The long-awaited baby: stimulation of labor. Stimulation of labor: mom is tired of waiting, baby, come quickly

In obstetrics, situations often arise when induction of labor is necessary. It is carried out using various methods that enhance the contractile activity of the uterine muscles and lead to the onset of spontaneous labor. This measure is carried out with the aim of delivering a newborn naturally within the next 24 hours, reducing the frequency of cesarean sections without increasing the risk of complications for the mother and child. During the period from 1990 to 2006, labor stimulation began to be performed 2 times more often.

Indications

There are the following indications for induction of labor:

• (gestational age more than 41 weeks);
• arterial hypertension that developed before or during pregnancy;
• intrauterine fetal death;
• , preeclampsia, eclampsia;
• pathology of the placenta, accompanied by oxygen deficiency of the fetus;
• maternal diseases: diabetes, kidney disease, chronic lung disease, antiphospholipid syndrome;
• fetal pathology: growth retardation, Rh conflict, oligohydramnios.

Labor activity can be induced for other reasons, for example:

• risk of rapid and precipitate labor;
• a long distance to the hospital if the woman is not hospitalized;
• danger of weak labor forces and postpartum hemorrhage in the mother.

In this case, at least one of the following criteria must be present:

• An ultrasound done at 20 weeks gestation or later confirms a current gestational age of 39 weeks or more;
• listening to fetal heart sounds during the last 30 weeks;
• 36 weeks have passed since the positive pregnancy test (blood and urine tests).

That is, before starting the procedure, it is necessary to ensure the viability of the fetus and the normal gestational age.

Contraindications

Any methods of inducing labor are prohibited in the following situations:

• placenta or umbilical cord previa;
• previously transferred;
• transverse position of the fetus in the uterus;
• umbilical cord prolapse;
• active herpetic genital infection;
• invasive cervical cancer;
• previously transferred with the opening of the endometrial (inner) layer of the uterus;
• previous uterine rupture;
• severe fetal heart rhythm disturbances.

A woman should understand that if stimulation is unsuccessful, she will need a cesarean section, and the process itself takes about a day from start to finish.

How labor is induced in the maternity hospital

When a woman enters the prenatal department, the condition of her genital organs is assessed using the Bishop scale:

The cervix is ​​considered not ready for labor induction when the Bishop score is 6 points or less. If labor is nevertheless induced artificially, the likelihood of a surgical completion (emergency caesarean section) increases. It is advisable to wait until the cervix meets the required parameters, and only then use stimulation methods.

If the Bishop score is more than 8, the cervix is ​​well prepared for spontaneous or induced labor.

Cervical preparation

Artificial induction of labor begins with preparation of the cervix if the organ does not meet the norm on the Bishop scale. For this purpose, medicinal and mechanical methods are used.

Medications include the prostaglandins misoprostol (PGE1), dinoprostone - Prepidil and Cervidil (PRE2), the antigestagen drug mifepristone (Ginestril, Miropriston, Pencrofton), as well as the hormone that directly contracts the uterus, oxytocin. In foreign practice, preference is given to prostaglandins - they are convenient to use (tablets and gel, rather than injections and infusions), they do not cause severe side effects.

Misoprostol

This is a synthetic analogue of prostaglandin E1, known as Cytotec. The drug is approved for the treatment and prevention of stomach ulcers. Induction with misoprostol is possible if there is no history of caesarean section.

The drug is available in the form of tablets of 100 and 200 mg. The tablets can be taken orally, buccally, sublingually, or vaginally. But most often, 25 mg of the drug is administered into the vagina every 3-6 hours.

How long does it take for misoprostol to work?

Contractile activity of the uterus begins in the near future, and its maximum occurs 10-16 hours after administration.

Dinoprostone

This is a prostaglandin E2 drug, available under the names:

• Prepidil: gel containing 0.5 mg of active substance in 2.5 ml of gel;
• Cervidil: vaginal suppositories or a special container system containing 10 mg of a slow-release substance (0.3 mg per hour).

Medicines are used to accelerate cervical ripening if the need to induce labor already exists or may arise in the near future.

How is the gel administered to induce labor?

Prepidil is administered every 6-12 hours up to a total dose of 1.5 mg (three injections) during the day. The Cervidil vaginal system is removed from the vagina and replaced with a new one every 12 hours.

Balloon catheterization

Using a Foley catheter to prepare the cervix for labor

This is a mechanical way of stimulating uterine contractility. It is carried out using the following devices:

• Foley catheter No. 16, into which 30-80 ml of saline is injected;
• double-balloon Cook catheter: one balloon is located intrauterinely and has a volume of 40-80 ml, the other is located in the vagina and has a volume of 20-60 ml.

A catheter for inducing labor is used in the following way:

• is installed in place using fingers or mirrors; if necessary, its position is controlled with ring-shaped forceps or ultrasound;
• can remain in the vagina for up to 12 hours;
• the balloon is filled with saline solution and placed over the internal os.

If sufficiently effective, after 12 hours the cervix will mechanically dilate so much that the catheter will be removed spontaneously. After this, an amniotomy is often performed, and if necessary, an oxytocin infusion is started.

