First aid during childbirth: stages and sequence of actions. Providing first aid for sudden childbirth Acceptance of childbirth in women algorithm of actions

It happens that the expectant mother is outside the maternity hospital during childbirth or on the way to the hospital. If you provide assistance during childbirth correctly and know how to act, it is quite possible to avoid complications and pathologies. The qualifications of doctors and the speed of their reaction play a role. When labor begins at home, it is necessary to figure out whether it is realistic to take the woman to the hospital.

Algorithm for providing assistance

Labor begins with the opening of the cervix and the appearance of regular contractions. This is the initial stage of childbirth. In the second stage, the birth of the fetus occurs. Adoption emergency childbirth in the first phase. Help consists of monitoring the intensification of contractions, the fetal heartbeat and the active movement of the head through the birth canal.

What to do if labor begins:

1. the obstetrician must perform an internal examination of the woman in labor to find out how the fetus is positioned;
2. periodically measure the child’s heart rate (the norm is 120-140 beats/min);
3. control the degree of cervical dilatation.

As a rule, the first stage of labor ends with the complete opening of the cervix and the outpouring of amniotic fluid. The baby's head should be pressed tightly against the entrance to the pelvis. If the obstetrician cannot determine the position of the baby, most likely it is incorrect (transverse or oblique). In this case natural childbirth impossible. It is possible to continue the birth process only by caesarean section, so as not to provoke uterine rupture. It is necessary to immediately transport the woman in labor to the hospital.

When providing first aid during childbirth outside a hospital with an oblique or transverse position of the fetus, the patient should be given ether mask anesthesia. Inhalation is established through a nasal catheter.
The second stage of labor is the time when the baby appears. Along with contractions, pushing also occurs.

Stress on female body at this stage it is very large, the baby also suffers - due to frequent and strong uterine contractions, hypoxia may occur. Providing first aid during childbirth at the pushing stage requires careful monitoring of the woman’s general condition (uterine spasms, fetal heartbeat, its movements along the birth canal).

After each effort, the child’s heart rate is measured; if they become more frequent or slow down, it means oxygen starvation occurs. This may also be indicated by meconium in the amniotic fluid, especially if the fetus is in a cephalic position. IN mandatory a pediatric intensive care unit headed by a neonatologist is called and waits for the end of labor in case complications arise,

Pain relief and relief of contractions

Tolerate discomfort not always correct. The pain of labor is exhausting, and the process of having a baby requires a lot of energy. Therefore, it is better to learn techniques to relieve the pain of contractions and pushing. There are several options for an expectant mother to cope with discomfort. This is self-anesthesia or taking special medications.

How to reduce pain yourself:

• change body positions;
• perform self-massage;
• using aromatherapy.

Frequent changes of body positions will help redirect a woman’s attention during labor. In the first stage of labor, the most comfortable position is considered to be an upright position. When experiencing a spasm, it is recommended to lean on something and stand on your toes. This makes it easier to endure the pain of uterine contractions.

Massage. Both the woman herself and her husband or mother can knead the sacral area. Execute circular movements thumbs. This is also a unique way to distract from fears of an upcoming event.

Aromatherapy. It is known that essential oils have a positive impact on human body . They promote relaxation of the expectant mother at the beginning of labor. You need to be extremely careful with this pain reliever, because some essential oils can cause rapid development of labor. Use lavender, ylang-ylang or chamomile oil. These options are effective, but do not cause.

side effects

1. Drug pain relief:
2. with the help of anesthetics (promedol);
3. mask (inhalation);

administering the medication to the desired area. Drugs that are administered intravenously or intramuscularly have many side effects. This is drowsiness, strong relaxation, the state of a drunk person. Sometimes such a state of health of a woman in labor interferes with the birth process. It happens that after the introduction the expectant mother feels nauseous and dizzy, so she loses control of herself.

Such anesthesia is prescribed during the first stage of labor. In addition, there are no problems with him regarding administration - even if the wife gives birth outside the hospital, the husband can ask her to administer the drugs anywhere: at home, in an ambulance.

