Pain relief for childbirth: with and without medications. How can I ease and independently relieve pain from contractions and pushing during childbirth in order to better endure them? What painkillers should you take during contractions?

It is clear that during childbirth the baby must somehow leave the mother's womb. The uterus contracts, and the baby gradually comes out through the dilated cervix and vagina. Pain during childbirth can occur due to stretching of the cervix, vagina, perineum, compression and rupture of soft tissues. Some women in labor suffer so much that their heart function and breathing may be impaired. In addition, prolonged pain often leads to premature fatigue, cessation of uterine contractions, and hypoxia (lack of oxygen) of the fetus.

The question of whether it is necessary to resort to pain relief during labor is something that every woman must decide for herself. Modern methods of anesthesia (medicinal anesthesia, epidural anesthesia, etc.) are considered quite safe for both mother and child, and make the process of giving birth more comfortable.

However, many experts are against labor pain relief. First, there is a risk (albeit small) of side effects. Secondly, the natural course of labor is disrupted (the administration of drugs can slow down or weaken labor).

On the other hand, everyone’s pain sensitivity threshold is different. Under the influence of “uncontrollable” prolonged pain, some women in labor may experience increased blood pressure, increased heart rate, and weakness in labor. This is harmful to the health of mother and child. In such cases, it is wiser to resort to anesthesia rather than suffer from unbearable pain.

However, it is best to prepare for childbirth in advance. With the help of so-called psychoprophylactic preparation, you can increase the threshold of pain sensitivity and ease the course of childbirth. It is believed that a woman who is psychologically ready for childbirth, has a good understanding of all stages of the birth process, knows how to breathe correctly, knows methods of self-relief of pain and is focused on results can easily do without pain relief. In such cases, childbirth is associated not with “torment”, but with the expectation of a miracle, great happiness - a quick meeting with the most beloved and wonderful person you have been waiting for for so long.

There are several ways to reduce pain during childbirth.

Psychological preparation

The pain of childbirth is aggravated by ignorance. So learn more about the birth process. You can obtain relevant information from pregnancy schools, antenatal clinics or from specialized literature. Women who are psychologically ready for childbirth find it much easier to give birth.

Water birth

A warm bath relaxes, distracts, has a good effect on labor and even improves blood supply to the fetus. Staying in warm water can significantly reduce the pain of a woman in labor during the first stage of labor, when the cervix dilates. However, before you fill your bathtub, seriously consider the pros and cons of this type of birth.

Reflexology

Some clinics use acupuncture for pain relief. It relieves pain during labor and normalizes labor. In Russia, this method is not yet very popular, most likely due to the lack of professional acupuncturists.

Drug pain relief

They tried to anesthetize childbirth many years ago. For this purpose, narcotic drugs were used, such as morphine, opium tincture, and nitrous oxide. The main disadvantage of these methods was the negative impact of narcotic painkillers on the fetus. In particular, they can cause weakened breathing in an infant.

In modern obstetrics, the most commonly used narcotic analgesic is promedol. It has a good analgesic effect and has less effect on the child than other drugs.

Often, due to painful, prolonged contractions, women in labor spend a sleepless night. Accumulated fatigue can interfere at the most crucial moment. In such cases, sleep-inducing medications are prescribed.

Before giving a woman painkillers, be sure to consult with an obstetrician-gynecologist or anesthesiologist.

Epidural anesthesia

This is a relatively new method of pain relief. The doctor places a thin needle between the vertebrae and injects an anesthetic substance under the dura mater of the spinal cord. In this case, local painkillers are used: lidocaine, marcaine, ropelocaine and others. After administration of the drug, all sensitivity below the level of its administration is temporarily blocked.

Epidural pain relief has its downsides. On the one hand, good pain relief is provided, but on the other hand, the woman cannot push effectively. Therefore, immediately before the baby is born, epidural anesthesia is suspended. In addition, in rare cases, epidural anesthesia can cause headaches and back pain that haunt a woman for quite a long time after childbirth.

Sometimes epidural pain relief is necessary for medical reasons, such as fetal malposition, twin births, or certain complications of pregnancy or childbirth.

