Pregnancy and childbirth are important processes for every woman that require careful preparation. None of the doctors divides pregnancy and childbirth into two different events, since they are deeply interconnected - one state smoothly passes into another. That is, childbirth is the final stage of pregnancy. Therefore, every woman should know how to prepare for childbirth, even in the process of bearing a baby.

There is no doubt that childbirth requires special preparation. This process is absolutely unpredictable, requiring, first of all, active participation and initiative from the woman in labor. So how do you prepare for childbirth?

Psychological readiness for childbirth is just as important as physical. Trained muscles of the perineum and the basics of breathing exercises are not yet a guaranteed success for the upcoming birth. No less important is the awareness of the woman in the process that is happening to her, thanks to which she will be able to control her behavior during childbirth, relax in time and breathe properly, which will positively affect not only her, but also the condition of the child.

And it is present in every woman. Primiparas are afraid of the unknown and stories about the birth of girlfriends and relatives, multiparous are worried about the failures that took place in previous births or during pregnancy. Psychological readiness for childbirth will help to avoid this fear.

Experts have proven that a woman who has undergone psychoprophylactic training before childbirth is easier to cope with pain during pregnancy, interacts more actively with medical personnel, and the condition of their newborns is better compared to other women in labor.

Psychologists distinguish 3 levels of psychological readiness for childbirth.

Low level

A woman experiences the following feelings:

• strong excitement;
• panic fear for their own health and the baby;
• expectation of suffering and pain in childbirth;
• aggressive attitude towards the father of the child, less often - towards the baby himself;
• unwillingness to listen to doctors.

The negative emotions that guide such a woman are wrong. Urgent help is needed from a psychologist who will tell you how to prepare for childbirth from a psychological point of view. Serious work is required on the moral state of the future woman in labor.

Middle level

It is determined by the following signs:

• optimistic attitude towards childbirth;
• gnawing doubts and self-doubt;
• experiencing the failures of strangers, fears of unverified information, etc.

Psychological assistance in this case consists not only in teaching how to prepare for childbirth, but also in supporting loved ones of the woman in labor. The goal is to cope with uncertainty and look optimistically at the process of childbearing.

High level

It means that:

• a woman is positively disposed to bearing a child and giving birth;
• knows how to prepare for an easy birth: studies, does self-massage, etc .;
• ready to help your baby in childbirth as much as possible;
• actively cooperates with medical personnel;
• positive emotions prevail in the mood;
• plans .

A high level of psychological readiness means that a woman is perfectly prepared for childbirth and must maintain this attitude until they occur.

Physical training

Physical training allows you to keep the shape of the expectant mother, which will make it easier to endure childbirth.

It consists of the following aspects:

• Motor activity and hardening. Both of these factors are necessary for every pregnant woman. In the absence of contraindications, it is recommended to walk more often in the fresh air, reasonably alternating activity and rest. The rhythm of loads is selected individually for the well-being and condition of the expectant mother.
• . Physical exercises are selected for each woman individually, depending on the nature of the pregnancy, the duration and the presence of complications. How to prepare the body for childbirth with the help of gymnastics for expectant mothers, a specialist will tell you. If a woman is engaged at home, then it is important that someone is nearby.

If the expectant mother has previously been involved in sports, then in the absence of contraindications, she can continue her classes by choosing the optimal and appropriate physical activity. After 36 weeks of pregnancy, it is better to refuse classes or minimize them, as there is a risk of developing premature birth.

1. Take up swimming. During classes in the pool, the expectant mother strengthens all the muscles of her body - perineum, legs, abs, back. The body becomes more flexible and resilient. Breathing functions improve, stretching increases. In general, water has a pronounced relaxing effect on the entire body, as a result of which the preparation for childbirth is more efficient.
2. Do a massage. It is included in the complex of exercises for the physical preparation of the body for childbirth. For expectant mothers, there are some peculiarities of massage - without active influences and kneading in the abdomen. Massage helps eliminate back pain, relieve muscle tension and lower extremities. It also includes self-massage of the intimate area with the help of special oils. The preparation of the perineum avoids excessive stretching and tearing of tissues in this area, and facilitates the process of the child's passage through the birth canal. How to prepare the uterus and perineum for childbirth, you should check with the gynecologist in more detail.
3. Learn to breathe properly. at the right pace in childbirth allows you to minimize pain during contractions and facilitate the very process of giving birth. Breathing exercises should be practiced regularly, starting from the 2nd trimester.
4. In the last weeks of pregnancy, the cervix should be prepared for childbirth to minimize the chance of complications, cracks, and ruptures.

Cervical preparation

It is impossible to accelerate the maturation of the cervix with the help of any training or muscle influences. Cervical preparation can be done medically or at home. Let's consider these options.

Medical preparation, aimed at preparing the uterus for childbirth, is as follows:

• the use of vaginal, and Kolposeptin;
• a drug that is safe for the unborn child;
• mifepristone, which is a potent drug and therefore less frequently prescribed.

How to prepare the cervix for childbirth at home:

• Regular intimate relationships in the absence of contraindications for the expectant mother. Frequent sexual intercourse effectively softens the cervix, and the vagina becomes elastic, and therefore more prepared for the upcoming stretch. Due to this, the onset of labor is naturally stimulated.
• Massage of the nipples, as a result of which oxytocin is produced - a hormone that provokes labor.
• Evening primrose oil also helps ripen the cervix, but you can buy it only with the permission of a doctor. It is rich in fatty acids that help soften the cervix and prepare for childbirth.

Methods of preparation for childbirth

Any method of preparing a woman for childbirth includes three important aspects:

• correct breathing;
• the ability to relax;
• positive thinking.

Modern methods of preparing for childbirth are similar and different at the same time. Every woman can choose what is closer to her.

So, we are preparing for childbirth using the following methods.

Grantley Dick-Read technique

This concept was developed over a hundred years ago by midwife Margaret Gamper and physician Grantley Dick-Read. The basis of their methodology is the achievement of a mild birth process with the necessary preparation for it.

Grantley Dick-Read argued that every woman is able to control the physical stress and pain that occurs during childbirth on her own. To achieve this, it is enough to strictly observe the main principles of independent childbirth.

For this, it is important for a woman preparing to become a mother to overcome her fear of the inevitability of pain and suffering, since it is fear that causes physical tension, which increases pain.

But not only the position of self-persuasion underlies this technique. Grantley Dick-Read offered his patients methods of deep relaxation, which also played a great role in childbirth. This technique is described in most detail in the book "Childbirth without fear", which every expectant mother can get acquainted with.

Lamaz technique

This technique became popular in the 1950s. Its founder was Ferdinand Lamaze. According to many doctors, this technique is more like training - a woman learns the same techniques for a long time, which are worked out to perfection, which allows her not to be distracted by physical discomfort during childbirth and keep the process under control.

Lamaze took Pavlov's theory of reflexes as the basis of his method. As for women, most of them believe that following the Lamaze method really gives a tangible result in childbirth. The main techniques of the Lamaze technique are meditation, breathing and relaxation. All of them can be practiced alone or with a partner.

Robert Bradley school methodology

As in the previous case, this technique became known in the middle of the last century. Despite this, it remains relevant today and tells how and when to prepare for childbirth.

Unlike the Lamaze method, the concept of this theory was the task of listening to your own feelings during the birth process and learning to actively interact with the body. Robert Bradley in his methodology developed a special balanced diet and a mandatory set of physical and spiritual exercises.

The author of the methodology believes that a thorough step-by-step approach to his theory will allow the expectant mother to realize that physiologically normal processes occur in her body during pregnancy and childbirth. Also, the task of the technique is to increase the level of confidence and calmness of a woman.

Joint preparation for childbirth with a partner and partner childbirth - Robert Bradley is campaigning for this. Prior to the advent of this theory, childbirth was considered an exclusively individual matter, and nothing was known about partner childbirth.

Sheila Kitsinger Method

You can get acquainted with the methodology of this author in the book "The Experience of Childbirth". Sheila Kitsinger views the preparation for childbirth as an indispensable combination of the following factors: breathing technique, massage, self-control and sacred experience, based on the social, personal and sexual peak in the life of a pregnant woman.

