Dilatation of the uterus during childbirth. How to speed up the process of childbirth: stages of cervical dilatation, methods of stimulation at different stages

The uterus is the main organ that distinguishes a woman from a man. It is thanks to their physiological characteristics that representatives of the fair sex can bear and give birth to a healthy baby. The uterus is a hollow muscular organ that is divided into three parts: the cervix, the body and the fundus. By looking at the cervix, the doctor can determine whether labor will begin soon.

Cervix during pregnancy

The cervix connects the vagina and uterus. Outwardly, it resembles a tube. If the pregnancy is progressing normally, the cervix will have a firm consistency, preventing the fertilized egg from descending too low. must be tightly closed. The cervix in the early stages does not indicate the beginning of pregnancy. If suspicious discharge appears, the expectant mother should immediately consult a doctor.

The cervix begins to change its structure and shape only a few weeks before birth. It is thanks to such changes that the child will be able to move almost unhindered through the birth canal. long before the expected birth date is a bad sign. At best, it will begin; at worst, the woman will lose her child.

Why does the cervix change its structure ahead of schedule?

Pathological changes in the uterus occur for a number of reasons. The risk group includes women who have once had an abortion or miscarriage. Cervical erosion, as well as injuries associated with previous births, can also cause the pharynx to open long before the desired date. In addition, hormonal imbalances lead to changes, such as, for example,

The expectant mother herself may notice changes in the early stages of pregnancy. Mucous discharge of a yellowish tint indicates that the cervix is ​​open. Whether this is normal or not, only a doctor can tell you. Therefore, a pregnant woman should immediately report any suspicions to a specialist.

Cervical dilatation

The longer the pregnancy, the more the connective tissue of the cervix is ​​replaced. Young fibers are more elastic. Thanks to this, the cervix opens quite strongly before childbirth, allowing the fetus to come out. The organ shortens and becomes looser.

Softening of the cervix before childbirth occurs gradually. This process begins from the 32nd week of pregnancy. For first-time mothers, preparation takes a little longer. Dilation begins from the internal os of the cervix. Gradually, the fetus moves outward, stretching the external pharynx. In women who give birth repeatedly, the cervix dilates much faster. For some pregnant women, this process may take only a few hours. By the end of pregnancy, the external cervical os may already be open to several fingers.

What problems might arise?

From the 37th week of pregnancy, the uterus is completely ready for childbirth. But this alone is not enough. Many women are so afraid of giving birth that they psychologically slow down the process. Fears prevent the production of hormones necessary for softening. The cervix remains firm before birth. If stimulating actions do not lead to the desired changes, the doctor may prescribe a cesarean section.

Regular labor is required for normal cervical dilatation. If the contractions are too weak, the uterus may remain at the prenatal level. Quite often, such a nuisance occurs with polyhydramnios or insufficient amniotic fluid. When the uterus is overstretched, its tone, that is, contractility, decreases. As a result, labor also weakens, and the cervix opens less intensively.

The risk group includes women who give birth for the first time after 35 years. The main reason for poor opening may be a decrease in tissue elasticity. Your doctor will examine your cervix before giving birth. If the organ does not have the structure necessary for this time, surgical intervention will be required.

Preparing the cervix for future births

Shortly before the expected date, the doctor will examine the woman in labor. If the cervix is ​​immature, it is necessary to carry out stimulating actions that will help release the necessary hormones and prepare the body for childbirth.

All such methods can be divided into medicinal and non-medicinal. With the help of medications prescribed by a doctor, it is possible to prepare the uterus for childbirth only in a hospital setting. All actions must be performed under the strict supervision of a physician. It is considered effective to introduce sticks into the cervical canal immediately before the expected date of birth. Under the influence of heat and moisture, kelp swells, affecting the organ. In addition, seaweed secretes substances that promote cervical ripening. In the best case, labor can begin within 5-6 hours.

Synthetic prostaglandin, which is introduced into the vagina in the form of a gel or suppository, can also stimulate the opening of the cervix. The desired effect can be achieved within a few hours.

Puncture of the amniotic sac

There are radical methods to stimulate labor. First of all, these include piercing the amniotic sac. If the cervix does not dilate properly during childbirth, the doctor may perform an amniotomy, which will cause the fetal head to lower and begin to press on the cervix. If additional medications are used, labor will begin to proceed much more intensely.

A cleansing enema also has excellent stimulating properties. It is no coincidence that this procedure is mandatory when a woman is admitted late into the maternity ward. The enema irritates the back wall of the uterus, stimulating contractions. Quite often after this, the mucous plug comes out. In this case, the cervix opens much faster before childbirth. It is worth noting that an enema is only appropriate for those women who have already reached their expected date. Stimulation before this period can be dangerous for the baby.

