Childbirth is a rather complex and unpredictable physiological process. However, the body healthy woman endowed with all necessary resources for a successful childbirth. To worry less and know what to expect, the expectant mother should know basic information about the periods of labor and their duration. This will allow the woman to mentally prepare for the difficult upcoming events, which will end with a real miracle - the appearance of the long-awaited baby.
How should normal labor begin?
Natural childbirth in a pregnant woman should begin spontaneously, spontaneously, at a period of 38 to 42 weeks. The water may break immediately or later. Throughout the entire process during a safe, normal birth, the body of the expectant mother does not need any intervention, everything happens as nature intended. Medical assistance needed if something goes wrong.
It is important to know! The minimum gestational age at which a baby can be born completely healthy and adapted to life outside the womb is 28 weeks, and the weight of the fetus must be at least 1 kg. Childbirth is considered natural from 38 to 42 weeks.
Such a baby is considered premature and will be in intensive care under careful observation for the first time, but he has every chance of survival.
A couple of days before the onset of labor, the expectant mother may feel strong pressure lower abdomen. Usually, a lot of mucus begins to be released from the vagina (the mucous plug that closes the uterine canal comes off), and the pelvic joints may begin to ache. Fetal activity is noticeably reduced, which is normal.
Main periods of labor
The birth process begins with contractions and the moment the cervix dilates, and ends after the placenta is expelled. It is impossible to determine exactly how long this entire difficult act of bringing a new life into the world will last. Everything is individual: for first-time mothers it can last longer – up to 1 day; In multiparous women, everything happens faster - within 5-8 hours. There are extremely rare cases when everything happens in a fairly short period of time - 2-3 hours.
The course of labor is divided into 3 periods:
- The first is preliminary (the period of disclosure). It begins with the release of amniotic fluid (they will leave later), and the first, still weak contractions, ends with the complete dilatation of the cervix.
- The second is expulsion of the fetus. It is recorded at the moment of full dilation of the birth canal and ends when the fetus is born.
- The third is subsequent. It is fixed after the fetus has already been expelled and ends with the release of the placenta (placenta).
If the pregnant woman is at home, then when the first stage begins, she must be immediately taken to the hospital.
In the clinic, labor management by periods can be carried out different doctors. Immediately before the birth itself, nurses monitor the patient; the obstetrician-gynecologist only periodically examines the woman in labor. At this stage, before giving birth, the patient is given a cleansing enema to completely empty the intestines.
With the transition to the second stage, the woman is transported from the prenatal ward to the sterile delivery room, and now obstetricians will be with her until the process is fully completed.
Let's take a closer look at each stage of childbirth.
Periods of childbirth. First stage of labor - dilatation
The initial, preliminary period of labor is recorded from the moment the uterus opens. Typically, a dilated woman feels the first contractions. They are not so painful yet and last only a few seconds. Unpleasant sensations start from the lower back and only then spread to the pelvic area. The intervals between contractions can be 20-25 minutes. In rare cases, the dilation of the cervix begins without contractions; the woman only feels a stretching in the back and lower abdomen.
During the 1st period, the body helps to soften the tissues of the uterine pharynx and smooth it out. The abdomen at this moment can become very hard and tense.
In multiparas and those giving birth for the first time, the stages of dilation occur differently. During the first birth, the uterine muscles first shorten and the cervix smoothes, and only then the external os opens. During repeated childbearing, these body actions often occur simultaneously.
On average, the uterus expands the pharynx at a speed of 1-2 cm per hour. Dilation is considered sufficient when the birth canal has dissolved by 8-12 cm (depending on the weight and physique of the woman in labor). The obstetrician periodically examines the vagina and monitors the progress of this process.
The fetus at this stage gradually approaches the pelvic floor with its head. Under such pressure, the amniotic sac (if it has not burst earlier) bursts and the amniotic fluid comes out. Bubble rupture does not always occur spontaneously. If the cervix has already dilated to 6-8 cm, but the waters have not yet broken, the doctor pierces the wall of the bladder so that the baby can move freely further. For the patient, this action (puncture) is almost imperceptible, and there is no need to be afraid of it.
