How long does labor last in nulliparous at different stages? What is pushing during childbirth
Attempts from the point of view of physiology are arbitrary contractions of the muscle groups of the anterior abdominal wall, due to which the fetus is born.
Attempts appear in the second stage of labor - from the moment the cervix opens completely - up to 10 cm, and their end coincides with the moment the baby is born.
In case of full opening of the cervix at the beginning of the second stage of labor due to uterine contractions the head of the fetus moves down, while "along the way" squeezing the walls of the rectum. The muscles of the diaphragm and the anterior abdominal wall, in response to irritation of the rectal receptors by the head of the fetus, begin a reflex contraction: this is typical for the onset of attempts. The fruit head presses on the muscles pelvic floor and on the rectum of the woman in labor, while causing her desire to empty the intestines - and the urge to defecate. This phenomenon and there is a push.
When to start pushing
Before you start pushing, you need to call a doctor to determine the location of the baby's head. It is necessary to start attempts only in the situation when the head has passed almost the entire birth canal and lies on the pelvic floor with its parietal surface. The presence of premature attempts in a woman leads to a violation of the uterine - placental circulation, rapid exhaustion labor activity, the appearance of weakness of attempts and hypoxia - a lack of oxygen in an infant.
The desire to push in all women can occur in different time. In the event that it appears when the head is low, however, in the absence of a complete opening of the cervix to the end, then due to the advancement of the head with the help of force of attempts, the woman in labor may experience a rupture of the cervix. A woman in labor is recommended to use a special breathing pattern in order to curb the occurrence of premature attempts.
- Step 1. Make it complete deep breath breast.
- Step 2. Hold your breath, as if swallowing air, with a parallel tension of the abdominal muscles (the main muscle groups of the buttocks, thighs and face are in a state of relaxation). Then you need to gradually increase the pressure on the bottom, gradually straining the abdominal muscles with greater strength for the implementation of ongoing assistance to advance through the birth canal to the child.
- Step 3. Make a smooth exhalation.
- Step 4. If there is a feeling of lack of breath, you need to exhale smoothly, avoiding a sharp exhalation with a “jerk”. A sharp exhalation with a “jerk” can lead to a sharp decrease in intra-abdominal pressure and a rapid “retreat” of the child’s head back, as a result - the appearance of a severe TBI - cranially - brain injury. Immediately after a smooth exhalation without rest and relaxation, you need to inhale and push.
All these actions must be repeated for three times during a full attempt.
After an attempt, you need to take a full breath and restore an even calm breathing in a state of complete relaxation. Thus, to perform the next attempt, you can quickly restore strength.
Attention! The midwife will ask you not to push at the moment the head is removed - then it is correct to breathe "dog".
What to do during an attempt
During the attempt, you need to press your chin tightly to your chest, grab your knees with your hands, then spread them apart and pull them to the armpit as much as possible. The main force of attempts should be directed to the point of development of maximum pain. The appearance of increased pain after an attempt testifies in favor of the correctness of your actions and the correct progress through the birth canal of the baby.
Average duration of pushing
This period in primiparous lasts an average of two hours, and in multiparous - for one hour. Its average duration can be influenced by various factors. For example, using such a pain relief technique as epidural analgesia, in nulliparous women, the second stage of labor can be extended on average up to three hours, in multiparous women, up to two hours.
Availability large fruit, weak labor activity, narrowed pelvis, overstretching of the muscles of the anterior abdominal wall can also increase the duration of this stage of labor. In contrast, women with well-developed abdominals have a shorter ejection period in labor.
Measures to prevent ruptures
It is necessary to start protecting the perineum from the moment the head erupts, that is, when the child's head does not “go away” between attempts in the opposite direction. Three fingers right hand the midwife prevents the head from moving quickly during an attempt; as a result, the skin in the perineal area is gradually stretched and tears are thereby prevented. The fetal head normally passes through all the birth canals with its smallest diameter - that is, in a half-bent state (with the chin pressed against the breast). To prevent ruptures, with two fingers of the left hand, the midwife clasps the baby's head and carefully monitors its correct progress through all the birth canals.
The occipital region of the head is cut through first, then the crown of the head is cut through, then the baby's head is completely unbent and a face is born. From the moment when the fetal head begins to unbend, until the moment full birth the face of the woman in labor should not push. The integrity of the perineum depends not so much on the correct actions of doctors, but on the behavior during childbirth of the woman herself.