Non-drug stimulation

If the pregnancy is already more than 40 weeks, and labor does not occur, some methods will help to stimulate it at home. The natural way can be called sexual intercourse. Sex promotes contraction of the walls of the organ, due to which the cervix opens much faster before childbirth. In addition, semen contains hormones that promote the onset of labor. Sexual intercourse is undesirable only if it has already moved away. The risk of infection increases.

Physical activity also contributes to the speedy onset of the process. Simple activities lead to more intense dilatation of the cervix before childbirth (a photo of a happy mother can be seen in the article). Physical activity should be fairly moderate. If possible, a pregnant woman should sign up for special gymnastics long before giving birth.

Long walks, climbing stairs, and cleaning the house stimulate the onset of labor just as well as special exercises.

Family support is an important element of a successful birth

The psychological attitude of the expectant mother is of great importance. Problems and fears about childbirth can lead to serious problems. It is within the power of loved ones to help a pregnant woman tune in to a successful outcome of events. In the last month, it is advisable to protect the expectant mother from family problems. Let her think only about the next meeting with the baby.

Childbirth is much easier for women with a husband or other loved one nearby. The right attitude and doctor’s recommendations will help to give birth to a healthy and strong baby.

Cervix, this is a very important component of this main organ during gestation, and it mainly depends on the cervix. The cervix is ​​something in the form of a tube connecting the uterus and vagina; the cervical canal is not located inside.

The cervix must be securely closed for almost the entire period of pregnancy in order for the fetus to hold tightly for the entire nine months.

However, in the final stage of pregnancy, the cervix undergoes changes that allow the baby to move through the birth canal without problems and, as a result, to be born with the least trauma for the mother. Such changes in the body of the expectant mother can begin early, and or premature birth.

Why does the cervix sometimes not dilate before childbirth?

However, conditions are more often observed when the cervix does not open. If this happens, doctors talk about insufficient preparation of the birth canal. That is, perhaps the contractions are not strong enough to trigger the dilatation process, or due to neuro-reflex disorders, a spasm of the cervical muscles develops, and this is always fraught with the risk of non-dilatation of the cervix.

During normal contractions, the uterus opens to such an extent that the fetus is able to cross the birth canal. to assist a woman in labor in such a situation, she must identify the reason for non-dilation and immediately prescribe adequate treatment, which is usually one of the methods of stimulation.

However, stimulation should not be carried out independently under any circumstances, since it is very easy to harm the child.

To prepare the uterus for childbirth, the doctor who has diagnosed non-dilatation of the cervix prescribes premature stimulation of the uterus, and in this case, childbirth usually occurs without complications. This question is especially relevant in the fortieth week of pregnancy, since at this stage the placenta begins to deplete and “grow old.”

Prenatal stimulation methods

Currently, two main methods of prenatal cervical stimulation are used: non-drug and medicinal, in which medications are prescribed, which can only be used in a hospital setting. These drugs initiate dilatation of the cervix.

In some cases, special algae are introduced into the canal of the neck - kelp sticks, which swell under the influence of liquid, which leads to the opening of the canal. In addition, these rods secrete endogenous prostaglandins, which contribute to the ripening of the cervix and prepare it for imminent childbirth. True, many women, trying to maintain the health of their child, try to use non-drug methods of stimulation.

With the non-drug method of stimulation, drugs are not used. It can also be used at home, however, it is preferable to consult a gynecologist to prevent any possible dangers. For example, a cleansing enema is used, which can initiate uterine contractions. After such a procedure, the mucous plug is released and the process of opening the uterus begins. It should be noted that an enema is done only when the scheduled date of birth has already passed. A natural stimulation for the opening of the cervix is ​​sex, during which uterine contractions occur and blood flow quickly increases. In addition, prostaglandins are present in sperm. However, if the mucous plug has come off, sexual intercourse is strictly prohibited, as it can lead to infection.

Another non-drug home method is physical activity - house cleaning, walking up the stairs, long walks. For hypertension, gestosis or placenta previa, this method is not applicable. In any case, in such a situation, you should consult a doctor.

Natural labor begins approximately upon reaching, and ends with the birth of the baby. In some cases, doctors have to stimulate labor. This may be due to medical conditions that arose before the expected date of birth, or due to post-term pregnancy of more than 42 weeks. Sometimes labor begins spontaneously and does not proceed very well or even stops. If contractions stop or are simply not enough for the normal opening of the cervix, doctors talk about weak labor and resort to its stimulation.

This is how medications are used if, twelve hours after the water broke, labor has not begun. Of course, stimulation is carried out only under the supervision of a qualified physician and with extreme caution. At the same time, it is mandatory to find out whether the woman has allergic reactions to any medications.

In order to influence the cervix, both medicinal and non-medicinal agents can be used.