The author of the methodology believes that with the help of childbearing, a woman is revealed as a person, while the level of her social significance and her own self-esteem increase. Such an attitude is necessary in preparation for childbirth, only in this case they will become favorable and successful for the woman in labor and her child, as well as for all her relatives.

Michel Auden's technique

According to the founder of this technique, childbirth is a process saturated with the deepest intuition. In order for them to be most successful, the woman in labor must learn the power of emancipation, she must follow her emotions and nature. To achieve this, it is important to observe certain subtleties.

Michel Auden suggested that women during pregnancy explore their talents, discover their new opportunities. It can be dancing, singing, drawing and other creativity. A woman should choose her own position during childbirth. According to the author of the technique, vertical births are the most suitable for women in labor.

Hypno- childbirth

The basis of this technique is the practical activity of ancient yoga. With its help, future mothers can learn self-hypnosis, self-hypnosis, the basics of meditation, positive thinking and much more.

What do you need to buy?

Approximately 2-3 weeks before giving birth, every woman begins to pack bags, thinking about what might be useful to her in the hospital. On average, within the walls of this medical institution, women in labor spend from 5 to 10 days, which means that you should not go there empty-handed. So, what should you buy for the expectant mother and her baby?

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The readiness of the body for childbirth

In the last 1.5-2 weeks of pregnancy, the preparation of the woman's body for the upcoming birth ends. This training covers all organs and systems, starting with the centers of higher nervous activity and ending with the executive organ - the uterus. The dominant of pregnancy is replaced by the dominant of childbirth, and the uterus turns from a fetus-place into an expelling organ.

The readiness of a woman's body for childbirth is characterized by a number of signs, the appearance of which indicates the possibility of the onset of childbirth in the near future. The most pronounced changes occur in the genitals. In contrast to the assessment of the state of the central nervous system or hormonal status, which requires the involvement of special, as a rule, complex research methods, the diagnosis of the state of the reproductive apparatus is carried out using conventional clinical methods for examining a pregnant woman and simple tests. These include: determination of "maturity" of the cervix, oxytocin test, mammary test, cytological examination of vaginal smears.

Preparing for childbirth

You have all passed and you just have to meet your child and bring him home, where you have prepared a cozy corner for him and where everyone has been waiting for him for so long. You have read many books, attended courses, consulted with friends and doctors, surfed the Internet, you know all the theoretical part about childbirth. You are a little afraid to forget all this and confuse it at the most important moment. Therefore, take the text below simply as a cheat sheet, because the full information is in books, courses, and other places. And this is a cheat sheet for the last moment, so as not to rummage through a pile of texts. As a basis for this cheat sheet, I took the summary of the "experienced puerperal" given on one of the "folk" sites, so if you see familiar words, do not be surprised. And once again - you all know this very well. But if fear and uncertainty remain in you, then the article can help you.

What you can do at home to prepare for childbirth and the hospital if you are going to one

Preparing the cervix for childbirth, softening the cervix

From 36 weeks - regular sex life without a condom. Sperm softens the cervix, preparing it for childbirth. That is why a condom is essential during pregnancy itself.
- From 34 weeks evening primrose oil in capsules - 1 per day, from 36 weeks - 2, from 39 - 3 capsules per day. Drink.

Preparing the skin of the perineum for stretching during childbirth and preventing tears and incisions in the perineum (episiotomy)

Massage of the skin of the perineum using vegetable oil (ordinary, olive, wheat germ). Before the massage itself, warm up the skin (with a warm heating pad or a warm bath). Dry and massage with your hands the dry skin between the anus and the vagina from the outside, rubbing oil into it, pull the lower fornix of the vagina down and to the sides. From 34 weeks - 2 times a week, from 38 - every day

Exercises for stretching the muscles and ligaments of the perineum:

Standing sideways to the back of the chair, rest your hands on it and take your leg to the side as high as it is comfortable - 6-10 times for each leg.
- With the same emphasis, raise the leg bent at the knee to the tummy.
- With legs wide apart, slowly sit down and hold in this position for several seconds, you can spring. Get up slowly and relax. You can repeat 3-5 times.
- Squat down, straighten one leg and set aside. Shift weight from one foot to another several times in a row. Arms outstretched forward will help maintain balance.

Everyday poses.

- "Pose of the tailor" - in a sitting position, cross your legs in front of you.
- "Butterfly" - sitting, connect the heels and pull them to the crotch. You can not move your legs, just remaining in this position, but most likely the "wings" will start dancing on their own. It's great and won't stop us from watching TV, reading, or peeling potatoes.
- “On your heels” - kneel down, tightly connecting them, and smoothly sit back on your heels.
- "Frog" - being in the position "on the heels", spread your legs and sit on the floor between the heels.
- in the “squatting” position: you can just squat, minding your own business, or you can (should!) wash the floor on your haunches!
- You can walk "in single file" - from the kitchen to the room

Choose a position that is comfortable for you and change position as soon as it becomes tiring.

Preparing nipples for feeding

Prevention of cracked nipples and mastitis

Contrast shower, massaging the nipples.
- Terry towel (rub gently).
- Air baths (more to walk with an open chest).
- Accurate stretching of the nipples, the formation of an elongated shape - with your own hands and with the help of your husband.
- Ice cubes from a decoction of oak bark.

It is not necessary to try hard in advance, because stimulation of the nipples causes uterine contractions.

Preparing for the maternity hospital

What to agree with the doctor in advance:

How to give birth (as far as you insist on natural childbirth, if there are relative indications for caesarean). Discuss the conditions under which the doctor considers the operation necessary, come to an agreement.

When to give birth (if a caesarean is being discussed) - planned or start naturally.

When to go to the hospital (when the contractions begin, the waters break, there will be contractions at certain intervals - which ones).

What kind of anesthesia to use and in what case (for caesarean - general or epidural, for natural childbirth - standard medical sleep, pain relief, at your request, for the reasons of the doctor, no pain relief without serious indications - as you wish)

The presence of relatives at birth. Husband, mother, girlfriend, assistant, what should they take with them (change, change of clothes, food, drink), what will they be allowed to do, can they give you a massage, hold your hand at any time, i.e. get in the way of the staff, pick up the baby first, cut the umbilical cord.

Stimulation of contractions - the introduction of oxytocin - and a puncture of the fetal bladder. Under what conditions the doctor insists on carrying out, discuss what is not done prophylactically if you do not want to.

Episiotomy (do you insist that it is not done without emergency indications, or are you yourself interested in making everything faster and easier, because it is done just for this, like the previous paragraph).

Sewing up with anesthesia - be sure to insist, this is the most painful procedure in childbirth.
- Attaching the baby to the breast and the first actions with him. When to cut the umbilical cord - immediately or after the cessation of pulsation (with Rh incompatibility is prohibited) and to whom. First, wash and weigh the baby, or put it on your chest first. How long to put, how long they will take for washing, weighing and instillation of the eyes, where, when they will return - as you want!

There are no standards that are perfect for everyone, you may be the first to want to sleep peacefully alone. If they take it to the nursery, whether to supplement it there, whether to supplement it with the mixture that you bring or the one that is there, whether it is possible with donor milk - all this will be discussed. If you are set up to feed on demand with separate placement, discuss that they immediately carry to you, and do not supplement. Is it possible to dress a child in home clothes.

Vaccinations. Hepatitis - whether to do in the hospital. If yes - only imported vaccine - buy and bring.
- If you have a negative Rh factor - buy and bring anti-Rh D-immunoglobulin, discuss its administration within 72 hours after delivery, the sooner the better.

What to take to the hospital?

