Postpartum contractions are contractions of the uterus. Contractions after childbirth. When the baby is already born

Postpartum contractions

During the first week after giving birth, you may experience postpartum contractions or uterine contractions. Their intensity varies among different women. They are stronger if this is not your first child, because the uterus has to do more work to restore its previous size and shape.

Now that your baby is with you, significant discomfort seems unfair. Do not despair. Remember that postpartum contractions play an important role in your recovery. Contractions will be more intense during feeding. Oxytocin, the hormone responsible for milk secretion, also stimulates uterine contractions.

The process of returning the uterus to its original state is called involution. Around the sixth week of the postpartum period, this process will be close to completion. Postpartum contractions can occur at any time during involution, but usually with less intensity than in the first days after birth. The uterus, which simultaneously housed your baby, placenta, and amniotic fluid, returns to its previous size, about the size of your fist.

If postpartum contractions are bothersome or painful, gently massage your lower abdomen. You will be able to feel your uterus. In the postpartum period, it is easy to distinguish: it is dense and approximately the size of a grapefruit. Try lying on your stomach on a hard pillow to press your uterus against other organs. Another method that women involuntarily use in response to postpartum contractions is to sit in a chair and, leaning forward, press the uterus with the palm of your hand. Gently massaging the abdomen helps even better.

During contractions, you can also use breathing exercises and relaxation techniques that you used during childbirth. But the best way is to lie on your back and place the baby on your stomach. Its weight and living warmth best relieve the pain and severity of contractions. Since the uterus does most of its work during feedings, you can breastfeed in the same position, using a pillow placed under the arm with which you support the baby's head.

Postpartum discharge

After giving birth, you will have a vaginal discharge called lochia. At first it will be an exhausting, menstrual-like flow of blood, mucus and uterine tissue. At first it is usually very red and may contain small blood clots. Within a few days, to a maximum of two weeks, the discharge becomes pink, then brown and finally yellow-white or pure white. Within six to eight weeks, the lochia should stop completely.

To prevent excessive discharge, stay off your feet as much as possible for the first five days after birth. But the best prevention of bleeding is your baby. When you breastfeed your baby, oxytocin is released, which causes the uterus to contract. The blood vessels where the placenta separates from the uterus are clamped, reducing bleeding.

Heavy uterine bleeding is a serious complication, but fortunately quite rare. If on the second day after giving birth, two large pads get wet within half an hour, or a clot the size of a lemon comes out, or clots the size of a cherry constantly come out, call your doctor. Also call it if the discharge turns red again after already being brown. A change in color may indicate damage to your uterus where the placenta was rejected. This type of damage most often occurs as a result of overvoltage. This means you are doing too much - stop! Your doctor will need to determine the cause of the lochia changes. These changes sometimes indicate an infection in the uterus, which requires immediate special measures to protect the woman's health.

During the first weeks after giving birth, do not use tampons. They irritate the healing tissues of the vagina and can harbor germs and therefore cause infection. Sanitary pads need to be changed frequently. Try not to use branded gaskets. It is best to sew soft pads from washed cotton fabric (or simply put clean rags, cotton wool, gauze napkins). These washable, reusable pads “breathe better,” reducing the risk of infection; they are more comfortable, environmentally friendly and economical than branded ones.

Do not do intravaginal douching! While rinsing with clean warm water, open the outer labia and rinse the entire area. around vagina, but not inside. Do this often. Warm water reduces pain from healing cracks, tears and seams, so you can wash the genital area and perineum directly while urinating, since urine irritates wounds and can cause sharp pain (“pinching”).

Remember to wipe from front to back after defecation, and not vice versa.

Caring for seams

If you have had stitches, ask what material was used to stitch it up. If it is silk, the sutures are usually removed on the 4th day after birth. If it is an absorbable material, then there is no need to remove the stitches, they will gradually dissolve inside the soft tissue, and the external threads will simply fall off, so do not be surprised if after a week or two the thread “falls out” of your vagina.

Any external (on the perineum, not in the vagina) seams require care. In addition to keeping the seam clean, often leave the crotch area open so that the seams do not get wet, but dry out. For better tissue healing, use homeopathic arnica ointment (vaseline-based) or solcoseryl: first jelly, and after 2-3 days ointment. They are applied to a sterile gauze pad and applied to the perineum. The same can be done to heal small cracks or small tears that do not require suturing. The napkin with ointment is changed as it gets wet and after defecation, but at least twice a day (morning and evening). In the maternity hospital, the seams are treated with a solution of potassium permanganate or iodinol.

In the first week after an episiotomy or sutured external perineal tear, it is not recommended to sit, so as not to stretch the perineum. It is better to sit slightly on one side, on the thigh or on one buttock. For small gaps, these conditions are not necessary.

Excerpt from the book by Akin A., Streltsova D. “Nine months and the whole life. Births of the new millennium." - 2nd ed., rev. and additional - M.:Genesis, 2009. - 637 p. (Series “Happiness as a way of life”)

About the book:

This book is about conscious conception, healthy pregnancy, natural birth and conscious parenting. The book discusses issues of preparation for the Birth of a child as a great sacrament carried out by family members and their loved ones. The authors take a balanced approach to such a complex problem, inviting future parents to determine for themselves where and how their child will be born. Two approaches to childbirth are considered - soft, physiological natural and clinical. Great attention is paid to breastfeeding the child.
According to the authors, how a person is born largely determines his future life. A child born in love and joy in a family that has consciously made its choice will be able to be in harmony with itself and the world and prevent its destruction.
In the publication you will find stories about childbirth and other problems of parents. The book will be of interest to a wide range of readers and will not leave anyone indifferent.