Signs that cervical dilatation needs to be stimulated during pregnancy:

The woman in labor has diabetes mellitus, gestosis or high blood pressure;

Excess of amniotic fluid too early, with the risk of infection;

A greatly distended uterus, which is caused by polyhydramnios, too large a fetus or twins;

The uterus does not open;

Weak or short, or completely absent;

Heart problems, presence of Rh conflict;

Premature placental abruption (as a threat to the child’s life);

In some cases, late toxicosis;

Deterioration of the condition of both mother and child.

The decision on stimulation is made by each doctor independently, focusing on the condition of the mother and research data (ultrasound, blood and urine tests, etc.). The waiting period for childbirth can be extended by another one or even two weeks, while the woman is recommended to go to the maternity hospital in order to fully monitor her and, if necessary, resort to prompt delivery.

Non-drug methods of stimulation include amniotomy, which is also called puncture of the amniotic sac. The main indication for this procedure is dilatation of 2 cm, which then stops. As a result of the puncture, labor intensifies. This causes amniotic fluid to flow out, which leads to a decrease in blood pressure.

The baby's head begins to put pressure on the pelvic bones, and this contributes to the necessary opening of the cervix. This method is quite painless and safe, it cannot harm the baby, and there are no nerve endings in the amniotic sac.

If the amniotomy does not dilate sufficiently, doctors use medications to speed up the process.

* One of the medicinal methods of stimulation includes the use of prostaglandins. These elements effectively prepare the cervix for subsequent opening. This method is very good, as it has virtually no side effects.

The specialist inserts a candle deep into the vagina, and the cervix begins to open faster. This is the beginning of labor. The drug affects only the mother's body and is not capable of harming the child. It begins to act after half an hour, and until this time the woman in labor is allowed to move freely around the room.

* Oxytocin stimulation is another type of drug effect on cervical dilatation. This drug can be administered into the body using tablets or a solution for intramuscular and subcutaneous injections, as well as for intravenous use.

Its side effects include increased pain during childbirth, so it is most often used in parallel with antispasmodics, and in addition, too active contractile activity of the uterus, which causes circulatory problems and can harm the child.

During intravenous administration, the woman is forced to lie down, and this also negatively affects the dilation of the cervix.

* Many expectant mothers manage to speed up labor by walking around the room. But it is worth remembering that each person is absolutely individual.

* There are several methods that the woman herself can use to prepare the cervix for labor. To do this, starting from the 37th week of pregnancy, she is recommended to include in her diet more salads seasoned with any vegetable oil.

* Swimming and diving, as well as long walking, give excellent results.

* You can drink a decoction of raspberry leaves, massage the auricle and little finger.

The expectant mother should carefully read the literature on childbirth and find out how to behave during labor. In addition, it is recommended to perform some physical exercises. This will reduce fear and learn to control your body. The ability to “listen” to your body is the best stimulation of labor. It is important to remember that pain is an integral part of childbirth and to control yourself while thinking about the baby.

Stimulation is the artificial induction of labor at various stages of pregnancy and the activation of labor activity already during childbirth. This procedure may be necessary if the duration of labor increases, which occurs if either the first stage of labor (cervical dilatation) or the second (expulsion of the fetus) is prolonged. Since not every “delay” in labor requires stimulation, doctors must analyze the situation, understand its causes and act accordingly.

When observing childbirth, the doctor pays attention to the following points:

1. The presence of contractions, their frequency, duration and strength. Objectively, these signs are confirmed by palpation of the abdomen (uterus), according to the readings of a tocodynamometer device, which allows you to accurately record the frequency and duration of contractions, as well as using a special intrauterine catheter to determine the pressure in the uterus during contractions (the latter method is used very rarely).
2. Cervical dilatation- this is the most accurate criterion for the normal course of labor. Typically, dilation is measured in centimeters. The minimum dilation is 0 cm when the cervix is ​​closed, the maximum is 10 cm when fully dilated. However, this indicator is not completely reliable, since even the same doctor’s obtained opening values ​​may vary, not to mention different doctors examining the same woman (the guideline for determining the degree of opening in centimeters is the width of the doctor’s fingers; 1 finger approximately corresponds 2 cm, 3 fingers - 6 cm, etc.). It is believed that the normal speed of cervical dilatation in the active phase of labor is 1-1.5 cm/hour. If dilatation occurs more slowly, the woman in labor may require some kind of stimulating influence. However, the actions of doctors are determined not only by the degree of dilation, but also by the woman’s condition.
3. Advancement of the presenting part of the fetus (usually the head). It is determined by palpation of the abdomen and/or vaginal examination.

With a normal pelvic size, correct fetal position and the absence of factors preventing the birth of a child through the natural birth canal, a protracted form of labor is facilitated by:

• sedatives;
• painkillers;
• position of the woman in labor on her back;
• woman's fear of pain;
• some diseases of pregnant women.

In addition, there are indications for artificially inducing labor:

• post-term pregnancy, especially if signs of abnormalities in the fetus or pathological changes in the placenta are detected,
• in some situations - late toxicosis,
• premature placental abruption (direct threat to the life of the fetus),
• premature discharge of amniotic fluid (since the likelihood of infection through the cervix increases), certain diseases (for example, severe diabetes), etc.