The pros and cons of using prostaglandins and catheters are still being studied. So far, scientists have not found significant differences in the effectiveness and safety of both methods.

Mifepristone

In planned cases, labor can be stimulated with Mifepristone. This is an antigestagenic drug that increases uterine contractility. It is prescribed in tablet form - 200 mg per dose once.

How long does it take for Mifepristone to work?

The effect is assessed by the dilation of the cervix one day after administration. If labor is inactive, another tablet is prescribed. When self-opening the amniotic sac, in order to avoid a long water-free interval, the interval between taking tablets is reduced to 6-12 hours.

The final assessment of effectiveness is carried out after 2-3 days; if necessary, activation of labor is continued with prostaglandins or oxytocin.

Oxytocin

This is a synthetic analogue of the female sex hormone responsible for uterine contractility. It stimulates labor by activating receptors that cause calcium to accumulate inside the uterine cells, which increases the force of their contractions. Stimulation by oxytocin during labor also increases the production of its own prostaglandins. The drug is not administered in all cases. Usually, with a well-prepared neck, the process begins on its own. Oxytocin is prescribed for weak labor forces.

This is a less suitable method for women with an unprepared cervix, that is, with low scores on the Bishop scale. Before using oxytocin, it is necessary to use the means listed above to ripen the cervix.

The drug is administered intravenously through a drip or infusion pump until persistent uterine contractions are achieved every 2-3 minutes, that is, it is necessary for development.

Other methods of inducing labor

Hygroscopic (osmotic) dilators (expanders) are used - kelp and Dilapan. They are used mainly to terminate pregnancy, and not to pre-ripen the cervix. These substances are injected into the cervical canal, absorb fluid and mechanically push its walls apart. Compared to the use of prostaglandins, activation of labor in this way entails a risk of bacterial infections in the mother and newborn. In addition, the introduction of such drugs into an unprepared cervical canal is accompanied by unpleasant sensations for the patient.

Extra-amniotic administration of a sterile saline solution is carried out through a catheter inserted into the paravesical space. The method is quite effective, but without advantages over the use of a catheter or prostaglandins.

Amniotomy is the artificial rupture of the amniotic sac surrounding the fetus to induce or accelerate labor. During this procedure, it is necessary to control the flow of fluid with your hand to prevent the umbilical cord loops or parts of the fetal body from falling out.

During a manual examination, the doctor may use his fingers to expand the lower uterine segment, expose the membranes in a circular motion, and slightly separate them from the uterine wall. The procedure can be performed on an outpatient basis in women whose cervix has begun to dilate to speed up the onset of labor. Usually after this, labor begins in the next 2 days. A similar procedure is best performed for women who are 40 or 41 weeks pregnant. It is quite effective, but carries the risk of premature rupture of the membranes and infection of the fetus and uterine cavity.

Measures to take at home

Stimulation of labor at home can be carried out by mechanical irritation of the nipples. This causes a reflex contraction of the muscles of the uterus. Nipple massage should not be used on women with an unprepared cervix. This procedure is less effective than using oxytocin. Natural stimulation is best suited for patients with a prepared cervix, and labor begins within the next 72 hours.

Among the rare or even exotic methods of stimulating labor activity, the following can be noted:

• use of glucocorticoid hormones;
• using castor oil internally;
• administration of hyaluronidase, isosorbide dinitrate;
• acupuncture;
• evening primrose oil;
• herbal preparations;
• sexual intercourse;
• physical exercise.

Physical exercise

Exercises can be performed at home, preferably when precursor contractions or other signs of impending labor already appear, in order to speed up the entry of the baby’s head into the small pelvis. The following types of load are offered:

• walking in a straight line or on stairs;
• swimming;
• preferential squatting position;
• mopping the floor with a cloth;
• picking up matches or buttons scattered on the floor.

Sexual contact stimulates labor quite well. However, the partner must be absolutely healthy so that the infection does not enter the woman’s genital tract.

Complications

The danger for the mother is:

• hyperstimulation of the uterus;
• unsuccessful induction;
• uterine rupture.

Hyperstimulation of the uterus can lead to increased fetal heart rate. This term refers to contractions that develop after stimulation with prostaglandins, exceeding 2 minutes, or if there are more than 5 of them in 10 minutes. Beta-2 adrenergic drugs are usually used for treatment, and in severe cases a caesarean section is required.

In some cases, stimulation does not lead to the desired result. It is important that sufficient time is allowed for adequate cervical ripening and development of uterine contractions. It is believed that under the influence of drugs for ripening the uterine cervix, it opens from 3 to 5 cm within 8-10 hours, and from 5 to 6 cm over the next 4-6 hours.

Even if a woman has only begun the latent phase of labor, stimulation leads to a decrease in the likelihood of a cesarean section. As soon as the active phase begins, it passes at the same speed or even faster than in unprepared patients.

When stimulation is considered unsuccessful:

1. If the cervix was prepared with prostaglandins or using a catheter 1-2 days before using oxytocin.
2. After 24 hours of oxytocin administration, contractions occur less frequently than every 3 minutes.
3. An artificial incision of the membranes was performed, but after this labor did not begin within 12 hours of oxytocin infusion.