• passport;
• exchange card;
• childbirth contract;
• mobile phone and charging;
• clock;
• robe;
• nightgown with ties in front (It is convenient to use a regular men's shirt.) 2-3 pieces;
• slippers (according to the requirements of some maternity hospitals, they must be washable. If not, then a second pair for the shower);
• underpants;
• gaskets Super;
• anti-varicose stockings / stockings / elastic bandages;
• socks;
• toothpaste and brush, comb, cream, toile. paper, napkins, sponge, baby soap, unscented antiperspirant (children are often allergic to their mother's deodorant and cream, and not at all to what she ate);
• two towels;
• plate, cup, spoon;
• hygienic lipstick! (lips dry during childbirth);
• hair clips, loose elastic bands;
• bras (special model, or soft knitted, in which you can easily release the chest);
• cream for cracks in the nipples - bepanten or lanolin;
• disposable bra pads;
• breast pump, if the maternity hospital does not rent or you do not want:
• bottled water, tea leaves, sugar, chewing gum;
• thermos with drink (rosehip infusion);
• a second thermos with reducing and hemostatic herbs;
• food: dried fruits, fruits, cookies;
• small electric kettle
• paper, pen, book, player (or tape recorder to listen with a child), cassettes with your favorite music;
• camera;
• plaid if winter;
• nightlight - if only overhead lighting is provided in the wards;
• Disposable diapers. You should not buy more than two packs in advance (in the first days, about 10 diapers per day can be spent in the maternity hospital), as there may be a negative skin reaction to one or another model, and you can also choose the size only for the child. Even if the maternity hospital offers their own diapers, it is better to immediately use the brand that you plan to use so that you do not have to change later;
• Wet cleansing wipes, non-alcoholic;
• Rompers are light - if the rules of the maternity hospital allow, then it is convenient to immediately put the baby in your clothes;
• spare shoes for the husband, if he is with you;
• food for the husband (bananas, sandwiches, water);
• contact numbers of those who you may need - a breastfeeding specialist, a doctor in charge of your pregnancy, a pediatrician. It is better to arrange with him and a breastfeeding specialist in advance so that you know who to call in case of problems in the maternity hospital.

How to prepare for childbirth

How to prepare for childbirth? This issue is of particular concern to expectant mothers who are about to give birth for the first time. Preparing for childbirth in advance is very important. So that in the rush and bustle of leaving for the hospital, do not forget something. Preparing for childbirth is not just packing a suitcase. Preparing for childbirth means choosing a maternity hospital, meeting with a doctor who will take delivery, and learning from courses. Both the expectant mother and the future father need to prepare for childbirth. So that at the right moment he knows what to do when, what to take where and what to carry (carry) when and where.

About two or three weeks before the birth, check if you have prepared everything for the birth for yourself and for the birth, for the baby. If you have already chosen a maternity hospital or agreed with a personal doctor, learn more about the list of things recommended in this maternity hospital for mom and baby. Some maternity hospitals indicate what you need to take with you, others give out all sick leave. Fold the necessary things in advance in bags: a bag for mom for childbirth, a bag for mom for discharge, a bag for a baby in the hospital and for discharge. Be sure to introduce these bags to dad. Often, when we meet with mothers after childbirth, they tell how the husband, in joy and excitement, mixed everything up, and instead of the third dress on the right, he brought the fifth sundress from the top, but it no longer fits - and the mood from the meeting was badly spoiled.

Dear ladies, do not overload dads, take care of them too. What may be needed in the hospital?

• documentation;
• things that will come in handy during childbirth;
• things that may be needed after childbirth;
• dowry for the baby in the hospital;
• things you need when you go home.

Harbingers of childbirth

In most pregnant women, childbirth is preceded by the so-called precursors, which usually appear 2 weeks before them: the stomach drops, and it becomes easier for the woman to breathe; body weight is somewhat reduced due to the increased release of fluid from the body; the uterus quickly tenses up - hardens due to the increased excitability of its muscles. The head of the fetus before childbirth in nulliparous women is pressed more tightly against the bones of the small pelvis.

In the very last days before childbirth, thick, viscous mucus is released from the vagina, often with an admixture of blood (the mucous plug that fills the cervical canal is pushed out), diffuse pains appear in the sacrum, thighs, and in the lower abdomen. With the appearance of these signs, it is impossible to leave home for a long time, because. at any time, regular contractions of the uterus - contractions can begin, which will require the immediate departure of the woman to the maternity hospital.

Some women with the onset of contractions (or before they appear) may begin to leak amniotic fluid - they are found on linen in the form of colorless spots. When this symptom appears, the pregnant woman must be hospitalized in the maternity hospital, because. along with the waters, a loop of the umbilical cord or a fetal handle may fall into the vagina. In addition, prenatal outflow of water contributes to the penetration of infection into the uterus.

The beginning of childbirth is the appearance of regular contractions. At first they are weak and do not cause any particular trouble to the pregnant woman, but gradually become more intense, prolonged (30-40 seconds) and frequent - after 5-6 minutes.

In primiparas, the duration of labor is on average from 15 to 20 hours, in multiparous, the duration of labor is from 10 to 12 hours. The duration of childbirth is affected by the age of the woman, the size of the fetus, the size of the pelvis, the activity of uterine contractions, etc. In primiparas older than 28-30 years, the duration of labor is longer.

There are three periods in childbirth. The duration of the first, longest period of labor in primiparous is on average 13-18 hours, and in multiparous, the duration of the first period of labor is 10-11 hours. In the first period, the lower pole of the fetal bladder wedged into the cervical canal, it opens, the fetal bladder bursts and amniotic fluid flows out.

In the second stage of labor, the fetus moves through the birth canal. In this period, there are attempts. At this time, the midwife, leading the birth, begins to receive the newborn. In cephalic presentation, the head is born first. After the head, the body is born. This ends the second stage of labor. In primiparas, the duration of the second stage of labor is on average from 1 to 2 hours, and in multiparous women, the duration of this period of labor is from 30 minutes. up to 1 hour. Immediately after birth, the baby begins to breathe and scream. The umbilical cord connecting the newborn to the placenta is cut and tied.

Contractions

The first rule is to sleep as much as possible. If it doesn't work, just rest. You can sacrifice all of the following and go unprepared, but not tired during the first hours of waiting, when you can and should calmly save your strength and rest. Nothing is needed from you now, except to relax. But then some serious work is needed, and you should not be exhausted by this time. This “later” can happen in a day! Sleep and rest while there is time. The strength of contractions is not in vain increasing gradually. Everything is thought out.

It is advisable to write down the duration and intervals between them, but not immediately, when they are rare and weak, and then when they no longer let you sleep.

If sleep and rest are not in one eye, then it is better not to lie down, move and look for a position in which it is easier. Use postures and techniques learned or read in courses. Alert the husband, check the techniques of massage, breathing, etc. with him. Do not strain the muscles of the body, especially the face, do not clench your teeth - this strains the muscles of the pelvic floor and the cervix and lengthens and aggravates the period of contractions. Tell your husband to remind you when you forget and not let you shrink. It is necessary not to fight with contractions and not to experience them, but to surrender to them, relaxing and drowning in them. It's not a pointless pain, not a spasm, not a constriction, not a contraction, although it feels that way. This is the OPENING of the cervix, this is their ultimate goal, and this is what should be promoted. You open up whether you like it or not, you will struggle and hurt both of you, or you won't fight and relax - either way you open up. And since this is inevitable, if you do not fight the inevitable, but understand its meaning, it will be easier for you to understand the meaning of "relaxing in contractions." Because it means "reveal on disclosure".

Discharge of water.

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Bath

Bath very well relieves pain, helps to relax. Allows you to determine whether labor has actually begun. If these are preliminary contractions, then under the influence of the bath they will subside, but if the birth has begun, then the bath, on the contrary, will somewhat stimulate the process. You can take a bath for no more than half an hour and only at an early stage of labor, when contractions are no more than 20 minutes, if you, of course, are going to go to the hospital. Women giving birth at home can also take a bath in a later stage of childbirth.

The shower is very helpful in relieving pain during contractions. It can be directed to the sacrum or lower back.

Even if the waters have already receded, you can take a bath, but it must be cleaned well and the filler added: pure sea salt or Rotokan.

Enema

Prepare 3 liters of water. 2 per enema, 1 just in case. You don't need to boil. Water temperature 30-32 gr. You need to do an enema at long intervals, when contractions go at intervals of 18-20 minutes. Water can be salted (a little sea salt) or acidified (1 tablespoon of lemon juice per 3 liters). It is necessary to do an enema in the knee-elbow position.

Shaving

Regular men's shaving foam helps reduce the number of cuts and discomfort

Drink, food

Stimulating and supportive drink. During childbirth and immediately after. Rosehip + 1 tsp honey. Fruits, dried fruits and crackers. Be sure to take it with you to the hospital.