The first stage of labor is painful for the expectant mother. In addition to contractions, a woman may feel nausea, dizziness, profuse sweating, chills or fever, frequent urge to emptying. Pain intensity and associated symptoms are individual and depend on the neuropsychological characteristics of each woman. For some, everything goes quite easily and quickly, for others the torment seems barely bearable.
In medicine, the preliminary period is divided into 3 phases:
- Phase I – latent. Its onset occurs with the first contraction and continues until the uterus dilates to 4-5 cm. The intervals of contractions in this period are usually 10-15 minutes, the speed of cervical dilatation is up to 1 cm per hour. In terms of time, the phase can last from 2-3 to 6-7 hours.
- Phase II – active. Contractions become noticeably more frequent (occur every 3-5 minutes) and become longer and more painful. The speed of opening of the pharynx increases (1.5-2.5 cm per hour). The phase ends when the uterus dilates to 8 cm.
- Phase III – slow. After the active and most severe phase, the process slows down somewhat; painful contractions gradually turn into strong pressure, which the woman begins to feel in the pelvic floor. At this stage, the uterus is fully dilated and the body is ready for childbirth.
Important! Throughout the entire preliminary period, the woman in labor should not push or strain. The main task for the expectant mother at this time is to breathe deeply in order to saturate her body and the baby’s blood with oxygen. Subsequent periods of labor largely depend on how the three phases listed above proceed.
Ideally, everything should happen in this order, but there are times when the sequence of stages is disrupted or pathological situations arise. In such situations, doctors decide on the spot what to do to safely resolve the birth. Sometimes you have to do an urgent caesarean section to save the baby's life.
When everything ends well in the first stage, the main part follows.
If the sequence of periods labor activity is violated, doctors may decide to resort to caesarean section. Second stage of labor - expulsion of the fetus
The most difficult and painful stage is over. Now the contractions practically stop and turn into pushing. The sensations are unpleasant, but not so painful. This act cannot be controlled. The pushing occurs reflexively, the muscles of the diaphragm, abdominals, and pelvic floor actively contract.
The fetal head begins to move intensively along the birth canal. The little man’s body gradually straightens, the arms straighten along the body, the shoulders rise towards the head. Nature itself guides the process.
During the second stage of labor, the patient is moved to the labor room, on a special couch, and the time comes when she must push. The doctor tells the woman what to do, how to breathe and at what point to tense up. The baby's head is shown in the perineum. With each push, the baby moves out a little. At this stage, some patients experience rupture of the soft tissue of the perineum. There is no particular danger in this; later the doctors will sew up the perineum and after a couple of months there will be no trace left on it. The woman giving birth herself, against the backdrop of strong attempts, no longer particularly feels the ruptures.
The duration of labor depends on the following factors:
- Woman's physique.
- Physical and psychological state women in labor.
- The position and activity of the fetus, its size.
The duration of the second stage of labor depends on many factors, the main one of which is the health status of the expectant mother. On average, the expulsion time lasts from 20 minutes to 2 hours. While the baby's head moves through the birth canal, it is very important to monitor the baby's pulse. If his face lingers in the pelvic area longer than necessary, hypoxia (lack of oxygen) may begin. This happens if suddenly, for unknown reasons, the attempts fade away. Doctors take action to expel the fetal head out as quickly as possible.
When the little man's head is completely out, the obstetrician removes mucus from his face to free Airways and completely removes the body from the mother’s womb. The baby is connected to the placenta, which is still inside, by the umbilical cord. It is cut and bandaged on the child’s body. The umbilical cord does not have nerve endings, so neither the mother nor the newborn feel any pain.
If the birth went well, the baby began to breathe and cried, he is placed on the mother’s chest for a few minutes. This action began to be practiced not so long ago. According to psychologists, this allows the woman to quickly come to her senses, and the baby to calm down, feeling the familiar beating of the mother’s heart in a new, frightening environment. Later baby They take him away and take him to a special department so that the baby can also rest after such severe stress. The woman in labor still remains on the couch.
At this point, the 2nd stage of labor is considered completed.
The third stage of labor is postpartum (afterbirth)
After some time (15-30 minutes), the mother again feels pain and straining. This is a completely normal and necessary phenomenon. The placenta (baby place) remains inside, and it should come out spontaneously.
