Olga Krasseinstein, doula:
Waiting to give birth is a special time. No matter how much you prepare, it is still exciting, especially if you are going to give birth for the first time. Well, the courses are completed, the birth plan is drawn up, the bag is packed. And now, the first long-awaited (or, conversely, for some reason slightly unexpected) contractions.
You want the birth to be as calm and gentle as possible, and probably with a minimum of medical interventions, such as puncturing the membranes and oxytocin stimulation. Of course, not everything depends on you and me, but if from the very beginning of labor we behave calmly and correctly, the likelihood that the birth will go well is greatly increased.
When you are admitted to the delivery room, doctors will expect you to make steady and fairly rapid progress in labor, which they will measure by the dilatation of your cervix and the descent of the baby's head.
Complications during childbirth that it is important for the expectant mother to know about in advance
What mom needs to know
Don't be afraid to give birth.
You need to understand that during childbirth, a woman is accompanied by obstetricians who are ready for any of the above-mentioned turns of events, armed with all the developments of modern medicine, knowledge and experience. And if the expectant mother has the opportunity to choose a doctor in advance, study his experience and get to know him, her chances of a successful delivery from childbirth increase significantly. Try not to voluntarily resort to “labor replacement” (artificially induced, induced, labor, early opening of the amniotic sac, caesarean section, epidural anesthesia) without compelling medical indications.
Childbirth is a natural process in which help is beneficial, but intervention can be harmful.
Don't neglect preparing for childbirth. Along with observation by a gynecologist, a pregnant woman’s visit to an osteopath will be very effective. This specialist will very gently help the internal organs, without consequences for themselves, to “give way” to the growing uterus with the future baby inside, and to prepare the pelvic bones for childbirth. And it will also very delicately help the baby take a comfortable position for the entire waiting period and properly “prepare for the start.” But this is only as a recommendation. The expectant mother can choose any method of preparing for childbirth.
But when we strongly advise you to contact an osteopath - this is immediately after childbirth, to show the newborn.
How will your body achieve a similar (or close to it) state?
First of all, for this you need to wait for the natural (spontaneous, if you use the medical term) onset of labor.
And then you need to competently go through the latent phase of labor.
It is during the latent phase that many make typical mistakes that lead to a protracted and difficult labor, or to childbirth with additional medical interventions. At this point, I suggest you first read the article about the latent phase, and then come back here and discuss common mistakes at the beginning of labor.
Focusing on the positive is the best way to avoid mistakes during childbirth
Timely detection of pathology can help a woman in labor give birth to a healthy child and not worry about his future health. But you shouldn’t focus your attention only on the negative aspects. After all, the birth of a child is wonderful and this event should not be aggravated by unwanted experiences.
Naturally, childbirth is an exciting event. But your task is to remain calm, not to panic and not to fuss. In many ways, the success of childbirth depends on the focus, calmness and self-confidence of the expectant mother. Remember, it is even harder for your baby than for you, since he must go through a difficult journey to meet you. He also experiences stress, fear and pain, and your worries and panic only make the birth process more difficult. All you need to do first is concentrate on meeting your baby, relax as much as possible and follow all the commands of the doctor and midwife. It’s good if your husband or loved one is with you to support and reassure you.
Date: 10/26/2016
Typical mistakes at the beginning of labor:
1. Premature trip to the hospital.
Leads to fatigue of the woman in labor, slowdown of the process, and often to more painful childbirth, requiring more interventions.
Often, due to inexperience, at the very first latent contractions, a woman decides that she is giving birth and goes to the hospital.
In the best case scenario, the woman will be sent for a walk, or home, informed that she is not yet in active labor. Then she will be exhausted and tired of waiting for a long time until she is seen, examined, and all the procedures are performed, including a monitor, a vaginal examination, and all this instead of to relax peacefully at home.
And in the worst case, they will mistakenly decide that this is already the active phase, and will be sent to the maternity room (because the generally accepted division into stages and phases depending on the dilatation of the cervix is very arbitrary - for some, the latent phase will also be 4, and at 5, sometimes even 6 centimeters, and for some, active dilatation will go straight literally from scratch).
And if a woman finds herself in the maternity room, she is expected to make progress corresponding to the active phase, i.e. constant increase in cervical dilatation. If there is no expected active progress, the woman will be stimulated with Pitocin, or a proposal to pierce the amniotic sac to speed things up (and these are all, by the way, separate long topics for discussion)
2. Notify the entire neighborhood that you are giving birth.
They will torture you with advice!
This can lead to calls from family and friends checking to see if you've given birth or not, literally every couple of hours. They will tell you “Why aren’t you in the hospital yet!!!”, express concern, and maybe even allow themselves to give instructions, disturbing your peace. Of course, I'm generalizing here, but in general, in my experience, this happens quite often.
It would seem that if you have sensitive and delicate relatives, this will not be so scary for you - they will not pester you. But you will know that they know and worry! And YOU will already worry about them - how are they doing, worrying about you, are they okay? And you and your family need your energy.