In these cases, after discussion with the patient, either continue with the induction attempt or perform a cesarean section.

Uterine rupture during induction of labor is extremely rare. If this complication is suspected, an emergency caesarean section is required.

The adverse consequences of labor stimulation for the child are represented mainly by mechanical damage, for example, prolapse of the umbilical cord. It sometimes occurs when the membranes are artificially ruptured, especially when the baby’s head is high above the entrance to the pelvis. To prevent such a complication, which threatens hypoxia of the newborn, the obstetrician must carefully check the genital tract of the woman in labor, especially after amniotomy.

The risk of all these complications in modern maternity hospitals is extremely small, and the benefits of timely birth of a child (preservation of normal metabolism, absence of poisoning by metabolic products, hypoxia due to an “overripe” placenta) significantly outweigh the danger of adverse events. In addition, obstetricians quickly cope with all such cases, prescribing appropriate treatment for the patient or performing a caesarean section.

Mothers who have already given birth so often talk about stimulating labor, scaring their pregnant friends, that it seems to them that no childbirth can proceed without forcing the process of dilation of the cervix. In fact, childbirth does not have to be “push” very often - according to official statistics, about seven women out of a hundred. How does this happen and why might induction of labor be needed?

The indications for inducing labor are obvious - labor does not begin, although it is long overdue, does not progress once it has begun, or for medical reasons it is necessary for the child to be born ahead of schedule. Stimulation can be natural or artificial.

With natural birth, the expectant mother speeds up the onset of labor with some simple actions. If this happens beyond 40 weeks, doctors most likely will not object. But, of course, you should consult with them first. As for artificial stimulation, it is performed only by doctors and only in a maternity hospital.

Administration of oxytocin

Why is it necessary? Oxytocin is a hormone that is responsible for triggering labor and enhancing the contractile activity of the uterus. Its synthesized analogue is administered to prepare the uterus for dilation if labor does not occur in the case of post-term (more than 42 weeks) pregnancy.

How is it administered? The hormone is administered intramuscularly or subcutaneously by injection.

Advantages and disadvantages. If labor begins, but then labor suddenly stops, oxytocin will start contractions again. But they will be powerful and therefore very painful, so the woman must be given painkillers. There is a possibility of an overdose of the drug, and some women may develop increased sensitivity to it.

When should it not be used? In case of placenta previa, abnormal fetal position, narrow pelvis and other pathologies that complicate natural childbirth. Oxytocin should not be used after a previous cesarean section when there is a scar on the uterus.

Administration of prostaglandins

Why is it necessary? In order to release the baby without injury, the cervix must ripen before birth - become soft, elastic, begin to stretch and open. If the due date has arrived, but the cervix is ​​not yet ready, its maturation is accelerated by prostaglandins - analogues of the hormones responsible for this process.

How is it administered? Gel or suppositories containing prostaglandin are injected deep into the vagina and cervical canal.

Advantages and disadvantages. The advantage is that prostaglandins do not penetrate the amniotic sac and do not affect the baby in any way. In addition, even with the drug administered, the woman is not limited in her movements in any way. But at the same time, prostaglandins can slow down the transition to the active stage of labor. Some women experience intolerance to the drug, resulting in headache or vomiting.

When should it not be used? Like any stimulation of labor, the introduction of prostaglandins should not be used when a woman has endocrine disorders, diabetes mellitus, after a cesarean section, or when vaginal delivery is impossible due to abnormal position, size of the fetus or deteriorating state of its health.

Amniotomy - puncture of the amniotic sac

Why is it necessary? A puncture of the amniotic sac is done when the pregnancy is postterm, when the condition of the placenta worsens and, as a result, there is a high risk of developing hypoxia in the child. An amniotomy can also be performed when a woman quickly develops gestosis - in this state, the rupture of water speeds up the process and alleviates the condition of the woman in labor, simultaneously preventing labor complications that can develop in the case of prolonged labor. Sometimes the indication for amniotomy is the risk of developing Rh conflict.

How do they do it? The operation is completely painless and safe, but, like any other operation, it is performed only by an experienced doctor and only for medical reasons. A special hook is inserted into the vagina, the amniotic sac is grabbed and opened, which causes the amniotic fluid to leak.

Advantages and disadvantages. The rupture of amniotic fluid starts the process and intensifies contractions. But sometimes contractions may not come even after this manipulation, and the water-free period should not last more than 12 hours. So women in labor will sometimes need the same oxytocin to still stimulate labor. In addition, if you do an amniotomy without compelling indications, the process can only be slowed down. The anterior waters, which are located above the baby's head in the amniotic sac, are a wedge that gently opens the cervix from the inside. Normally, water flows out only after the cervix is ​​almost completely dilated and the baby is ready to be born.

When should it not be used? Amniotomy can be performed only after the baby’s head has passed into the pelvis, compressing the amniotic sac and the vessels located on its surface. If the puncture is made earlier, there is a high risk of bleeding and prolapse of the umbilical cord, as well as infection.

Long walks, mopping floors without using a mop, and running up and down stairs are the most common methods for natural labor stimulation among expectant mothers. The most physiological way is walking.