As soon as the woman felt abdominal contractions and pressure again, the third stage of labor began. Everything happens much faster and not so painfully. If the placenta does not come out within half an hour after completing the second stage, doctors perform “squeezing” or manual cleaning under anesthesia.
At the end of the third period, the obstetrician sews up the perineum (if there were tears), disinfects birth canal. The woman can move into a more comfortable position, but must still remain in her position, lying on her back. For an hour, sometimes two after birth, doctors observe the patient at intervals of 15-20 minutes. If no complications or pathologies are observed, she is transported to the postpartum ward. Now a woman in labor is considered a postpartum woman.
It is important to know!
The first couple of days a new mother may have elevated temperature(within 38º
C). This is a normal reaction, the temperature will gradually return to normal. 
At the end of the third period, the woman is recommended to lie on her back for several hours.
The duration of childbirth significantly exhausts the body and an experienced mother usually experiences severe weakness. Along with fatigue, you may experience a feeling of thirst or hunger, chills, drowsiness, and fever. Coming from the vagina bloody issues. These are all completely normal reactions. The woman in labor is put on underwear and a gauze swab is placed in the perineum, which will need to be changed periodically. You cannot use regular sanitary pads after childbirth; they do not allow air to pass through, promoting the growth of bacteria, and can lead to tissue suppuration.
Gradually, the happy mother’s condition returns to normal.
On a note! If the birth went well and there were no ruptures, the woman can get up on her own within 3-4 hours.
These are the main three stages of labor that any woman who gives birth goes through. naturally. Our body is perfect and has sufficient resources to safely withstand such a serious and difficult act of bringing a new life into the world. Today there are various preparatory courses for pregnant women that teach proper behavior and breathing during childbirth. The more confident and calm a woman is, the easier and it will pass faster the whole process. A positive mental attitude also has a huge positive impact on childbirth.
The birth process is usually divided into 3 main periods:
first period - dilatation of the cervix,
second period - expulsion of the fetus,
the third period is the successive period.
Each of these periods has its own flow characteristics, which I will tell you about. Understanding the birth process helps relieve unnecessary stress and anxious expectations, which contributes to the successful birth of the baby.
The onset of labor is considered to be the appearance of regular labor (labor contractions). I have already talked about how to determine the onset of labor and how to distinguish labor pains from the precursors of labor in the article “How labor begins.” Now you will learn about the further course of labor.
What happens in the first stage of labor? Contractions lead to the fact that the cervix (the first obstacle on the way of a newborn baby) begins to open. Before the onset of labor, the cervix looks like a cylinder 2.5 - 3 cm wide and 2 - 3 cm long. In the center there is a cervical canal leading to the uterine cavity. During pregnancy, the cervical canal is closed, and not long before childbirth, when the harbingers of labor appear, it begins to open slightly (during an obstetric examination, it misses 1-2 fingers).
During childbirth active dilatation of the cervix begins. It occurs during contractions, due to contraction of the muscles of the uterus and pressure on the cervix of the fetal bladder or the presenting part of the fetus after the release of amniotic fluid. At the beginning, the cervix shortens until it effaces - the latent phase of labor. At the same time, contractions are infrequent (1 contraction every 7 - 10 minutes), weak and less painful. The latent phase of labor lasts on average 4 - 6 hours. After cervical effacement, the active phase of labor begins, which leads to full dilatation of the cervix (approximately 10 cm). The intensity of contractions increases as labor progresses. Gradually, contractions become more frequent, stronger and more painful. The active phase of labor lasts about 4 - 6 hours. In multiparous women, the process of dilatation of the cervix proceeds somewhat faster than in primiparous women. The boundary between the first and second stages of labor is the complete dilatation of the cervix.
Amniotic fluid is released at the end of the first stage of labor due to increased intrauterine pressure. Sometimes the water breaks out before contractions begin (premature rupture of water) or at the very beginning of labor (early rupture of water). The rupture of amniotic fluid does not lead to a deterioration in the condition of the fetus, since the baby’s vital activity depends on blood circulation in the umbilical cord and placenta. If there are medical indications that complicate the course of labor, the obstetrician may decide to open the amniotic sac - perform an amniotomy. There is a separate article on amniotomy on this site.