The birth of a child is one of the most pleasant and at the same time difficult events in a woman’s life. Expectant mothers are unable to cope with the fear of pain on their own. Despite the fact that nature has a certain mechanism of reactions in the body to reduce sensitivity, the genetic memory of “birth in agony” takes over. To help, special techniques have been developed and used to relieve pain and make contractions less painful. There are also medicinal methods that minimize the suffering of the woman in labor.

Physiology of pain

Contractions are part of natural childbirth. Their occurrence means the beginning of the opening of the cervix and the movement of the child to exit the female womb, but not the expulsion itself. By definition, pain means some kind of defensive reaction, a signal from the body to the brain about a problem. But in the case of childbirth, it is different.

Why pain occurs during contractions:

at the end of pregnancy, the uterus becomes a huge muscular organ of the body, its compression, accordingly, is felt most intensely;
contraction means involuntary compression and displacement of longitudinal and transverse muscle fibers;
during contraction there is compression of the nerve endings and tension, tension of the ligaments in the uterine area;
As the intensity of contractions increases and the interval between them decreases, the woman’s body gets tired and does not have time to switch, and a feeling of excruciating pain arises.

Before pushing, the nature of the sensations changes. In addition to the general pain during contraction, strong pressure on the perineum is added. This is a reaction to the insertion of the presenting part of the child into the pelvic inlet. Discomfort in the sacral area increases. Before the actual expulsion of the fetus, the peak of sensations occurs locally in the vagina, rectum and perineum.

What determines the pain during contractions:

psychological state - fear, stress contributes to the release of adrenalin, which aggravates sensations;
duration of labor - the exhausted body is not able to adequately respond to events, so the pain intensifies;
the presence of complications - a large fetus, breech presentation, other pathological conditions of the woman in labor affect the nature of the pain.

Modern research shows that the more actively a woman mentally tries to intervene in the process, the more difficult it is for her to cope with the pain during contractions. All mammals, which includes humans, are born according to a similar pattern. But the difference in the perception of a natural process and something terrible directly affects the feeling as a whole.

Pain relief methods

The environment in which the woman finds herself helps to endure the contractions correctly before childbirth. Calmness, friendliness and confidence of the staff, a sense of security put the pregnant woman in the right mood. In this state, it is easier for her to accept what is happening, manage her emotions and control sensations.

There are two main methods that are used to relieve pain during labor: medicinal and non-medicinal. In the first case, drugs with different active ingredients are used. This group includes antispasmodics, analgesics, and drugs with narcotic and sedative effects.

In most cases, drugs are effective when it comes to real anesthetics used in modern obstetrics. But they are not suitable for independent use and have a number of contraindications. The main disadvantage of an anesthetic during labor is that the active substance penetrates to varying degrees into the mother’s blood and through the placenta to the child.

A non-drug or independent method that helps to survive contractions during childbirth is understood as professional psychological training for pregnant women. It includes special types of massage, the use of water, special breathing, postures, relaxation, aromatherapy and more.

Do contractions in the maternity hospital provide pain relief? Yes, but not always. It all depends on the specific case and indications. You can count on the assistance of medical staff provided that you have previously agreed to carry out the birth under epidural anesthesia.

Self-anesthesia

The main component of the success of using any independent methods that suppress pain is mastering the techniques during pregnancy. Practical self-help skills can be obtained in special courses for future parents.

How to relieve pain during childbirth yourself:

master self-massage, remember relaxation points on the body;
stand in a comfortable position or move, do not sit still;
if you don’t have the strength or desire to walk around the room, it’s better to jump or swing on a fitball;
learn to breathe correctly during contractions and pushing, at the peak of pain;
if the clinic’s equipment allows, use water procedures.

The maximum effect is achieved by combining several methods. By massaging the sacrum you can breathe correctly at the same time. Experienced women still manage to swing on a fitball or walk.

Massage. We are talking about stimulating local areas on both sides of the spine in the sacral area. In order to block pain impulses in this way, you need to apply gentle pressure. Mothers who tried to press the points to ease contractions during childbirth note that the position during manipulation did not matter much. Some massaged their backs while standing or slightly leaning forward, others while sitting on a fitball, while others were helped by their husbands.

