), a creature with black beady eyes, stained with white grease, is laid on its stomach for half a minute, the midwife squeezes a drop of colostrum into its mouth and, having cut the umbilical cord (or entrusting this matter to the new dad), leaves to weigh and wrap baby. The father, shocked by the miracle of the birth of his own child, comes with her, with a camera at the ready.

You can be in the maternity room with your spouse if there are no other women in labor there or if other women in labor have given their explicit consent to this.

Notes from the courses:

We were lucky - we were alone in the delivery room. But, by the way, during childbirth, the last thing you think about is how you look from the outside, who is looking and where.

You can sit during early contractions without squeezing the pelvic floor (on a fitball). You can also lie down. From 6 cm it is advisable to take a vertical position. They can take you into the delivery room when you are 6 cm dilated. You can push only with the permission of the medical staff. *They took me after 8, and while we hobbled, although it was not far to go, all 10 were already there. In any case, after 6 centimeters, events develop rapidly.

On a chair, push “like a hedgehog”, with abdominal tension, with your eyes closed. Push not into the eyes, but into the perineum. After the next attempt, do not relax the muscles of the perineum, so as not to “pull” the child into you, but continue to breathe well. The birth of the parietal region and face should occur without any effort.

*The first three types of breathing can be combined in any way.

Dear readers! Do you remember how your birth went? Did you like the attitude of the staff? Did childbirth preparation courses help you? We are waiting for your comments!

The normal length of labor may vary slightly. As a rule, the second and subsequent births go faster than the first.

• In primiparous women, the average duration is about 9-11 hours, the maximum permissible duration is about 18 hours.
• In multiparous women, on average, about 6-8 hours, the maximum permissible duration is about 13-14 hours.
• If the duration of labor exceeds the maximum permissible duration, then the labor is considered protracted.
• If labor ends within 4-6 hours for primiparous women (2-4 hours for multiparous women), then this labor is called rapid. If labor ends in less than 4 hours for primiparous women (2 hours for multiparous women), then this labor is called rapid.
• Any duration of labor that does not correspond to standard indicators will be pathological.

Periods of labor

The onset of labor is considered to be the appearance of regular labor (labor contractions). There are 3 periods of childbirth: the first period (dilation), the second (expulsion), the third (successional).

Cervical dilatation

The onset of contractions leads to the dilatation of the cervix. Retraction of muscle fibers (displacement of muscle fibers relative to each other) is also characteristic. The contraction begins in one of the uterine angles and spreads to the body of the uterus, the lower segment. During a normal contraction, the so-called triple downward gradient is observed - the duration, strength and extent of the contraction decreases as it spreads from the bottom to the lower segment.

The cervix should open from 2-3 cm at the beginning of labor to 10-12 cm (depending on the size of the pelvis) or the so-called full opening. Full opening of the cervix (or when the cervix is ​​not detected) is the boundary between the first and second stages of labor. The opening of the cervix occurs along with its shortening (smoothing).

Most often, at the end of the first stage of labor, under the influence of many factors acting during childbirth, the amniotic sac is opened and amniotic fluid is poured out.

Opening up to 4 cm is slow (0.35-0.5 cm per hour) and is called the latent phase of the first stage of labor. From 4 to 8 cm, the cervix opens quite quickly (1-2 cm per hour) and this phase of the first period is called active. From 8 cm to full opening, the speed of opening of the cervix slows down again and this phase is called the deceleration phase.

The duration of the opening period is from 5-8 to 9-12 hours. As a rule, in primiparous women it lasts longer than in multiparous women.

Premature rupture of amniotic fluid

Premature rupture of amniotic fluid - rupture of the membranes and rupture of amniotic fluid before the onset of labor. From the onset of labor to the opening of the cervix 8 cm, the rupture of amniotic fluid is called early.