It’s better to go to the maternity hospital then when contractions become more frequent than once every 7 minutes, when it becomes clear that this is childbirth, and not harbingers of labor, that contractions do not weaken, but intensify. You can find out what to take with you to the maternity hospital from the article on this site.
IN reception department An obstetrician will see you at the maternity hospital. After registration medical documentation and conducting hygiene procedures(cleansing enema, shower) you will be taken to the maternity ward.
Childbirth is a natural process, invented by nature, so if childbirth proceeds without complications, then expectant tactics for labor management will be used, i.e. monitoring the natural dynamics of labor development, general condition mothers and the intrauterine condition of the fetus. The woman’s condition is assessed based on complaints appearance, heart rate and numbers blood pressure, inspection data. We can judge the condition of the fetus by listening to the fetal heartbeat and assessing cardiotocography data, which allows us to determine the condition of the fetus during labor with high reliability. Any doctor’s intervention during childbirth (medical or instrumental) must be justified by the presence of certain medical indications.
Childbirth is usually accompanied by pain varying degrees expressiveness. The strength of the pain depends on the state of the central nervous system, individual characteristics threshold of pain sensitivity, emotional mood and attitude towards the birth of a child. Pain during contractions is caused by dilation of the cervix, compression of nerve endings, and tension of the uterine ligaments. Don't forget about self-anesthesia methods.
Here are some recommendations:
·
deep breathing during contractions;
·
stroking the lower abdomen from the midline to the sides;
·
pressing the thumbs on the sacrum or rubbing the sacrum.
During contractions, it is important not to clamp down, but rather to relax the muscles, which shortens the duration of labor and reduces pain. During contractions, you can choose the position that is most comfortable for you: you can lie down, walk, stand on all fours, or kneel. Free behavior during childbirth makes it easier. To ease pain tolerance, it is important to remember that the intensity of the contraction increases gradually. The contraction has its peak, which lasts 2 - 3 seconds, and then weakens and ends quite quickly. After a contraction there is always a period of time when there is no pain, you can relax and rest. At a certain intensity pain The question of pain relief may arise. Depending on pain tolerance, the patient’s wishes, the nature of labor, the condition of the mother and fetus, and the dilatation of the cervix, the doctor who conducts the birth decides on one or another method of labor anesthesia. ABOUT various methods pain relief for childbirth, their advantages and disadvantages, you can learn from the interesting article “
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Harbingers of childbirth
1. 2-3 weeks before birth, the fundus of the uterus drops below the xiphoid process. The tightness of the diaphragm stops, breathing becomes free.
2. The presenting part descends lower, towards the entrance to the pelvis, which leads to increased urination.
3. Protrusion of the navel.
4. The uterus is easily excitable. Contractions appear - harbingers, accompanied by nagging pain in the lower back and sacrum, do not have correct rhythm, short, rare, weak strength, not accompanied by opening of the uterine pharynx.
5. Thick vaginal discharge stringy mucus as a result of the mucus plug being pushed out of the cervical canal.
6. On the eve of childbirth, the signs of “maturity” of the uterus are well expressed: it is located along the axis, softened; in multiparous women, the cervical canal allows a finger to pass through. Clinical objective signs of the onset of labor are:
a) true labor contractions - contractions of the muscles of the uterus, repeated at certain intervals. Initially lasting 10-15 seconds, intervals 10-15 minutes. Then the duration of the contraction increases, and the intervals between them decrease. The maximum duration of the contraction at the end of the opening period is 60-70 seconds, and the intervals are 1-2 minutes;
b) discharge of mucus from cervical canal, stained with blood;
c) smoothing and opening of the cervix;
d) formation of a cone of amniotic sac;
e) in some cases, rupture of amniotic fluid occurs: premature (before the onset of labor) and early (in the 1st stage of labor until the cervix is fully dilated by 8 cm).
The dynamics of the birth act and the advancement of the head are determined by internal obstetric examination, which is performed upon admission to the hospital. maternity hospital and after the rupture of amniotic fluid, during pathological childbirth - according to indications.