How do they do it? During a long walk, the baby puts pressure on the cervix, which causes it to begin to open. Other active actions also contribute to this. However, the expectant mother should avoid extreme loads; they should be feasible and light.

Advantages and disadvantages. The method only works if the cervix has already begun to prepare for childbirth - to soften and smooth out. In addition, it is difficult for a woman who wants to give birth “as soon as possible” to refrain from overexertion, and washing floors in a half-bent position and conquering skyscrapers without the help of an elevator clearly belongs to them. All such actions can cause premature placental abruption!

When should it not be used? For gestosis and other complications of pregnancy, for indications for cesarean section, for up to 40 weeks of pregnancy, for chronic diseases not related to pregnancy.

Sexual intercourse

Why is it necessary? Semen contains natural hormones, prostaglandins, which soften the cervix, and orgasm promotes its muscle contractions. Massaging the breasts (especially the nipples) increases the level of oxytocin in the blood.

How do they do it? In the old fashioned way and taking into account the interesting position of the mother: a pregnant woman should not feel pain, but be comfortable and pleasant.

Advantages and disadvantages. What if the couple doesn’t want anything at all? Then the spouses will have to give up sex (and the woman will only have to go for a long walk). As for nipple massage, it’s not so simple either: in order for it to work, it needs to be done three times a day for 10-20 minutes. Not everyone is able to withstand such foreplay.

When should it not be used? The most obvious is if one of the partners has an STD. After all, contact protected by a condom may be pleasant, but it is an almost meaningless “stimulant”. If the couple was prescribed complete sexual rest during pregnancy, they should also consult a doctor.

Sometimes women resort to natural (but unconventional) methods of inducing labor such as acupuncture, aromatherapy and homeopathy. We must remember that, like any other medical procedure, stimulation of labor can be beneficial or harmful, especially when it is done unjustifiably and illiterately.

Comment on the article "Induction of labor: 5 methods. Drug administration or sex?"

Discussion

What do you mean by stimulation - oxytocin? it gives continuous contractions, which are not only difficult for the mother, but also for the child, as he experiences constant and excessive compression for which he may not be ready. Natural contractions are always softer and intermittent.
opening the bubble? The cervix does not always open after it; often the entire ECS ends. or it opens, but the tissues are not elastic enough, hence ruptures and/or episiotomy. By the way, in cases of premature birth they almost always do an episiotomy, although the babies are tiny, but the tissues are not ready yet.
It’s better to prepare for childbirth and give birth when the time comes. You can always monitor the condition of the baby, umbilical cord and placenta using additional ultrasounds.
I gave birth at almost 41 weeks, a large baby 4250g, without tears or incisions. I was preparing for childbirth, breathing correctly, pushing correctly, helping my baby, and he helping me. I wish you an easy natural birth too:)

Now half of the children, if not more, have hypoxia without any walking or stimulation. Plus, not every woman will agree to stimulate and for this you need to go to the maternity hospital in advance, and there is not always room there. Everything is individual

Induction of labor without indications.... Medical issues. Pregnancy and childbirth. Induction of labor without indications... Almost a horror story, but knowing is better than not knowing!!!

Discussion

So, Arisha and I were very lucky... We had piercings, and she had hypoxia, and a huge headache...

perhaps that is why in most RDs they are now waiting until the victory and do not stimulate. I was actually surprised when I started reading this conference that so many people were being stimulated. I remember last time, the doctor very clearly told me that now they are trying not to interfere, when there are no more options...

Labor with stimulation. Zamyatnina Tatyana. Stimulation of labor. This is exactly the sex I have with my firstborn >. methods of natural stimulation of labor: 1. walk high, lifting...

Stimulation before childbirth. Medical issues. Pregnancy and childbirth. At the moment I have been in the maternity hospital for 41 weeks and they decided to give me stimulation.

Discussion

reflected - maybe. An acquaintance reached 42 weeks and gave birth to a boy of 3500 (the girl herself is tall and big) - without stimulation.
If there is no “crime” - aging of the placenta, meconium in the water, etc. - then you probably shouldn’t be stimulated. IT ITSELF knows best - when...

I was stimulated after my water broke. A drip with an analogue of oxytocin, just called differently. The only effect of it was that it was painful, and there were no effective contractions to open the cervix.

Natural stimulation. I’m already 38 weeks old, the baby weighs 3350g. And the doctor is going on vacation for the duration of my birth. Tell me how to persuade the baby to be born quickly.

Discussion

you can't persuade

You should not induce labor until at least 40 weeks. Once it begins, you can use natural methods that will not harm, but will only tune the body to the process.

Dosed physical activity after 40 weeks - yoga, Nordic walking, breathing exercises and exercises on a gymnastic ball are very useful, but only with the permission of a doctor. You can simply do some general cleaning or walk up and down the stairs.

If physical activity causes severe malaise, fatigue, swelling, increased blood pressure or other unpleasant symptoms, you should reduce its intensity or even abandon it to avoid more serious consequences.

Sex is especially useful on the eve of childbirth for two reasons:

• A man's semen contains prostaglandins, which have a positive effect on the cervix. Under their influence, it softens, shortens, and opens.