The body of a woman in labor in the postpartum period does not stop working: multiple hormonal changes occur, lactation occurs, and the uterus itself continues to contract. The complete process does not take place in one month. But when it hurts after childbirth, should you worry? What is considered normal, and when do you need to urgently call an ambulance?

The first month or two after giving birth, a woman in labor is in a difficult emotional and physical state. The birth has taken place, but the processes of degeneration of the body continue. This is a natural and nature-provided period that is simply worth experiencing. However, some situations raise downright concerns. In particular, when cramping or aching pain occurs in the uterus after childbirth, is this considered a normal postpartum process? What symptoms should you be wary of, and when should you really worry about your health?

Uterine contractions in the postpartum period are obligatory, and even moreover, a necessary phenomenon that should not cause concern to the mother in labor. Thanks to such contractions, it frees its cavity from the remnants of blood clots, the placenta, and the sensations of spasm are associated with contraction of the muscles of the organ, which, after release, must return to its previous shape and size. But it is impossible to say that such contractions are very painful. Severe pain in the abdomen, back, and inner thighs should cause concern in a woman in labor. After all, such a manifestation of painful symptoms may indicate the presence or formation of complications.

Interesting!

Less pain after childbirth (uterine contraction) is felt by women in labor who gave birth naturally without the use of additional anesthetics. Women in labor who gave birth by cesarean section are susceptible to stronger contractions after the birth of the baby, especially in the first 5 days.

The main causes of pain

To find out whether it is normal for the uterus to hurt after childbirth, it is necessary to clarify the reasons why such a sensation may occur.

Uterine pain: natural causes

Contractions after childbirth are not as strongly localized as during labor. Nevertheless, such sensations are noticeable and quite tangible. However, a woman should not worry about this. On the contrary, the absence of contractions immediately after the birth of the baby should cause concern. This can lead to serious complications and stimulation of contractions with the help of medications.

The more and more often you put your newborn baby to the breast, the faster the uterus can contract, the better for the mother in labor.

Natural causes of uterine pain after childbirth that are not cause for concern include:

1. Oxytocin response. The uterus contracts immediately after the baby and birth place (placenta) are removed. This becomes possible only if there is the required amount of oxytocin, which is produced by the female body. Mild but tolerable pain can be clearly observed in the first 5-7 days. These are the kind of contractions that are visible even to a woman in labor: during feeding, the uterus contracts, the stomach literally vibrates.
2. Wound surface. The uterine cavity is a solid muscle, which immediately after birth is literally an open wound. When contracted, such a muscle, like any wound, hurts, this is normal.
3. Intestinal. After pregnancy, the stomach, liver, and pancreas again “learn” to work in the same rhythm, returning to their original place. Therefore, symptoms such as colic, stomach cramps, nausea, and fermentation often occur.
4. Contractions of the cervical part. The cervix dilates up to 10 cm so that the uterus can pass the baby's head at the moment of pushing. After pushing out (especially if you do not push correctly), tears may appear in the part where the child passed. After birth, the obstetrician examines all organs and applies stitches if necessary. Of course, for the first 5 days (before discharge) the uterus will ache and ache. After this period, a decrease in pain occurs.

Contraction of the uterus after childbirth and dangerous symptoms

Pain in the lower abdomen in the first few weeks after delivery should cause concern if, along with these symptoms, the following signs appear:

• increase in temperature (as a rule, the increase occurs instantly, and it is virtually impossible to reduce the temperature);
• purulent discharge or blood with a rotten fish or purulent odor;
• there is no reaction to light (the pupils do not constrict);
• the abdomen on palpation is hard, painful, tight (possibly hot to the touch);
• vomiting, nausea, headache;
• uterine contractions acquire an increasingly painful spasmodic effect;
• Breasts swell, nipples are painful to touch.

All of the above symptoms are life-threatening for a woman in labor. For example, symptoms of endometritis develop in just a few hours. As a rule, problems may arise with the presence and development of infection, which after childbirth are deadly diseases.

Increased mortality among women in labor who decide to give birth at home is associated with the development of peritonitis. 80% of diagnosed complications of home birth are fatal

What to do

If the cause of a serious illness is an infection, remnants of the placenta in the uterus, or blood clots, then only prompt hospitalization will help preserve the health and life of the mother in labor.

If no disease is detected after childbirth, and doctors after childbirth associate the painful condition in the lower abdomen with the natural processes of contraction, then you can only relieve the pain using simple methods:

• cold compresses immediately after birth down the abdomen (nurses bring);
• lie on your stomach (especially the first few days after birth);
• do not take a hot shower;
• carry out constant rubbing of the external genitalia;
• do breathing exercises during the period of pulsation;
• do not lift anything heavier than the weight of the child;
• do not endure the need, urinate regularly;
• do the exercises .

It is important to remember that the most noticeable painful manifestations occur during the first days when the baby is applied to the breast. After intense contraction, the pain will go away, and mommy will not respond to the constant internal contractions of the organ, which continues to contract for another 2 months.