With the help of breathing "dog" through the mouth, attempts can be weakened to a large extent. In 95 - 96 percent of cases, the born head is facing backwards; in the future, the child turns his face either to the right or to the left thigh of the mother. With the external rotation of the head, the internal rotation of the shoulders is simultaneously carried out, after which the anterior shoulder is born, which is located at the pubic joint, then the posterior shoulder, which is located at the sacrum. In the future, the birth of the legs of the child and the trunk occurs without much difficulty.
Pushing during childbirth is a natural thing. They help the mother push the baby out and help her cuddle with her. Try to move this time as calmly and evenly as possible. Remember that the baby will help you in everything and with your support, both of you (or maybe three or four) will succeed.
What is pushing
Attempts are involuntary, undulating (offensive) contractions of the muscles of the vagina and pelvic organs, which help the muscles of the uterus and vagina to push the baby to the light.
The muscles of the uterus contract with a very strong force, it is necessary to control them with the help of a doctor. It will tell you when to push. Uncontrolled attempts can suffocate the baby or, by cutting off oxygen to him, “slow down” his development. Keep yourself in control and think only of the child.
Attempts are a reflex feeling, they occur when the baby is ready to be born. But, its weight can be very large, and the baby’s head tries to push into the light during childbirth, and this all happens with reflex actions, the most main function pushing is helping a baby to be born.
What happens when pushing
When the uterus is ready to "escort" the baby into the light of day, attempts begin. As I wrote above - contractions of the muscles of the small and large pelvis. They, straining, increase significantly, which presses all the organs of the large pelvis - the intestines, and the renal system. Therefore, during childbirth, absolutely involuntary urination and defecation (feces come out). You should not worry too much, this is not a reason to be shy and worry, the birth of a baby comes first.
When trying, be sure to follow the advice and instructions of the doctor. Spontaneous attempts will not lead to anything good, the baby already suffers from a lack of oxygen during this process, and if the mother does not save him, he will not survive or be born healthy.
How to behave when pushing
- breathe deeper and faster (dog breathing);
- relax as much as possible before the attempt (inhale the air, exhale and look at the ceiling while relaxing);
- do not speed up the process;
- obey the doctor's instructions;
- listen to your body;
It is not necessary to scream when trying, it will not help you in any way. Instead, concentrate on pushing the baby out as safely as possible. If you vote, it will save you morally, but will not help the baby in any way. Concentrate and take 10-20 short breaths to pull yourself up on maximum level, then the same number of breaths and again attempts. Be sure to listen to your doctor. After all, giving birth, you do not know how the process takes place, and he, as a professional, will be able to advise and prompt you. Not listening to the doctor, you will only harm the child.
Placenta
When trying, there is such a thing as a "final attempt". It means pushing children's place- placenta and amniotic fluid. To push it out, it will no longer require such efforts as during childbirth, but, nevertheless, they must be applied and endured. After the baby comes out, the doctor will slap him on the pope, he will scream and the mother will understand that all her efforts were not in vain.
Hello dear readers of my blog! Today the topic of the conversation will touch on one of the important periods tribal activity. Most expectant mothers are interested in the question: attempts during childbirth, what is it? I will try to answer it as clearly and informatively as possible.
Attempts are contractions of the abdominal and diaphragmatic muscles. Surely inexperienced young mothers are wondering how long these contractions last?
This question cannot be answered unequivocally, everyone's body is different. But on average, their duration is up to 15 seconds.
They arise as a result of irritation of the nerve endings in the cervix, vagina and pelvic floor muscles by the fetus being born. But how do these contractions differ from contractions? The fact that they can be partially controlled, despite their involuntary nature!
What a feeling
In order to understand what it feels like during attempts, imagine that you have a need to ... cleanse your intestines. This is due to the fact that during contractions there is pressure on the rectum. However, not everyone has these sensations, some may not feel anything at all.
Surely you still want to know if it is possible to anesthetize attempts? Currently, obstetricians do not do this, so as not to reduce their effectiveness. Many note that the soreness goes away a little after joining the contractions of attempts. But then again, everything is determined by the individual pain threshold and sensitivity.
Why do we need
The appearance of attempts begins when the cervix is opened for the appearance of the baby. Abbreviations are necessary in order to ensure the appearance of the child.
With their appearance, the next stage of childbirth begins. Half way done. Muscles are already involved in the process various groups: abdominals and diaphragm. Due to the increase in intra-abdominal pressure, conditions are created for the birth of a child.
Stronger attempts come when the contractions intensify, becoming longer and more painful.