Nipple stimulation on the chest sends signals to the brain to release oxytocin, the level of which quickly increases in the blood. It is also useful for preparing the body for childbirth. It is recommended to irritate both nipples alternately or together several times a day for 3-5 minutes.

The nerve plexuses of the intestines and uterus are interconnected. Irritation of some leads to activation of others. This can be used to “wake up” the uterus. It is recommended to include the following foods in your diet:

• pineapple fruit;
• garlic cloves;
• hot spices - pepper, etc.;
• liquorice root;
• vegetables – cabbage, carrots, beets;
• raspberries are suitable for berries;
• caraway oil or tea.

There are active points, massage which will also be favorable for the onset of labor. It is recommended to do this several times a day for 3-5 minutes. Here are the two most commonly used points:

Can be used at home device for DENAS therapy, influencing the abdominal area, cervical-collar area.

Homeopathy medications will help based on Pulsatilla and Caulophyllum. However, they should be used only as prescribed by a homeopathic doctor or at least a gynecologist.

Indications for induction of labor in the maternity hospital:

• post-term pregnancy - after 41 weeks;
• if there is no need for a caesarean section;
• complications of pregnancy requiring delivery in the absence of labor, for example, with oligohydramnios, suspicion of some malformations in the fetus;
• somatic diseases of a woman that require earlier delivery, for example, cardiovascular pathologies.

Mother's assessment upon admission to the maternity hospital using the Bishop scale

Conditions for holding:

• live fruit;
• absence of significant bleeding from the genital tract, detachment;
• the size of the fetus and the woman’s pelvis corresponds to the normal course of natural childbirth;
• readiness of the birth canal for the onset of contractions, especially for the cervix - its length should be no more than 2 cm and the opening should be no less than 1.5-2 cm.

• After stimulation, contractions are somewhat more painful, so additional pain relief is often required.
• More than 1/3 of inductions ultimately result in a caesarean section. "
• The incidence of complications such as weak contractions, placental abruption, fetal hypoxia, and injuries to the birth canal of the woman and child is higher during induced labor than during natural labor. However, the use of drugs and some methods is carried out on an initially abnormal pregnancy.
• All medications reach the fetus. The baby still experiences a lot of stress in utero.

Methods of inducing labor:

• Amniotomy. This is a stimulation method as close as possible to the physiological process. It can be performed both before the onset of contractions and during them. When performing an amniotomy, the membranes of the fetal bladder are opened with a special instrument. At this moment the front waters pour out. By their number, color, smell, one can judge the intrauterine state of the baby. This is a painless procedure that is performed on a gynecological chair.

• Cook's catheters(you can replace them with regular urine ones if you don’t have them). The doctor inserts a catheter into the cervical canal up to the internal os and fills its end with saline solution. A part of the catheter remains outside and hangs freely. For convenience, it is attached to the pregnant woman’s thigh. Thus, the filled catheter puts pressure on the cervix, promoting its structural changes. The catheter is installed for 12 hours, after which it is removed. Sometimes it can fall out on its own - this means that the cervix has opened to such an extent that it can no longer hold it. Typically, additional stimulation methods are required after catheter placement.
• Laminaria– pressed seaweed. Kelp is introduced into the cervical canal and left for 8-12 hours, after which it is removed. During this time, they gradually swell as they are in a moist environment, exerting mechanical pressure on the cervix and leading to its opening.

Using kelp to dilate the cervix

Stimulation drugs in the maternity hospital:

• Prostaglandins. In addition to stimulating contractions, they promote transformation of the cervix, therefore they are used when the birth canal is not yet completely ready for childbirth (for example, a long or tight cervix, a small opening). The effect is mild, contractions are not so painful.
• Oxytocin. It is used if the cervix is ​​already ready for contractions, since the drug only stimulates its contractions. It is administered intravenously or via lineamate, a special device that regulates the rate at which the drug enters the bloodstream.

• Desaminooxytocin. It is usually used to stimulate contractions during pushing or as an addition to basic medications. The drug is not used alone to induce labor, as it is difficult to dose and control contractions, and it is less effective compared to other drugs.

If oxytocin drugs, prostaglandins are used, and an amniotomy is performed, then three hours are given for the development of effective labor. After this time, if it is insufficient, other drugs can be added, or some drastic decision is made, for example, indications for a cesarean section are identified.

Read more in our article about inducing labor in the maternity hospital.

Read in this article

Methods of natural stimulation of labor

Once the 37th week has arrived, you don’t have to worry about labor starting. But you shouldn’t try to stimulate labor, as there may still be almost five weeks ahead—day 42, inclusive.

After the 40th week has arrived, you can think about methods of natural stimulation of labor. They definitely won’t harm, but can help the body tune in to the birth process.

Dosed loads are useful throughout pregnancy. They will help control body weight and make the body more resilient. After 40 weeks, it is still possible and beneficial to do yoga, Nordic walking, breathing exercises and exercises on a gymnastic ball. But this is all with the doctor’s permission and if the pregnancy proceeds physiologically. Any deviations may result in a ban on this type of activity.