Duration of labor

In primiparas, the duration of labor is on average from 15 to 20 hours, in multiparous, the duration of labor is from 10 to 12 hours. The duration of childbirth is affected by the age of the woman, the size of the fetus, the size of the pelvis, the activity of uterine contractions, etc. In primiparas older than 28-30 years, the duration of labor is longer.

There are three periods in childbirth. The duration of the first, longest period of labor in primiparas is on average 13-18 hours, and in multiparous women, the duration of the first period of labor is 10-11 hours. In the first period, the lower pole of the fetal bladder wedged into the cervical canal, it opens, the fetal bladder bursts and amniotic fluid flows out.

In the second stage of labor, the fetus moves through the birth canal. In this period, there are attempts. At this time, the midwife, leading the birth, begins to receive the newborn. In cephalic presentation, the head is born first. After the head, the body is born. This ends the second stage of labor. In primiparas, the duration of the second stage of labor is on average from 1 to 2 hours, and in multiparous women, the duration of this period of labor is from 30 minutes. up to 1 hour. Immediately after birth, the baby begins to breathe and scream. The umbilical cord connecting the newborn to the placenta is cut and tied.

After the birth of a child, the third stage of childbirth begins, called the postpartum period. The duration of this period of labor is on average 30 minutes. During this period, the placenta separates from the walls of the uterus and the afterbirth is born. The afterbirth consists of the placenta, umbilical cord and fetal membranes.

Start of labor

Contractions

The first rule is to sleep as much as possible. If not, just relax. You can sacrifice all of the following and go unprepared, but not tired during the first hours of waiting, when you can and should calmly save your strength and rest. Now you don't need anything but to relax. But then some serious work is needed, and you should not be exhausted by this time. This “later” can happen in a day! Sleep and rest while there is time. The strength of contractions is not in vain increasing gradually. Everything is thought out. It is advisable to write down the duration and intervals between them, but not immediately, when they are rare and weak, and then when they no longer let you sleep.

If sleep and rest are not in one eye, then it is better not to lie down, move and look for a position in which it is easier. Use postures and techniques learned or read in courses. Alert the husband, check the techniques of massage, breathing, etc. with him. Do not strain the muscles of the body, especially the face, do not clench your teeth - this strains the muscles of the pelvic floor and the cervix and lengthens and aggravates the period of contractions. Tell your husband to remind you when you forget and not let you shrink. It is necessary not to fight with contractions and not to experience them, but to surrender to them, relaxing and drowning in them. It's not a pointless pain, not a spasm, not a constriction, not a contraction, although it feels that way. This is the OPENING of the cervix, this is their ultimate goal, and this is what should be promoted. You open up whether you like it or not, you will struggle and hurt both of you, or you won't fight and relax - either way you open up. And since this is inevitable, if you do not fight the inevitable, but understand its meaning, the meaning of “relaxing in contractions” will be easier for you. Because it means "reveal on disclosure".

Outflow of waters

The waters can break at any time: at the beginning of childbirth, in the middle or just before the attempts. All this is within the normal range.

Transparent or whitish - the norm

Green - the child is experiencing hypoxia, medical assistance is required.

With small streaks of blood - part of the mucous plug, does not pose a danger

With bright blood - placental abruption, urgent hospitalization is required

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The course of childbirth

Childbirth is an unconditional reflex act aimed at expelling the fetal egg from the uterine cavity when the latter reaches a certain degree of maturity. The gestation period must be at least 28 weeks, the body weight of the fetus must be at least 1000 g, height must be at least 35 cm.

During the birth act, 3 periods are distinguished: I - the period of disclosure; II - period of exile; III - succession period. A woman with the onset of labor is called a woman in labor, after the end of childbirth - a puerperal.

In the first stage of labor due to contractions, the cervix opens. Contractions are involuntary periodic contractions of the uterus. During contraction in the muscular wall of the uterus, the processes of contraction (contraction of each muscle fiber and each muscle layer) and retraction (displacement of muscle layers relative to each other) occur. In the pauses between contractions, contraction is completely eliminated, and retraction is only partially eliminated.

Myometrium consists of two layers, different from a functional point of view. The outer layer is mainly represented by longitudinally located muscle fibers. This layer, powerful and active in the fundus and in the body of the uterus, comes to naught in the distal cervix. The inner layer contains predominantly circular muscle fibers. It is best expressed in the cervix and lower segment of the uterus. There are few circular muscle fibers in the bottom and body of the uterus. With the development of regular labor activity, coordinated contractions of the outer and inner layers of the myometrium are observed.

The primary source of labor excitation (pacemaker, pacemaker) is a more or less localized group of cells in the uterine wall. Most researchers believe that pacemakers are located in both tubal corners of the uterus. From here, electrical activity (a wave of contractions) spreads during a contraction to the underlying sections of the uterus - to the body and lower segment. N. Alvarez and R. Caldeyro-Barcia (1952) called this propagation of the contraction wave from top to bottom a triple downward gradient. The strongest and most prolonged contractions of the uterus are observed in the bottom area (bottom dominant). In the future, the contraction wave extends downward to the body and cervix (first gradient). In the body, and especially in the lower segment of the uterus, there is a decrease in the strength and duration of contraction (the second and third gradients).

Physiologically developing labor activity is characterized by reciprocity (interconnection) of the contractile activity of the uterine body, lower segment and cervix. Each contraction of the longitudinal muscles of the uterus is accompanied by active stretching (distraction) of the lower segment and cervix, which leads to the opening of the uterine os. For the normal course of the birth act, coordination (consistency) of uterine contractions is characteristic. In addition to vertical coordination of contractions (triple downward gradient, fundus dominance and reciprocity), there is horizontal coordination in the form of coordinated contractions of the right and left halves of the uterus. With coordinated contractions, there is a synchronism in the onset of the phase of maximum contraction of the uterus in its various departments. The propagation time of the contraction wave, which captures the entire organ, is 15 s.

With a well-defined labor activity, the intensity of uterine contractions is usually 30 mm Hg. Art., and the frequency of contractions is at least two in 10 minutes. As the birth act develops, the intensity and duration of contractions gradually increase, and the duration of the intervals between contractions decreases.

During each contraction, an increase in intrauterine pressure occurs, which is transmitted to the fetal egg, which takes the form of the uterine cavity. Amniotic fluid rushes to the lower part of the fetal bladder, where one of the large parts of the fetus (head, pelvic end) is located. Until the membranes are broken, the uterus is a closed, fluid-filled ball.

During childbirth, due to the contraction of the longitudinally located muscles of the uterus and the reciprocally relaxing circular muscles, the lower segment of the uterus and the region of the internal cervical os are stretched. The upper part of the cervical canal gradually expands in a funnel-like manner, and the fetal bladder rushes there during contractions (the lower pole of the fetal membranes with part of the amniotic fluid contained in them). Irritating the nerve endings in the area of ​​​​the internal pharynx, it contributes to the intensification of contractions. The contractions of the muscle fibers of the body of the uterus, due to its ovoid shape, are directed upwards not vertically, but tangentially to the circular muscles of the lower segment of the uterus and the cervical canal. This relationship and the action of the muscles of the bottom and body of the uterus on the opening of the cervical canal are so pronounced that the opening of the cervix occurs even with premature outflow of water (when the role of the fetal bladder in the opening of the cervix is ​​completely excluded) and even with the transverse position of the fetus (when the presenting part is absent) .

During contractions, as a result of retraction, the upper and lower muscle layers, as it were, intersect with each other and gradually move upward. During pauses between contractions, they do not fully return to their place. Therefore, the upper part of the body of the uterus gradually thickens, and the area of ​​the lower segment becomes thinner. The boundary between the upper part of the uterus (bottom, body) contracting during childbirth and the actively relaxing lower segment is called the contraction ring (boundary groove, boundary roller), tiro can be determined after the outflow of amniotic fluid during contractions. The lower segment of the uterus covers the presenting part of the fetus with a ring tightly adjacent to it - the inner belt of contact.

In this case, an external contact zone is formed between the lower segment of the uterus and the bone ring (the head is fixed by a small segment at the entrance to the pelvis). Due to the presence of contact zones, the waters are divided into two unequal parts: the larger part that is above the contact zone is the “rear waters”, and the smaller part that is below the contact zone and fills the fetal bladder is the “front waters”.