Breath. Breathing is used to relieve pain during childbirth. This is at the same time a way to relieve discomfort, relax muscles and saturate tissues with oxygen. Controlling the actions performed helps the woman in labor to distract herself from thoughts about the painful contractions of the uterus.

How to breathe through contractions:

While the pain can be tolerated, it is important to breathe deeply, sparingly - inhale through the nose and exhale longly through the mouth;
as the intensity of sensations increases, there is a desire to curl up into a ball, to tense up - this cannot be done, you need to try with all your might to relax the muscles, you can stroke your stomach from top to bottom;
breathing in this period will no longer be possible, so you should switch to the “dog-style” method - often, quickly, intermittently;
with the beginning of pushing, attention switches to the obstetrician - she tells you when to breathe out the contraction, and when to take in air and push the exhalation “down”.

For greater comfort, the mother in labor is recommended to remove excess or restrictive clothing and, if possible, frequently ventilate the room. It would be good if there was a humidifier in the room. Useful skill for a woman unwind and relax. Equally important are attempts to rest during the break between contractions: close your eyes, fall asleep.

Medication methods

It is almost impossible to completely anesthetize labor pains. Even the most potent drugs suppress the feeling of incompleteness. But this is not required; to control the progress of labor, it is important not to “turn off” the pain, but to make it less pronounced.

There are three main ways to relieve pain in the maternity hospital:

intramuscular injection - a woman is given antispasmodics, analgesics, opiates, sedatives or a special mixture of them, most often in the thigh;
epidural anesthesia - an anesthetic is injected into the space near the spine, the woman in labor ceases to feel the body below the catheter;
laughing gas - nitrous oxide and oxygen inhaled by the pregnant woman with each contraction, common in Europe and the USA.

For short-term and incomplete pain relief from contractions, the so-called lytic mixture is most often administered intramuscularly. It consists of promazine hydrochloride, promedol, diphenhydramine and novocaine. The cocktail is injected if there are 2 or more hours left before the expected attempts, there are no contraindications on the part of the woman and child. It is also administered when the woman in labor has severe anxiety.

What painkillers can you take during contractions:

antispasmodics: No-Shpa, Drotaverine;
antispasmodics + analgesics: Spazmalgon, Baralgin, Revalgin;
non-steroidal anti-inflammatory drugs: Ketones, Emodol.

Any independent use of medications should be under the supervision of doctors. But - Spa during contractions will not give results, even if the dosage is selected correctly. An incorrect dose of other pills, untimely administration, or the presence of contraindications can only cause harm. Labor activity will subside or become uncoordinated.

Does baralgin relieve pain during real contractions? Usually no, only the intensity of sensations decreases. Taking such drugs is considered one of the methods for checking training contractions of the uterus from real ones.

Whether to try to reduce the pain during contractions or endure it until the end - the woman must decide for herself. There are also situations when strong stress is contraindicated and the birth of a child occurs exclusively under anesthesia. Childbirth without pain should also not cause a false sense of guilt. This is fine.

Childbirth is very rarely painless. However, pain was developed in the process of evolution as a protective reaction of the body, and we can control it.

For the birth to be easy, the woman must feel safe, and the birth of the baby must take place in a calm and friendly environment. In addition, there are a wide variety of methods that are used to relieve pain during childbirth.

There are medicinal and non-medicinal pain relief for childbirth. Undoubtedly, the latter option has several important advantages: the absence of side effects and influence on the child and ease of use.

Physiological (non-drug) methods of labor pain relief include relaxation, breathing exercises, active behavior, massage and water treatments. In order to be able to use the entire arsenal of these methods, you need to master them in advance - even during pregnancy.

Learning to relax during childbirth

When preparing for childbirth, it is very important to learn to relax. The fact is that tension quickly depletes strength, and hormones produced in response to stress, which, as a rule, inevitably arises when a woman is very tired during childbirth, reduce the effectiveness of uterine contractions.

Prolonged stress reduces the supply of oxygen to the baby, and also affects the heart rate, impairs blood circulation, and causes headaches for the expectant mother. By learning to consciously relax, a woman is able to manage her stress level and avoid many unwanted complications.