Your actions during pregnancy and childbirth

The desire to have a successful birth should not remain a dream unsupported by concrete actions. Moderate physical activity during pregnancy, physical exercises that train the abdominal muscles, perineum, breathing exercises, the ability to relax - all this will one way or another have a beneficial effect on the course of childbirth. Knowledge about the course of childbirth and correct behavior during it will reduce the fear of childbirth, therefore, you will be able to influence the process of the birth of your child to a greater extent. The listed useful knowledge and skills are quite effective methods of stimulating labor.

If you have the opportunity to choose conditions for childbirth and the ability to choose a maternity hospital, one of the selection criteria should be the ability to walk during childbirth (of course, if you have no contraindications to this). It has been proven that the supine position increases the duration of labor, since one of the factors of cervical dilatation - fetal pressure on the cervix is ​​not realized. Studies were conducted in the USA that showed that freedom of movement (the ability to walk, sit in different positions) can be no less effective than drug stimulation during labor!

If you have the opportunity to familiarize yourself with the room where the birth will take place, take advantage of it. Surprisingly, the factor of preliminary acquaintance with the maternity ward also has a beneficial effect on the process of childbirth (this was also revealed by the meticulous Americans in their research).

During childbirth, you can use an old, but scientifically proven method - nipple stimulation. At the same time, the body increases the production of oxytocin, a hormone that stimulates labor and largely determines the course of labor and its successful outcome. It is this circumstance that can explain the fact that putting a baby to the breast immediately after birth speeds up the birth of the baby and reduces the likelihood of postpartum hemorrhage. If, according to doctors, your pregnancy is gradually becoming post-term, and there are no signs of approaching labor, you can also resort to this method.

Unfortunately, it is impossible to guarantee the effect, but there will be no harm from this method (of course, if you do not overdo it, because during this period the nipples can be easily injured).

Increased physical activity can also trigger the onset of labor. But this “method of stimulation” is fraught with obvious danger to the life of the mother and child.

Doctors' actions during childbirth

It should be said that the frequency of use of drug stimulation is growing from year to year. There are several reasons for this. The main ones are the health status of women and the desire of doctors to minimize the risk to the fetus. If you would like medications to be used during your labor only when absolutely necessary, discuss this with your doctor. In addition, different maternity hospitals have their own “favorite” methods of stimulation. You may find it useful to know which method of stimulation is preferred by obstetricians at the maternity hospital of your choice.

So, what methods of inducing labor do doctors have in their arsenal? All of them can be formally divided into those that stimulate uterine contractility and those that affect the dilatation of the cervix. Sedatives stand somewhat apart. Fear of pain can slow down labor. Therefore, by muffling negative emotions, in some situations it is possible to restore the normal course of childbirth.

Methods affecting the contractile activity of the uterus

In this group, the most popular among obstetricians are amniotomy and synthetically produced analogues of natural hormones, in particular oxytocin.

Amniotomy- opening of the amniotic sac. It is performed during a vaginal examination using a sterile plastic instrument that resembles a hook. This procedure is painless because the amniotic sac is devoid of pain receptors. The mechanism of action of amniotomy is not fully understood. It is assumed that opening the amniotic sac, firstly, promotes mechanical irritation of the birth canal by the fetal head, and secondly, indirectly stimulates the production of prostaglandins, which enhance labor. Information about the effectiveness of amniotomy is conflicting. In general, the prevailing opinion is that amniotomy, even without combination with other methods of stimulation, reduces the duration of labor. But this method is not always effective. And if doctors come to the conclusion that a given woman in labor requires stimulation, but the amniotic sac is still intact, an amniotomy will be performed first, and after that, if necessary, they will resort to the help of birth-stimulating drugs.

If the amniotomy proceeds without complications, it does not affect the child’s condition in any way. Amniotomy is considered a safe method, and any complications are quite rare. Nevertheless they exist.

An amniotomy can be thought of as cutting open a well-inflated balloon. It becomes clear why in some cases of both amniotomy and spontaneous rupture of the bladder, prolapse of the umbilical cord occurs. This complication threatens the development of acute oxygen deficiency in the fetus due to compression of the umbilical cord between the fetal head and the birth canal. This situation requires emergency medical intervention.

Blood vessels, including quite large ones, run along the surface of the fetal bladder. Therefore, if a blind incision of the bladder damages such a vessel, bleeding is possible, in some cases threatening the life of the child.

To avoid complications, whenever possible, they try to carry out amniotomy after the fetal head enters the small pelvis, squeezing the amniotic sac and the vessels passing along its surface. This prevents bleeding and prolapse of the umbilical cord.

If, despite amniotomy, labor does not resume, the likelihood of infection of the uterus and fetus increases, which is now not protected by the membranes and amniotic fluid.