Expulsion of the fetus

From the moment the cervix is ​​fully opened until the fetus is born, this period of labor is called the expulsion period or the second stage. Within this period, obstetricians distinguish the period of pushing - when voluntary contractions of the diaphragm and muscles of the anterior abdominal wall are activated on the part of the woman. The fetus “performs” translational and rotational movements in the second period. (fetal movements are involuntary, due to the expelling forces of the uterus, obstacles from the pelvis - it has the appearance of a transverse ovoid at the entrance, and a longitudinal ovoid at the exit; resistance of the perineum and unequal articulation of the cervical spine and skull). The movements are called the biomechanism of childbirth and there are moments that differ depending on the presentation, type and insertion of the fetus. It is advisable to “connect” efforts to contractions when the presenting part completes the internal rotation, and even better when “lowering” the presenting part to the pelvic floor.

In the fetus, as the object of labor, presentation is distinguished (head, pelvic - purely gluteal, mixed and leg variants), appearance (the relationship of the back of the fetus to the anterior abdominal wall of the mother - anterior or posterior). At the presenting part, identification points are distinguished, by which the physiological or pathological course of labor is judged. At the head, this is a sagittal suture (between the parietal bones of the skull) and the small and large fontanelles (the junction of three or four bones of the cranial vault). In the case of breech presentation, identification points are distinguished - the intertrochanteric size and the sacrum of the fetus. Identification points of the presenting part of the fetus are considered in relation to the sizes, parts and planes of the woman’s pelvis.

In the second period, the woman receives benefits to protect the perineum from rupture. This benefit was widely used when it was necessary for a woman to be able to resume work soon after giving birth. Nowadays, some elements of perineal protection have not lost their relevance as a factor preventing birth trauma for women. Excessive emphasis on protecting the perineum leads to birth injury to the fetus. Surgical protection of the perineum - perineo- or episiotomy - is often used as a compromise that prevents, on the one hand, severe trauma to the woman, and on the other, to the fetus.

Serial

This period begins with the birth of the fetus and ends with the birth of the placenta. The placenta consists of the placenta and membranes. In the third period, 2 processes occur: separation (detachment) of the placenta and release (birth) of the placenta. It is believed that the third period should normally end in 30 minutes. In order to control the physiological course of the third period, signs of separation of the placenta are used in practice. If there are signs of separation of the placenta, but the placenta is retained in the uterus, techniques for releasing the placenta are used. With the birth of the placenta, the birth is considered over and the postpartum period begins, lasting (according to the orders of the Russian Federation and WHO recommendations) 42 days, of which the first 2-4 hours are the early postpartum period.

Biomechanism of childbirth

The set of basic movements performed by the fetus as it passes through the birth canal is called the biomechanism of labor and includes insertion, advancement, flexion of the head, internal rotation of the head, extension of the head, external rotation of the head and expulsion of the fetus.

For didactic purposes, various moments of the biomechanism of childbirth are considered as if they occur separately, but in fact they are all closely connected and occur simultaneously. Indeed, flexion, extension and rotation of the head are impossible if at the same time the fetus does not move down the birth canal. In addition, the contractile activity of the uterus affects the articulation of the fetus, especially after the head has descended into the pelvic cavity - the fetus straightens, and the limbs are pressed more tightly to the body. Thus, the fruit from an ovoid shape becomes cylindrical and in all its parts (head, shoulders, pelvic end) has approximately the same size.

Insertion

Overcoming the large segment of the head (a circle corresponding to the biparietal size - the maximum transverse size of the head in the occipital presentation) of the entrance to the small pelvis is called its insertion. Insertion can occur in the last weeks of pregnancy or after the onset of labor. Before insertion, the head is free, mobile above the entrance to the pelvis and moves during palpation. The head of a full-term baby is almost never inserted so that the sagittal suture is installed at the direct size of the inlet into the pelvis; usually it is located either transversely or in one of the oblique dimensions.

Asynclitism

The sagittal suture of the fetal head tends to enter the small pelvis through the transverse dimension of the entrance plane, but in practice it can, while remaining parallel to this dimension, lie not strictly between the promontory and the pubic symphysis, but shift either back, to the promontory, or forward, to the symphysis. Such lateral tilts of the head with displacement of the sagittal suture back and forth are called asynclitism.
A slight asynclitism is common for normal childbirth, but severe asynclitism is dangerous due to the discrepancy between the size of the fetal head and the normal pelvis of the woman in labor (clinically narrow pelvis).