The mechanism of opening the cervix in primiparous and multiparous is not the same. In nulliparous women, the opening of the cervix begins from the side of the internal os. With full disclosure of the internal os, the cervix is ​​smoothed out, the cervical canal is absent and the external os begins to open. A complete dilatation of the cervix is ​​one in which the uterine cavity and vagina are a single birth tube. In multiparous women, the opening of the internal and external os occurs simultaneously and in parallel with the shortening of the cervix.

With the complete or almost complete opening of the uterine os, the fetal bladder ruptures. This is facilitated by a complex of reasons: 1) increasing intrauterine pressure due to an increase in the frequency and intensity of contractions; 2) an increase in overstretching of the membranes of the fetal bladder due to an increase in intrauterine pressure and a decrease in their resistance to rupture; 3) lack of support for the lower pole of the fetal bladder from the side of the cervix with full or almost full disclosure. If the fetal bladder opens with incomplete opening of the cervix, then the role of the stimulus of the receptors of the internal pharynx is performed by the presenting part of the fetus. In some cases, with excessive density of the membranes, the fetal bladder does not open even when fully opened. In these cases, it must be opened so as not to disturb the physiological course of childbirth.

Full disclosure of the cervix indicates the end of the first stage of labor. The second period of childbirth begins - the period of exile, during which the birth of the fetus occurs.

After the outflow of amniotic fluid, the contractions briefly stop or weaken. The volume of the uterine cavity is significantly reduced, the walls of the uterus come into closer contact with the fetus. Contractions intensify again and contribute to the progress of the fetus through the birth canal, which began during the opening period. The presenting part of the fetus approaches the pelvic floor and exerts increasing pressure on it, in response to which attempts appear. An attempt differs from a contraction in that a reflex contraction of the striated skeletal muscles of the abdominal press, diaphragm, and pelvic floor joins the reflex involuntary contraction of the smooth muscles of the uterus. The strength of the attempts can be arbitrarily regulated by the woman giving birth. The presenting part of the fetus stretches the genital slit and is born. Behind it, the entire body of the fetus is born and the posterior amniotic fluid is poured out.

After the birth of the fetus, the third period of childbirth begins - afterbirth. At this time, the placenta and membranes separate from the walls of the uterus and the birth of the placenta.

A few minutes after the birth of the fetus, contractions resume. With the first subsequent contraction, the separation of the child's place begins, which occurs in the spongy layer of the falling membrane at the site of its attachment to the uterine wall (placental site). With subsequent contractions, the entire musculature of the uterus is reduced, including the area of ​​\u200b\u200bthe placental site. The placenta does not have the ability to contract, and therefore it rises above the decreasing placental area in the form of a fold or tubercle. The connection between the placenta and the placental site is broken, the vessels rupture, which leads to the formation of a retroplacental hematoma, which is an accumulation of blood between the placenta and the uterine wall. Retroplacental hematoma, together with uterine contractions, contributes to an increasing and, finally, final detachment of the placenta. The separated placenta is born from the uterine cavity with the force of attempts and drags the membranes with it. The placenta exits the genital tract with an aqueous (amniotic) membrane outside. The maternal surface of the placenta faces the inside of the born placenta. This is the most common central route of placental abruption and afterbirth described by Schultz.

Another variant of placental abruption may be observed, when the separation does not start from the center, but from the periphery. In this case, the outflowing blood does not form a retroplacental hematoma, but, flowing down, exfoliates the membranes. With each successive contraction, all new areas of the placenta exfoliate until it is completely separated from the uterine wall. In addition, the separation of the placenta contributes to its own weight. The placenta is born from the birth canal forward by the lower edge of the placenta (its maternal surface), and the amniotic membrane is inside - the placenta is separated according to Duncan.

The birth of the afterbirth, separated from the walls of the uterus, is facilitated by the attempts that occur when the afterbirth moves into the vagina and irritation of the pelvic floor muscles.

Pain in childbirth. How to reduce labor pain

Pain and childbirth are in the human mind side by side. Many women are terrified of the pain that inevitably (from their point of view) accompanies childbirth. More reasonable ladies are preparing for childbirth in advance. The correct attitude to pain in general, and to pain in childbirth in particular, the ability to largely regulate pain in childbirth, the absence of fear of pain during childbirth is the result of proper preparation for childbirth and competent training of a pregnant couple.

Psychologists - practitioners of body-oriented therapy believe that pain is a powerful signal of our body, a means of its "communication" with our consciousness.

Sometimes, we work so hard, eat poorly, do not rest at all, smoke, - in general, we are exhausted, and the body is forced to resort to a powerful weapon - pain. This is the positive function of pain: it is the only way to “get through” to us. When we are in pain, we finally stop and catch our breath. The pain knocks out of the daily fuss, makes you turn to yourself.

It just so happened that pain is an indispensable companion of the birth of a person. Now, with the help of modern medical science, it has been proven that childbirth is a test not only for the mother, but also for the baby. The baby sometimes experiences pain many times stronger than the pain of the mother. Therefore, during pregnancy, it is necessary to thoroughly prepare for a meeting with pain. To make her your ally, not your enemy.

But first you need to stop being afraid of labor pain, because fear often stops the contractions that have begun. We are talking, of course, about physiological pain, and not pathological pain, in which anesthesia and surgical intervention are necessary. Preparing for childbirth is, first of all, relaxation. A relaxed woman is occupied exclusively with childbirth, her body follows the “beaten path”, following instincts. During pregnancy, you need to learn to listen to the processes taking place inside your body, learn to respond correctly to changes, “catch” the flow. In any manual, you will find advice not to be nervous and to rest more often during pregnancy. But in addition to relaxation, both professional massage for pregnant women and a relaxing massage of a loved one will help you. What is it for?

During the period of expectation of a child, it is important to remove the so-called clamps in the muscles so as not to interfere with the woman's body to perform its main "work" - childbirth. Often massage also brings therapeutic benefits - the baby turns over and takes the correct position upside down. Massage will be your best assistant, both during contractions and at the beginning of attempts. But this is not just a massage, but a massage of the sacrum, the area in the lower spine. If your husband is present during childbirth, it is he who will help you relieve stress. You yourself are in labor until you go to the hospital, taking a shower, you can direct the jet to the sacrum. You will learn the massage technique at any parent school.

In childbirth, it is better to move actively, change position, select the one that is the least uncomfortable, for example, my birth was “standing”. In the last period of childbirth, a woman withdraws into herself, tuning in to signals coming from within. Meditation will help to acquire this skill.

It is known that the throat area in childbirth is connected with the cervix. The desire of a woman to scream is not just a spontaneous reaction to pain, but a strong instinct. The fact is that crying relaxes the throat and cervix, thus helping the child to pass through the birth canal. But screaming can be destructive not only for others, but also for mom and baby. Therefore, it is better not to shout, but to SING. Singing in childbirth is a tradition of our great-great-grandmothers. The so-called reference voice, which we, the townspeople, have lost, has been successfully used as a powerful pain reliever.

Its effect increases if your husband or midwife sings with you, in the case of home birth.

It is difficult to relax when a bright white light blinds your eyes, and 5 more women in labor are moaning nearby. Therefore, if it is within your capabilities, bring the baby's birth environment closer to home. After all, at home you feel protected, so subdued light, your favorite things, a dressing gown will help you.

In attempts, the nature of pain is somewhat different, not comparable with contractive pain. At the last stage, the pain should not be reduced or avoided, but "go to it", pushing where it hurts. Proper breathing will help here. By following at least some of these simple recommendations, you will find a common language with your body. And it will answer you in childbirth - a hundredfold.

Self-anaesthesia of childbirth

To begin with, painless and painless childbirth is not uncommon. Many women in labor cross the threshold of the maternity hospital in the active phase of labor, when the opening of the cervix is ​​already more than 2-3 cm, sometimes with almost complete opening of the cervix, that is, at the end of the 1st stage of labor, without experiencing severe pain. And some women already during attempts in bewilderment ask: “Doctor, when will it hurt me?” What is it: individual sensitivity? Or exceptions that just prove the rule? Let us try to understand the reasons for such individual sensitivity, or rather, insensitivity.