Oxytocin- a synthesized analogue of the hormone produced by the pituitary gland. The action of oxytocin is based on its ability to stimulate contractions of the muscle fibers of the uterus. It is used to artificially induce labor, with weakness of labor throughout labor, with postpartum hemorrhage, and to stimulate lactation. To avoid severe complications, oxytocin is not used in cases of fetal position anomaly and clinically narrow pelvis, when the size of the pelvic ring is insufficient for spontaneous childbirth.

Oxytocin is used in the form of tablets, but more often - in the form of a solution for intramuscular and subcutaneous injections and especially intravenous administration. The last option for using the drug is the most common. True, it has a significant drawback: a woman with a connected drip system (“drip”) is very limited in her movements.

Different women respond differently to the same dose of oxytocin, so there is no standard regimen for using this drug. Doses are selected individually, therefore, when using oxytocin there is always a danger of overdose with side effects.

Oxytocin has no effect on the readiness of the cervix to dilate. In addition, in most women, after oxytocin begins to act, labor pain intensifies, so, as a rule, it is used in combination with antispasmodics (drugs that relax the muscles of the uterus).

Oxytocin is not used if it is undesirable or impossible to give birth to a child through the natural birth canal, abnormal fetal position, hypersensitivity to the drug, placenta previa, the presence of scars on the uterus, etc.

The most common side effect of oxytocin is excessive contractile activity of the uterus, which can lead to poor circulation in this organ and, as a result, to a lack of oxygen in the fetus.

Methods affecting the cervix

For some women, the reason for the slow progress of labor is the unpreparedness of the cervix to open - in the language of doctors, its resistance, or immaturity. The most common method to help the uterus “mature” is the use of prostaglandins.

Prostaglandins are hormones that have a pronounced effect on reproductive function. They are found in small quantities in almost all tissues of the body, but most of them are in seminal fluid and amniotic fluid. Prostaglandins can stimulate smooth muscles, including the fallopian tubes, uterus and cervix. Drugs in this group, like oxytocin, are administered in different ways. However, routes of administration leading to systemic effects of these drugs (in the form of tablets, intravenous solutions) are not very common. This is explained by the fact that, while stimulating the uterus with approximately the same effect as oxytocin, they lead to a greater number of side effects (nausea, vomiting, diarrhea, fever, excessive stimulation of uterine contractions, etc.) and, moreover, are more expensive. Therefore, prostaglandins are often used not for stimulation during childbirth, but for artificial termination of pregnancy in the early stages, artificial induction of labor in almost full-term or full-term pregnancy.

Currently, the method of introducing a viscous gel or suppositories containing prostaglandins into the vagina or cervical canal is quite widely used. With this method of administration side effects are minimal, and the effect on cervical dilatation is significant. It is also important that with local administration of this labor stimulant, the woman’s movements are not limited.

Of course, there are many means that enhance labor. Many of them are very rarely used during childbirth, but are used as a means of combating postpartum hemorrhage, which occurs due to insufficient contraction of the uterus (its hypotension). Among them are herbal preparations (ergot, barberry, nettle, shepherd's purse herb, spherophysin, etc.). Some funds have lost ground in recent years. This applies, for example, to artificially synthesized hormones estrogens, the effectiveness of which is inferior to oxytocin. There are methods that have an effect on the course of labor, but require additional research, such as acupuncture.

Unfortunately, a method that would suit both obstetricians and their patients in all its parameters does not yet exist, just as there are no two similar women in labor. Therefore, the choice of the method of labor stimulation remains with the doctor, who makes a decision taking into account the conditions of pregnancy, childbirth and the individual characteristics of the woman.

Tatiana Zamyatnina
Obstetrician-gynecologist,
doctor of the highest category,
medical center "MEDSWIS"

Discussion

No, well, why the hell did they inject me with oxytocin if I had contractions and my neck didn’t open properly?? Good article, thank you!

Thanks for the wonderful article. Everything is clearly written and now it has become clear what and why.

This is almost the first time I read a clear article about stimulation, listing various methods of stimulation, their pros and cons. Otherwise, most of the articles on this subject are more of an “educational” nature - that if a doctor prescribes stimulation, then that means it’s necessary, but essentially there is zero information. Thanks for the clarification, I think many people are interested in this!

Tell me how long a woman should give birth. after she was given an IV to induce labor.

04/15/2007 11:56:57, Victoria

Comment on the article "Labor with stimulation"

Need advice on stimulation. Second and subsequent births. Induction of labor without indications.... Medical issues. Pregnancy and childbirth. yes, that seems to be all about her for now...

