The message that childbirth will have to be stimulated is always alarming for expectant mothers. They fear that the acceleration of the natural course of events will harm the child.
In reality, the opposite is true: the means by which labor is stimulated is necessary in order to eliminate the cause that inhibits the normal process.
Births are divided into two periods. Until one is completed, the next one cannot begin. So, at the first stage, two points are key – softening of the cervix and its gradual opening due to contractions.
If the tissues of the uterus are not prepared for childbirth, contractions will not begin or will be ineffective and the cervix will not open. Attempts – the main event of the second period – start only after its diameter reaches 10 cm. Hams occur at any of these stages for various reasons.
Very young (up to 20 years) mothers are more likely to be at risk, since their reproductive system is not yet mature enough. After 35 years, complications occur because the muscles and ligaments lose elasticity. Women of asthenic physique often need additional help: they simply lack physical strength.
Sometimes the natural course of events is hampered by chronic endocrine, hormonal or metabolic disturbances or sluggish inflammatory processes. But most often, childbirth does not begin simply because the woman is not in tune with them and is very afraid of pain.
Doctors eliminate all unplanned “stops” with the help of artificial hormones and biologically active substances. If you need to start labor activity, obstetrician-gynecologists talk about “labor induction”, and if it is important to strengthen it, about “family stimulation.”
The first problem: the cervix is not disclosed. For readiness (doctors say – “maturity”) of the uterus for childbirth respond biologically active substances prostaglandins.
They are contained in the cells of different tissues and contribute to their reduction. The main task of prostaglandins on the eve of childbirth is to soften the cervix so that it can open. It is from this process that the generic activity begins.
Under the influence of prostaglandins, the muscle tone of the lower part of the uterus increases, and in the cervix, on the contrary, it decreases, and its tissues become more elastic and stretch better. The production of prostaglandins increases naturally on the eve of the X hour. Doctors believe that these biochemical reactions in the mother’s body are triggered by a signal that comes from the child’s brain, or rather from the gland located in it (the epiphysis).
If prostaglandins produce an insufficient amount, the cervix does not open. Doctors fill the deficit with the help of artificial analogues of these substances.
The drug in the form of a gel is injected into the vagina and cervix. 4 hours after that, it softens and the contractions begin.
Another failure in the first stage of labor may occur if cervical dilation stops. Normally, contractions begin with a whole bladder, which puts pressure on the cervix and helps it to expand. When the opening diameter reaches 4 cm, the pressure in the uterus rises.
And the fetal bladder should burst at this moment, otherwise the process will slow down. If he remains whole, the doctors do an anmiotomy – they pierce him with a special tool.
If, after the use of amniotic fluid, the cervix still does not begin to open, the labor activity is activated with the help of an artificial analogue of oxytocin, a hormone that regulates muscle tissue contractions, including those that form the reproductive organs.
The dose of the drug is calculated based on the weight of the pregnant woman. The drug is injected into the body intravenously through a catheter.
While oxytocin enters the body, the doctors monitor the intensity of contractions and the baby’s well-being especially carefully with the help of cardiotocograph (CTG) sensors fixed on the future mother’s belly. On the monitor there are data on the speed of heartbeats of the child.
And it depends on the intensity and frequency of contractions. When the uterus contracts, the blood flow in the placenta slows down.
From this, the oxygen content in the baby’s blood falls, and short-term hypoxia (oxygen starvation) occurs. In this case, the baby’s heartbeat quickens, as evidenced by the CTG data. Normally, the contraction at the end of labor takes 1 minute and is repeated every 2–3 minutes.
During breaks, the baby’s body manages to compensate for the effects of hypoxia, and the heartbeat is restored. But if contractions occur more often, oxygen starvation lasts continuously and hurts the child, and the monitor registers a slowing of the heart rate. In this case, the baby is born with the so-called oxytocin syndrome, which weakens the adaptive mechanisms and reflexes.
That is why doctors closely monitor the reaction of the uterus to the drug. And if it starts to shrink too intensely, stop the introduction of oxytocin. In order to avoid severe hypoxia, stimulation is stopped after 4–6 hours, even if the neck has not opened.
Then the output is a cesarean section.
Oxytocin is also used to solve the main problem of the second stage of labor – weak attempts. In the event of a normal development during the attempts, the diaphragm, the abdominals and the uterus become the driving forces. Under pressure from these organs, the baby moves through the birth canal and goes outside.
If during labor the woman fails to effectively strain the diaphragm and the abdominals, then the uterus has to “push” the child alone. To do this, it must be greatly reduced several times, and without oxytocin such powerful actions are impossible.
Some of the unconventional methods of labor stimulation – homeopathy, herbal medicine and acupressure are officially allowed in other countries. Homeopathy is used by doctors in England, Germany, the Czech Republic, and acupressure by Asian specialists.
Herbal medicine is addicted to the United States: when loosening contractions, mothers will be offered red raspberry tea leaves. And just making sure that it does not help, they will proceed to the drug stimulation. In Russia, these techniques are not officially banned, but are not welcome.
Alternative medicine helps if it is resorted to at the first sign of a weakening of labor activity. However, such methods should not be carried away: if the situation has not improved within half an hour, it is necessary to act in accordance with the official medical protocol.