3. An attempt to actively “speed up” the process.
Leads to premature fatigue of the mother in labor.
Often a woman (and sometimes her husband) gets tired of the slow swing, and she, having studied all sorts of different methods of “naturally accelerating” childbirth, begins to diligently apply them. This includes hours of walking up and down stairs, nipple stimulation, enemas, and the like. It can be like looking at a flower and waiting for it to open. Or worse, you try to open it with your hands.
Occasionally there is a need for these remedies, but they must be used wisely, so as not to upset the hormonal balance and not tire the woman. It is better to do this under the guidance of a doula.
4. Infinite tracking of the frequency and duration of contractions.
This will not let you relax.
Of course, you need to understand what is happening with your contractions, whether you have yet entered the active phase. But don't count your contractions all the time - this activity is tiring and attracts too much attention. It is worth returning to your program for counting contractions on your smartphone when you have a subjective feeling that they have become more frequent and stronger, or once every few hours. And you certainly shouldn’t wake up on purpose (if you’ve already managed to doze off) in order to count contractions.
5. Call a doula early if you have one according to plan.
For now, you can handle it on your own - leave the muzzle as the “heavy artillery.”
This is a somewhat subtle matter, and a lot depends on you, and on the experience of the doula, and on your personal agreement with her, but, roughly speaking, the closer to the active phase she arrives, the better.
You should use her telephone support during the latent phase, and ask her to come closer to the active one.
Why? It's simple. While you are in the latent phase, you can do something else between contractions - sleep, relax, cook, watch a movie, make love with your husband, in the end. You need to relax and rest. And a tired and overworked doula, who has sat with you for a day or more, protecting you during the latent phase, will be much less effective in active labor.
However, you should definitely call your doula during the first contractions - but you, of course, will discuss this with your doula in advance. Typically, during the latency phase, you call your doula every few hours, or as your condition changes, and ask her to come when you feel that you really need her help.
Diagnosis and treatment of prolonged labor
The diagnosis is made based on clinical data. It is necessary to identify the cause of protracted labor, because this determines further treatment tactics. Assessing pelvic size and fetal size and position can help determine whether fetopelvic disproportion is causing a prolonged labor. For example, a fetal weight greater than 5000 g suggests the presence of fetal-pelvic disproportion. When the fetal weight is more than 4500 g, patients with diabetes can also be diagnosed with the same disproportion. Uterine dysfunction is diagnosed based on the duration and frequency of uterine contractions during palpation of the uterus or using an intrauterine catheter. Diagnosis is often based on response to treatment. If the 1st or 2nd stage of labor is too long and the fetal weight is less than 5000 g, labor can be accelerated by administering oxytocin, which is used to treat hypotonic dysfunction. If normal advancement of the head is restored, labor may end on its own. Otherwise, fetopelvic disproportion or severe hypotensive dysfunction is suspected, and delivery by cesarean section may be required. In the 2nd stage of labor, obstetric forceps or vacuum extraction can be used after assessing the size of the fetus, presentation and position of the head and assessing the size of the mother's pelvis. Treatment of hypertensive uterine dysfunction is difficult, but reduction and analgesics may help.
Let me remind you what to do during the latent phase:
- Live in peace.
- Get used to contractions, get ready for childbirth.
- Sometimes pay attention to your contractions - once every few hours, look at the frequency with which they occur, how long each of them lasts.
- Be patient - lots and lots and lots!
- Sleep! Can't sleep? Then pretend that you are sleeping - between contractions.
- Eat and drink - little by little, but definitely.
In general, pretend that you are not giving birth yet. For now, your body is still preparing - although very noticeably - for active labor. And after such good, painstaking preparation, everything will go on like clockwork.
Birth pathologies: causes
Pathological births are those that can threaten the health and well-being of the mother and fetus. They require urgent intervention of medical staff in the process and careful monitoring.
Any violations and potential complications must be diagnosed and eliminated as early as possible: only preventive measures can protect the woman in labor from injury, rupture, surgical intervention, and the fetus from damage and death.
The overwhelming number of complications become clear even before the onset of labor. This is a multiple pregnancy, a post-term fetus, early rupture of membranes, incorrect presentation of the baby (normally cephalic - legs up) - pelvic, when the baby lies sideways or pelvis down, or other incorrect options.
Some complications can develop and be detected already in the process of resolution.
- Amniotic fluid embolism.
- Delay of the shoulder during occipital presentation, discrepancy between the shoulder girdle and the mother's pelvis, inability of the shoulder to be born after the head within a minute.
- Disproportion between the pelvis and the fetus.
- Prolonged labor, premature birth.
- Umbilical cord prolapse.
- Uterine rupture.
The causes of complicated childbirth include an overly narrow woman’s pelvis, a large physique of the fetus, dysfunction of the uterus, incorrect position of the child in it, and the presence of a uterine scar. A large child is a child whose weight exceeds 4 kg. A factor for the birth of a large baby can be a post-term pregnancy, a late onset of critical days in puberty, or an extended menstrual cycle.
Pathological birth