Approximately the degree of dilatation of the cervix during childbirth is judged by the height of the contraction ring (the border between the contracting hollow muscle and the stretching lower segment uterus). During childbirth, the cervix is usually dilated as much as the transverse fingers of the contraction ring are located above the pubic arch.
The duration of labor for primiparous women is 12-14 hours, for multiparous women it is 7-8 hours. Pathological labor includes labor that lasts more than 18 hours. Rapid labor - duration for primiparous women is from 6 to 4 hours, for multiparous women - 4-2 hours; rapid labor- for primiparous women 4 hours or less, for multiparous women - 2 hours or less.
There are three stages of childbirth
I period - opening period- smoothing and opening of the cervix. Its duration for primiparous women is 10-11 hours, for multiparous women it is 5-6 hours.
1. The dilation of the cervix occurs unevenly: in both first- and multiparous women, the first half of the dilation period lasts approximately 2 times longer than the second.
2. Observation of the general condition of the woman in labor every 2 hours (coloring skin, headache, dizziness, temperature, Ps, blood pressure, urination control - if delayed for more than 3-4 hours - emptying Bladder, if labor lasts more than 8-10 hours and the presenting part has not descended to the pelvic floor - a cleansing enema).
3. Perform external obstetric examination systematically and repeatedly, auscultation every 15-30 minutes, monitor the degree of fixation of the head.
4. When the water breaks, more vigilant observation, especially of fetal heart sounds (every 5-10 minutes).
In this article:
Childbirth is a difficult process for every woman, especially if it is the first. Every expectant mother looks forward to them and is a little afraid. About how childbirth proceeds, as well as about three labor periods Let's find out in more detail.
Preliminary (preparatory) period of childbirth
The preliminary period of childbirth is not yet childbirth, but a preparatory period lasting no more than a day. Discomfort expectant mother it does not cause, the cervix is prepared for childbirth. It opens slightly and softens. At the same time, the woman feels small, almost painless contractions, which begin to intensify over time.
If this stage proceeds pathologically, then it acquires great importance– drags on over time with irregular painful contractions. Only a doctor can determine whether the preliminary period is proceeding correctly. The pathological course occurs mainly in excitable women who experience fear or uncertainty before childbirth. Their sleep is disturbed, an increasing feeling of anxiety and fatigue appear. Therefore, labor pathological activity often occurs.
However, the course of the birth itself does not depend on how the preparatory period of childbirth proceeds. As some mothers of many children say, childbirth is a lottery.
So, there are three periods of labor: opening (first), expulsion (second) and afterbirth (third). The process of giving birth to a baby is quite extensive and complex. That’s why childbirth is carried out according to periods; let’s look at them in more detail.
First period
The 1st stage of labor is the longest and most painful. It is characterized by regular contractions, with the help of which the cervix opens. The fetus hardly moves through the birth canal during contractions. During the latent phase, which lasts up to 6 hours, contractions are less painful and rare, but regular.
In the second phase of this stage, contractions intensify. They become more frequent, and the cervix dilates 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 layer.
Contractions of the uterus begin with the muscles that are located closer to its bottom and gradually spread throughout the entire organ. The 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 cervix smoothes and opens.
The main indicators of the first stage of labor are the strength of contractions, regularity, frequency and speed of uterine dilatation. The condition of the cervix is determined by a doctor during a vaginal examination, the quality is determined by special devices that simultaneously record fetal heart contractions.
In the absence of a monitor, contractions are counted using a stopwatch. This determines their duration and the interval between them. The strength of contractions is determined by the tension of the uterus, using the palm of the hand, which is placed on the belly of the laboring woman.
The amniotic sac helps maximize the dilatation of the cervix. The fetal head is pressed against the pelvis, and the amniotic fluid is divided into posterior and anterior. With each contraction, the bubble inflates more and more and begins to put pressure on the neck, which contributes to its faster opening. When it opens up to 5 centimeters, the bubble is no longer needed and bursts. The waters are receding.
If they depart before contractions, then their departure is called premature. The water-free period should not exceed 6 hours, their safe absence is 72 hours. But in any case, this is not considered normal during the first stage of labor, and the woman should be under continuous medical supervision.
During the first stage of labor, the woman in labor can move freely and use pain relief methods. If necessary, it is possible to use antispasmodics, narcotic and non-narcotic analgesics, and epidural anesthesia is performed.