The suffering of women during normal, uncomplicated childbirth is contrary to the laws of nature. The fact is that pain is given to us as a defensive reaction in order to recognize the disease in time and save our life and health. Therefore, during childbirth, a sharp pain syndrome is a companion of certain complications that require qualified medical assistance. With a favorable course of childbirth, when nothing threatens either the mother or the child, the appearance of pain is not justified.

The nature of labor pain

During contractions in the first stage of labor, irritation of the nerve endings of the body and cervix, blood vessels and ligamentous apparatus occurs. In the second stage of labor - the period of expulsion of the fetus - the nerve endings of the perineum and external genitalia are predominantly irritated. Both those and other impulses, entering the central nervous system, are normally blocked and are not perceived as pain signals, that is, they remain under the threshold of pain sensations. In addition, there are additional protective "analgesic" factors. Firstly, before childbirth, there is a partial destruction of the nerve endings of the uterus, and therefore its sensitivity decreases in comparison with the 1st and 2nd trimesters of pregnancy. And secondly, during childbirth in the body there is a powerful release of endorphins and enkephalins - “hormones of pleasure”, natural painkillers, related in structure to narcotic analgesics.

But from generation to generation, the fear of childbirth, recorded on the pages of the Old Testament, is passed on to women. This fear has a real historical background. After all, hundreds of years ago, in the absence of adequate obstetric care, many births really proceeded very hard, with dangerous complications and often ended in the death of the woman in labor. The fear of inevitable pain disrupts the harmony of relationships in the structures of the brain, sharply lowering the pain threshold, in connection with which those painful stimuli begin to be perceived, which normally should not penetrate our consciousness. This is the so-called psychogenic component of labor pains. As a result of the passage of pain impulses through the central nervous system, reflected pain occurs on the surface of the body: in the lower abdomen, in the lumbosacral region, in the upper third of the thighs and in the groin.

Down with the psychogenic factor!

What is the opposite of fear? Holiday anticipation. Do you remember how, as a child, you were waiting for your next birthday or New Year, how your heart skipped a beat in anticipation of fun and gifts? And how joyful should be the expectation of a miracle, great happiness - meeting with the most beloved and most beautiful person that YOU will give to the world! The embodiment of a dream, new facets of love, a new phase of merging with a loved one. I want to bring the sweet moment closer and, having plunged, drink it whole, to the bottom. Dream of contractions, remember that pain is sometimes very sweet.

And what about women's curiosity? Of course, you have read and heard a lot about this, but it is insanely interesting to experience everything yourself, it is interesting how it will happen with you. Moreover, even repeated births are not similar to the previous ones.

In addition, childbirth is, perhaps, the only work and pleasure inaccessible to a man. And although many future dads now strive to be present at the birth of their child, they still cannot feel it like a woman, because seeing and feeling are not the same thing.

Sometimes women want to go to the hospital a few days before giving birth. This is not always justified. Not a single, even the best, maternity hospital can replace the warmth and comfort of your home. If the pregnancy proceeds without complications, and there are no indications for prenatal hospitalization, it is better to spend the last days before childbirth surrounded by loved ones, and not in the department of pathology of pregnant women, where you will inevitably be haunted by the load of other people's problems. It happens that a woman herself, going to the hospital, cannot accurately determine whether she has started giving birth. If in this case the doctor who examined you in the emergency department states that these are only harbingers of childbirth and suggests that you return home, heed his advice. The maternity block is the place where you need to give birth, and not languish, empathizing with others.

And in conclusion

Childbirth is something that every pregnant woman is waiting for and at the same time afraid of. Especially if it's her first birth. Numerous stories of girlfriends about how painful and terrible it is, do not add self-confidence. The opinion of a mother or grandmother that childbirth is a simple matter is also not taken seriously. The closer the cherished day, the more doubts and nerves. There is only one way out: to learn as much as possible about childbirth from specialists in advance.

When there are several hours left before the baby arrives, and contractions become incredibly painful, unprepared women in labor begin to panic. Once on the delivery table, such mothers cross their legs and do not listen to the prompts of the obstetrician, without thinking about what terrible consequences this can lead to.

In women unprepared for childbirth, especially those pregnant with their first child, the birth canal is often damaged, and babies are born with birth injuries. In this regard, physical training is the key to the health of the mother and the newborn. It is important to know that the psychological aspects are equally important, because successful childbirth depends on the mood of the expectant mother and her ability to control her actions.

Psychological nuances of preparing for childbirth

Some believe that the main condition for a full-fledged birth is the preparation of your body. This is an erroneous opinion, since the course and result of childbirth directly depends on the moral state of the woman in labor, her ability to relax in time and keep her emotions under control.

It has been proven that a woman who has attended courses that prepare for the upcoming motherhood, copes with pain during contractions more easily, responds more adequately to the requirements of medical personnel. In addition, children in this case do not receive birth trauma.

The level of readiness of the woman in labor

Each woman in her own way relates to the upcoming event:

• women expecting their first child are afraid of the unknown;
• multiparous are afraid of already experienced pain.

The psychologist must find out how prepared the pregnant woman is mentally, and if necessary, support the woman, dispelling all her doubts and prejudices. There are 3 levels of prenatal psychological readiness: low, medium and high.

Low requires immediate help from a psychologist, is characterized by the following negative emotions on the part of the woman in labor:

• excitement, intensifying every day;
• constant fear of dying during childbirth or losing a child;
• expectation of labor pains;
• dislike for the father of the child, sometimes for the baby;
• disregard for the advice of medical personnel.

The average level does not need emergency help, since the expectant mother perceives the upcoming birth relatively calmly:

• optimistic mood for childbirth;
• constant doubts about a favorable outcome;
• lack of confidence in their abilities;
• susceptibility to other people's tragic stories of childbirth, projecting such situations onto oneself.

A woman with a high level of psychological readiness does not need the help of a psychologist and is looking forward to the birth of a baby. For her, the main thing is to maintain such a mood in the hospital. High level signs:

• every day brings happiness to the expectant mother;
• daily physical training: teaching proper breathing, self-massage, etc.;
• implementation of all recommendations of the midwife;
• genuine joy in every little thing.

In addition, in the latter case, the woman plans to take all the burden on herself, making it easier for the baby to give birth, and is determined to breastfeed.

How to deal with fear

Optimistic women also worry about everything going well and worry about everything. How to deal with emerging fear? It is enough to know and follow the following recommendations of a psychologist:

1. Take your mind off worrying thoughts. Be more outdoors, preferably where babies walk, watch instructive videos about caring for newborns.
2. A pregnant woman has a lot of free time, especially in the last month. It is not surprising that a woman may have new hobbies (for example, knitting or origami), which bring a lot of positive emotions.
3. Do exercise, yoga, gymnastics. In a sports woman, the production of endorphin, the hormone of happiness and a natural antidepressant, increases.
4. Understand the intricacies of absolute relaxation. To do this, you can listen to relaxing music, inhale aromatic oils, sign up for massage sessions, relax in nature, etc. The main thing is to allocate time for relaxation.
5. Follow your whims. The whims of a pregnant woman are the requirements of the baby, which should be fulfilled. You should not restrain your impulses, because the joy experienced by the mother is transmitted to the child.

Physical training

In order for the body to withstand the enormous load during childbirth, physical preparation is important. Due to the fact that the internal organs of the future woman in labor work for two, the immune system weakens, the hormonal background changes, which leads to disorders. To support the work of the body and reduce the load as much as possible, a woman needs to try.

Exercises and gymnastics for pregnant women

There are special exercises that help prepare the body for childbirth. They can be performed under the guidance of a midwife or on your own. Gymnastics is simple to perform, but effective against muscle spasms with concomitant pain, promotes rapid delivery without additional complications:

1. As a warm-up - walking in place. Runs for 1 minute.
2. Put your feet shoulder-width apart, feet parallel to each other, stretch your arms forward, your back should be straight. Performing slow half-squats, raise and lower your hands (to the beat). Follow your breath. (10 tricks)
3. Extend your arms to the sides. Leaning forward, take turns touching your toes with them. Do it at an average pace. (12 tricks)
4. Bend the torso slightly, stretch the arms at the seams. Slowly tilt your head, relax your arms and shoulders. After 5 seconds, stand straight and bend your back a little. (8 reps)
5. Stretch your arms to the sides, put your feet shoulder-width apart. Bending over, turn the torso to the right, while touching the toes of the left foot with the right hand, to the left - the toes of the right foot. After completing 10 repetitions, take the starting position and relax. (4 passes)
6. Tilt the body to the right, raise the left hand above the head, bring the right hand behind the back. When the side of the slope changes, the hands change places. Perform at an average pace. (12 reps)
7. Put your feet together, straighten your back, stretch your arms at the seams. Tilt the body to the left and right, while sliding your hands along the sides and not tearing them off. Follow your breath. (10 reps)
8. Do some breathing exercises. Inhale deeply through your nose 10 times and exhale through your mouth.