Childbirth is the most important work in a woman’s life. In this process, the expectant mother needs to skillfully combine moral and physical strength so that everything goes well. When contractions begin, the woman experiences severe pain and stress. After some time, when the child is actually born, the woman also has a hard time. In most cases, tears and cracks occur in the perineal area, which then take a long time to heal and are very painful. Let's find out when the pain goes away after childbirth?

What hurts most often after childbirth?

Gynecologists note that, as a rule, young mothers complain about pain in the perineum after childbirth. Because no matter how much a woman prepares for childbirth or follows all the necessary recommendations, there are very rarely cases when a baby is born and the woman in labor has absolutely no tears or cracks. Often these are the wounds that hurt the most. In addition, in the first days after the birth of the baby, the woman feels discomfort in the perineal area; it seems to her that the unpleasant painful sensations in this part will never go away. But this is not so, every day the pain will fade away. Meanwhile, of course, it is necessary to wait until the wounds heal. This process may take at least one and a half to two months.

Many women after childbirth complain that their back and lower back hurt. There is nothing surprising about this. During pregnancy, the spine and back muscles were subjected to powerful stress and changes as the fetus grew. As a result, after giving birth, the young mother experiences pain. This pain goes away gradually, but it takes at least six months. In addition, the painful condition may worsen, since the woman has to carry the baby in her arms, sometimes for several hours a day, at least. Therefore, if pain in the back and lower back after childbirth does not go away after two to three months, but only worsens, then you need to consult a doctor. A woman may need to undergo a course of massage or physiotherapy that has an analgesic effect and can be used during lactation.

Also, women in labor often complain of pain in the lower abdomen. These unpleasant sensations are associated with contraction of the uterus, since this organ in the female body undergoes the greatest changes during childbirth. In the first days after childbirth, the uterus contracts strongly, especially when the baby suckles, and the pain is sometimes as strong as during contractions. But it passes quickly, and literally after 5 days such unpleasant sensations no longer bother the young mother.

How to help the body so that it does not suffer from pain?

Many women in the first weeks after childbirth feel that their whole body aches and hurts. This is due to the fact that during childbirth the mother’s body experienced a huge load on all organs and muscles of the body. And now it just takes several weeks, or even months (depending on how the birth went) for the body to recover.

Thus, in order to get rid of different types of pain after childbirth, a young mother needs to take care of her health. Despite the numerous worries about the baby, you should make time for yourself. Do not forget that if a woman in labor has had tears and cracks in the perineal area, then for the first week you cannot sit on a chair, you can only lie down or sit in a “reclining” state. After a week you can sit down carefully. A young mother is obliged to rest more when the baby is sleeping, not to lift weights, not to carry a stroller, and not to move suddenly. A woman also needs to carefully monitor her diet to avoid constipation. Because when going to the toilet, “by and large”, in case of constipation, you will have to push, and such muscle tension will also lead to pain.

In addition, the mother needs to eat well so that the body recovers quickly after childbirth, and monitor her psychological state. Experts also do not recommend “getting hung up” on your painful condition and not forgetting that all pain will gradually pass. We would like to draw your attention to the fact that if the pain is too severe and torments you every day, then you need to seek help from a doctor who will advise you on what needs to be done to reduce the pain.

Especially for- Tatyana Argamakova

The last weeks of waiting are over. Contractions begin. The climax of the entire pregnancy is coming - a few more hours and you will see your baby. Of course, you will worry and worry about the outcome of labor, but if you are well prepared and understand what to expect, what happens at each stage of labor, then your courage will also return. Give life to a child! After all, this is such happiness! Prepare yourself, master techniques and methods of relaxation and breathing control in advance - they will help you maintain composure and cope with pain. And don’t be alarmed if during contractions something doesn’t turn out quite as you expected.

HOW TO DETERMINE THE BEGINNING OF CONTRACTIONS

YOUR ANXIETY that you will miss the onset of contractions is absolutely groundless. Although false contractions that occur in the last weeks of pregnancy can sometimes be mistaken for the beginning of labor, you will not confuse real contractions with anything.

SIGNS OF CONTRACTS

Appearance
By opening slightly, the cervix pushes out the blood-stained mucus plug that clogged it during pregnancy.
What to do This can happen a couple of days before contractions start, so wait until the abdominal or back pain becomes constant or the amniotic fluid has broken before calling your midwife or hospital.

Leakage of amniotic fluid
Rupture of the amniotic sac is possible at any moment. The water may flow out in a stream, but more often it oozes out little by little - it is retained by the child’s head.
What to do Call a midwife or ambulance immediately. Hospitalization is safer, even if there are no contractions yet, since infection is possible. In the meantime, place a waffle towel to absorb moisture.

Uterine contractions
At first they make themselves felt as dull pain in the back or hips. After some time, contractions will begin, similar to the sensations during painful menstruation.
What to do When contractions become regular, fix the intervals between them. If you think contractions have started, call your midwife. As long as they are not very frequent (up to 5 minutes) or painful, there is no point in rushing to the maternity hospital. The first birth usually lasts quite a long time, 12-14 hours, and part of this time is best spent at home. Walk slowly, stopping to rest. If your water has not yet broken, you can take a warm shower or have a light meal. The maternity hospital may advise you not to arrive before the contractions intensify and begin to repeat every 5 minutes.

HARNESSES OF CONTRACTS
Weak uterine contractions occur throughout pregnancy. In the last few weeks, they become more frequent and more intense, so sometimes they can be mistaken for the beginning of contractions. When you feel such contractions, get up, walk around and listen to see if they continue and if the pauses between them become shorter. Precursors of contractions are usually irregular.