Discussion

They gave me a pill at the maternity hospital to soften my cervix. I don't remember the name. Now I really regret it, because... one intervention leads to another. The softness of the cervix directly depends on the baby’s readiness to be born. The neck is not ready, which means he is not ready either.
I gave birth at 43 weeks and 4 days. After that, I read on the Nikitin family’s website that they had read a lot of literature on this issue and it turned out that my time limit was not the limit. I feel like I could give birth myself one of these days. But because According to the doctors, the deadline was unrealistic, I succumbed to their persuasion, which I greatly regret now. In my case, everything worked out, but they pierced my bladder, and then they vying with each other to say that my water had gone, there was a risk of infection for the child, and at the same time they did not forget to climb into me to check every half hour, they all peeled off, easily holding a non-sterile one in the other hand mobile phone. They offered to inject me with everything, not believing that I would give birth, and they intimidated me with everything. At the end they set a deadline - half an hour, if the opening is not complete, then they will take you to a caesarean section. And I just needed to be left alone. The doctors will come out for half an hour, there are contractions, they come and the contractions become less frequent. In the end I kicked them out, and everything went as usual. I did it in half an hour. But how much nerves and anxiety it cost me. Those. Instead of focusing on the birth, I fought my way to giving birth on my own for several hours. And all this happened in one of the best maternity hospitals in Vidnoye, where people from Moscow come to give birth, under the leadership of the “wonderful” doctor Myamisheva, with whom I so wanted to give birth before.
Now I have completely lost my desire to give birth in the presence of doctors.
All the doctors calculated my cycle on paper and could not take it for granted that this happens, and 2 ultrasounds in the first and second trimester confirmed my timing. They still didn’t believe that this could happen, and upon discharge they gave me 2 papers in which it was written that I had an emergency birth at 41 weeks.
They also frightened me with the fact that the baby inside was supposedly suffocating, that there would be post-maturity, in the antenatal clinic the doctor generally stated that after 38 weeks it was dangerous for the baby to be upside down, in the maternity hospital they installed a CTG sensor in such a way that the baby began to shudder, and from this the CTG result turned out to be terrible, she ran away with bulging eyes and came running with this pill. They didn’t want to redo my CTG; they agreed only after I took the pill. It turned out that my CTG was normal, the child just didn’t like the position of the sensor on his body before.
I’m not urging you to do anything, it’s up to you to decide, I just described my experience. By the way, my child was born with a weight that was far from post-maturity (they didn’t even reach 3600).
I wish you a calm, easy, independent birth!!! The main thing is to have the right mindset.

Candles "Buscopan". They helped me very well. 2 candles a day are enough (morning and night).

Stimulation of labor. I don’t understand why a woman is allowed to get to 42 weeks and then labor is still induced.

Discussion

What do you mean by stimulation - oxytocin? it gives continuous contractions, which are not only difficult for the mother, but also for the child, as he experiences constant and excessive compression for which he may not be ready. Natural contractions are always softer and intermittent.
opening the bubble? The cervix does not always open after it; often the entire ECS ends. or it opens, but the tissues are not elastic enough, hence ruptures and/or episiotomy. By the way, in cases of premature birth they almost always do an episiotomy, although the babies are tiny, but the tissues are not ready yet.
It’s better to prepare for childbirth and give birth when the time comes. You can always monitor the condition of the baby, umbilical cord and placenta using additional ultrasounds.
I gave birth at almost 41 weeks, a large baby 4250g, without tears or incisions. I was preparing for childbirth, breathing correctly, pushing correctly, helping my baby, and he helping me. I wish you an easy natural birth too:)

Now half of the children, if not more, have hypoxia without any walking or stimulation. Plus, not every woman will agree to stimulate and for this you need to go to the maternity hospital in advance, and there is not always room there. Everything is individual

What is stimulation? Stimulation is the acceleration of contractions by intravenously administering an additional dose of the hormone oxytocin, which should be produced during childbirth...

Induction of labor without indications.... Medical issues. Pregnancy and childbirth. Induction of labor without indications... Almost a horror story, but knowing is better than not knowing!!!

Cervix before childbirth

The cervix before labor is the main method for determining whether labor is imminent. Pregnancy is a physiological process during which great changes occur in the female body. The changes mainly concern the internal genital organs, which must prepare for childbirth in a short period.

During this time, muscle fibers lengthen, thicken and multiply. The number of elastic fibers increases. The connective tissue is loosened. The vascular network increases significantly. The cervix begins to soften.

What should the cervix look like at the end of pregnancy?

Before childbirth, the cervix becomes soft, juicy, and distensible. Blood vessels lengthen, veins dilate and fill with blood.

The main functions of the cervix during pregnancy are:

• retention of the fetus in the uterine cavity;
• preventing premature birth;
• smooth stretching of the cervix during childbirth;
• prevention of pathological course of childbirth.

Pregnancy is intended by nature and usually proceeds without problems, but may be accompanied by unforeseen situations. If pregnancy proceeds naturally, the pharynx is closed and securely holds the fetus in the uterine cavity.

