Pubic shaving is not considered mandatory, but in many obstetric centers this procedure is still practiced. According to the deep conviction of doctors, it reduces the likelihood of infection during childbirth. Before shaving, the bikini area must be treated with disinfectants to kill germs on the skin’s surface.
The same measure becomes preventive in case of accidental cuts. Different maternity hospitals use different antiseptic substances, and, like any medicine, they can also cause allergic reactions.
If there were precedents, it is better to inform the doctor about them immediately. There is always an alternative, and most often it becomes an almost harmless, but effective ethyl alcohol.
When processing pubic antiseptics often there is a slight tingling, because the skin may be imperceptible to the eye micro-scratches. This is a common reaction to ethyl alcohol, which is part of most antiseptic solutions.
The same procedure is used for treating the skin of the anterior abdominal wall before a cesarean section and for disinfecting the internal genital organs during vaginal examination.
All future mothers are aware of the benefits of the right psychological attitude. This is repeated more than once in the preparation courses for childbirth. However, not everyone can cope with emotions, and doctors are ready for such a turn.
The sedatives that are popular in everyday life: motherwort, valerian root, valocordin, Corvalol are not taboo, they relieve nervous tension well. The only restriction is that they can be taken orally only in the form of a spirit tincture (usually 25–30 drops is enough).
Despite the sufficient effectiveness of these almost popular sedatives, doctors rarely use them. Much more often during childbirth, antipsychotics are used – drugs that remove the “presence effect”. They cloud the mind and reduce anxiety, thanks to them the woman ceases to control the situation and relaxes as much as possible.
Neuroleptics can be used in parallel with epidural anesthesia and during administration of antispasmodics. Sometimes the “effect of the presence of” doctors clean at the request of the woman, for example, when a planned caesarean section, when she has the opportunity to discuss this point on the eve of the operation.
In an emergency, they make this decision on their own.
Neuroleptics are safe for the health of mother and baby, but they have one minus – they cause drowsiness in both, so doctors try to inject these drugs a maximum of two hours before the expected end of labor.
Sometimes doctors have to speed things up. If at the very beginning of labor the cervix does not open, prostaglandin drugs come to the aid – a substance that triggers this important process. In their natural form, prostaglandins accumulate in large quantities in the amniotic fluid and begin to act after their discharge.
If for any reason the natural mechanism does not work, an additional dose from the outside is required. The drug has the form of a gel, is injected into the cervix and stimulates its reduction. Sometimes this measure is enough to start labor.
Otherwise, oxytocin is used to challenge or enhance contractions. This hormone is normally produced during labor in the pituitary gland, and its task is to cause contractions.
Oxytocin is administered intravenously via an infusion pump, an apparatus resembling an electronic dropper.
With the help of prostaglandins and oxytocin, doctors imitate natural processes, so they do no harm. The doctor selects the dose individually.
Both drugs are administered gradually, in small portions, to achieve the desired effect, and always against the background of cardiomonitoring. The device CTG allows you to assess the reaction of the baby to increased contractions.
With contractions of the uterus, its vessels are compressed each time, causing blood circulation to be disturbed. At these moments, the heartbeat of the child should be increased.
If, on the contrary, it weakens, there is a risk of hypoxia (oxygen starvation). To improve the situation allows the dropper with saline and drugs that activate uterine blood flow and microcirculation in the vessels.
Sometimes doctors add drugs that enrich the blood with nutrients.
In the first stage of labor contractions are not very strong and not very long, the cervix is just beginning to shorten and prepare for the opening. Nevertheless, a woman at this stage may complain of discomfort and pain. In this case, doctors usually use antispasmodics, most often “No-shpu” and rectal suppositories (with papaverine, buscopan).
These drugs weaken the spasms of the smooth muscle muscles that make up the cervix. “No-shpu” is administered only intramuscularly. The advantage of rectal suppositories is that the medicine is absorbed in this form, bypassing the liver, which minimizes the harmful effects on the body.
All antispasmodics that are used during labor do not pose a danger to the baby.
In the active stage of labor, contractions and painful sensations intensify. At this stage, in most cases, epidural anesthesia or antispasmodics are used. The first option is used very widely, but, of course, in the absence of contraindications (injuries and spinal surgery, the presence of an intervertebral hernia in the lumbar region, etc.).
Before starting the procedure, the area of skin where the catheter is inserted is treated first with an antiseptic, then with local anesthetics. The medicine itself has not only an anesthetic effect: it improves uteroplacental blood flow and lowers blood pressure by relieving vascular spasms.
Anesthetic does not get to the baby, so there is no danger to his health.
Antispasmodics are usually used in second or third labor, when doctors expect a quick finish. The fact is that preparation for epidural anesthesia takes time, and the drug itself does not begin to act immediately.
If a woman agrees to suffer a little, doctors prefer to do with small means. Antispasmodics at this stage are also administered intramuscularly or rectally.
If the baby is at risk of infection with any infection during childbirth, there is a need to use antibiotics. The dose depends on the degree of risk.
For example, with a prolonged anhydrous period, which proceeds without clinical symptoms, a single administration of drugs for purely prophylactic purposes is sufficient. But if there are signs of infection (the temperature has risen, the amniotic fluid has acquired an unusual color or smell, a large number of leukocytes was found in the blood), full anti-bacterial therapy will be needed.
Doctors will resort to it even if the birth proceeds against the background of exacerbation of a disease (for example, bronchitis, tonsillitis, chorioamnionitis – inflammation of the fetal membranes).
In both situations, only mild antibiotics are used, which are approved for use during pregnancy, because they reach the child through the bloodstream. Sometimes the treatment has to be extended even after delivery in order to avoid infectious complications (most often endometritis – inflammation of the uterus), and sometimes it is also prescribed to the baby.
Pills that are taken by mouth are never used during labor. There are two reasons for this.
First, in the period of cervical dilatation, approximately 30% of women develop nausea, which can result in vomiting. The symptom is considered natural, but oral medications against its background do not have time to be absorbed in the intestine, and therefore do not give the expected effect. Secondly, doctors always remember that childbirth is a physiological process, but unpredictable, so an operation may be required at any time.
If in case of emergency you have to do general anesthesia, the stomach should be empty. This condition will avoid life-threatening complications (regurgitation), in which the contents of the stomach can get into the respiratory tract.
For the same reason, during childbirth, water is allowed to drink only in a small amount and only in small sips, and from the food only chocolate is allowed.