What do you need to learn? You can master the relaxation technique by following these recommendations. Sit comfortably. Try to relax your facial muscles first: they are connected to the internal organs. Unclench your jaw and let your chin drop. Then focus your attention on the muscles in your neck and upper back. You can turn your head a little without straining your muscles, as if rolling your head from side to side. Relax parts of your body, causing a feeling of warmth in them and accompanying this process with positive thoughts: “Everything is going as it should,” “I feel easy and calm.” Imagine some pleasant image that evokes a feeling of inner peace and joy: warm rays of the sun, swimming in warm water. Then proceed to relaxing your right hand, left, then the muscles of your legs and perineum, while imagining your arms and legs hanging freely. Remember how you feel. During the contraction, it is advisable to remain in a relaxed state. But this relaxation is not passive, but an active conscious process that requires concentration.

With the increase in regular labor, a woman’s positive attitude towards a favorable completion of childbirth should not weaken. It is important to switch your attention from pain to something else, for example, focus on proper breathing, which is very helpful during childbirth.

Correct breathing during childbirth

Special breathing techniques are rightfully recognized as one of the most effective ways to relieve pain in childbirth.

What is the effect based on? It turns out that when certain types of breathing are used during childbirth, the blood becomes oversaturated with oxygen (hyperoxygenation), which causes the release of endorphins into the blood. These substances are also called hormones of joy or happiness. They influence a person’s pain sensitivity threshold. The more endorphins are released into the blood, the higher the pain threshold, that is, for the expectant mother, contractions become less painful and she tolerates them much easier. This explains the pain-relieving effect of breathing. In addition, the uterus is a muscular organ, and for its effective functioning it requires oxygenated blood.

What do you need to learn? Breathing techniques are good because they can be used at any stage of labor without restrictions, in any position of the body, during normal labor and even during the development of various labor abnormalities.

However, each stage of labor has its own way of breathing.

At the beginning of labor When contractions are practically painless, abdominal breathing is recommended. When the contraction begins, the woman inhales slowly and relaxedly through her nose, and then exhales through her mouth for a long time, trying to stretch out the exhalation as much as possible (as if blowing on water). This technique helps to relax, relieves nervous excitement and saturates the blood with oxygen, stimulating and pain-relieving contractions.
When contractions intensify and become painful, you can use “candle breathing”: in this case, you need to breathe frequently and shallowly, taking short breaths through the nose and exhaling through the mouth (as when blowing out a candle). As the contractions intensify, you need to breathe more intensely, but also very often. You should only breathe this way during a contraction. In between, it is recommended to take a deep breath and exhale, calm your breathing and rest until the next contraction. You can also use a “tired exhalation” - this is breathing with a so-called voiced exhalation, which will help relieve tension accumulated during childbirth and replenish your strength. Remember how we breathe when we are very tired and want to throw a heavy burden off our shoulders.
When the cervix is already fully dilated and contractions become especially long and frequent, the strongest pain-relieving effect is exerted by “train” breathing. At the beginning of the contraction, you need to breathe with your stomach, which allows you to save energy. As the pain increases, it is recommended to breathe more often, and at the peak of the contraction, the most intense. As soon as the pain begins to subside, breathing needs to be evened out and calmed down.
In the second stage of labor, when the fetus begins to move along the birth canal, pushing begins. They are accompanied by a feeling as if you want to empty the intestines (due to the fact that the fetal head is pressing on the rectum, located next to the vagina). At this stage, it is important for the woman in labor to avoid premature pushing and relax as much as possible, helping the baby move down the birth canal. Dog breathing helps to restrain efforts - in this case, you need to take frequent and shallow inhalations and exhalations through your mouth, which resembles the breathing of a dog. In addition, it has a strong analgesic and relaxing effect.

Pain relief for childbirth: active movement

Another option for natural pain relief is active labor. It lies in the fact that a woman can behave freely during childbirth: constantly change positions, move around the ward or corridor, looking for the most comfortable position for herself.

