Stimulation of childbirth. Natural induction of labor

Induction of labor is a measure to accelerate the onset of labor. It happens medical, that is, it is carried out in a maternity hospital, and independent. The latter represents the actions that the expectant mother herself performs in order to speed up the process. Natural stimulation of labor is possible if the doctor gives the go-ahead, and the pregnancy is full-term. In the maternity hospital, doctors will carry out any actions only if the pregnancy is post-term and there are no contraindications for natural delivery.

Why Women Decide on Natural Labor Induction Methods

We will give just a few of the reasons.

1. Protein in the urine and periodic increase in blood pressure. These are well-known symptoms of incipient preeclampsia - a severe pathology of pregnancy, dangerous for both the mother and the baby, the treatment of which is only childbirth. Meanwhile, true preeclampsia is a contraindication to certain types of stimulation. For example, at high pressure, the administration of oxytocin is contraindicated. Yes, and self-stimulation of childbirth is also not safe. It is possible to provoke an untimely, too early separation of the placenta.

2. They are afraid of the birth of a child that is too large, more precisely, birth injuries, ruptures of the perineum and cervix. In this case, there are indications for inducing labor only if the mother has a narrow pelvis. It happens that doctors say that you will give birth to a child with such a weight, but with this it is no longer. Although in this case, not even the weight plays a role, but the circumference of the head. If she is 36 cm or more, problems may arise. However, if at 32-34 weeks a tendency to a large fetus was set, this does not mean at all that this trend will continue to the birth. It often happens that a woman has a large belly, and a large fetus was previously placed, and an ordinary, average baby weighing 3300-3500 grams is born. That is, natural stimulation of labor carried out at home at 40 weeks is not required at all.

3. Feel bad: there are problems with sleep, lower back hurts, leg cramps tormented, frequent going to the toilet, tachycardia, etc. But this is not a reason to hasten the onset of labor. Just a little more patience. Then you will miss your pregnancy.

4. The expected date of delivery has arrived. Not all women give birth on this day. Childbirth at 41 and even at 42 weeks is considered the norm, if there are no signs of a prematurity of the fetus. They are detected by ultrasound and CTG.

5. False contractions often appear, but they do not turn into true ones. Braxton Higgs contractions in some women occur from 20 weeks ... This is not an indicator that labor is about to begin. But not a reason to induce labor itself.

6. There are no symptoms of impending labor. In fact, some women do not have any precursors until the very contractions. For many, the mucous plug only comes off during contractions, then the stomach drops. Well, the “cleansing” of the body is generally a very subjective sign of an early birth.

7. I want to give birth on a certain day or, conversely, not to give birth, for example, on a holiday. Childbirth is triggered not so much by the mother's body as by the child himself, when he is ready for them. Many mothers worry that giving birth on the holidays is not safe. Allegedly, doctors and midwives will celebrate, drink, and they will not care about women in labor. This is not true. Ordinary horror stories. A child born on a holiday will probably even be proud of his date of birth.

Natural Ways to Induce Labor: An Overview of Techniques

1. Primrose oil and other remedies from naturopaths and herbalists. It is taken orally, in the form of capsules, a dietary supplement sold in a pharmacy, at a dosage of 500-2000 mg per day. Primrose oil is also used as a lubricant for perineal massage. Massage is recommended for all nulliparous women, as it is a kind of prevention of perineal ruptures during childbirth, improving elasticity. It is necessary to pull it down with 2-3 fingers. There should be no pain, you need to do it very carefully.
Primrose oil is said to contain prostaglandins, which is why it is so effective.

2. Various "laxative" techniques. The most popular is castor oil. Recommended dosages from experienced mothers and doctors vary. Someone says that you need to drink the whole vial, and someone - that two tablespoons is enough. Read the instructions or ask your doctor.

Why give yourself diarrhea at all? Of course, this is not the point, but the activation of intestinal motility. The intestines, in turn, will tone the uterus.

You can use an enema with water or glycerin suppositories for the same purpose. It is very good to eat foods with a laxative effect, such as cabbage, beets, cucumbers, prunes, vegetable oil, etc.

3. Physical activity. Walking up and down stairs is usually advised, but walking on level ground will do. The main thing is to be more upright so that the fetus quickly sinks deeper into the pelvis and thereby stimulates the opening of the cervix.

4. Sex. Without a condom and with the obligatory strong excitement and orgasm. This will bring the uterus into hypertonicity, and the sperm will contribute to the rapid maturation of the cervix, as it contains prostaglandins - substances that are used even in maternity hospitals to stimulate labor. The effect of one sexual intercourse is unlikely to be. It will take more than one day of active sex life.

5. Conversation with an unborn child. Tell him how you and all your relatives are waiting for him, love him, how much you bought for him, how you prepared. Even doctors agree that such conversations are effective.

6. Meditation and taking sedatives (valerian tablets). Stop waiting for childbirth, pay attention to any little thing, and they will begin faster. Relieve stress.

7. The so-called exercises that stimulate the onset of childbirth. The simplest is squatting or mopping on all fours.

8. Obstetric cocktail. There are different folk recipes, but they all boil down to the fact that a generic cocktail (not necessarily liquid, it can be a salad, for example) should contain substances that promote the maturation of the cervix and have a stimulating effect on intestinal motility. One American café even has a "labor-inducing salad" on the menu.
The labor-inducing foods include ginger, pineapple, licorice, eggplant, pepper, vinegar, and cinnamon.