By the time of birth, changes occur in the cervix:

• muscles are partially replaced by connective tissue;
• Collagen production is activated, which promotes stretching and softening of the cervical tissue.

From 33 weeks of pregnancy, the cervix begins to slowly prepare for childbirth. Under the pressure of the fetus, which descends and presses from the inside, the cervix first shortens, then smoothes and opens.

After 37 weeks of pregnancy, delivery is considered timely. If the cervix begins to open earlier, the birth will be premature and the fetus will be born immature. In a period of more than 42 weeks, pregnancy is considered post-term, and problems with the placenta and fetus appear. Doctors, after a vaginal examination, assessing the state of maturity of the cervix, decide on the completion of labor by stimulating labor.

How to assess cervical maturity

The Bishop scale assesses the degree of maturity, which consists of three indicators:

• cervical density;
• length of the cervical canal;
• degree of opening (from 1 cm to 12 cm);
• position of the cervix in relation to the pelvic axis.

Each indicator is scored with two points. The neck is considered immature if the score is up to five. If there are 6–8 points in total, the cervix is ​​considered mature.

What happens to the cervix before childbirth

The main labor expulsion force is contractions of the uterus (contractions), due to which the cervix opens, followed by the expulsion of the fetus and placenta.

There are three periods of childbirth:

1. The period of dilation begins with the first regular contractions and ends with complete dilation of the external os of the cervix.
2. The second period of expulsion begins from the moment of complete opening of the external pharynx until the birth of the child.
3. The afterbirth period begins with the birth of the baby and ends with the birth of the placenta.

Disclosure period

With the onset of labor, the cervix gradually smoothes out and opens to a degree sufficient to expel the fetus from the uterine cavity.

During contractions, the following processes occur:

• contraction of muscle fibers (contraction);
• displacement of contracting muscle fibers (retraction).

The amniotic sac also helps dilate the cervix. With each contraction, amniotic fluid moves towards the cervical canal and puts pressure on it. The amniotic sac exfoliates from the walls of the uterus and, penetrating into the cervical canal, stretches it.

In primiparous and multiparous women, the smoothing and opening of the canal does not occur in the same way.

The period of cervical dilatation in first-time mothers occurs in the following order:

• the internal pharynx opens;
• the channel expands;
• edges are smoothed;
• the external os opens.

During repeated births, the external os at the end of pregnancy is already slightly open and freely allows the tip of the finger to pass through. The outer and inner pharynx open simultaneously. As it opens, the edges of the pharynx become thinner and by the end of the period they have the shape of a narrow border.

When the pharynx has opened by 12 cm, dilation is considered complete.

At this point, the uterus is ready for the expulsion phase. During a vaginal examination, the doctor determines the degree of readiness .

How long does it take for the cervix to dilate?

The duration of disclosure is determined by many factors:

• intensity of contractions;
• the size of the fetus;
• the presenting part of the fetus;
• the size of the mother's pelvis;
• time of discharge of amniotic fluid.

The cervix dilates more slowly in the first birth. If labor proceeds without any peculiarities, dilatation lasts up to 10 hours for primiparous women, and up to 6 hours for multiparous women. It is impossible to predict in advance how long it will take for a woman to dilate her cervix.

Periods and degrees of cervical dilatation

The opening of the canal during childbirth occurs in three stages:

1. Latent period.
2. Active phase of disclosure.
3. Complete opening of the cervix.

Sensations of a pregnant woman during cervical dilatation

The latent phase proceeds calmly, without much pain. The woman in labor experiences nagging pain in the lower back and lower abdomen. The pain is irregular in nature and intensity. This stage lasts in each case individually (from several hours to 1 – 2 weeks). A pregnant woman does not always understand what is happening to her body while doing her usual activities.

When the contractions take on a constantly increasing character, the second phase of opening begins. The cervix smoothes and opens under the action of contracting muscles and the amniotic sac. This is the most painful phase. The intensity of contractions increases, the periods between them decrease, the woman gets tired of the increasing pain. The duration of this period takes 5 – 6 hours. During this time, the body has time to prepare for the expulsion of the fetus.

Childbirth is a natural process, but given the pain, at the request of the pregnant woman, this period of labor can be anesthetized with medication.

If the cervix is ​​not ready for childbirth

In cases where the dilatation of the cervix is ​​delayed, there is a need to stimulate labor.

Intervention in the birth process is carried out according to certain indications:

• post-term pregnancy;
• prolonged labor;
• ineffective contractions;
• large fruit;
• unopened amniotic sac;
• pharynx rigidity.

To prevent weakness of labor, careful monitoring of the condition of the woman in labor and the fetus is necessary.

If the reason for the weakening of contractions is the whole amniotic sac, the membranes are opened. In each case, the doctor individually decides how to prepare the cervix for childbirth.