FREQUENCY OF CONTRACTS
Monitor the dynamics of contractions over the course of an hour: beginning and end, intensification, increase in frequency. When contractions stabilize, their duration should be at least 40 seconds.

FIRST PERIOD

AT THIS STAGE, the muscles of the uterus contract to open the cervix and allow the fetus to pass through. During the first birth, contractions last on average 10-12 hours. It is possible that at some point you will be overcome by panic. No matter how well prepared you are, the feeling that something is happening to your body beyond your conscious control can be frightening. Stay calm and try not to disturb your body, do what it tells you. It is now that you will truly appreciate the presence of your husband or girlfriend nearby, especially if they know what contractions are.

BREATHING IN THE FIRST PERIOD OF LABOR
At the beginning and end of the contraction, breathe deeply and evenly, inhaling through your nose and exhaling through your mouth. When the contraction reaches its peak, resort to shallow breathing, but now inhale and exhale through the mouth. Don't breathe like this for too long - you may get dizzy.

ARRIVAL AT THE MATERNITY HOSPITAL

At the reception department you will be met by a nurse-midwife who will carry out all the formalities and preparatory procedures. Your husband may be next to you at this time. If you are giving birth at home, you will be prepared for the birth in the same way.

Midwife Questions
The midwife will check the registration records and your exchange card, and will also check whether your water has broken and whether there has been any release of mucus plug. In addition, he will ask a series of questions about the contractions: when did they start? how often do they happen? How do you feel? what is the duration of the attacks?

Survey
Once you have changed, your blood pressure, temperature and pulse will be taken. Your doctor will do an internal examination to determine how dilated your cervix is.

Fetal examination
The midwife will feel your stomach to determine the baby's position and use a special stethoscope to listen to the baby's heart. It is possible that she will record the fetal heartbeat through a microphone for about 20 minutes - this recording will help determine whether the child receives enough oxygen during uterine contractions.

Other procedures
You will be asked to provide urine to be tested for sugar and protein. If your water hasn't broken yet, you can take a shower. You will be directed to the prenatal ward.

INTERNAL INVESTIGATIONS
The doctor will, if necessary, conduct internal examinations, monitoring the position of the fetus and the degree of dilatation of the cervix. Ask him questions - you should also know what is happening. Usually the uterus dilates unevenly, as it were. in jerks. The examination is carried out in the intervals between contractions, therefore, if you feel the next contraction approaching, you will have to inform the doctor about it. You will most likely be asked to lie on your back, supported by pillows, but if this position is uncomfortable, you can lie on your side. Try to relax as much as possible.

CONTRACTS
The cervix is ​​a ring of muscles that are normally closed around the uterine os. The longitudinal muscles that form the walls of the uterus extend from it. During contractions, they contract, pulling the cervix inward and then stretching it enough to allow the baby's head to pass through the uterine os.
1. The cervix relaxes under the influence of hormones.
2. Weak contractions smoothly smooth the cervix.
3. Strong contractions cause the cervix to dilate.

PROVISIONS FOR THE FIRST STAGE OF LABOR
During the first period, try to try different body positions, finding the most comfortable one for each stage. These positions must be mastered in advance so that at the right moment you can quickly take the appropriate pose. You may suddenly feel like it would be better to lie down. Lie not on your back, but on your side. The head and thigh should rest on pillows.

Vertical position
At the initial stage of contractions, use some kind of support - a wall, a chair or a hospital bed. You can kneel if you wish.

Sitting position
Sit facing the back of a chair, supported by a pillow. The head is lowered on the hands, the knees are spread apart. Another pillow can be placed on the seat.

Leaning on my husband
During the first stage of labor, which you will probably endure on your feet, during contractions it is convenient to place your hands on your husband’s shoulders and lean on him. Your husband can help you relax by massaging your back or stroking your shoulders.

Kneeling position
Kneel down, spread your legs and, relaxing all your muscles, lower your upper body onto the pillows. Keep your back as straight as possible. In the intervals between contractions, sit on your thigh.

Four point support
Kneel down, leaning on your hands. This is convenient to do on a mattress. Move your pelvis forward and backward. Don't hunch your back. Between contractions, relax by lowering yourself forward and resting your head on your hands.

LABOR PAIN IN THE BACK
In cephalic presentation, the baby's head pushes against your spine, causing back pain. To make it easier:
during contractions, lean forward, placing your weight on your hands, and make forward movements with your pelvis; walk at intervals
In the intervals between contractions, let your husband massage your back.

Lumbar massage
This treatment will relieve back pain and also calm and reassure you. Let your husband massage the base of your spine, pressing on it with the heel of his palm in a circular motion. Use talcum powder.

HOW TO HELP YOURSELF

Move more, walk between contractions - this will help cope with pain. During attacks, choose a comfortable body position.
Stay as straight as possible: the baby's head will rest against the cervix, contractions will become stronger and more effective.
Focus on your breathing to calm yourself and take your attention away from your contractions.
Relax during breaks to save energy for when you need it most.
Sing, even scream, to relieve pain.
Look at one point or object to distract yourself.
React only to this fight, don’t think about the next ones. Imagine each attack as a wave, “riding” which you will “bear” the child.
Urinate more often - the bladder should not interfere with the advancement of the fetus.