Promotion (broadcast)

The forward movement of the fetus along the birth canal is the primary condition for normal childbirth. In nulliparous women, insertion of the head is possible even before birth, but further descent of the fetus will not occur until the second stage of labor (expulsion period) begins. In multiparous women, fetal advancement coincides with insertion. There are several forces that ensure the advancement of the fetus along the birth canal: 1) pressure from amniotic fluid, 2) direct pressure of the uterine fundus on the pelvic end of the fetus during contractions, 3) contraction of the striated abdominal muscles during pushing, and 4) extension of the fetal body.

Head flexion

When the head encounters an obstacle in its path, be it an undilated cervix, the pelvic wall or the pelvic floor muscles, it bends. In this case, the chin is pressed even more tightly to the fetal chest, and instead of a straight size, the head turns into the birth canal with a small oblique shape.

Internal rotation of the head

Internal rotation consists of such rotation of the fetal head that the occiput gradually turns either forward, towards the pubic symphysis, or, less commonly, backward, towards the anterior surface of the sacrum. Internal rotation is required for delivery of a full-term fetus; it can fall out of the general biomechanism of childbirth only when the fetus is unusually small. Internal rotation is always combined with forward movement of the fetus, but does not occur before the lower pole of the head reaches the iliac spines, that is, after insertion.

Head extension

When the head reaches the plane of exit from the small pelvis, the birth canal turns upward, and for further advancement it rests with the suboccipital fossa (fixation point) on the lower edge of the pubic symphysis and rotates around this point; thus, extension of the head occurs. Extension is ensured by the simultaneous action on the fetus of the forces developed by the uterus and the resistance of the pelvic floor muscles.

External rotation of the head

The born head, trying to return to its natural position, turns in reverse side: if before the internal rotation the back of the head was directed to the left, then now it turns to the left, towards the left ischial tuberosity; if it was directed to the right, then it turns to the right, towards the right ischial tuberosity. Further rotation of the head occurs due to the internal rotation of the shoulders, which are set by the interacromial size in the direct size of the outlet from the pelvis. In this case, one (anterior) shoulder extends beyond the pubic symphysis, and the second (posterior) shoulder lies on the anterior surface of the sacrum. Internal rotation of the shoulders is carried out under the influence of the same forces that cause internal rotation of the head.

Expulsion of the fetus

Almost immediately after the external turn of the head, the front shoulder appears under the pubis, and soon the rear one is born. Following this, the expulsion of the fetal body quickly occurs.

Terminology

Mother and mother in labor

• Woman in labor - medical term in obstetrics and gynecology; a pregnant woman who is already in labor (giving birth).

• Postpartum woman - this term refers to a woman who has already (just, recently) given birth.

Literature

• Joanna Stone, Keith Eddleman, Mary Murray Pregnancy and childbirth for dummies = Pregnancy For Dummies. - M.: “Dialectics”, 2007. - P. 384. - ISBN 0-7645-5074-8
• Persianinov L.S., Sidelnikova V.M., Elizarova I.P. Hemolytic disease of the fetus and newborn, L., 1981.

see also

Links

Wikimedia Foundation.

2010.:

Synonyms

See what “Childbirth” is in other dictionaries: CHILDREN - CHILDREN. Contents: I. Definition of the concept. Changes in the body during R. Causes of R.................................................. 109 II. Clinical course of physiological R. 132 Sh. Mechanics R. ................. 152 IV. Maintaining R......................... 169 V …

Great Medical Encyclopedia CHILDREN, childbirth (childbirth region), units. No. The physiological process of birth, the emergence of a baby from the mother's body. Easy birth. Difficult birth. Difficult birth. First, second births. Pain relief for childbirth. “He was married to a poor noblewoman who died in childbirth.”... ... Dictionary

See what “Childbirth” is in other dictionaries: Ushakova - occur after (on average) 280 days (40 weeks, or 10 lunar months) of pregnancy (see). During pregnancy, substances accumulate in the blood and tissues of a woman that sharply increase the excitability of the muscles of the uterus, its neuromuscular... ... Concise Encyclopedia

household Synonym dictionary

Modern encyclopedia

The complex physiological act of expelling the fetus and placenta from the uterine cavity. In humans, normal birth occurs on average after 10 obstetric months of pregnancy (280 days, 40 weeks), when the fetus becomes mature and capable of extrauterine... ... Big Encyclopedic Dictionary