They are reflex in nature and are due to the very process of labor activity.
Are contractions more painful than pushing? During contractions, the pain does not depend on the desire of the woman. And with the advent of attempts, they can be controlled, thereby influencing pain. The doctor at some point may ask to restrain them, and at another push harder - in order to push the baby out of the womb. Be sure to listen to the recommendations so as not to harm yourself and the child.
your behavior
The next question, which I will try to answer as simply and clearly as possible: how to behave when trying?
You have already understood that with their onset, you are moving to the stage of active participation in the process. When the doctor gives the go-ahead, you should try to push with all your might in order to see your baby as soon as possible.
If you are asked to hold them (by medical reasons), you will have to be patient, because your task is to go through this period of childbirth well, and prepare directly for the birth of a child! There isn't much left.
On the forums of pregnant women, there is often a discussion of possible emptying Bladder or intestines at this time. Of course, such moments can happen, but this is quite normal for childbirth.
And if this happened to you, you should not dwell on your own shyness. Focus on your main task- the birth of his long-awaited miracle. And leave the rest to the medical staff.
And a few words about how you behave. It’s good if you attended parenting training courses and learned from them how to breathe and how to push. Your lifesaver can now be a midwife who will guide your efforts.
If you have not prepared yourself for childbirth, leave your fears and feelings, and even more so listen to what they tell you.
The effectiveness of labor activity depends on how you perform all the actions. The birth is a huge stress for the child. And it is you who must help him in this important and responsible matter.
The kid is also actively involved and fulfills his role. You are a tandem, your actions affect him, and your proper breathing will help reduce the lack of oxygen in the crumbs as he walks forward.
Some mothers are especially sensitive to pain, they scream a lot, forgetting that this makes their baby even worse. And much worse than you.
In addition, with screams, the process drags on even more, your strength is wasted, and there is almost none left for childbirth. At the same time, the child hears your screams, and even more driven into stress, because unlike you, he does not understand why your body pushes him out of a cozy house.
Therefore, try to concentrate and help, not harm.
Long-awaited meeting
A little time will pass, and all your efforts will be rewarded with a long-awaited cry! Your meeting has taken place! I congratulate you! Soon you will forget your discomfort who have experienced and will enjoy motherhood.
But before that, only one effort is still needed in order to complete the whole process - to get rid of the placenta. But it is no longer difficult and not for long.
If you want to know more about the whole process of childbirth, read about how long the first birth lasts. If you are preparing for the second, then there is also for you helpful information to another
Before new meeting, dear readers. Subscribe to my blog and you will learn so many useful things There are many more interesting publications ahead!
I hug
Anastasia Smolinets
Every woman is afraid birth process. In particular, this fear is observed when expected Only after learning about pregnancy, future mom worries about how the birth will pass her firstborn.
Duration of labor
It is difficult to say, in primiparas, because the body of each woman individually copes with this process, so it is difficult to predict anything. It depends on several factors. In particular, the following indicators are of great importance:
- how quickly the cervix will open;
- will the size of the baby correspond to the size of the birth canal;
- mother's breath, because it depends on him how the process will go, with correct breathing the woman may feel less pain;
- the intensity of the fights.
In addition, the woman in labor must follow all the advice of the doctor. It is also very important to prepare for childbirth in advance. If the primiparous knows how to behave during this process, then it will last no more than 10 hours. Although it is difficult to say how long childbirth lasts in primiparas with any pathologies. In some cases, it may even be necessary C-section. It is also worth noting that you should not panic. If a woman in labor cannot pull herself together, then the birth of the first child can last twice as long. But this does not mean that all 20 hours will have to be spent in the delivery chair. After all, the process of childbirth is not only the birth of a baby, but also the opening of the cervix, contractions.
Why is the first birth the most difficult?
The complexity of childbirth in primiparas is due to two aspects: psychological and physiological. Childbirth is a process that cannot be imagined until you feel it for yourself. The future mother, who is to give birth to a child for the first time, does not yet know what she will have to experience. Because of this, fears may arise, which can lead to complications in the course of childbirth. In addition, women do not know the first time. Of course, it hurts, and it does not depend on which births are on the account. It's very hard to pick comfortable posture during contractions, learn how to push properly in a few minutes. Therefore, it is recommended to attend special classes and courses in order to be ready for anything.