HOW CAN A HUSBAND HELP

Praise and encourage your wife in every possible way. Don't be put off if she gets annoyed - your presence is still important.
Remind her of the relaxation and breathing techniques she learned in the courses.
Wipe her face, hold her hand, massage her back, offer to change her position. You need to know in advance what kind of touches and massage she likes.
Be a mediator between your wife and the medical staff. Stay on her side in everything: for example, if she asks for a painkiller.

TRANSITION PHASE

THE HARDEST time of labor is the end of the first period. Contractions become strong and long, and the intervals are reduced to a minute. This phase is called transition. Exhausted, you will probably be either depressed or overly agitated and tearful at this stage. You may even lose track of time and fall asleep between contractions. This may be accompanied by nausea, vomiting and chills. In the end, you will have a great desire to strain and push the fetus out. But if you do this ahead of time, swelling of the cervix is ​​possible. So ask your midwife to check that your cervix is ​​fully dilated.

BREATHING IN THE TRANSITION PHASE
If premature pushing begins, take two short breaths and one long exhale: “oof, oof, fu-u-u-u.” When the urge to push stops, exhale slowly and evenly.

How to stop pushing
If the cervix has not yet opened, in this position, take a double breath and exhale long: “oof, oof, fu-u-u-u” (see above right). You may need pain relief. Kneel down and, leaning forward, put your head in your hands; the pelvic floor should seem to hang in the air. This will weaken the urge to push and make it more difficult to push the fetus out.

HOW CAN A HUSBAND HELP

Try to calm your wife down, encourage her, wipe away the sweat; If she doesn't want it, don't insist.
Breathe with her during contractions.
Put some socks on her if she starts getting chills.
If you start pushing, call your midwife immediately.

WHAT HAPPENS TO THE CERVIX
The cervix, palpable at a depth of 7 cm, is already sufficiently stretched around the fetal head.
If the cervix can no longer be palpated, it means that its dilation has completed.

SECOND PERIOD AS soon as the cervix is ​​dilated and you are ready to push, the second stage of labor begins - the period of expulsion of the fetus. Now you add your own efforts to the involuntary contractions of the uterus, helping to push the fetus out. The contractions have become stronger, but they are less painful. Pushing is hard work, but your midwife will help you find the most comfortable position and guide you on when to push. Don't rush things, try to do everything right. During the first birth, the second stage usually lasts more than an hour.

BREATHING IN THE SECOND STAGE OF LABOR
When you feel the urge to push, take a deep breath and, leaning forward, hold your breath. Take deep, calming breaths between pushes. Relax slowly as the contraction subsides.

POSITIONS FOR EXPELATION OF THE FETUS
When pushing, try to stay straighter - then gravity will work for you.

Squatting
This is the ideal position: the lumen of the pelvis opens, and the fetus comes out under the influence of gravity. But if you haven't prepared yourself for this pose in advance, you will soon feel tired. Use a lighter option: if your husband sits on the edge of the chair with his knees apart, you can sit between them, resting your hands on his thighs.

On the knees
This position is less tiring and also makes pushing easier. Having support from both sides will give your body greater stability. You can just lean on your hands; your back should be straight.

Sitting
You can give birth sitting on the bed, surrounded by pillows. As soon as you start pushing, lower your chin and clasp your legs with your arms. In the intervals between attempts, rest by leaning back.

HOW TO HELP YOURSELF
At the moment of contraction, strain gradually, smoothly.
Try to relax your pelvic floor so much that you feel it sinking.
Relax your facial muscles.
Don't try to control your bowels or bladder.
Rest between contractions, save your strength for pushing.

HOW CAN A HUSBAND HELP
Try to somehow distract your wife between attempts, continue to calm and encourage her.
Tell her what you see, such as the appearance of a head, but don't be surprised if she doesn't pay attention to you.

CHILDREN

THE PEAK OF BIRTH has arrived. The baby is about to be born. You will be able to touch your baby's head, and soon you will be able to hold him in your arms. At first, you will probably be overcome by a feeling of great relief, but it will be followed by surprise, and tears of joy, and, of course, a feeling of immense tenderness for the child.

1. The fetal head approaches the vaginal opening, pressing on the pelvic floor. The top of the head will soon appear: with each push it will either move forward, or perhaps roll back somewhat as the contractions weaken. Don't worry, this is completely normal.

2. As soon as the top of the head appears, you will be asked not to push any further - if the head comes out too quickly, perineal tears are possible. Relax, catch your breath a little. If there is a risk of serious ruptures or any abnormalities in the child, you may have an episiotomy. As the head expands the vaginal opening, a burning sensation occurs, but it does not last long, giving way to numbness, which is caused by strong stretching of the tissue.

3. When the head appears, the baby's face is turned down. The midwife checks to make sure the umbilical cord is not wrapped around the neck. If this happens, it can be removed when the entire body is released. The infant then turns his head to the side, turning around before fully releasing. The midwife will wipe his eyes, nose, mouth and, if necessary, remove mucus from the upper respiratory tract.

4. The last contractions of the uterus, and the baby's body is released completely. Usually the baby is placed on the mother's stomach, since the umbilical cord is still holding it in place. Perhaps at first the baby will seem bluish to you. His body is covered with vernix, and there are traces of blood on his skin. If he is breathing normally, you can pick him up and press him to your chest. If breathing is difficult, the patient's airway will be cleared and, if necessary, an oxygen mask will be given.