Inhalation method– withdrawal pain symptom nitrous oxide. Usually this anesthetic is always on hand for emergency physicians. The drug is not difficult to administer; it is enough to put an oxygen mask on the woman in labor. Medicine is used for pain during the first stage of labor.

Local anesthesia is used at the stage of suturing ruptures and cracks. Injections of lidocaine, novocaine or ultracaine are given. The doctor injects the required area, and the pain goes away.

A feature of childbirth outside a hospital is the lack of opportunity to perform epidural anesthesia. This method considered the safest and most comfortable for women. But in order to insert the catheter into the desired area of ​​the back and correctly determine the dosage, the presence of an anesthesiologist is required.

How to deliver a baby

If a woman is outside the hospital, she will need medical help. These people know how to act in most cases. There is a certain scheme that the doctor needs to follow.

Rules for non-hospital childbirth, tactics of an ambulance paramedic:

1. decide on the issue of transportation (is it possible to do this);
2. collect anamnesis (how many pregnancies there have been, weight gain, measure blood pressure, study the exchange card);
3. estimate general state women in labor;
4. find out what stage labor is at;
5. diagnose discharge for the presence of blood, amniotic fluid, or meconium;
6. if there is a need, examine the woman internally;
7. to make a conclusion;
8. if possible, it is better not to give birth outside a hospital, urgent Care will quickly take the mother to the hospital.

If there is no chance of hospitalization, the ambulance team begins to act according to the protocol. Every car has a generic set of tools.

The expectant mother is given an enema and her pubic hair is shaved. The genitals are washed boiled water with soap and blot with sterile wipes.

What should a husband do when his wife gives birth?

• prepare everything for hygiene procedures(machine, soap, water);
• lay linen at the place where the birth will take place;
• make or provide materials to make a polster (pillow-lining for the pelvis);
• prepare things for the baby's reception.

As soon as the cervix has reached the limit of 9-10 cm of dilation, the fetus begins to actively move towards the exit. At this point, contractions change to pushing and within 10-15 minutes the baby is born. First, the head appears, and then, after 2-3 attempts, its body appears. At this time, the baby makes its first cry. Dad needs to have the umbilical cord cut.

If possible and the mother’s condition allows, I place the baby on her chest to strengthen the thermal chain. Next, doctors wait for the baby's place to be born, after which it is examined for integrity. If everything is fine with the placenta, it is given to the parents or thrown away.

Treatment of a newborn

First aid for sudden childbirth is not only accompaniment and support of the mother, but also an assessment of the condition of the newborn baby. After expulsion, the child is placed between the woman’s legs on clean diapers, and another one is covered on top. For the newborn, mucus is removed from the throat and nostrils to prevent amniotic fluid from entering the Airways.

It is very important not to overcool the baby. The paramedic assesses the baby's condition using the Apgar scale from 1 to 10. The examination is performed twice: immediately after birth and 5 minutes later. The doctor evaluates the baby based on five factors: heartbeat, breathing, color skin, muscle tone and reflexes.

It is considered that from 7 to 10 points is a good result. This state of health is satisfactory and the child does not require urgent hospitalization. If the score was from 3 to 6 points, we can talk about pathological condition crumbs (lack of regular breathing, weak muscle tone, rapid heartbeat, which can be adjusted by taking the baby to the hospital on time). From 0 to 3 – this is severe asphyxia. Such children need to be resuscitated immediately. A stillborn baby has a score of 0.

As soon as the baby screams, the doctor steps back about 1 cm from the umbilical ring and, after treating the umbilical cord with alcohol, fixes the area with two sterile clamps. The tube is then cut at the desired location and tied with silk.

After this, the navel is lubricated with iodine and a bandage is applied to it. Bracelets are tied to the arms, indicating the gender, date, time of birth of the baby and the history number birth process. Next, a full diagnosis is made by a pediatrician (neonatologist) in a maternity hospital.

