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Childbirth is not according to plan

Childbirth is not according to plan

The preparatory stage is delayed more often than others. The future mother feels weak, irregular contractions, comes to the maternity hospital, where it turns out that the cervix is ​​not ready for childbirth.

This means the contractions were false. If they are not too tired for a woman, she will have to wait for a real start at home, and more often in a day or a few days, ineffective contractions are replaced by productive ones.

Staying in the maternity hospital is offered to those expectant mothers for whom preparatory labor has become tedious.

Rare, short and irregular, in some cases they are also painful. In this case, the woman will need sedatives, vitamins, minerals – to supply the muscles of the uterus; medications relaxing the uterus.

After ineffective contractions can be stopped, doctors begin to prepare the uterus neck for childbirth. Most often after this, the appearance of successful bouts will not take long to wait.

The reasons for the delay in the onset of labor are not fully understood. It is precisely known, for example, that the signal to the “start” is given by the baby. In its epiphysis – the endocrine gland of the brain – a hormone is produced that starts labor, and many prostaglandins and oxytocin, the main rhodtimulants, enter the blood of the mother.

It is possible that breakdowns in the chain of these reactions or lack of hormones inhibit the stage of preparatory labor.

Although the reasons are also more noticeable: the unavailability of the cervix (it is still dense, closed, long), the flat fetal bladder (normally it is “supposed” to be convex, in order to stretch the cervix during contractions, helping it to open), lack of water ( if the amniotic fluid is small, the fetal bladder will not be able to press on the neck) polyhydramnios (there is so much fluid that the muscle of the uterus stretches and the contractions become weak; besides, the baby’s head cannot swim into the hole in the mother’s mouth). But a hitch at the beginning of labor does not mean that things will go on like this – it can have a good ending.

Childbirth is not according to plan

In fact, childbirth begins with the appearance of strong, regular contractions, the interval between which is 3-5 minutes, and, most importantly, with changes in the cervix. Under the action of contractions, it becomes soft to the touch, shortened and opened by 10 cm.

The opening time of the cervix is ​​the 1st period of labor, it can be delayed if the contractions become weak and irregular. Then within 4 hours, doctors will try to adjust their rhythm with the help of drugs.

The lack of results after this time is the reason for the operation.

From the moment of complete opening of the cervix begins the 2nd period of labor, during which the baby moves through all the planes of the pelvis. Now an obstacle can be the wrong location of the child’s head (it is bent, not bent and pressed to the chest), which is still not moving to the “exit”; violations of the shape of the pelvis of a woman blocking the passage of the baby; narrow pelvis of the future mother; large child; its transverse arrangement.

All these problems can slow down or even stop childbirth.

3rd period of labor – separation of the placenta and the birth of the afterbirth (fetal membranes, placenta and umbilical cord residues). Normally, it comes out on its own due to a sharp contraction of the uterus.

But sometimes it happens that the placenta is not separated from the walls of the uterus – completely or in some part, and then the obstetrician will have to “help” her; with its release, there is a risk of onset of bleeding.

What problems are fraught for an expectant mother with an emergency “caesarean section”?

First we must say that the whole process of the birth of a baby is controlled by a doctor, and it depends on his qualifications how he decides to act in a difficult situation. Obstetricians joke: it is much easier to teach how to do a cesarean section, than to explain in which cases it should be done.

Indeed, each story of birth is unique in its own way, although, of course, there are common reasons for all that force doctors to interrupt the natural course of events and resort to surgery.

1) The baby lacks oxygen (acute hypoxia).

A small device is monitored by a special device, a heart monitor, which signals the danger.

Why is this happening? Due to chronic illness of the mother, complications of pregnancy (late toxicosis – preeclampsia, premature detachment of the placenta) and childbirth (weakness of labor activity, tight and / or repeated cord entanglement, umbilical cord being lost, detachment of the normally located placenta).

In addition, if during pregnancy the doctors found hypoxia in the baby (in this case it is called chronic), then it can become acute during birth.

Childbirth is not according to plan

2) Childbirth does not begin, and with this delay it is not possible to cope with the help of medications (weakness of labor activity).

For example, the water moved away ahead of time, and the signals of the onset of labor do not appear even after the doctor has introduced medicine to the expectant mother.

Most often, such problems occur in women who have any endocrine disorders (for example, hyperandrogenism, diabetes mellitus).

3) Going out for the baby is too small (clinically narrow pelvis).

In order to be born, a child needs to “get through” through the mother’s small pelvis, and if the size of the latter is normal, and the child is large (from 4000 g), his head may simply “not fit” between the bones of the woman’s pelvis and it will not work. Doctors call this situation a clinically narrow pelvis, it should not be confused with an anatomically narrow pelvis, when its size is small by nature.

4) The placenta, which protects and nourishes the baby, loses its connection with the mother’s body (detachment of a normally located placenta).

This most often happens with late toxicosis – preeclampsia, uterine myoma, varicose veins, acute viral infections or exacerbation of chronic infections (for example, flu and genital herpes).

5) Together with the amniotic fluid that has poured during the birth, a part of the umbilical cord is outside (the umbilical cord loops fall out).

The most common causes are high water and too small a child’s weight.

6) The baby is not located correctly.

It happens that the head of the child unbends, that is, it does not lean towards the breast, but leans back to the back. Then, not the temechko, but the forehead or face of the small one, will move first out, which is quite dangerous.

It also happens that the head of the baby is inserted into the small pelvis of the mother wrong.

Most often, all these problems arise due to the anatomically narrow pelvis of the mother, too strong or too weak labor activity, uterine fibroids, the large size of the baby, its developmental defects that prevent him from straightening his head.

Before starting to stimulate contractions, the doctor opens the fetal bladder and, if necessary, prescribes pain relief to the expectant mother. He selects the dose of the necessary hormones – oxytocin or prostaglandins – in such a way as to achieve a natural pace of labor – 3-5 fights in 10 minutes.

Before the start of stimulation, a woman should gain strength, especially since after a good rest and the opening of the fetal bladder, the contractions usually gain the necessary frequency and strength.

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