THIRD STAGE OF LABOR
At the end of the second stage of labor, you will probably be given an intravenous injection of a drug that increases uterine contractions - then the placenta will come out almost instantly. If you wait for it to peel off naturally, you may lose a lot of blood. Discuss this point with your doctor in advance. To remove the placenta, the doctor places one hand on your stomach and gently pulls the umbilical cord with the other. After this, he must check that the placenta has come out completely.

APGAR SCALE
After delivering the baby, the midwife evaluates his breathing, heart rate, skin color, muscle tone and reflexes, calculating a score on the 10-point Hangar scale. Usually in newborns this indicator ranges from 7 to 10. After 5 minutes, a second count is carried out: the initial score, as a rule, increases.

AFTER CHILDBIRTH
You will be cleaned and, if necessary, stitches will be placed. The neonatologist will examine the newborn, the midwife will weigh and measure him. To prevent the baby from developing a rare disease associated with insufficient blood clotting, he may be given vitamin K. The umbilical cord is cut immediately after birth.

Question and answer "I'm afraid of injury during childbirth. Is there such a danger?"
Don’t be afraid, there is no such danger - the vaginal walls are elastic, their folds can stretch and allow the fetus to pass through. “Should I breastfeed my baby immediately after birth?” You can give breastfeeding, but if the baby doesn’t take it, don’t insist. In general, the sucking reflex in newborns is strong, and when they suck, they are in a good mood.

ANESTHESIA

CHILDREN RARELY painless, but pain also has a special meaning: after all, every contraction is a step towards the birth of a baby. You may need painkillers, depending on how your contractions are progressing and your ability to cope with the pain. You may be able to overcome it using self-help techniques, but if the worsening pain becomes unbearable, ask your doctor for pain medication.

EPIDURAL ANESTHESIA
This anesthesia relieves pain by blocking the nerves of the lower body. It is effective when contractions cause back pain. However, not every hospital will offer you an epidural. The time of its use should be calculated so that the effect of the anesthetic ceases by the 2nd stage of labor, otherwise labor may be slowed down and the risk of episiotomy and forceps may increase.

How does this happen
Epidural anesthesia requires approx. 20 minutes. You will be asked to curl up with your knees touching your chin. An anesthetic will be injected into the lower back with a syringe. The needle is not removed, which allows you to administer an additional dose if necessary. The effect of the anesthetic wears off after 2 hours. It may be accompanied by some difficulty in movement and trembling in the hands. These phenomena will soon pass.

Action
On you The pain will pass, clarity of consciousness will remain. Some women experience weakness and headache, as well as heaviness in the legs, which sometimes lasts for several hours.
Per child None.

NITRIC OXIDE WITH OXYGEN
This gas mixture significantly reduces pain without completely eliminating it and causes euphoria. Used at the end of the 1st stage of labor.

How does this happen
The gas mixture enters through a mask connected by a hose to the apparatus. The effect of the gas appears after half a minute, so at the beginning of the contraction you need to take several deep breaths.

Action
On you The gas dulls the pain, but does not relieve it completely. When you inhale, you will feel dizzy or nauseous.
Per child None.

PROMEDOL
This medicine is used in the 1st stage of labor, when the woman in labor is excited and finds it difficult to relax.

How does this happen
An injection of promedol is administered into the buttock or thigh. The onset of action is after 20 minutes, duration is 2-3 hours.

Action
On you Promedol manifests itself in different ways. For some, it has a calming effect, relaxing, causing drowsiness, although the consciousness of what is happening is completely preserved. There are also complaints about loss of self-control and intoxication. You may feel nauseous and shaky.
Per child Promedol can cause respiratory depression and drowsiness in a child. After childbirth, breathing can be easily stimulated, and drowsiness will disappear on its own.

ELECTRO-STIMULATION
The electrical stimulation device reduces pain and stimulates the internal pain coping mechanism. It works on weak electrical impulses that affect the back area through the skin. A month before giving birth, find out if there is such a device in the maternity hospital and learn how to use it.

How does this happen
Four electrodes are placed on the back where the nerves leading to the uterus are concentrated. The electrodes are connected by wires to the manual control panel. With its help you can regulate the current strength.

Action
On you The device reduces pain at the initial stage of labor. If contractions are very painful, the device is ineffective.
Per child None.

MONITORING THE CONDITION OF THE FETAL

DURING the entire period of labor, doctors constantly record the fetal heart rate. This is done with a regular obstetric stethoscope or using an electronic monitor.

OBSTETRIC STETHOSCOPE
While you are in the delivery room, the midwife regularly listens to the fetal heartbeat through the abdominal wall.

ELECTRONIC FETAL MONITORING
This method requires sophisticated electronic equipment. In some hospitals, such monitoring (control) is used throughout labor, in others - occasionally or in the following cases:
if labor is induced artificially
if you have had an epidural
if you have complications that could threaten the fetus
if abnormalities are detected in the fetus.
Electronic monitoring is absolutely harmless and painless, but it significantly limits freedom of movement - thus you cannot control contractions. If your doctor or midwife has suggested continuous monitoring, find out if this is really necessary.