Medical care for birth pathologies

Often, a “home” birth ends in a completely different way. During its implementation, certain difficulties arise.

Possible pathologies during childbirth:

1. lack of disclosure;
2. incorrect position of the child;
3. the fetus does not come out on its own;
4. C-section.

If the cervix does not dilate, offer stimulating treatments. This may be the administration of oxytocin, the use of gels or prostaglandins. It all depends on what health workers have and how urgently it is necessary to act. The usual puncture of the bladder is not enough to labor activity began to develop.

With a transverse position of the fetus, it is very difficult to perform a birth outside the hospital. An emergency caesarean section may be needed at any time, and this is difficult without an anesthesiologist. Of course, if the baby is low birth weight or premature, you can try to unfold the fetus correctly. This is done provided that the cervix is ​​fully dilated. No one can give an absolute guarantee that the baby will not return to its original position again.

If an arm or leg fell out, it is prohibited to adjust the limbs. The ideal solution for this pathology is a planned caesarean section. Manually turning a child most often ends in complications.

The use of obstetric forceps is a type of obstetric aid when the baby cannot be born for a long time. The method is used if the mother’s body does not respond to stimulation, or if there is a threat of asphyxia or fetal hypoxia. The procedure is performed when the cervix is ​​fully dilated. A premature or large fetus is a contraindication to the use of forceps. The manipulation is performed under anesthesia. As a rule, mask anesthesia is used.

Most dangerous pathology is to conduct caesarean section. This is an operative delivery that requires hospitalization. Held surgical intervention under control pediatrician and an anesthesiologist. If doctors determine that there is no time or opportunity to take the woman in labor to the hospital, doctors perform the operation themselves, consulting with the maternity hospital doctors over the radio.

First of all, the pediatric intensive care unit is called, and then the doctors begin surgical procedures. After the operation is completed, in the presence or absence of pathologies, both mother and baby should be taken to the nearest maternity hospital.

When a wife gives birth, the father needs to do a lot at home to arrange everything for the baby's arrival. This applies to everyday life, purchasing necessities for a newborn. It is better to agree on the main nuances with your wife in the maternity hospital. You should listen to your doctor’s recommendations or consult with experienced parents.

If there is no planned partner birth, the first thing to do is future dad– find out if the baby was born. This information is free for the woman's relatives.

How to find out if your wife gave birth in the maternity hospital? To do this, you need to go to the nursing station in the maternity ward and ask about the progress of the birth process. Another option is to wait for your mother’s call and find out about everything first hand.

There are a number of tasks that need to be completed after dad has taken his wife to the maternity hospital. As soon as the baby is born, you should notify all relatives and friends about the baby's arrival.

What should a husband do while his wife is in the hospital?

• prepare a sleeping place for the baby;
• buy personal hygiene products for your baby;
• arrange an extract;
• execute general cleaning in the house;
• ventilate the room before the arrival of the newborn.

It would be nice to organize a small surprise for mom: make a festive garland or poster dedicated to the birth of the child and discharge. By the time mother and newborn return, everything should be finished and ready.

Childbirth is a complex physiological process that requires great effort from both the mother and the people around her (husband, doctors). If the birth of a baby for any reason takes place outside the maternity hospital, it is carried out by emergency doctors. These doctors know how to act in emergency situations.

Medicine is constantly evolving, and those old methods that were previously used in certain situations with patients sometimes even seem barbaric to us, because now with the help latest technologies we looked at medicine completely differently.

In this article we will describe what complications occur during childbirth, and compare how doctors deal with them now and how it was before.

If the cervix does not dilate

Sometimes it happens that a woman in labor has already lost her amniotic fluid, but the cervix has not yet dilated. This significantly complicates childbirth and can lead to injury to the baby and rupture of the mother’s cervix.

How did doctors deal with this problem before?

About thirty years ago, doctors would have helped the uterus open with their own hands, or with a special rubber balloon that was inserted into the cervix. This process was very painful, and could lead to serious damage to the uterus, and also, with such actions, there was a risk of contracting various infections.