If you don’t want to do any special exercises, you can simply do some general cleaning at home or walk up and down the stairs, for example, if a pregnant woman is in the hospital.

Expert opinion

If physical activity causes severe malaise, fatigue, swelling, increased blood pressure or other unpleasant symptoms, you should reduce its intensity or even stop altogether to avoid more serious consequences.

Sexual contact

Sex is allowed throughout the entire gestation period if the pregnancy proceeds without complications. Intimate relationships on the eve of childbirth are especially useful for two reasons:

• A man's semen contains prostaglandins, which have a positive effect on the cervix. Under their influence, it “prepares for childbirth” - it softens, shortens, and opens. This effect is possible only with a certain hormonal background of a woman, so you should not be afraid of sexual intercourse until a full-term pregnancy.
• During arousal, oxytocin is released in a woman's body. It promotes contraction of the uterus, which will thus prepare for real contractions.

Watch this video about whether sex will help speed up labor:

Nipple stimulation on the chest

The areola areas of the breasts are very sensitive. When they are irritated, signals are sent to the brain to release oxytocin, the level of which quickly increases in the blood. It is also useful for preparing the body for childbirth.

Special diet

The nerve plexuses of the intestines and uterus are interconnected. Irritation of some leads to activation of others. This can be used to “wake up” the uterus. It is recommended to include the following foods in your diet:

• pineapple fruit;
• garlic cloves;
• hot spices - pepper, etc.;
• liquorice root;
• vegetables - cabbage, carrots, beets;
• raspberries are suitable for berries;
• caraway oil or tea.

Acupuncture and similar methods

There are active points, massage of which will also be favorable for the onset of labor. Here are the two most commonly used:

• on the palmar surface of the hands between the thumb and index finger;
• outside the ankle at a distance of 5-7 cm from the “bone” upward.

You can also use such a device for DENAS therapy at home, affecting the abdominal area and the cervical-collar area.

Herbal infusions and decoctions

Plants can also help stimulate labor. The most commonly used are the following:

• nettle;
• ergot;
• shepherd's purse;
• barberry.

Recipes can be for preparing infusions, tinctures, and decoctions. Sometimes it is recommended to add castor oil to the prepared solutions or make microenemas with it. It irritates the intestinal walls, and this in turn leads to reflex stimulation of the uterus. However, it should be borne in mind that castor oil can provoke intestinal colic.

Other methods

Homeopathy medications are also used to stimulate contractions. For example, based on Pulsatilla and Caulophyllum. However, medications should be used only as prescribed by a homeopathic doctor or at least a gynecologist.

Indications for induction of labor in the maternity hospital

After 40 weeks, and in some cases even earlier, women are sent as planned to the maternity hospital for hospitalization, where doctors draw up a plan for future labor and determine its time, if it has not occurred before this point. The main indications for inducing labor are as follows:

• post-term pregnancy - after 41 weeks;
• gestosis, if there is no need for a cesarean section;
• complications of pregnancy that require delivery in the absence of labor, for example, stimulation is often used for polyhydramnios and oligohydramnios, suspicion of some malformations in the fetus;
• somatic diseases of a woman that require earlier delivery, for example, diabetes mellitus, cardiovascular pathologies.

Conditions for holding

Any method of inducing labor is used if there are conditions from the obstetric situation for implementation. They are as follows:

• live fruit;
• stable, controlled condition of the woman;
• absence of significant bleeding from the genital tract;
• the size of the fetus and the woman’s pelvis corresponds to the normal course of natural childbirth;
• readiness of the birth canal for the onset of contractions, especially for the cervix - its length should be no more than 2 cm and the opening should be no less than 1.5-2 cm.

Advantages and disadvantages

Almost all women are quite categorical about any kind of stimulation of contractions, as they consider it a non-physiological process. Indeed, each method has its own advantages and disadvantages.

The advantages of inducing labor include the following:

• it is possible to reduce the duration of labor;
• in case of weak contractions, they become stronger, which prevents possible suffering of the fetus, and the risk of complications for the woman becomes less;
• This way, in many cases, a caesarean section can be avoided.

The disadvantages of the procedure are the following:

• After stimulation, contractions are somewhat more painful, so additional pain relief is often required. This is due to the fact that during natural childbirth without the use of any drugs, the muscle fibers do not contract all at once, but one at a time. When stimulated, it immediately affects more than 50% of the myometrium, which sometimes even provokes unbearable pain.
• More than 1/3 of inductions ultimately result in a caesarean section. “Forced fights” are not always productive. After long trials with contractions, a woman can be operated on for various indications, ranging from ineffective stimulation to bleeding, acute hypoxia, etc.
• The frequency of complications such as weak contractions, placental abruption, fetal hypoxia, and injuries to the birth canal of the woman and child is higher during induced labor than during natural labor. However, it should be noted that the use of drugs and some methods is carried out in an initially abnormal pregnancy - after all, labor is induced if there are some indications for this.
• All medications used to enhance uterine contractions reach the fetus. The baby still experiences a lot of stress in utero.

According to scientific data, drug-induced labor several times often have the following consequences:

• placental abruption during childbirth;
• fetal hypoxia (lack of oxygen);
• serious injuries to the birth canal;
• often end with a cesarean section.