What is the effect based on? Firstly, movements allow you to take your mind off the pain, which in itself significantly reduces pain. Secondly, if a woman does not move, the overall blood flow decreases, less oxygen reaches the muscles of the uterus, which is their energy fuel, and because This makes the pain intensify. And with active movement, blood flow increases, more oxygen is delivered to the muscle tissue of the uterus and pain is not felt as much. Thirdly, as noted above, the feeling of pain depends on whether a woman is tense or relaxed: the more she tenses, the more painful she becomes, and vice versa. Quite often, women completely stop moving during a contraction - they seem to freeze out of fear of pain. But such behavior will not allow you to hide from pain, but will only intensify it. So, in addition to the techniques of conscious relaxation, in such situations, constant physical activity will come in very handy, because during movement the muscles naturally tense and then relax, so their excessive overstrain is excluded. It becomes easier for a woman to relax, which means the pain will be felt less.

What do you need to learn? It is important to know what movements are acceptable during childbirth. They are very diverse. And if childbirth proceeds without complications, then there are no special restrictions, except that you cannot sit on a hard surface and make sudden and impetuous movements. You are allowed to walk calmly around the hall and ward, lean to the sides and forward, sway and rotate your hips, make turns and stretches with your whole body, step from foot to foot, squat shallowly, arch your back, squat with your knees apart, kneel with your knees apart, them to the sides, stand on all fours, etc. Often relief during childbirth is brought by poses using a large gymnastic ball (fitball) - you can swing on it, spring, rotate the pelvis, etc.

If, for medical reasons, you have to give birth in a lying position, then you should move here too: you can bring your legs together and spread them, rock your pelvis, turn from side to side, and make springy movements with your hips.

Pain-relieving massage during childbirth

Massage is an excellent help for reducing pain during childbirth.

What is the effect based on? The use of massage techniques allows you to switch attention from the pain during a contraction to the tactile sensations from the massage effect. Impact on certain points and areas on the body during contractions allows the expectant mother to reduce pain and relax better. For example, massage of the sacral region (lower back) has a fairly strong analgesic effect. In this zone there are nerve nodes that innervate the uterus and other pelvic organs. Massaging the sacral area during a contraction stops the transmission of the nerve impulse, and the pain decreases.

What do you need to learn? A woman can perform a massage on her own, but if her husband or someone else close to her is present at the birth, then it is more convenient to entrust it to him. Massage of the sacral area can be done with one or both hands, the pads and knuckles of the fingers, the base of the fist, the base of the palm, the inside of the palm, or a hand massager. Movements during a massage can be stroking, pressing, patting, pinching and even lightly tapping.

Massaging the protrusions of the pelvic bones on the sides in the lower abdomen will also help to take your mind off the pain and make it easier to survive contractions. These bones should be treated in the same way as the sacral area: press and release, stroke, pinch. Experiment and choose the effect that will be most effective.

During the contraction, you can gently stroke the bottom and top of the abdomen in a semicircle. These movements calm and help the woman relax.

Massaging the inner thigh helps reduce pain and maximize relaxation (the recurrent nerve, which innervates the pelvic organs, passes through this area). It is more convenient to do it lying on your side or sitting on a ball. Press the insides of your palms against your inner thighs at your groin. During the contraction, move your hands with pressure, without lifting your palms, to your knees and back to your groin.

If you are planning a birth with your husband, then he should learn the simplest massage techniques.

Eight: take a large pillow and ask the expectant mother to kneel down, spread them gently to the sides, sit on her heels and rest her forehead on her hands crossed on the pillow. This position is quite often used during contractions; it is convenient to massage the back. Putting our hands on the woman’s shoulders, we draw a figure eight – the palms meet on the lower back and tailbone. Then, with the backs of your hands, move your hands along the spine from bottom to top and draw a figure eight again.
Screwing: clench your hands into fists and very lightly twist them into the lumbar region, without pressing on the spine itself. Gradually increase the pressure, but do not forget to focus on the sensations of the expectant mother. It should tell you the strength and area of pressure.
Acupressure: With your thumbs, press on points along the spine from bottom to top, stepping back two centimeters from the protruding processes, and go from the sacrum to the cervical region. You can stay longer on more sensitive points.
Foot, neck and shoulder massage often brings relief and helps to relax. First, the foot needs to be rubbed up and down with quick but light movements, on both sides. The heel and pads of the toes should be massaged in a circular motion separately and with effort, paying attention to each, then press on the hollows between the toes. This massage should be completed by stroking the foot. Start your neck massage by stroking, performing smooth, light movements with your palms from top to bottom. Then start rubbing, moving 2 cm to the left and right from the protruding bone processes of the vertebrae (while grasping the back half of the neck with your thumb and forefinger). Next, we gently knead the neck muscles, including vibration techniques, patting and tapping. The massage ends with stroking.