Today, this procedure looks completely different. Firstly, doctors give the woman in labor painkillers, which makes the uterus open even more slowly. And then they lubricate it special gel, which contains prostaglandin hormones - they make the uterine tissue smooth. Also in this situation good helpers There will also be sticks made from kelp algae - they swell and dilate the cervix.

After the above procedures, contractions should begin. Sensors are installed on the woman's stomach to monitor contractions. If this process is delayed, then doctors take measures to prevent oxygen starvation The child has. To stimulate contractions, another drug is administered - oxytocin.

If contractions do not begin, then you need to do a caesarean section - this is an operation with the help of which the fetus is removed through abdominal cavity. Preparation for the operation lasts no more than 10 minutes, the procedure itself also lasts about 10 minutes.

20 years ago, this operation was performed extremely rarely in our country. But now the list of indications for cesarean section has expanded, either for reinsurance, or women have become weaker - but cesarean section is performed on every fifth woman in labor.

Transverse position of the fetus

This is one of the clearest examples of changes in obstetric practices. Transverse position of the fetus is when the fetus is located transversely to the exit of the uterus. Previously, the child was removed from the uterus by hand, the method was called “turning on the leg.” Accordingly, the child came out with his legs. If the fetus is too large, a caesarean section is performed.
This method is very dangerous for both the woman and the child.

Fortunately for women in labor, there are now completely different ways to help a woman with a transverse position of the fetus: firstly, doctors review all the readings of the mother and child through an ultrasound, and then prescribe a cesarean section.

Obstetric forceps

Sometimes it happens that when a child moves along the birth canal, difficulties arise and the baby cannot be born on its own, without medical care. Previously, such assistance looked like applying obstetric forceps or using a vacuum extractor. But now the same method is used, only the tools look completely different.
The forceps are used very rarely, and will probably soon come off altogether.

A more common method is a vacuum extractor, the device is different from the one that came before. The modern extractor is lightweight and does not injure the baby.
Every mom wants childbirth to go smoothly naturally, without medical intervention. Sometimes it happens that a woman needs the help of a doctor. As we see, today, with the help modern methods women do not need to worry about their health and their baby.

In any situation, listen to the doctors, they will help you and tell you how to behave correctly.

Currently, it is difficult to imagine childbirth outside a hospital. Nowadays, cellular communications, transport and access to different parts of the Earth are well developed. But even amid such powerful developments in technology, there are cases when a woman is forced to give birth in unprepared conditions. We suggest you play it safe and read the instructions on what to do if the birth of a baby occurs spontaneously.

Table of contents:

To begin with, let’s imagine situations in which such “force majeure” may occur. It could be:

1. Early, premature birth that began without this condition.
2. Carrying twins. In this case, labor begins more early stages(35-36 weeks) than a singleton pregnancy.
3. Threat of premature birth of the fetus.
4. The woman has a history of premature birth.
5. Not the first birth. In such cases, the process of the birth of a child occurs more quickly.

Many of listed items classify a pregnant woman as a risk group, and doctors recommend going to the hospital in advance in order to avoid emergency situations. But no one is immune from the fact that labor may begin spontaneously or on the way to the hospital. Let's consider the situations in which a woman may find herself at the beginning of the most important process:

Childbirth at home

Instructions for action if childbirth begins in a residential area, transport, or other places:

Assistant Responsibilities

If you have had to give birth in unprepared conditions, we advise you to read the information below.

How to give birth correctly

Birth of a child in extreme conditions

There are cases when labor begins in such conditions where it is absolutely impossible to call for help, or even call someone. At such a moment, the woman in labor is forced to take full responsibility upon herself. Try to find something that can be used to compensate for the list of items required for childbirth, described above.

Let it be rags or items of clothing, rope and water. Of course, one cannot dream of such things being sterile, but in the current situation there is nothing to choose from.