If a loss of strength occurs during this period, then activity stimulation may be used. If the amniotic sac does not spontaneously burst in time, an amniotomy is performed.
Second stage of labor
The second period is called expulsion of the fetus. It received a second name, like pushing. At the beginning, contractions are already strong and prolonged. The cervix dilates enough for the fetal head to descend into the 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), during 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, which she is unable to fight. The sensations in this case are very similar to the desire to “go big,” and inexperienced first-time mothers often confuse pushing with evacuation.
Most often, pushing begins when the cervix dilates 8 centimeters, and if a woman begins to push at this time, she may get a cervical injury. That is why, at the very beginning of pushing, it is suggested to breathe using special techniques, but pushing is still prohibited. The doctor examines the vagina and the midwife makes sure that the cervix is dilated enough for proper labor.
Time during pushing is of great importance and 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, helping the woman in labor remember how to breathe correctly. Since during this period a woman can simply forget everything she learned in the preparatory courses, if she attended them.
Then the second stage of this period begins, called the birth stage. He is very responsible, since the child must make several internal upheavals that are difficult for him, and at the same time he experiences enormous stress. Therefore, medical control occurs almost every minute.
First, the fetal head is assembled to pass through the plane of the small pelvis, then, repeating the shape of the birth canal, it turns, emerges from the genital slit and unbends. After which birth occurs. Then the shoulders appear, first performing an internal revolution, and then the body and legs come out unhindered. If the child is very large, or the mother narrow pelvis, then a natural birth is impossible and a caesarean section is performed.
In the 2nd period, labor activity may weaken and efforts become weaker. As a result, there is a danger of the fetus getting “stuck,” leading to hypoxia, tilting of body parts incorrectly, and weakness of the woman in labor. As well as bleeding, which may indicate placental abruption, which is severe complication. At the same time, the heartbeat of the child being born changes. It is heard not only during pregnancy, but also during childbirth using a stethoscope after each effort.
After the head has appeared, mucus is removed from the mouth and nose to prevent it from entering the respiratory tract when the newborn begins to breathe on his own. The placenta, which is still in the mother's womb, is separated using two clamps. And as soon as the baby makes its first cry, it is considered a newborn. This ends the 2nd stage of labor.
Third period
The third period is called the successive period. After the birth of a child, the volume of the uterus is greatly reduced, and it takes time for it to acquire normal tone, since the placenta is separated and birth is 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 are the second and subsequent ones, since their uterine muscles have reduced tone due to stretching due to previous births. Usually the birth of the placenta occurs within 20 minutes.
If under the influence uterine contractions the placenta does not separate from the wall in any way, and 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 experiences unpleasant short-term sensations. Once the placenta is delivered, labor is considered complete.
Upon completion birth process, the woman remains in maternity ward for another couple of hours. This is necessary 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 cause may be the placenta, which has an abnormal attachment to the walls of the uterus. Bleeding is also possible when the ability of uterine contractions decreases, or when the birth canal is injured.
In this case, the necessary measures are taken:
- the born placenta is removed manually;
- The uterus is massaged through the abdominal anterior wall;
- apply ice to the lower abdomen (for about 20 minutes);
- drugs that contract the uterus are administered;
- suturing damage to the tracks.
Duration of labor
For many women in labor, the periods of labor and their duration are different. True, it changes slightly. The first labor is generally longer than the subsequent ones, lasting from 9 to 11 hours. The longest duration is 18 hours.
For those who give birth for the second and subsequent times, the process takes from 6 to 8, and maximum – up to 14 hours. Protracted labor are considered if they exceed the maximum duration, and those completed earlier are called fast. Those that ended earlier than 4 hours in first-time mothers are considered rapid.
Postpartum period
It begins with the birth of the placenta, its 40 days average duration. The early postpartum interval is 2 hours after the successful delivery of the woman. During this period, just very high risk hypotonic bleeding.
This is followed by a recovery period. This is a time when a young mother is required to follow certain rules: adequate sleep and rest and restrictions sex life. During this period, breastfeeding is established and health is restored. Discharge and lochia begin, which accompany the contraction of the uterus, and its size is gradually restored to its previous state.