Breathing training

Proper breathing improves blood circulation, gas exchange, relaxes the uterus and soothes. For a noticeable effect, the exercises must be performed daily. A pregnant woman should listen to inner feelings. As more oxygen enters the brain, dizziness may occur. Breathing algorithm:

1. Breathe rhythmically. Getting ready for the upcoming fight. Inhale (5 s) - hold the breath for 3 s - exhale (5 s) - hold the breath for 3 s.
2. To relax between contractions, breathe with your diaphragm. By placing a hand on the chest, you can control the fluctuations of the abdomen and chest. Inhale deeply for 3 seconds, moving the diaphragm. The stomach should stick out. Exhale through your mouth for 3 seconds. Then repeat.
3. To restore breathing after a contraction, breathe from the chest. Hands at the sides, slightly above the waist. Inhale deeply and slowly through your nose, and exhale even more slowly through your mouth, making your lips whistle.
4. To relieve pain during contractions, doggy breathing is suitable. Stick out your tongue and breathe deeply.

How to prepare the birth canal?

There are sets of exercises designed for a specific muscle group. To avoid tears, you need to prepare the vagina for childbirth by increasing muscle tone.

You can do the following exercises:

1. Sit down with legs wide apart, stay in this position for 7 s. Slowly get up and stand for a while. Do 5 repetitions.
2. Sitting on your haunches, take the straight leg to the side, and transfer the weight of the body to the second. Stretch your arms out in front of you to help you keep your balance. Do 5 repetitions.
3. Standing on joined knees, slowly roll back and sit on your heels.

By regularly performing Kegel training exercises, the future woman in labor will be able to strengthen the perineal area and prevent possible tears. During execution, the following recommendations must be observed:

• exercises are recommended to be performed on a hard surface, alternately tensing and relaxing the muscles of the pelvic floor;
• after the number of repetitions reaches 50 times, you can proceed to the next stage (maximum tension and muscle retention, slow relaxation with pauses);
• a week after the start of classes, you should strain-relax the muscle quickly.

Breast preparation

Often, women in labor with unprepared breasts already in the hospital begin to have difficulties with feeding the baby. Microcracks appear on the nipples, the breast loses elasticity, is covered with stretch marks. To eliminate these problems, the exercises are performed in the following algorithm:

1. Keeping your hands in front of your chest, each alternately toss a small ball. Do not change hand position.
2. Standing on all fours, bend your elbows. Then sharply straighten your arms and legs.
3. Standing facing the wall, rest your hands on it (at shoulder level). Perform 15 push-ups.
4. Arms spread out to the sides shoulder-width apart. Make “scissors” with sharp swings with your hands.
5. Straight arms to the sides. Do "scissors", but behind your back, trying not to bend your arms.

Each exercise should be done at least five times. Daily exercises will help to maintain the shape of the breast after childbirth and provide the child with healthy mother's milk without additional complications during lactation.

When is additional preparation of the cervix necessary for childbirth?

According to statistics, about 17% of women expecting their first child and 3.5% of multiparous women during natural childbirth experience difficulties with the opening of the uterus. If the woman in labor has endocrine system disorders (obesity, diabetes), the cervix needs additional preparation. Also, special training is necessary if the following factors arise:

1. Hormonal changes take place in the body. Estrogen, which is responsible for the full functioning of the ovaries, is produced in insufficient quantities, respectively, the cervix does not have time to prepare for childbirth.
2. Tumors and scars in the uterus. As a rule, women over 35 are at risk.
3. Much less often, such factors as anemia, gynecological diseases in an advanced stage, which led to a decrease in the elasticity of the birth canal, become the cause.
4. genetic predisposition.

If these risk factors occur, the cervix needs special procedures, which are recommended to start from the first weeks of pregnancy. Otherwise, ruptures of the perineum, birth canal, injury and even death of the baby may occur. If the baby is ready to be born and the uterus has not opened, surgery may be needed to save the baby's life.

Proper nutrition in the third trimester

Preparation for natural childbirth includes a special diet. In the last weeks of pregnancy, a woman needs to correctly compose a menu, because the birth process can begin at any time. Basic rules of the diet:

1. Vegetables and fruits rich in fiber will help to avoid postpartum complications such as hemorrhoids. Preference should be given to apples, pears, plums and broccoli, completely abandoning flour.
2. It is necessary to abandon allergenic foods (honey, nuts, citrus fruits, chocolate). Due to the fact that childbirth can begin rapidly, the baby's face can be strewn with prints of "mother's sweets."

Special preparatory courses

Attending courses for pregnant women will be useful, because competent preparation for childbirth is the key to a positive result. The instructors teach breathing exercises, body control techniques and explain how to make the birth easier for the baby. Psychologists help to overcome fears, setting up for childbirth without pain.

When it comes to partner childbirth, you can attend courses with the father of the child. Experts say that communication with the same frightened women has a positive effect on the condition of the future woman in labor. The woman becomes more confident, fears gradually disappear. Video courses do not give such results.

Methods of preparation for childbirth (Grantley Dick-Read, Lamaza, R. Bradley, M. Auden)

There are many ways to prepare for childbirth. Each includes 3 key aspects:

• breath;
• relaxation;
• positive attitude.

The methods are similar to each other, but have some differences. The most popular include:

1. The Grantley Dick-Read method prepares for a gentle natural birth. To do this, you need to overcome fear, since it is he who provokes physical stress, which increases pain during delivery.
2. Preparation according to the Lamaz method is quite in demand and gives a tangible result. The bottom line is that the future woman in labor studies and performs certain techniques for a long time, improving so much that she is able to control labor pain.
3. R. Bradley's method teaches you to listen to the body during natural childbirth and interact with it. The methodology is based on diet, physical and spiritual exercises. On a subconscious level, the expectant mother must be aware that childbirth is not a terrible pain, but a physiological process. Gradually, she calms down, gaining confidence in her abilities.
4. M. Auden's method teaches a woman to respond freely for the development of intuition. She tries her hand at creativity, looking for her favorite pastime. The author of the technique is sure that developed intuition helps to speed up and simplify the birth process, in addition, he promotes vertical childbirth.

What to take with you to the hospital?

For a trip to the maternity hospital, the expectant mother needs to prepare in advance. The standard list for which you need to collect includes the following items:

• money and documents (passport, insurance, exchange card, birth certificate);
• phone, charger;
• rubber slippers;
• 2 nursing bras;
• 2 bathrobes;
• comb, elastic band;
• baby soap, toothpaste with a brush, towel;
• dishes;
• drinking water without gas;
• prenatal, postnatal and breast pads;
• disposable diapers and underwear;
• wet wipes for mom and separately for baby;
• cream "Bepanten";
• diapers No. 1, if the estimated weight of the newborn is not too small;
• thin and flannel diapers, undershirts, sliders, hats, socks, mittens so that the baby does not scratch himself, etc .;
• large towel;
• children's hygiene products (powder, ear sticks);
• pacifier, bottles with nipples.

Childbirth is a short but important final stage of pregnancy. Therefore, preparation for childbirth, as well as, is extremely important for their successful implementation. It is better spend enough time preparing than to regret later about the possible consequences. In order to avoid a large number of problems, it is necessary to clearly understand how to prepare for childbirth.

Preliminary preparation for childbirth includes physical and psychological components. The importance of each of them is difficult to overestimate. Unfortunately, a large number of doctors still do not recognize the importance of preparing for the birth process, citing the fact that the body is able to cope on its own. However, for a successful outcome of childbirth, as well as for minimizing the number of possible complications, preparation will be far from superfluous.