How to give birth on your own and alone

Possible complications when giving birth outside a hospital

Childbirth outside a hospital is a very serious and unsafe process, when there are huge risks of complications associated with the health of the child or mother. This may be a lack of breathing in the newborn or bleeding in the mother, let's talk about this in more detail.

If the newborn does not cry or breathe in the first minute after birth, you need to take actions that can encourage him to do this.

Emergency care if a newborn baby is not breathing

1. Keep the baby in vertical position from the back by the armpits, holding the head, wipe his chest and body so that it turns pinkish.
2. Place your newborn on his back, bring his feet together and clap them together.
3. With the child lying on his back, give him artificial respiration and not direct cardiac massage. Keep in mind that a baby's lungs are very small and the rib bones are quite fragile.
4. Take the child by the legs and shake him in a suspended state.

Lack of breathing in a child is sometimes caused by asphyxia, which can be caused by mucus entering the respiratory tract or compression of the neck by the umbilical cord during birth.

Mother's bleeding

Normally, a woman can lose no more than 2 glasses of blood during childbirth. If the bleeding is heavy and prolonged, you should be wary. This can be more dangerous, since uterine bleeding is comparable to bleeding caused by aortic rupture.

Stop uterine bleeding outside the hospital

In situations where childbirth takes place outside a hospital, it is very difficult not to panic and to act correctly and consistently. A woman faces more of a test, where the main thing is to maintain a sober mind, gain strength to withstand the existing conditions, and nature will help everyone.

Childbirth- a complex physiological process that completes pregnancy, during which the fetus and placenta (placenta, umbilical cord and membranes) are expelled from the uterine cavity through the birth canal. Physiological birth occurs after 10 cusher (9 calendar) months pregnancy when the fetus becomes mature and capable of extrauterine life. A woman during childbirth is called a woman in labor, after it is over - a puerpera.

For most pregnant women, within 2 weeks. before childbirth, so-called precursors are noted: the stomach drops and it becomes easier to breathe; body weight is slightly reduced due to increased secretion of fluid from the body; Irregular contractions of the uterus appear. At the very last days before childbirth, thick, viscous mucus is released from the vagina (a mucus plug that filled the cervical canal), often mixed with blood, and diffuse pain occurs in the sacrum, hips, and lower abdomen. From now on, you can’t leave home for a long time, because... At any moment, regular contractions of the uterus - contractions - may appear, which is considered the beginning of labor and requires the woman to be immediately sent to the maternity hospital. Sometimes, before the onset of contractions or with their onset, leakage of amniotic fluid is observed (found on underwear in the form of colorless spots). In these cases, it is necessary to hospitalize a woman as quickly as possible due to the possibility of complications: prolapse of the umbilical cord loop or fetal arm into the vagina, infection of the uterus.

In primiparous women, labor lasts on average from 15 to 20 h, for multiparous women - from 6 h 30 min to 10 h. The duration of labor is influenced by the woman’s age (in first-time mothers over 28-30 years of age, it lasts longer), the size of the fetus, the size of the pelvis, the activity of uterine contractions, etc. Labor can be so violent that labor is completed in 1-2 h, sometimes faster (swift P.). This is more often observed in multiparous women. Rapid labor increases the risk of soft tissue ruptures. birth canal and the perineum of the woman in labor, birth trauma of the fetus.

There are three periods in childbirth: cervical dilatation, expulsion of the fetus and the afterbirth period. The period of cervical dilatation - from the beginning of regular contractions to complete dilatation of the cervix and the release of amniotic fluid - is the longest, lasting on average 13-18 in primiparous women. h, and for multiparous women - 6-9 h. Contractions are initially weak, short-term, rare, then gradually intensify, become longer (up to 30-40 With) and frequent (after 5-6 min). Due to contractions of the uterus, its cavity decreases, the lower pole of the amniotic sac surrounding the fetus begins to wedge into the canal of the cervix, contributing to its shortening and opening. This removes the obstacle to the fetus' path through the birth canal. At the end of the first period, the membranes rupture and amniotic fluid flows out of the genital tract. In rare cases, the membranes do not rupture, and the fetus is born covered with them (“in a shirt”).

