12. Physiological childbirth

Periods of childbirth

The opening period is the first period. It starts with the first fight. They are frequent, intense, long. The first period is divided into two phases - the slow opening phase and the fast opening phrase. During the first phase, the cervix opens up to 4 cm, during the second - from 4 to 10 cm. The transition from contractions to attempts and the discharge of amniotic fluid completes the first period.

The second period (exile) is characterized by the expulsion of the fetus.

Third period (sequential). The beginning is the moment of the birth of the child, the end is the separation of the placenta and the birth of the placenta.

The first stage of labor. Its duration for first-time mothers is about 12 hours, for repeat births - about 7 hours.

Immediately after the onset of contractions, it is necessary to monitor the fetal heart rate.

Amniotomy is performed according to the following indications:

1) polyhydramnios, flat fetal bladder, marginal placenta previa, premature detachment of the placenta;

2) the need for direct access to the fetus for invasive procedures;

3) labor induction and rhodostimulation.

The second period of childbirth. The period of expulsion begins from the moment the cervix is ​​fully dilated and ends with the birth of the child. The duration of the second period in primiparous women is about an hour; in multiparous women it is 2 times shorter. During this period, attempts appear. In some cases, this period in first-time mothers for a number of reasons can be extended to 2 hours or more.

Third stage of labor ends with the birth of the afterbirth. Its duration is 10-20 minutes.

Delivery through the natural birth canal

Birth of the head. When pushing, the genital slit is stretched by the fetal head. First, the head is embedded - the head appears in the genital slit only during pushing, disappearing when they stop.

Birth of hangers. Most often, the shoulders appear immediately behind the external rotation of the head and are born independently.

Delivery with cephalic presentation

Regulating the advancement of the erupting head. To prevent extension of the head during labor during pushing, it is necessary to hold the head with three fingers of the right hand.

Removing the head. After the birth of the fetal head, the woman in labor is advised to breathe deeply and rhythmically to control the efforts.

Release of the shoulder girdle. Turning the head to face the mother's thigh to the right or left occurs after her birth. At the same time, the shoulders rise in the straight size of the pelvis (internal rotation of the shoulders)

Birth of the torso. After releasing the shoulders, the palms of the hands on both sides are placed on the fetal chest and the body is directed upward. The birth of the lower torso occurs.

Author: Ivanov A.I.

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