CHILDREN, ov. The physiological process of the birth of a baby or cub. First rivers Difficult, easy childbirth. | adj. generic, oh, oh. Birth pains. Ozhegov's explanatory dictionary. S.I. Ozhegov, N.Yu. Shvedova. 1949 1992 … Ozhegov's Explanatory Dictionary

And male childbirth, plural. birth, release from pregnancy, separation of a child or baby from the mother. Lie in. Die in childbirth. Neither clan nor tribe. Which kind of family is loved, that kind of family rises (about the royal favorites). Generation after generation goes on. Not a fool, but that's how I was born. From… … Dahl's Explanatory Dictionary

Physiol. the process of expulsion of the fetus and placenta from the uterine cavity in placental mammals and humans. Labor periods: dilation of the cervix, birth of the fetus and release of the placenta. Many people participate in the preparation and implementation of R. body systems: center, and... ... Biological encyclopedic Dictionary

Childbirth- BIRTH, the physiological act of expulsion of the fetus and placenta from the uterine cavity. In humans, normal birth occurs on average after 10 obstetric months (40 weeks) of pregnancy. At the beginning of labor, regular contractions of the uterus appear, then to them... ... Illustrated Encyclopedic Dictionary

- (medical birth act, delivery, Geburl, accouchement, partus) represent a physiological process that occurs with the help of the contractile activity of the uterus and the assistance of the abdominal press, and is expelled out through the stretched canal of the cervix and ... Encyclopedia of Brockhaus and Efron

Based on the time of onset of labor, births are divided into timely, premature and delayed. Timely delivery is delivery between 38 and 42 weeks. Like all physiological processes, childbirth is largely instinctive and controlled at the hormonal and neurological level. However, you shouldn’t expect a “small miracle” to appear without making efforts.

Pregnancy and childbirth are painstaking work which can only be carried out by the woman herself. While obstetricians and pediatricians will ensure the health of mother and child and help in unforeseen situations.

Psychological attitude

A woman should cultivate the correct attitude towards childbirth and self-confidence throughout her pregnancy. Courses and trainings for expectant mothers, as well as reading additional literature, will greatly help you with this. From the very beginning, you need to configure yourself that giving birth is not scary.

You should not convince yourself that the birth process is absolutely painless. This is not true at all and everyone knows it. Try to think about what will happen after you see your baby and can kiss and hug him. Gather all your strength and willpower and try to give birth to your child in such a way that it is as easy as possible for him to survive this serious transitional moment.

In fact, the process of childbirth is much more difficult and dangerous for a child. Imagine: the baby lived inside your warm and soft body, received ready-made broken down nutrients and oxygen through the placenta directly into the blood and only occasionally moved his arm or leg slightly, and now he needs in some 5-10 hours through unusual movements and efforts be born, start breathing, screaming, seeing, hearing, eating and drinking... Try to help, not hinder him!

Natural birth or caesarean section?

Childbirth is divided into spontaneous, that is, through the natural birth canal, and operative - C-section. Caesarean section can be planned, i.e. The date of birth in this case is determined in advance and is an emergency when indications for a caesarean section arise suddenly. A caesarean section is a surgical operation in which the fetus is removed through an incision in the anterior abdominal wall and uterus.

The risk to a woman's life and health during a cesarean section is many times higher than during spontaneous childbirth. Therefore, like any other surgical operation, cesarean section is performed strictly according to indications when spontaneous birth is impossible or contraindicated. Therefore, the motivation “I don’t want to give birth, it will hurt, my figure will deteriorate, I’d rather have a caesarean section” is fundamentally false. For both the fetus and the woman in labor, vaginal birth is the healthiest and most natural.

Where to give birth?

“Where to give birth”? - this is the next one serious question, which a woman needs to decide before giving birth.