Considering that any stimulation of labor has not only advantages, but also significant disadvantages, in each case one should take a differentiated approach to determining the indications.

Watch this video about what stimulation of labor leads to:

Methods of inducing labor and how it all happens

There are many stimulation options. In each case, it is necessary to choose the most optimal, “soft” one - this is the doctor’s task.

Amniotomy

This is a stimulation method as close as possible to the physiological process. It can be performed both before the onset of contractions and during them. The role of the amniotic sac is important until approximately 6-7 cm of cervical dilatation; it works “like a wedge”, exerting gentle pressure on the cervix, causing it to open.

When performing an amniotomy, the membranes of the fetal bladder are opened with a special instrument. At this moment the front waters pour out. By their number, color, smell, one can judge the intrauterine state of the baby. Amniotomy is a painless procedure that is performed in a gynecological chair.

What kind of catheter is used

The essence of this effect is as follows:

• The doctor inserts a catheter into the cervical canal to the internal os and fills its end part, which expands into a balloon, with saline solution.
• A part of the catheter remains outside and hangs freely. For convenience, it is attached to the pregnant woman’s thigh.
• Thus, the filled catheter puts pressure on the cervix, promoting its structural changes.

The catheter is installed for 12 hours, after which it is removed. Sometimes it can fall out on its own - this means that the cervix has opened to such an extent that it can no longer hold it.

Expert opinion

Daria Shirochina (obstetrician-gynecologist)

Before installing the catheter, two hours later, and immediately after its removal, it is necessary to record a CTG (fetal heartbeat) to prevent possible complications.

After the catheter is removed, the issue of further stimulation is decided. Rarely do women experience spontaneous contractions; additional methods are usually required. For example, if the result is good and the cervix is ​​open, an amniotomy is performed. Prostaglandins, oxytocin and other stimulants may be prescribed.

Laminaria

They are compressed algae. They have an effect similar to a catheter. Kelp is introduced into the cervical canal and left for 8-12 hours, after which it is removed. During this time, they gradually swell as they are in a moist environment, exerting mechanical pressure on the cervix and leading to its opening.

A drug

This is a hormonal drug, available in the form of tablets for oral administration and placement into the vagina or rectum, a gel for vaginal or cervical use, and a solution for intravenous infusion.

Prostaglandins, in addition to stimulating contractions, promote the transformation of the cervix, therefore they are used when the birth canal is not yet completely ready for childbirth (for example, a long or tight cervix, a small opening).

The effect of prostaglandins is milder, contractions are not as painful.

How long will it take for it to work?

Each case of labor stimulation has its own criteria by which one can judge whether the method works or not.

If oxytocin drugs, prostaglandins are used, and an amniotomy is performed, then three hours are given for the development of effective labor. After this time, an examination is carried out and the effectiveness of stimulation is assessed. If it is insufficient, other drugs can be used, or some drastic decision is made, for example, indications for a cesarean section are identified.

The effectiveness of installing a cervical catheter and laminaria is assessed by structural changes in the cervix. If she is already ready for real birth, further stimulation is carried out, but with medications.

Useful video

Watch this video about stimulating labor in the maternity hospital:

Each new day of pregnancy brings a woman closer to meeting her already beloved baby. And with each new day, the woman awaits this meeting with greater impatience, preparing in every possible way for the birth of the baby. But the cherished “day X” seems to have arrived, according to doctors’ forecasts, the baby should already make itself felt... But for some unknown reason, this is not happening.

Often, in connection with the expectant mother, it is suggested that she go to the hospital for artificial diarrhea. But not every woman will consider such a step necessary, preferring to stimulate labor without the use of medications. And in this case, inducing labor at home can play a very, very good role. It turns out that there are many ways to stimulate using this method. Some of them are more effective, some less, but all of them, when used correctly, are harmless and can still bring results.

One of the “pleasant” ways to stimulate labor at home can be long walks in late pregnancy. By walking 2 hours a day or more in the fresh air, a woman simultaneously receives a “portion” of health, maintains physical fitness, and maintains a good mood.

The same effect is ensured by physical activity: morning exercises, light gymnastics, dancing - all this, in general, can also be attributed to methods of stimulation at home. To speed up childbirth, it is advisable to abandon the elevator: it is useful for a mother who is “waiting” for her child to, as a stimulation of labor, climb to her floor on foot on the stairs, stepping over two steps and raising her legs as high as possible.

After a long walk, you can take a warm bath, a warm or contrast shower, apply a warm compress to the lower back, because all this is also stimulation of labor at home. A warming soft massage of the lower back and an iodine mesh, again, in the lumbar area, are also suitable.

A warm bath or shower, in turn, inspires the pregnant woman to do something pleasant and, if there is a delay in meeting the baby, even something useful - sex. Why useful? Yes, because sex is a great way to try to speed up labor. The whole secret is that sperm contains a special component - the hormone prostaglandin, which helps soften the cervix and prepares it for childbirth. An additional method of stimulation is a gentle massage of the nipples - this can also be done during sex. In the process of stroking the nipples, another hormone is produced -. It, in turn, causes uterine contractions and is considered a good antidepressant.