Water procedures for pain relief during childbirth

Water is an accessible, safe and pleasant remedy. Using water for healing purposes is an ancient method that has proven its effectiveness. In the absence of contraindications (premature rupture of amniotic fluid, high blood pressure), it is allowed to take a warm bath or shower in the first stage of labor.

What is the effect based on? Warm water reduces pain during contractions, relieves muscle and emotional tension, and helps to relax in the intervals between contractions of the uterus. In addition, the body weight in water is less, and often a woman giving birth feels more comfortable. You can also wash your hands from elbows to wrists in cool water, thereby activating blood circulation and relieving fatigue.

As you can see, pain during childbirth can be overcome. Tension and anticipation of pain slow down the birth process, and proper breathing, relaxation, comfortable body position and massage help move the baby’s head along the birth canal and make birth easier.

Partner childbirth is always a big responsibility: whether the expectant mother is accompanied by a friend, husband or one of her relatives, he should become a support and, if possible, alleviate the suffering of the woman in labor. Teachers in prenatal training courses often mention ways to alleviate a woman’s suffering due to contractions, but we decided to systematize this information.

1. Facial massage helps relieve stress and relax;

2. Remind the expectant mother to go to the toilet every hour: a full bladder is not only very unpleasant, but also increases the feeling of contractions;

3. Place a cold compress on the mother’s neck and face or lightly moisten it with cool water;

4. If doctors do not prohibit it, you can offer the woman water and light snacks - they will help replenish the energy that the expectant mother loses during labor;

5. Help the woman in labor change her position to speed up the process of cervical dilatation. Some positions will be painful, others will provide a short respite from the pain, your task is to find the best option for it;

6. During contractions, the expectant mother suffers from back pain: massage her lower back, lightly press on the sacrum. The position “on all fours” also helps to cope with pain;

7. Be close: Even if a woman does not want to be massaged during contractions, feeling the presence and support of a loved one is very important. Encourage her with words, hold her hand;

Light shower. Many doctors agree that water perfectly relaxes muscles and relieves pain, so if there are no contraindications, you can help a woman take a warm shower;

9. Try to distract the woman from the pain: if her condition allows, talk to her, listen to her favorite music, read something interesting. Be a mediator between the woman in labor and the medical staff;

10. Remind her that soon the painful sensations will pass, and the expectant mother will be able to hold her baby in her arms - this always works.

Video: Childbirth without pain

The appearance of contractions

Many women who will become mothers for the first time are worried that they will miss the onset contractions. In the last weeks of pregnancy, false contractions are observed, which are mistaken for harbingers of labor, but real contractions cannot be confused with anything. Harbingers of contractions can be: the passage of amniotic fluid, the appearance of a mucus plug that clogs the cervix, dull pain in the hips or back. The first contractions are similar to the pain and cramps during menstruation, but soon these sensations intensify. When contractions become regular, it's time to rush to the hospital. When the situation stabilizes, the duration of contractions ranges from 40 seconds.

This is the beginning of the first stage of labor, when the cervix begins to dilate. If this is your first birth, your uterine muscles may contract for 10-12 hours, so don't be alarmed or worried. You will have a formal interview and first examination at the maternity hospital; you may be asked to take a test for the presence of protein and sugar. If your water hasn't broken yet, you can take a shower.

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Comfortable positions during contractions

You can relieve pain or at least get a little distraction by changing body positions - your birth partner can help you with this.