How does this happen
You will be asked to sit or lie down on a couch. The body will be supported with pillows. Adhesive tapes with sensors will be placed on the abdomen to detect the fetal heartbeat and record uterine contractions. The instrument readings are printed on paper tape. After the amniotic fluid has broken, the baby's heart rate can be measured by placing an electronic sensor near his head. This monitoring method is the most accurate, but not very convenient. Some maternity hospitals use radio wave monitoring systems with remote control (telemetric monitoring). Their advantage is that you are not tied to bulky equipment and can move freely during contractions.

SPECIAL DELIVERY METHODS
EPISIOTOMY
This is a dissection of the vaginal opening to prevent rupture or to shorten the second stage of labor if the health of the fetus is threatened. To avoid an episiotomy:
learn to relax your pelvic floor muscles
When expelling the fetus, stay straighter.

Indications
An episiotomy will be needed if:
the fetus has a breech presentation, a large head, other abnormalities
you are in premature labor
use forceps or vacuum
you don't control your attempts
the skin around the vaginal opening does not stretch enough.

How does this happen
At the climax of the contraction, an incision is made into the vagina - downwards and, usually, slightly to the side. Sometimes there is no time for an anesthetic injection, but you still won’t feel pain, since partial numbness of the tissues also occurs due to the fact that they are stretched. Suturing after an episiotomy or rupture may be quite lengthy and painful - a complex procedure that requires special care. Therefore, insist that you have a good local anesthetic. The suture material dissolves on its own after some time and does not need to be removed.

Consequences
It's normal to feel discomfort and inflammation after an episiotomy, but the pain can be severe, especially if it becomes infected. The incision heals in 10-14 days, but if something bothers you then, consult a doctor.

FRUIT EXTRACTION
Sometimes forceps or vacuum extraction are used to help the baby be born. The use of forceps is possible only when the cervix is ​​fully dilated and the fetal head has entered it. Vacuum extraction is also permissible in case of incomplete dilatation - in the case of protracted labor.

Indications
Forced extraction is performed:
if you or the fetus have any abnormalities during childbirth
in case of breech presentation or premature birth.

How does this happen

Forceps You will be given pain relief - inhalation or intravenous anesthesia. The doctor applies forceps, wraps them around the child’s head, and gently pulls it out. When applying forceps, pushing is completely eliminated. Then everything happens naturally.
Vacuum extractor This is a small suction cup connected to a vacuum pump. It is brought through the vagina to the fetal head. While you push, the fetus is gently pulled through the birth canal.

Consequences
Forceps may leave dents or bruises on the fetus's head, but they are not dangerous. After a few days these marks disappear.
Vacuum The suction cup will leave a slight swelling and then a bruise on the baby's head. This too will gradually go away.

STIMULATION OF LABOR
Stimulation means that contractions will have to be induced artificially. Sometimes methods are used to speed up contractions if they are going too slowly. Physicians' approaches to stimulation often vary; so try to find out what the practice of inducing labor is in the area where you will be giving birth.

Indications
Contractions are induced artificially:
if, when labor is delayed for more than a week, signs of abnormalities in the fetus or dysfunction of the placenta are detected
if you have high blood pressure or any other complications that are dangerous for the fetus.

How does this happen
Artificially induced labor is planned in advance, and you will be asked to go to the maternity hospital in advance. There are 3 methods of stimulating contractions:
1. The hormonal drug cerviprost is injected into the cervical canal, softening the cervix. Contractions can begin in about an hour. This method is not always effective during the first birth.
2. Opening of the amniotic sac. The doctor makes a hole in the amniotic sac. Most women do not experience any pain. Soon uterine contractions begin.
3. A hormonal drug is administered intravenously through a drip that promotes contraction of the uterus. Ask for an IV to be placed on your left arm (or right arm if you are left-handed).

Consequences
The introduction of a hormonal drug is preferable - you can move freely during contractions. When using an IV, contractions will be more intense and the intervals between them will be shorter than during normal labor. Besides, you have to lie down.

BUTICAL PRECTION
In 4 cases out of 100, the baby comes out with the lower body. Childbirth in this position of the fetus is longer and more painful, so it must take place in a hospital. Since the head, the largest part of the baby's body, will be the last to appear during birth, it is measured in advance with an ultrasound scanner to ensure that it will pass through the pelvis. An episiotomy will be required; Caesarean section is often used (in some clinics it is mandatory).

TWINS
Twins must be delivered in a hospital because forceps are often used to remove them. In addition, one of them may have a breech presentation. You will likely be offered an epidural. There will be one first stage of labor. There are two second pushes: first one child comes out, followed by the second. The interval between the birth of twins is 10-30 minutes.

C-SECTION

With a CESAREAN section, the baby is born through an open abdominal wall. You will be informed in advance about the need for surgery, but this measure may be caused by complications during childbirth. If a caesarean section is planned, an epidural will be used, meaning you will be awake and able to see your baby right away. If the need for surgery occurs during contractions, then epidural anesthesia is also possible, although general anesthesia is sometimes required. It is difficult to come to terms with the fact that you cannot give birth normally. But these experiences can be overcome if you prepare yourself psychologically.

HOW DOES THIS HAPPEN
Your pubic area will be shaved, an IV will be placed in your arm, and a catheter will be inserted into your bladder. They will give you anesthesia. If you have an epidural, a screen will probably be placed between you and the surgeon. Typically a horizontal incision is made, then the surgeon uses suction to remove the amniotic fluid. The child is sometimes removed using forceps. After the placenta is delivered, you will be able to hold him in your arms. The operation itself lasts about five minutes. Stitching takes another 20 minutes.