During 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 the newborn baby. During this period, the love and care of her family and friends, as well as their help and moral support, is very important to her.
Useful video about the three stages of labor
counting latent active, slowdown
Disclosure
fetal timely premature early belated
The course of the second stage of labor.
The second period or period of expulsion of the fetus is characterized by expelling contractions and pushing. For primiparous women it lasts up to 1 hour, for multiparous women – 30 minutes. The period of pushing is shorter and in primiparous women it lasts 30–40 minutes on average, in multiparous women it is 20 minutes. Under the influence of labor forces, the head descends into the pelvic cavity, and the fetus moves along the birth canal. The set of movements that the fetus makes while passing through the mother's birth canal is called biomechanism childbirth When the head descends to the pelvic floor, the genital slit begins to open, and a gaping of the anus appears. First, the head “cuts in”, that is, during the pushing it goes beyond the genital slit, and when it’s finished it disappears. Next, the head begins to “erupt”, that is, after the end of the attempt, it does not go back. Under the influence of contractions and pushing, the birth of the head occurs; in the anterior view of the occipital presentation, the head is turned with the occiput anteriorly and the face posteriorly. After birth the head erupts shoulder girdle, behind it the body and legs of the fetus are born without hindrance. This concludes the second stage of labor.
During the period of expulsion, the woman in labor experiences the greatest load or tension, as she must push. During pushing, the face turns red and the veins in the neck swell. The woman in labor rests her hands and feet on birth table. From the moment the head erupts, obstetric assistance is provided for childbirth in order to protect the perineum from damage. If there is a threat of rupture of the perineum, its dissection (perineotomy) is possible. After the pulsation stops, clamps are applied to the umbilical cord of the born fetus and it is crossed between the clamps, that is, the child is separated from the mother. To create skin-to-skin contact, the baby is placed on his stomach next to his mother, having previously indicated to the mother the sex of the baby, and covered with a dry, warm diaper.
Pathological childbirth always requires increased attention from medical personnel, responsibility and professionalism.
The course of the first stage of labor.
The first stage of labor is the longest and is characterized by opening contractions. Normally, the wave of contraction begins in the fundus of the uterus, spreads to the body of the uterus, and then moves to the lower uterine segment. Therefore, to evaluate and counting During contractions, the hand is placed on the fundus of the uterus. During the first stage of labor, there are 3 phases. The first phase is called latent, it begins with the onset of labor and lasts until the cervix is dilated to 3–4 cm. This phase is the longest, takes up 2/3 of the labor process, and is characterized by 1–2 contractions per 10 minutes, 15–25 seconds each, and low-painful. 2nd phase active, lasts from 3 - 4 cm of cervical dilatation to 8 - 9 cm. Contractions become painful, frequent, 3 in 10 minutes, 50 - 60 seconds each. Therefore, in the active phase of labor, pain relief is recommended (at 5–6 cm of dilation). The 3rd stage of labor is the phase slowdown, it lasts until full dilation (10 cm) and completes the first stage of labor.
Disclosure cervix in primiparous and multiparous women occurs differently. In first-time mothers, the internal os opens first, the cervix shortens and smoothes, then the external os opens. In multiparous women, already at the end of pregnancy, the external pharynx skips 1–2 cm; with the onset of contractions, the process of opening the internal pharynx, smoothing the cervix and opening the external pharynx occurs simultaneously. Therefore, repeated births normally proceed faster.
In addition to contractions, dilatation of the cervix is promoted fetal bubble. This is amniotic fluid that is located in front of the fetal head. During contractions, the amniotic sac “fills up”, wedges itself into the cervical canal from the side of the internal pharynx and promotes its opening. At the height of one of the contractions, with full or almost complete dilatation of the cervix, the amniotic sac opens (ruptures) and the anterior amniotic fluid flows out. Posterior amniotic fluid flows out after the birth of the fetus. IN in this case this is about timely rupture of amniotic fluid. In addition, there are premature(antenatal) rupture of amniotic fluid, that is, before the onset of labor; early effusion, that is, up to 6 cm of cervical dilatation; belated discharge of amniotic fluid, that is, after complete dilatation of the cervix (in the second stage of labor).
