1 Each birth is individual and unique in its own way: short and even rapid, prolonged and painfully long, requiring surgical intervention or special tools for obstetric care. Predict the course of birth is quite accurately impossible, but to be in some way ready for possible options is necessary. By themselves, the variants of delivery do not pose a particular danger to the mother and infant, but create additional problems. Sometimes there are complications when it is not possible to solve the problems that arise with the efforts of the parturient woman, in other cases complications arise unexpectedly and require immediate medical attention. Most complications can be detected by monitoring the condition of the mother and child. Constant monitoring (tracking) of the maternity and fetus allows the doctor to make the right decision. If there are any complications (rarely, but this happens), you should, first of all, not panic, rely on the experience of physicians and try to follow the doctor's instructions exactly. Deviations from the norm include:

  • weakness of labor - prolonged labor;
  • problems with presentation of the fetus;
  • prolapse of umbilical cord.

Let us consider these problems in more detail.

Prolonged delivery

Weakness of labor can slow downDuring childbirth for up to a day or more, such births are considered protracted. There are primary and secondary weakness of ancestral forces. With the primary weakness of the contractions, the sluggish and short-lived from the very beginning of the labor activity, the secondary ones, can develop when the parturient is tired. Normal fights weaken, the duration between them increases. Weakness of labor can arise for many reasons: hormonal disorders, disruption of the central nervous system, the effects of previously transmitted inflammatory diseases, large fetal sizes, etc. In this case, stimulation of labor is shown. You can help yourself, trying to stay calm and not despair. Consider a slow course of labor as a temporary phenomenon, be distracted, rest, perform self-stimulation techniques. If childbirth develops slowly at the very beginning, this does not mean that all births will be protracted. In the active phase (after the opening of the cervix), the delivery process in most cases is normal. Do not rush to the hospital, consult a doctor and try to use this period for rest: eat and drink, do a back massage, lie down in the tub. A warm bath will relieve tension, slow down unproductive labor. If your bouts become tiresome or last more than a day, despite your efforts, you can resort to medical intervention. In this case, two options are possible: try to stop the fights and give you a rest with the help of medications (tranquilizers, relaxing uterus, or sedatives) or stimulate more effective contractions with the help of procedures such as separation of the fetal membrane, opening the fetal bladder, injecting oxytocin, etc. When slowing labor activity after the onset of active labor, problems may arise related to the ineffectiveness of uterine contractions, unfavorable presentation or fetal position, and a narrow pelvis. Immobility, bed rest, full bladder, drugs that slow or stop the contractions, fear, anxiety and stress can also cause a slowdown in labor. In this case it is necessary: ​​every hour to empty the bladder, as it can slow the feeling of the fetus; stop taking medications that slow down the labor activity, try to get them out of the body with an abundant drink; to change your position - to resemble, sit, get on all fours. The doctor will assess the decline in progress in the labor and well-being of the child. Refer for help to medical personnel: more frequent examination of the vagina, checking the opening of the cervix, pustules or turn of the child should be under more precise control. They should listen more often to the child's pulse, possibly using electronic monitoring of the fetus. A dropper to prevent dehydration, pain relievers and medications for relaxation are more appropriate if your births are excessively prolonged. A doctor or midwife can artificially open a fetal bladder to speed birth or administer oxytocin to increase the intensity and frequency of contractions. If a child is under stress, as indicated by a change in his pulse during a fight, or the child continues to develop slowly, despite the measures taken, it may be necessary to resort to a cesarean section.

Face (posterior-occipital) presentation

One of the most frequent causes of protractedfights is posterior-occipital presentation, when the nape of the child is directed toward the back. In this case, the child must first turn to an anterolateral presentation, opening and omission may be delayed. Most babies are turned into anterolateral prenatal by the time of full disclosure of the uterus, however some babies are born in this position with a face turned to the mother's stomach. In the posterolateral presentation, considerable pains in the lower back during fights and even between them are possible, since the hard round part of the child's head (nape) presses on the sacrum, stretching the sacroiliac joints and causing pain in the entire lumbar region. Help the child to turn around and relieve the pain you can, following our advice:

  • Change position every 20-30 minutes to take advantage of gravity and motion.
  • Do not lie on your back. This will only intensify the pain, because in such a pose the child presses his head even harder on your spine. In addition, your tailbone, which must straighten out, will remain motionless.
  • Most of the time during labor is spent onon all fours or in the knee-elbow position. This will help not only to remove pressure from the back, but also help the child to turn over using the force of gravity, since the heaviest part of the child's body (the back of the head and the torso) will be attracted to the floor.
  • Do rotational movements with your pelvis. Standing on all fours or in a knee-elbow position, rotate the pelvis to make the child turn over.
  • Continually move! When walking, the pelvic bones will move freer. This will help the child spin and turn around in search of the easiest way through the pelvic region. Think twice before asking you to do epidural anesthesia. If you lie horizontally, the child may not turn over, which can lead to the application of forceps or a caesarean section.
  • Apply a cold or hot compress totime of fights or between them on the abdomen, lower back or crotch. Compresses help to relieve muscle tension. Most women prefer hot compresses, but some benefit from cold ones, such as a towel soaked in iced water or an ice sheet.
  • Stand up or sit under the shower and direct the stream of water to the painful area.
  • Ask your partner or nurse to squeeze yourthighs during fights. To do this, put your hands on your buttocks and squeeze your hips on both sides. You can show the exact place and say how and how much to push.
  • If there is a hydromassage bath, take it by filling it with water above the stomach level. The deeper you dive into the water, the easier it will be for your child to turn.
  • It is possible to use electrostimulation. In the method of anesthesia, four stimulating pads are superimposed on the back, on which pulses from the hand generator are generated, creating a slight itching or tingling in the lower back. A woman can adjust the level of electrostimulation by herself. Experts believe that, like acupressure, electrostimulation interferes with the passage of pain signals to the brain and promotes local secretion of endorphin, so that it is possible to lower the threshold of sensitivity to pain.
  • Use the technique of breathing and relaxation.

One of the reasons for the delay in laborafter the opening of the cervix, there may be a short umbilical cord that restricts the child and causes a slowing of his pulse during labor. Very rarely there is a delay in the appearance of the shoulders of the child after the birth of the head. This serious complication occurs when the shoulders are so wide or so rotated that they do not pass through the pelvis. Conducting cesarean section after the appearance of the head is impossible. In this case, it is possible to use obstetric forceps or a vacuum extractor to conduct a reception that allows the child to turn and release the shoulders. It is important to do everything quickly, as supplying the baby with oxygen through the umbilical cord can decrease.

Cord loss

Cord loss is rare, but very seriouscomplication. If the umbilical cord slides through the cervix into the vagina before the baby is born, it can be trapped between the child and the wall of the partially exposed cervix or the bones of the mother's pelvis. During labor, this squeezing of the umbilical cord can dramatically reduce the supply of oxygen to the fetus, which threatens the child's life. The prolapse of the umbilical cord is most likely (although still rare) with a sudden opening of the fetal bladder and breech presentation or transverse position of the fetus, or when the fetus head "wanders" and does not fall into the pelvis. In case of dangerous presentation of the fetus, if the water has flowed off the stream, it is necessary to kneel before the doctor's arrival and drop to the floor; in this position, the force of gravity will move the child and, possibly, the umbilical cord dropped from the cervix. It is desirable and on the way to the hospital in the car to stay in the described position, where the mother will be provided with qualified medical care.

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