A positive attitude during pregnancy helps a woman to endure the entire period of childbirth more easily, as well as minimize it for psychological reasons. Women in labor who are ready for delivery from the moral side, behave more actively during contractions and attempts, and, accordingly, make it easier for the child to pass through the birth canal.

Therefore, psychological preparation for childbirth plays a huge role in the successful completion of the process. Before as start working on the moral aspect, you should assess the level of readiness for the most important day. It is important to approach this issue as objectively as possible, and perhaps ask your loved ones to look from the outside.

How to determine readiness level

A low readiness level is indicated by:

• severe psycho-emotional state;
• annoying feelings about your life and the life of the baby;
• ignoring objective facts for the sake of myths;
• the presence of panic manifestations;
• strong fear of pain;
• aggressive attitude towards the father of the child, and possibly the unborn baby;
• categorical refusal to make contact with medical personnel.

Only a psychologist can answer how to mentally prepare for childbirth in this case. Because It is extremely difficult to fix this condition on your own. and often impossible. It is important to understand that constant stress can lead to.

Average level of readiness:

• the predominance of positive emotions;
• the constant presence of hesitation and doubt;
• self-doubt;
• exposure to any information, both objective and subjective.

With an average level of readiness, it is important to get comprehensive support from close people, and you can also visit a psychologist for preventive measures.

Signs of a high level of readiness include:

• being in high spirits throughout the entire period of pregnancy;
• full and comprehensive theoretical and practical preparation for childbirth;
• mood for active participation in the process;
• willingness to cooperate with medical personnel.

This readiness level does not require adjustment. It is important to keep it until the very moment of childbirth. Psychoprophylactic preparation for childbirth in this case is not necessary. Can only recommend watching motivational programs and videos, communication with positive people.

Physiological preparation for childbirth

An active lifestyle has already become habitual for the vast majority of people. It's no secret that in order to maintain your body in a healthy state, regular physical activity is essential. The state of pregnancy is no exception. After all, childbirth is primarily hard physical labor.

If a woman did not engage in sports activities before pregnancy, then you should not start quickly. In an interesting position, a woman should take good care of your body, and dose the load. However, evening walks are shown at any time. If there are no contraindications, then it is desirable to visit the pool and perform special gymnastics.

It is important to understand that up to the process of formation of the placenta, and therefore the risk of abortion is very high. All this period of physical activity should be minimized, and possibly eliminated.

Preparation for childbirth and courses for pregnant women, videos of which can also be found on the Internet, will be good helpers in the matter of physical preparation for childbirth. There you can learn a lot about special breathing techniques, as well as exercises that prepare a woman's body for the process of delivery.

Exist contraindications for physical activity during pregnancy:

• risk of abortion;
• complicated course of pregnancy, including;
• chronic diseases in the period of exacerbation;
• periodic increase or decrease in pressure;
• inflammatory process.

Physical activities should not exceed a half-hour period. Need closely monitor the deterioration. If you experience pain in the lower abdomen or dizziness, classes should be stopped.

If dizziness persists for half an hour, or bleeding from the vagina appears, you should immediately call an ambulance or go to the hospital yourself (depending on the severity of the condition).

Breathing exercises can be attributed directly to the physiological preparation for childbirth. Breathing exercises are related to. It is breathing practices aimed at relaxation that will show you how to prepare for childbirth without pain.

Preparation of the birth canal

Preparing the perineum for childbirth is one of the key stages in preparing a woman for labor. It is the internal muscles of the woman that will be involved in the last stage of attempts, and the ability to produce a child without breaks depends on the elasticity of the tissues of the vagina.

There are a number of activities that prepare the birth canal:

• Timely treatment of infectious and inflammatory processes. A protracted inflammatory process can reduce the elasticity of tissues, and, accordingly, lead to ruptures.
• Performing a Kegel exercise for training internal muscles. The success of attempts at the birth of a child, as well as the restoration of tissues after childbirth, depends on the work of the muscles of the vagina.

• Perineal massage with special oils. The impact on the tissues of the vagina and anus with massage manipulations increases elasticity and helps to minimize the occurrence of abrasions and tears.
• Preparing the cervix for childbirth. At home, this can be done through regular intercourse without the use of contraceptives. Male sperm helps ripen the cervix and soften it for later opening.
• Taking special vitamins It is recommended to start taking vitamin E and fish oil in the third trimester. Both vitamins help improve the elasticity of the birth canal.

Preparing for the hospital: what to bring with you to the hospital

For the entire period of waiting for the baby, you have probably already learned everything about childbirth and preparation for childbirth. Now it’s worth learning more about how to prepare for a trip to the hospital and what to take with you. Often, each medical institution provides lists necessary things for expectant mothers. However, there are things that will be needed in any maternity hospital.

Things needed in the hospital:

• 2 nightgowns, providing for the possibility of breastfeeding;
• robe;
• rubber slippers;
• postpartum pads (some maternity hospitals require homemade pads from a cut of clean and ironed fabric);
• moisture-absorbing diapers from 20 pcs;
• wet and dry wipes;
• liquid soap for yourself and your baby;

• paper towels;
• personal hygiene items;
• special disposable shorts (5-6 pieces);
• 2 sets of bed linen for the mother and 1 for the child;
• things for the child (undershirts, sliders, hats, socks);
• baby diapers;
• set of dishes;
• drinking water;
• necessary medicines for the mother (if necessary).

The list of necessary things varies depending on the maternity hospital, so it is worth visiting it in advance and clarifying what things you need to bring with you.

Nutrition before childbirth

The recommendations of older generations about the need to eat a pregnant woman in double volume have long gone. Of course, fasting also has no place in a woman's life. Most physicians, however, agrees that nutrition should be varied and rich in vitamins and micronutrients. The diet shortly before the expected date of birth should also be slightly adjusted.

How to eat before childbirth:

• About a month before birth, nutritionists advise switch to lighter and faster-digesting foods. Unloading does not fit.
• Increased stress on the intestines should be avoided, as well as eating before bedtime should be excluded.

For the prevention of hemorrhoids, it is useful to introduce olive oil into the diet.

• Better commit gradual transition from a meat-based diet to a vegetable-based diet with lots of dairy products. A week before the expected date of birth, it is better to give preference to a vegetarian menu.
• After the start of contractions, it is better to refuse food altogether.. In extreme cases, you can eat something small and light. If the contractions are already strong and childbirth is close, then eating can cause vomiting.

Preparing husband for childbirth

So, the preparation for childbirth is completed, but what you need to know about preparing your partner for the upcoming birth. Primarily, it is worth deciding whether you want to give birth together, and, accordingly, who will be present in the delivery room. Most often, the choice falls on the spouse, because every pregnant woman wants to receive support from her other half. But here a natural question arises: is the husband ready for such tests?

It is important to understand that childbirth itself is a huge stressor. And for men, this stress is many times higher. In addition to the fact that one has to watch far from pleasant procedures, the sight of a tormented wife does not add optimism either. Before childbirth it is important to have an honest and frank conversation with your husband regarding his willingness to endure with you all the hardships of the birth process. And if there is no such confidence, then perhaps it is worth taking a close woman, for example, a mother, with you to give birth.

Of course, the husband must be ready not only from the psychological side, but also from the physical side. It is not advisable to invite a physically unhealthy person to the maternity hospital.

The partner must have a fresh fluorography result with him to be present in the maternity hospital. It must be completed in advance.

How the birth will go, how to prepare for the birth, whether there will be complications - all these thoughts create stress for the mother. Therefore, it is important to maintain a positive attitude and focus on a successful outcome. Of course, preparation for childbirth is not only desirable, but also necessary. Having a base of theoretical knowledge and a prepared body, a woman can be sure of a successful outcome of the entire event.

Attending specialized courses will be a huge plus in preparation for childbirth. Regarding their implementation, you can ask your gynecologist.

Video about preparing for childbirth

We offer you a video that will allow you to better understand exactly how childbirth takes place, how best to prepare for it, as well as how to experience each stage of childbirth with maximum comfort and minimize pain during the process itself.

It is difficult to overestimate the importance of preparing for childbirth. However, I would like to know about your personal experience. Have you prepared for childbirth and how exactly? Did the preparation help? What advice would you give expectant mothers?