Vertical position. Effective in the initial stages of contractions: you can lean against a wall or bed. You can sit on a chair (facing the back), leaning on a pillow. To make sitting softer, another pillow can be placed on the surface of the chair. Lower your head into your hands, breathe calmly and measuredly, spread your knees to the sides;
Kneeling or supported position. During contractions, you can put your hands on your husband's shoulders and lean on him while standing. Ask for a relaxing massage. You can also kneel down, spread your legs, and place your hands on the pillow. Try to keep your back straight;
"On knees". It is most convenient to take this position on a mattress: make forward movements with your pelvis, try to relax between contractions, resting your head on your hands. If you put your weight on your arms, you will reduce the back pain caused by the baby's head during cephalic presentation (it rests directly on the mother's spine). In the intervals between spasms, you can walk, your partner can massage - pressing in a circular motion on the base of the spine is especially effective;
Movement helps to cope with the pain from contractions - you should walk at intervals, keeping your back straight, then the baby's head will rest against the cervix and the dilatation process will go faster. Try to relax during breaks, focus on breathing. Visit the restroom more often - a full bladder is not the best feeling, and it can interfere with the progress of the fetus.

Second stage of labor or pushing

For a woman, the most difficult time is the end of the first phase, contractions become long and painful, and also very frequent. At this moment, the woman needs help and support, since you may encounter tears, depression, the expectant mother may begin to feel chills or begin to fall asleep. Breathe with her, support her, wipe away the sweat. If you see that the woman in labor is cold, take care of a warm robe and socks. If you start pushing, call your midwife.

The second period is the expulsion of the fetus, so in addition to contractions, the woman in labor needs to make her own efforts, listen to the guidance of the midwife. The duration of this period is up to several hours.

Video: Breathing during contractions and pushing

Positions for the second phase of labor:

"On knees". Gravity opens your pelvis faster, but you may feel tired quickly. It is best if your husband sits on the edge of the chair and spreads his knees, and you can sit comfortably between them and rest your hands on his thighs;
On the knees. The position is less tiring and reduces pain. It is best to have your spouse support you to make your body more stable. If you feel tired, lean on your hands, but keep your back straight;
Sitting on the bed. If it’s not very comfortable, surround yourself with pillows. As you begin to push, you can lower your head down and clasp your legs with your hands; do not forget to rest in the interval.

Childbirth

During this period, all the expectant mother needs is to listen to the doctors’ instructions. As soon as the baby's head appears, you will no longer need to push, relax, catch your breath. After a few contractions, the baby’s body will appear: after the little miracle is placed on the woman’s stomach, the torment is quickly forgotten. Then the baby is taken for examination: the neonatologist makes a control weighing, takes measurements, and cuts the umbilical cord.

After giving birth, women often receive an injection that increases the contractions of the uterus to help the placenta come out faster, otherwise, if you wait until it comes out naturally, you can lose a lot of blood. This issue is discussed in advance with the doctor, as is pain relief.

Childbirth is a tiring and difficult process, but all unpleasant sensations are forgotten when you hold your baby for the first time.

Each stage of labor has its own types of breathing, but the basis for all is the same: abdominal breathing. To train it, place your hands on your stomach and try to breathe so that your chest remains motionless, and your arms (and stomach) rise and fall. And remember, during childbirth, all inhalations should be through the nose, and exhalations through the mouth, while the lips should be folded into a tube (this increases the resistance to the blown air, and, therefore, stretches the exhalation).

So, the long-awaited contractions began, at first they were weak, not yet painful, but already unpleasant. At this time, Breathing is usually not yet required, but when the strength of the contraction increases and the first painful sensations appear, this is where the first type of breathing will help - delayed. Usually a person makes up to 17 breathing movements per minute and the inhalation is always shorter than the exhalation. To relieve pain from moderate contractions, you need to breathe deeply and slowly. To begin, inhale slowly and deeply for 3 seconds and exhale for 7 seconds. (It is better to train with a watch with a second hand in front of the gases). This will result in 6 breathing movements per minute. The stronger the contractions, the slower you need to breathe: inhale for 5 seconds – exhale for 10 (that’s 4 breathing movements per minute). And then even less often: inhale for 6 seconds – exhale for 12 (that works out to about 3 breathing movements per minute). However, the latter option requires some training.