To bring the due date closer, it is advisable to adjust the diet. Thus, the presence of large quantities of fresh vegetables is welcome - both in their usual form and in the form of salads. At the same time, it is better to season salads with vegetable oil: vegetables, due to the presence of fiber, will improve intestinal motility, and oil will help soften the uterus. The use of raspberry leaf tea can be useful in stimulating labor: 2-3 glasses daily, starting from 34-36 weeks of pregnancy. At the same time, you can start using evening primrose oil - it contains a large amount of fatty acids and promotes the production of prostaglandins. To stimulate labor at home, it should be taken in capsules that are sold in pharmacies.

And, of course, for the speedy birth of a baby, you need to communicate with him as often as possible, talking about your love for him and your desire to meet him soon. Psychologists say: already in the womb, the baby recognizes the voice and intonations of the future parents, “listens” to the words, even if he does not understand them. Therefore, the care and attention shown to the child verbally will certainly “affect” his desire to meet his mom and dad as soon as possible.

Especially for- Tatyana Argamakova

Every expectant mother expects her baby to be born at exactly the appointed time. Carefully preparing for this day. Perhaps he even chooses a name according to the church calendar. But then the cherished day comes, and... Nothing?

After 40 weeks doctors insistently suggest that mommy go to the hospital for artificial stimulation of labor. The word itself is not very pleasant, and the procedures carried out in the hospital are even more so. They put kelp, they introduce a special gel, give hormonal pills... Women who experienced this in their first pregnancy, as a rule, stay at home the second time until contractions. But those who give birth for the first time can easily afford it.

Main principle waiting at home - confidence in the child’s safety. To do this, it is enough to go through 1-2 times a week CTG (cardiotocogram) fetus. She will show if the baby has oxygen starvation whether he is getting enough nutrients. You can undergo an additional ultrasound to see degree of maturity of the placenta, state of amniotic fluid. In addition, it is worth asking about the birth history of your relatives (mother, grandmothers, sisters, aunts). They may also have given birth after 40 weeks - then you have genetic predisposition to post-term pregnancy, and there is no need to worry too much. And if everything is fine, you can wait for hospitalization for now. And get busy natural stimulation of labor.

Principle two– do things that were not allowed during pregnancy (or in recent months). Not all of course, but a lot. The most effective thing is to renew intimate life with husband.Male sperm contains prostaglandin, the same hormone on which the stimulating gel used in maternity hospitals is created. It will soften the cervix and gently prepare it for childbirth. Kissing and gentle stroking of the breasts during sex help produce another hormone, oxytocin, which causes contractions of the uterus and is also antidepressant. Additionally, having sex simply helps increase blood flow in the lower abdomen, which in turn tones the uterus and will help induce contractions.

Physical exercise at this time are also very useful. This does not mean, of course, that you can lift weights in the gym or jump until you’re blue in the face in aerobics. Here's the classic one charger or simple Eastern dance- that's it. Personally, during second pregnancy I just carried my eldest son in my arms more often. And the most effective method is considered to be the method of our grandmothers called “ washing floors» . You can use a mop, but it’s better to use your hands. Very effective. Climbing stairs up and down is also a very useful stimulating exercise. And in general it costs more often hike-and will help to bring the due date closer and maintain physical fitness.

Various warming procedures are also effective, also aimed at increasing blood circulation: pepper patch on the lower back, iodine mesh on the lower back, very warm(almost hot) or cold and hot shower or bathhouse.

Lovers folk remedies I recommend drinking a tablespoon castor oil. Castor oil, which has relaxing properties, will help the cervix open faster. Thanks to it, you will also cleanse your intestines and be able to avoid a not very pleasant hospital procedure. But this rather refers to emergency measures. In general, you can start a kind of stimulation in advance by slightly adjusting your diet: if you include more fiber-rich foods in your diet (cabbage, beets, fresh vegetable salads), due to increased intestinal motility, the uterus will also contract. Salads are best seasoned with vegetable oil.

In order to speed up the process of cervical ripening, from 34 weeks of pregnancy you can start taking evening primrose oil, which is sold in capsules in almost any pharmacy – 1 capsule per day. It is rich in fatty acids and promotes the production of prostaglandins. You can start taking the oil later: from 36 weeks - two capsules and three - from the 39th. Raspberry leaves are also considered an excellent remedy for approaching labor. It is recommended to brew them and drink 2-3 glasses a day, starting from 34-36 weeks of pregnancy. Raspberries soften the ligaments around the birth canal, which promotes uterine contractions and also reduces the risk of ruptures during childbirth. Just make sure that before taking any herbal remedies and oils you should: consult a doctor who is seeing you in a consultation or medical center; Find out about possible side effects, and then choose the method that’s right for you.

Psychologists give their advice for expectant mothers: be sure to talk to your baby, talk about how everyone loves and waits for him, stroke his belly, make the baby want to meet his mother as soon as possible. Rest assured that everything will be fine.

And the most important thing! Not a single woman has ever remained pregnant forever. If you and your baby are feeling well, don’t rush! Everything has its time. The baby himself determines the day and hour of his birth.