Incision
The bikini incision is made horizontally, above the upper pubic line, and once healed it is almost invisible.

AFTER OPERATION
After giving birth, you will not be allowed to lie down for a long time without getting up. Walking and movement are completely harmless for you. The incision will still be painful for the first few days, so ask for pain relief. Stand straight, supporting the seam with your hands. After two days, start light exercise; in another day or two, when the bandage is removed, you can swim. The stitches are removed on the 5th day. In a week you will feel quite good. Avoid heavy exercise for the first 6 weeks. After 3-6 months the scar will fade.

How to breastfeed
Place the child on pillows so that his weight does not put pressure on the wound.

Very often, after childbirth, women complain of severe pain of various types. Many women in labor experience a headache, which is caused by improper breathing during contractions and normally goes away within a few days after childbirth. Often, young mothers complain of chest pain due to the flow of milk and hardening in the mammary glands. In this case, doctors advise them to purchase a breast pump and constantly express the remaining milk after each feeding.

Also, unpleasant pain after childbirth can occur in some parts of a woman’s musculoskeletal system - in the neck, spine and muscles. In its intensity, childbirth can be compared to intense sports training. And for an unprepared body such a load can be excessive. This may well lead to a feeling of stiffness in the neck and shoulders. Stretching of the spinal muscles during childbirth leads to lower back pain, which can spread to the legs. Your hands may also hurt a little, but not because of a difficult birth, but because the woman is forced to constantly carry her newborn baby in her arms.

But the most severe pain after childbirth usually occurs at the sutures, in the lower abdomen and back.

Pain in the sutures torments not only those mothers who gave birth by cesarean section, but also those women who developed ruptures during childbirth. The stitches should heal within a few weeks after delivery. And all this time they need to be properly handled, avoiding contamination, getting wet, and heavy load on them. You cannot sit on the seams suddenly, but it is better to generally adapt to sitting down reclining.

If your stitches hurt a lot after childbirth, you can take painkillers. But it is important, together with your doctor, to choose a drug that is safe for breastfeeding. Try to move more. You will feel some discomfort in the stitches, but this will prevent you from experiencing really bad pain. If you notice swelling of the suture or bleeding, contact your doctor immediately.

Abdominal pain after childbirth

Abdominal pain also brings a lot of discomfort to a woman. They are completely natural, since the genitals return to normal after the child passes through the birth canal. Stretched and damaged internal tissues heal, microcracks formed in them are healed. And during the first week after giving birth, my stomach feels very tight.

The stomach also hurts after childbirth for another reason - under the influence of the hormone oxytocin, the uterus begins to actively contract, causing sensations similar to contractions. Abdominal pain worsens during breastfeeding, when oxytocin is most actively produced. But such pain also goes away within 1-2 weeks. And the more often you put your baby to your breast, the faster everything will pass.

In some cases, after childbirth, scraping of the placenta remains from the uterus is required. Doctors may notice this immediately after birth or a few days later with an ultrasound. Curettage is a rather painful procedure and is subsequently accompanied by prolonged pain in the uterine area.

Sometimes the cause of abdominal pain is endometritis. This is an inflammation in the uterus that occurs due to the entry of bacteria, viruses or fungi into it during a difficult birth or cesarean section (also very common during abortion). In addition to abdominal pain, endometritis is accompanied by an increase in temperature, as well as bloody discharge in a woman. Treatment should be started as soon as possible.

And it also happens that the cause of abdominal pain is problems with the gastrointestinal tract or, for example, constipation. And in this case, to get rid of pain, a woman only needs to adjust her diet.

But it is often difficult to independently determine the cause of pain. Therefore, it is best to consult a doctor who can diagnose and prescribe the correct treatment.

Another problem that plagues young mothers is back pain after childbirth. The lower back, neck and shoulders hurt, and there can be many reasons for this. Stress during childbirth and daily carrying of a child in your arms are only a small part of the possible causes.

During the birth of a child, a woman's pelvic muscles are greatly stretched to allow the baby's large head and body to pass through. Also, during childbirth, a woman may experience birth injuries - displacement of the hip joints or vertebrae of the sacral and lumbar regions. It is especially difficult for women in labor who are overweight, women with spinal curvature, and those who lack physical fitness.

In order to avoid such problems, doctors advise pregnant women to attend preparatory courses, where they will be taught how to breathe correctly and take the safest positions during labor. In addition, doctors recommend that women in labor refuse strong anesthesia, which does not allow the woman to control the birth process. When there is a strong load on the joints, the woman in labor feels increased pain and automatically changes position to ease the load. If anesthesia completely relieves pain, then the woman may not feel the displacement of the joints. And having painlessly survived several hours of labor, she begins to suffer from severe daily pain in the hips and lower back, which only goes away within a year. And in case of severe birth trauma, even surgical intervention may be required. But most often they use physiotherapy, exercise therapy and massage. The choice of drugs during lactation is very limited, so choosing a pain reliever is extremely difficult.

Another common cause of abdominal pain after childbirth is stretching of the abdominal muscles and contraction of the back muscles during pregnancy. Such pain tends to persist in the postpartum period, reminding itself during moments of squatting, bending and lifting heavy objects.

Whatever the causes of pain after childbirth, women should remember that during the postpartum period it is very important to limit their activity, not engage in heavy labor and simply take care of themselves. Pay attention to your health so that your body’s recovery is quick and painless.