After the cervix is ​​fully dilated and amniotic fluid is released, the period of expulsion of the fetus begins. It lasts 1-2 h in primiparous women, 5 min- 1 h in multiparous women. The advancement of the fetus along the birth canal occurs under the influence of contractions of the uterine muscles. During this period, rhythmically repeating contractions that reach the greatest strength and duration are joined by contractions of the abdominal muscles and diaphragm - pushing occurs. During the birth process, the fetus undergoes a series of sequential and strictly defined movements that facilitate its birth. The nature of these movements depends on the position of the fetus in the uterus. Usually it is located longitudinally, with the head down, while above the entrance to the pelvis of the woman in labor there is often the back of the head of the fetus, facing to the right or left (occipital presentation of the fetus). At the beginning of the period of expulsion of the fetus, its head is pressed against the chest (bent), then, moving along the birth canal and turning around its longitudinal axis, it is installed with the back of the head in front, and the face posteriorly (towards the sacrum of the woman in labor).

When the fetal head, emerging from the pelvic cavity, begins to put pressure on the pelvic floor muscles, on the rectum and anus, the woman in labor feels a strong urge to lower herself, the pushing sharply intensifies and becomes more frequent. During pushing, the head begins to appear from the genital slit; after the end of pushing, the head disappears again (head embedding). Soon there comes a moment when the head, even in pauses between attempts, does not disappear from the genital slit (eruption of the head). First, the back of the head and parietal tubercles erupt, then the fetal head unbends, and its facial part, facing posteriorly, is born. With the next push, the born head, as a result of turning the fetal body, turns its face towards the right or left thigh of the woman in labor. After this, after 1-2 attempts, the shoulders, torso and legs of the fetus are born. Immediately after birth, the baby takes its first breath and begins to cry.

After the birth of the child begins succession period childbirth In this period, the duration of which for first- and multiparous women is on average 20-30 min, the placenta separates from the walls of the uterus and when the woman in labor strains, an afterbirth is born, consisting of the placenta, umbilical cord and membranes. Separation of the placenta is accompanied by slight bleeding.

With the end of the third period begins postpartum period, lasting 6-8 weeks. During this period, the uterus contracts almost to its original size and gradually, by the 4-5th week after birth, discharge from the genital tract, which is bloody in the 1st week, stops.