Often, especially in primigravidas and in women with previous cervical injuries, the pharynx becomes rigid. With this pathology, the process of opening is inhibited, which slows down the progress of labor. Contractions become frequent and painful.

Using a Foley balloon catheter to dilate the cervix

If there is rigidity, digital dilatation of the pharynx is used, and if the waters have broken, a Foley balloon catheter can be inserted. Your healthcare provider knows how to use a Foley catheter to dilate the cervix correctly.

The cylinder is a medical device that is intended for repeated use. The material from which it is made does not cause irritation or discomfort to the patient. Due to the fact that it can be subjected to heat treatment, the risk of the spread of bacterial flora in the body is reduced. The surface of the balloon is smooth, designed for painless insertion.

Foley catheter dimensions.

Most often, a two-way female catheter number 18 is used to induce labor.

Self-insertion of a catheter is contraindicated. Only a physician should insert a Foley balloon.

Cervical dilation gel

To gently open the cervix, it is recommended to use substances that soften and make the cervical canal more elastic. Prostaglandins are used in the form of suppositories or gels. The drugs are harmless to the fetus and easy to use, greatly facilitating the dilatation of the cervix during childbirth. .

There are contraindications to the use of prostaglandins:

• history of caesarean section;
• incorrect position of the fetus (transverse, gluteal, oblique);
• clinically narrow pelvis;
• diabetes mellitus in a pregnant woman;
• threat of uterine rupture.

Taking into account the condition of the pregnant woman, the doctor chooses a method for preparing the cervix.

To ensure a successful outcome of childbirth, gymnastics is recommended during pregnancy.

Physical exercises to prepare for childbirth

Gymnastics during pregnancy includes exercises related to:

• with strengthening the pelvic floor muscles;
• preparing the pelvic bones;
• stretching of the muscles of the femoral part of the lower extremities.

1. Walking is an excellent method. During movement, the fetus gradually descends into the pelvic cavity and automatically the fetal head presses on the lower segment of the uterus. The cervix begins to stretch and open. A woman’s body begins to produce oxytocin, which promotes the onset of labor.
2. Swimming helps relieve muscle tension, improves blood circulation, and relieves swelling. The pregnant woman’s nerves calm down and the fear that the woman experiences on the eve of childbirth goes away.
3. Squatting is a simple exercise that helps the fetus take the correct position.
4. Rocking is a preventive exercise before childbirth. You can swing at home on a ball or on a swing while sitting on the sofa.

It is better to start doing gymnastics in advance, memorizing the exercises and repeating them periodically. This will make childbirth easier for both the woman and the baby.

If there are no contraindications, home stimulation methods are used.

Self-induction of labor

A proven method for preventing labor weakness is nipple massage. Irritating the nipples with your hands promotes the production of oxytocin, the main hormone that “triggers” the labor mechanism. The main thing is not to overdo it, so as not to cause cracks. After the massage, the nipples are lubricated with an antiseptic, for example an oil solution of chlorophyllipt.

At home, it is permissible to use an enema filled with cool water. By stimulating the work of the intestines, the smooth muscles of both the intestines and the uterus begin to contract, which leads to an acceleration of the onset of labor.

It is known that sex is a natural method of stimulation. This method replaces in total: walking, swimming and massage. The only contraindication for intimacy is the threat of premature birth.

The reasons for cervical incompetence are different; in any case, the task of the pregnant woman and her doctor is to carry the pregnancy to term until the fetus matures.

If the cervix opens prematurely

If there is a threat of premature birth, it is necessary to create certain conditions for the pregnant woman:

• provide strict bed rest;
• relieve uterine tone (magnesium preparations, Ginipral);
• calm the nervous system (Nervonorm, Persen);
• strengthen blood vessels (potassium, magnesium, B vitamins).

The surgical method - suturing the cervix gives a good result, but this operation is performed in the early stages of pregnancy. This method is not used before childbirth.

Consequences and complications

If you miss the onset of labor weakness, complications are likely to occur, such as:

• placental abruption;
• threats of uterine rupture;
• the onset of fetal asphyxia.

Complications can be avoided with timely medical care. If stimulation methods do not have an effect, it is recommended to end the birth with a Caesarean section.

The amniotic sac must remain intact until labor begins. If water begins to leak, then the pregnancy continues for two weeks under the guise of antibiotics. At the same time, the cervix and the fetal lungs are prepared to accelerate their maturation.

It is necessary to control the quality of discharge so as not to miss infection of the uterine cavity. If there is a threat to the life of the woman or the fetus, regardless of the stage of pregnancy, a Caesarean section is performed.

In order to prevent unforeseen situations during childbirth, a conversation is held with the pregnant woman about correct behavior and lifestyle.

An obstetrician-gynecologist regularly monitors the course of pregnancy from its very beginning. In case of abnormalities that require emergency assistance, hospitalization is recommended.

Only mutual trust between the doctor and the patient can painlessly solve all problems and achieve the desired result.