When contractions become strong and painful, slow breathing no longer helps. It is replaced by the following type of breathing - wave breathing. The contraction proceeds in waves, at first it increases, then it lasts for some time, then the strength of the contraction decreases. Breathing should repeat this wave: at first the breathing is slow and deep, then the strength of the contraction increases, and breathing becomes frequent and shallow (the so-called doggie breathing), then the contraction subsides, and breathing gradually becomes slow and deep again. In the breaks between contractions, you need to relax, but if the breaks have become short, and the contractions are strong and painful, you need to breathe in a slow type of breathing between contractions (so as not to “miss” the beginning of the next contraction), for example, inhale for 3, exhale for 7 seconds.

Dog breathing can be replaced by other types if desired. First - breathing with a candle(slow, deep breath in through the nose and exhale sharply through the mouth). You can still do respite(inhale - exhale as when breathing “dog” - blow out - slightly stretched, but quickly exhale). You can also " build pyramids"(inhale – exhale – blow out, then 2 “inhale – exhale” – blow out, 3 “inhale – exhale” – blow out and in the reverse order). This also distracts from pain. Don’t forget that you need to breathe with your stomach, and also that you need to inhale through your nose and exhale through your mouth (an exception is dog breathing - here you can breathe either only with your mouth or only with your nose).

This type of breathing dries out your nose and mouth. You can rinse your mouth with water, and lubricate your nose with Vaseline oil, or you can use Aquamaris spray (both must be prepared in advance and taken with you to the hospital).

Note! If after the end of the contraction you feel very dizzy (“out of breath” - there is excess oxygen in the blood), then you need to create a slight hypoxia - cover your nose with your hand or a blanket and breathe for a few seconds.

It is also important to move more during contractions. When muscles work, they require more oxygen, which means the speed of blood flow increases (and the heartbeat becomes faster), and, therefore, blood flow increases everywhere, including in the placenta.

If you really want to scream, don’t waste precious energy on it. In this case it is better sing. It is better to sing vowel sounds: “A”, “O”, “U”, etc. Take a deep, slow breath through your nose and as you exhale, make a vowel sound. You can also buzz (pull the sound “Zh”), hum (sound “M”) or itch (sound “Z”).

At some point, pushing joins the contractions. You can’t push right away - you need to call a doctor, he will evaluate the dilatation of the cervix and either allow you to push, or you will have to “breathe” through several attempts. You will also have to “breathe” at the moment of birth of the face (at this moment the midwife will say that you cannot push). For removing pressure can be used doggie breathing or sobbing(deep breath, then many small exhalations, or vice versa, many small breaths, then smooth exhalation).

And so the doctor allowed me to push, and the most important period of childbirth begins - pushing. During this period, the main thing is to completely obey the midwife. But even here you need to breathe correctly. Breathing while pushing: take a deep breath through the mouth, hold your breath (at this time you need to look at the navel and push on the perineum (as with constipation)). SLOW exhale. The most important thing here is not to exhale sharply or scream. Otherwise, all the force of the attempt will go into a cry, and the attempt will be ineffective. If everything is done correctly, then in one push you need to push 3 times.

It is better to train all these types of breathing every day. If you devote at least 15 minutes a day to breathing training, then, firstly, it will become familiar to the body and will be remembered by itself during childbirth, and, secondly, it will train the baby. It is important for the baby that the mother practices holding her breath during pregnancy. This will help the baby better adapt to hypoxia during labor.

Another component of pain is fear of it. If you expect pain, it will seem very strong. You can’t set yourself up for pain. When you know that pain can be reduced, fear also decreases. Expectant mothers, remember that the baby is also scared during childbirth, he does not know what will happen next. Don’t forget to talk to him during childbirth, let him hear your voice - he will be calmer, because now you are the whole universe for him... Health to you and your babies. Have a calm pregnancy and easy birth.
py. sy.)) that’s how it’s written - that’s how I breathed. really good... and I had time to talk on the phone))) so don’t waste time shouting, it’s better to breathe carefully. don't rush it, lalya. and everything will be alright)) if you have any questions, ask))))))))