The most common and safest option is delivery in a hospital, i.e. in the maternity hospital. Here, constant and continuous monitoring of the condition of the woman in labor and the basic vital functions of the fetus will be carried out. In the hospital during childbirth, there is a person who assesses the condition of the child after birth and immediately provides assistance in case of any deviations. We must also not forget about the possibility of unforeseen complications during childbirth, which, as a rule, happen suddenly and require emergency medical attention.

When choosing a maternity hospital, you should check the availability of the following services: anesthesiology department, pediatric intensive care unit (even with normal labor, the child may need intensive care immediately after birth), blood transfusion department. Pay attention to the statistics: the number of births per year, maternal and perinatal mortality rates. Great importance has a comfortable stay in the maternity hospital: attentive staff, comfortable rooms, the possibility of visits from relatives, etc.

Home birth attracts people because the mother in labor is in familiar conditions and feels freer and more confident. However, it has been statistically proven that the number of complications and poor outcomes of such births is many times higher than in hospital ones. This is explained by the lack of dynamic monitoring of the condition of the mother and fetus and the extremely low qualifications of the staff (compare a midwife or doctor who performs 20 births daily in a hospital with those who perform 1-2 births per month at home).
However, if you decide to give birth at home, you should consider the possibility of transportation to the nearest hospital or maternity hospital in case complications arise. Otherwise, you risk not only your life, but also the life of your child.

Childbirth is most often carried out on a special bed with the woman lying on her back with her legs bent and spread apart. In the countries of the Middle East and India, women often give birth in a squatting position or on special beds that provide an upright position. In our country, vertical childbirth has also gained popularity, and in modern maternity hospitals it is possible to conduct childbirth in a vertical position. Talk to your obstetrician about whether this option is right for you.
Water births have also become popular in our country. This reduces the duration of the first stage of labor and achieves a high analgesic effect. For water births, a special pool is used. It should be understood that the process of giving birth to a child does not take place in water, but on a chair. After all, man is a land animal and it is inherent in nature that a child should not be born into an aquatic environment.

Pain during childbirth

Childbirth is accompanied by pain of varying degrees of severity. Each woman perceives this pain differently, depending on her psychological mood for childbirth and her pain sensitivity threshold.

In some cases, a woman in labor may require pain relief. People have two common misconceptions about pain relief: it is dangerous for the child; childbirth should be natural, I should be in pain.

In fact, women in labor are sometimes unprepared for the pain that accompanies childbirth. The problem is that the body can react to such an uncomfortable birth radically: for example, by stopping labor. Pain relief in such a situation not only helps the expectant mother, but also promotes the smooth movement of the fetus through the birth canal. Moreover, now anesthesiologists have at their disposal not one, but many safe options for relieving labor pain. This can be various sedatives, or epidural anesthesia. Drugs used to relieve pain during labor do not inhibit labor and do not have any negative influence for the baby.
Specify possible options anesthesia with your doctor in advance. Of course, no manipulations, including pain relief, will be performed on you without your permission. Only in exceptional cases, if the life of the patient or her child is in danger, does the doctor have the right to independently decide on the urgent implementation of a particular procedure or operation.

Childbirth process

Childbirth consists of three periods: The first stage of labor is the period of contractions in which the cervix opens. The second stage of labor is the expulsion or pushing period during which the baby is born. The third period is the period when the placenta is born. Contractions are regular contractions of the uterus, accompanied by nagging pain in the lower abdomen and/or lower back. At first, contractions are weak, last a few seconds, and the interval between them is 10-12 minutes. Sometimes contractions immediately begin every 5-6 minutes, but not very strong. Gradually, contractions become more frequent, stronger, longer, and more painful. Typically, in primiparous women, contractions last 10-12 hours, in multiparous women, 6-8 hours.

Sometimes labor begins with the rupture of amniotic fluid. In this case, you should immediately go to the maternity hospital.

Once you arrive at the maternity hospital, follow all instructions from the medical staff. Rely on doctors. These people have attended hundreds of births and will not recommend anything that could harm you or your baby. If future mom ready for childbirth, has a positive attitude, feels her body and her baby, and also trusts the doctors and listens to their tips, her birth will most likely be easy, painless and smooth, leaving behind the most wonderful memories.