First aid for childbirth outside the hospital. In the event of an emergency - childbirth outside the hospital ( maternity hospital, hospitals) - first of all, you need to find out whether the woman is giving birth for the first time or repeatedly. First childbirth proceed more slowly, and, therefore, there is a greater chance of having time to deliver the woman in labor to a medical institution. If it is not possible to transport a woman or find a doctor, she must be calmed down, isolated from others, and placed on a clean cloth or oilcloth that is at hand. Tight clothing that compresses the stomach and interferes with breathing should be removed. You should not touch your stomach with your hands or stroke it, because... this can cause irregular contractions and disrupt the labor process. In the first stage of labor, a woman can take any position convenient for her (on her side, back) and even stand up for a short time; You can't sit, because... this interferes with the process of dilation of the cervix. During the period of expulsion of the fetus, before which, as a rule, amniotic fluid flows out, the woman in labor should lie on her back with her legs apart and bent at the knees, resting her heels on some fixed object. While pushing, she should hold tightly to the knees of her bent legs and pull them towards herself. If possible, it is recommended to wash the external genitalia and inner thighs with soap and water or wipe with cotton wool moistened with a 5% alcohol solution of iodine or vodka; close the anus with cotton wool or a piece of clean cloth. A clean cloth, towel, sheet or, as a last resort, the mother's underwear should be placed under the buttocks. Outside of pushing, the woman should breathe deeply. After the fetal head appears from the genital slit, it is necessary to restrain efforts, for which the woman in labor must breathe frequently and shallowly with her open mouth. The task of the person helping the woman is to support the head and then the body of the newborn baby. Before these manipulations, you must thoroughly wash your hands up to the elbows with soap and a brush, if impossible, wipe your hands with a 5% alcohol solution of iodine, ethyl alcohol or vodka. After the baby is born, the umbilical cord should be tightly tied in two places with a piece of bandage or any clean cloth ( rice. ): approximately 5 cm above the umbilical ring of the newborn and departing from this node 10-15 cm. Between nodes (about 2 cm above the node closest to the umbilical ring), the umbilical cord is cut with scissors or a knife, previously wiped with a 5% alcohol solution of iodine, ethyl alcohol or vodka, or calcined over a flame. In places of ligation and cutting, the umbilical cord should be treated with the following: antiseptics. The end of the umbilical cord remaining with the child should also be treated with these solutions and tied with a bandage, a clean piece of gauze or other fabric. After this, the baby must be dried, wrapped in a clean, warm cloth and placed on the mother’s chest. The sucking reflex in a newborn is well developed; irritation of the nipple of the mammary gland causes contraction of the uterus and accelerates the separation of the placenta and the birth of the placenta. Under no circumstances should you pull or tug on the umbilical cord hanging from the vagina, because... this may interfere with the separation of the placenta and cause bleeding. The separation of the placenta is indicated by a change in the shape of the woman’s abdomen - it becomes asymmetrical, because After separation of the placenta, the uterus takes on an elongated shape and deviates from the midline, its bottom is located slightly above the level of the navel. At this time, the woman feels the desire to push, in 1-2 attempts the placenta is born and discharges up to 250 ml blood. After the birth of the placenta, the abdomen becomes symmetrical, because the uterus takes its original position, its bottom drops below the navel. At the end of childbirth, wipe or, if possible, wash the woman’s external genitalia. It is recommended to place an ice pack or bottle on the abdomen (on the area of ​​the fundus of the uterus), cold water or snow or, if this is not possible, heaviness (2-3 kg). These measures contribute to faster contraction of the uterus and the prevention of uterine bleeding. The mother and child need to be transported as quickly as possible to maternity hospital or hospital. Along with them, it is necessary to send the afterbirth, which must be examined by a doctor to establish its integrity, because retention of parts of the placenta in the uterus after childbirth can become a source of uterine bleeding and inflammation.

3246 0

Despite a wide network of maternity hospitals and thorough medical examination of pregnant women, sometimes it is necessary to provide first aid to women giving birth at home, by train, or by plane.

First aid

When providing assistance, you must thoroughly wash your hands and disinfect scissors or a knife, prepare a sterile bandage or put it in alcohol ( alcohol solution iodine) strong thread, ribbon necessary for processing the umbilical cord. If the baby is born with asphyxia, a rubber bulb can be used to suck out amniotic fluid from the nasal passages and mouth.

The newborn baby is placed on a clean sheet (diaper) ironed with a hot iron. After the pulsation of the umbilical cord has stopped, it is tied twice at a distance of 5 and 10 cm from the child’s navel with thread, ribbon or a strip of bandage, and then cut between the ligatures (Fig. 65).

The end of the umbilical cord must be treated with an antiseptic solution and secured with a sterile bandage, fixing it with a thread to the umbilical cord.

Rice. 65. Ligation (a) and intersection of the umbilical cord (b)

If the child does not breathe, it is necessary to begin artificial respiration using the mouth-to-mouth principle, having first sucked out water from the child’s nose and mouth with a rubber bulb.

The mother and the newborn child should be taken to the maternity hospital as quickly as possible.

After the baby is born, within the first hour, the baby's place (placenta) should leave the birth canal along with the remains of the umbilical cord. The separated baby's place must be shown to a doctor, who will determine the completeness of the placenta's separation.

A retained placenta may cause serious illnesses. After childbirth, the perineum should be covered with a clean diaper or piece of cloth.

Buyanov V.M., Nesterenko Yu.A.