Let’s start from the very beginning: the beginning of childbirth is preceded by the phase of preparatory contractions, they are weaker than the real ones, they appear from time to time, with large intervals. “Debutantes” feel them quite clearly, and moms with experience may not notice. This period lasts about 7 hours. For the first time, the preparatory fights may be delayed, which means they will prevent the expectant mother from resting and gaining strength for the upcoming “work”.
Then the doctor will inject a sedative to give her a chance to sleep.
This is where fights help her: they become regular and intense. Under their action, the neck softens, shortens and opens slightly.
The cervix resembles a tube with 2 contractions: the first “closes” the entrance to the uterus (the baby floats there in the amniotic fluid), and the other “exit” to the outside. It is this last narrowing and carries the greatest burden during childbirth: he will have to open more and more to miss the baby.
For clarity, imagine a balloon (uterus), the leg (cervical canal) of which is tied up with two ropes (internal and external narrowing of the cervix). With the onset of contractions, the upper rope is untied (that is, the inner constriction is stretched), and then the lower (outer) one.
For mummy “debutantes” they open one after another, and for “experienced” ones – at the same time.
The first period for “inexperienced” mothers lasts 12–18 hours (7 preparatory ones are included here), during the next birth it takes 6–8 hours. For the first time, the rhythm of contractions at this stage may deviate from the nature’s position, then they become short, irregular, and the cervix does not open as a result.
This happens if the phase of the preparatory fights was delayed and tired of the future mother or the amniotic fluid poured out ahead of time. In this case, the doctor will introduce a sedative medicine to her to give her a chance to relax and restore the rhythm.
It also happens that by the time the labor starts, the cervix of the mother “debutant” is not ready, that is, it does not soften or shorten. Then the doctor will begin to prepare the neck with the help of drugs, such as a gel, which consists of biologically active elements – prostaglandins, or candles with substances that relax its muscles.
It begins with the full opening of the cervix and ends with the birth of the baby. At this time, the contractions become more intense, they join the attempts. The head of the baby presses on the muscles of the pelvic floor of the woman, irritates the nerve endings, from which she has an unbearable desire to pull.
The second period lasts for “debutantes” longer, from 1 hour to 2. This is partly due to the fact that women who become mother for the first time have pelvic floor muscles, perineal tissues are less elastic, which means that they are not too willing to stretch and have more resistance to the birth of a child. For this reason, injuries of the birth canal in the “debutantes” occur 2-3 times more often.
To prevent this, the doctor resorts to dissecting tissue.
It starts from the moment the baby is born and ends with the birth of the afterbirth (that is, the placenta with fetal membranes). The third period lasts about 5–10 minutes. During this time, the uterus contracts, drops to the level of the navel, from which its connection with the placenta is broken, it exfoliates and, with the help of contractions, is expelled out along with the membranes.
There is no particular difference in how “inexperienced” and “experienced” mothers experience this period.
ELENA BRAIN, obstetrician-gynecologist, head of the 3rd maternity ward of the Research Institute of Obstetrics and Gynecology. BEFORE. Otta, St. Petersburg
Repeated natural childbirth has its own characteristics. The anterior abdominal wall and the uterine walls of such expectant mothers are less elastic, so the baby’s head, which is closer to the exit, may remain mobile above the pelvic entrance and not pressed to it, as during the first birth, until the beginning of labor.
Because of this, a woman does not feel that her stomach has “dropped” – usually it happens 2-3 weeks before giving birth.
The cervix ripens more easily and faster during repetitive labor. The only exceptions are those expectant mothers who suffered a serious cervical injury during previous births.
Fortunately, now such situations are rare. If the cervical ruptures were all its length and did not heal or a scar appeared in their place, doctors can refer the woman to a planned cesarean section.
Cervical dilatation during repetitive labor goes faster and takes an average of 6–8 hours. Simultaneously with the first contractions, the opening and shortening of the neck begins.
If a newborn child does not significantly exceed the size of the first one and lies correctly, then the 2nd stage of labor also passes faster. The baby walks “along the beaten path”, and if for the first time from the moment of complete disclosure of the cervix until the birth of a child, usually 1–1.5 hours pass, then later it takes 20-30 minutes.
Due to the fact that repeated deliveries go faster and the stage when contractions become painful, does not last long, the need for serious anesthesia occurs less often. Analgesics are more commonly used for pain relief, they are administered once intramuscularly or intravenously.
Damage to the cervix and perineum at repeated births occur less frequently than the first time, provided that the soft tissues are not inflamed. And newborns, due to the fact that the movement through the birth canal is faster, is usually more active and better take the breast when you first feed.
Since each subsequent birth increases the risk of bleeding in a young mother, the doctor and midwife are especially vigilant about the condition of experienced parents in the 3rd period of labor and in the first hours after their termination.
In the first days after the second birth, some women notice a more painful contraction of the uterus, sometimes even requiring a little pain relief. However, these feelings pass quickly, and the lesser tiredness of the process itself and the experience gained in caring for the firstborn helps women to get stronger quickly.
Of course, every pregnancy and childbirth is a test for a woman. And the first birth, provided that they developed naturally, still almost always remain in the memory of a young mother as a difficult job, while the latter leave a feeling of much less stress and fatigue.
Is this not a reason to think about the third child?
If the first pregnancy ended with a cesarean section, are natural childbirth possible afterwards? Usually, the operation is done again in a situation where the reason for which it was assigned for the first time has been preserved (for example, mother’s narrow pelvis).
If the grounds for cesarean section were different (the child’s position was incorrect), after the operation about 3 years passed and the scar on the uterus is in good condition, childbirth is naturally possible. However, before you make a verdict, the doctor needs to be examined.
For this, the future mother will be determined in the maternity hospital in advance, at the 38th week of pregnancy.