In addition, many women are unaware of primiparous. In this case, there is a significant difference. After all, the birth canal of a nulliparous woman is very narrow, unstretched. Therefore, it can be much slower. As a result, the first period can last much longer (instead of 5-8 hours, it takes 10-12). The second period also lasts longer. There is a lesser intensity of attempts. And after the first birth, the walls of the vagina stretch and never return to their original shape.
First stage of labor
How long does labor last in primiparas in the first period? It also depends on the characteristics of the woman's body. But it should be noted that this is the longest stage. Contractions may take up most of the time, but they will be short and infrequent. Here, for the first time, a woman will feel what prenatal pain is (if it wasn’t there. The cervix will slowly open, but future mother without feeling any discomfort. That is, the pain will appear only during contractions. Therefore, if you feel something (after all, you still have no idea how childbirth begins in primiparas), then urgently go to the hospital, otherwise there is a chance to give birth right at home. The second part of the first period lasts less, but more intense contractions are already observed. Be sure to move around so that the uterus opens faster. The third phase lasts no more than an hour. Now from fights you need to move on to attempts.
Second birth period
Next, consider how long childbirth lasts in primiparas in the second phase, which involves an increase in the woman's activity. Now she has to push. Usually this process does not last long (from 5 to 40 minutes). Mom should help the baby move faster through the birth canal. After all, the baby himself will not be able to do this. If the mother's body is somehow weakened and she cannot push, then doctors may resort to surgery. In the second birth period you must follow all the doctor's advice, breathe properly. At the same time, it is necessary to push only when they talk about it. It is important to relax as much as possible and not be afraid. Because of fear, the uterus will be tense, so the child will not be able to actively move. As a result, doctors will have to use special tools to extract it. And this can harm the baby, so it's better not to risk it. Only in this case everything will go well.
Third period
It would seem that everything: the baby has already been born, which means that the birth is over. But it's not. A woman will have to do something else - it almost does not hurt to give birth, and this stage lasts a couple of minutes. Of course, if a woman is too tired, then the process may be slightly delayed - for about 30 minutes. If she does not have the strength at all to give birth to an afterbirth, then the doctor will help her.
In order to understand and answer the question regarding what it is - attempts during childbirth, you must first talk about what 2 stages the entire process of childbirth is divided into.
So, in the process of delivery, a period of disclosure and a period of exile are usually distinguished. The first is the opening of the uterine cervix. It is accompanied by periodic ones, which only intensify over time, and the interval between them is reduced. At the end of this stage, the cervix is fully opened (10 fingers) and it forms, as it were, a connecting channel between the uterus and the vagina, allowing the baby to be born.
After this, the second period begins - the expulsion of the fetus from the uterine cavity. As it develops, contractions begin to intensify even more, become longer and the interval between them can be only 5-10 seconds. It is at this time that attempts join the contractions.
What are contractions and how do they differ from contractions?
As can be seen from the above, these 2 phenomena are very similar to each other, but let's try to figure out what is the difference between contractions and attempts.
By themselves, attempts are nothing more than a contraction of the abdominal muscles, and with them the diaphragm, which separates the chest and abdominal cavity. If we talk about contractions, then these are contractile movements of the uterine myometrium, which lead directly to the opening of the cervix. Thus, in any childbirth, contractions should normally occur first, and after the opening of the cervix, attempts should be made, which, as it were, push the baby out.
If we talk about how long attempts last in primiparas, then on average given period takes about 2 hours, in multiparous women it is about 2 times less - no more than 1 hour. The average duration of the push itself is about 10-15 seconds.
It is thanks to the attempts that an increase in intra-abdominal pressure occurs, which, together with an increase in pressure inside the uterine cavity (due to contractions), allows the child to move through the birth canal.
Another difference between contractions and pushing is the fact that despite the fact that they develop reflexively, a woman is able to control pushing. So, the obstetrician always tells about the onset of an attempt and tells the woman to push, which in turn increases intra-abdominal pressure and contributes to the speedy birth of the baby.
Comparing which is more painful: contractions or attempts, most women claim that after the attempts are replaced by contractions, it decreases slightly.
How to understand that attempts have begun?
This question is often of interest to expectant mothers. Most often, attempts are felt by women in labor as a very strong, even uncontrollable desire to empty the intestines, pronounced unpleasant pressure on the rectum and involuntary contractions abdominal muscles. Such phenomena are a description of what sensations a woman in labor experiences during attempts.
The obstetrician usually notifies her that the woman in labor has begun to push, indicating the period when she needs to push. Therefore, you must carefully listen to the doctor and follow his instructions.