9. Stimulation of the nipples with hands and a breast pump. You can simply massage the chest in a circle. But it is more effective to take a breast pump and try to "pump". This will lead to a very active production of oxytocin and will tone the uterus. If you notice colostrum - it's not scary. The mammary glands have long been prepared for breastfeeding.

Artificial stimulation of labor

Doctors often observe two trends among women with full-term pregnancies:

• simple, in terms of assistance and effectiveness of manipulations - when there are all obstetric harbingers of the imminent birth of a child, but the uterus is calm, there is no hypertonicity;
• more complex - when the birth canal is not yet ready, that is, the cervical canal is tightly closed and has a length of more than 3-4 cm according to the results of a manual examination by a gynecologist and (or) ultrasound using a vaginal probe.

In the first case, to provoke labor, doctors perform an amniotomy or puncture of the amniotic sac. The anterior waters recede, the fetus descends lower into the pelvis. Contractions appear within 1-2 hours. If there are no contractions, they put a dropper with oxytocin for the entire period of contractions and attempts. Oxytocin provokes active contractions.

If the cervix is ​​not ready, the bladder will not be punctured, first by introducing a special gel or medication, by mifepristone tablets, the cervix is ​​prepared for opening. It should become shorter and softer. With a small opening, an amniotomy is performed and, if necessary, oxytocin is administered.

Many women are very afraid of the puncture procedure and the so-called manual separation of the membranes. But this is not scary at all, does not cause pain and, of course, does not require anesthesia. Much more unpleasant are frequent examinations of the cervix in the process of its gradual opening and other obstetric manipulations.

Stimulation can be artificial or natural, it is not so important what prompted the onset of labor. The most important thing is that they pass quickly and without injury.

Doctors have been studying the technology of stimulating labor and its effect on the body of the mother and child for a century. What is labor induction? Medical rhodostimulation is one of the controversial procedures and suspected of all sins. Who needs it and why, except for doctors who allegedly want to finish the birth as soon as possible? Stimulation of childbirth - why is it needed? Stimulation of labor is needed when labor is weak, when labor has already begun, there are contractions, but they are weak, the cervix opens slowly. Labor induction is an artificial evocation childbirth at various stages of pregnancy. Stimulation childbirth performed mechanically (Foley catheter) or using an intravaginal hormonal gel.

Labor induction- this is an artificial induction of labor at various stages of pregnancy and the activation of labor activity already during childbirth. First of all, we note that urgent childbirth (childbirth on time) occur between 37 and 42 weeks. And with normally flowing childbirthstimulationchildbirth not required.

Nature is designed to childbirth started at 39-40 weeks of gestation. But sometimes it happens that childbirth late ... After 40 weeks, the doctors insistently suggest that mommy go to the hospital for artificial stimulationchildbirth.

Labor induction is used only as a last resort, when something threatens the child or his mother. Also, if you are overstaying your due date and still aren't going into labor, doctors may suggest induction. From some of the reasons leading to "overwear", and hence to stimulation, you can get rid of yourself, without resorting to the help of doctors. For example, the fear of childbirth, as well as the use of drugs, including painkillers, can lead to artificial stimulation.

All methods of stimulation can be divided into two types, which stimulate the ability of the uterus to contract, and which accelerate the process of opening the cervix. Stimulationchildbirth is a fairly common procedure in modern maternity hospitals. Sometimes with a normal start generic activity, there is a weakening or complete attenuation of contractions. And with normally flowing childbirthstimulationchildbirth not required. Medical stimulationchildbirth At home, labor induction (in the absence of an experienced obstetrician-gynecologist nearby) is contraindicated.

Amniotomy- opening the fetal bladder, is one of the most popular means that affect the active contraction of the uterus. The essence of this method of stimulation lies in the fact that the doctor pierces the fetal bladder with a special tool similar to a hook, after which the water leaves. After that, the pressure inside the uterus drops sharply, the child begins to put pressure on the pelvic bones, the cervix opens and provokes childbirth. This method is considered safe, and it does not affect the child's condition in any way. In addition, an amniotomy is an absolutely painless procedure, and only in rare cases it may not be particularly pleasant. It is worth considering that for medical reasons, this stimulation can be resorted to only after the baby's head enters the small pelvis. Otherwise, you may need a drug to stimulate contractions. Now, for these purposes, Oxytocin is used in medicine.

Oxytocin is an analogue of a hormone produced by the pituitary gland. The action of this drug is aimed at stimulating the contractions of the muscular tissues of the uterus, but does not affect the readiness, for disclosure, of the cervix. It is mainly administered intravenously, although there are also solutions for intramuscular injections, and even tablets. When exposed to oxytocin, labor pain increases, so it is used together with antispasmodics. For each woman, doses are selected individually. The action of oxytocin is based on its ability stimulate contraction of the muscle fibers of the uterus.

Prostaglandins- hormones that affect the readiness of the cervix to dilate. These hormones are found in large quantities in seminal fluid and amniotic fluid. For artificial stimulation, prostaglandin suppositories and gels are used, their action is also aimed at stimulating uterine contractions.

The decision on the need for stimulation is made by the doctor, taking into account the conditions of the course of pregnancy.

The 40th week is approaching, but the birth does not begin in any way, or maybe they don’t want to continue, what should I do? Whether it is necessary to resort to excitation or stimulation of childbirth. How does this happen and what are the consequences for the child?

When the due date is approaching, doctors conduct studies (ultrasound, cardiotocography, etc.), according to the results, determine whether the pregnancy is overdue or not?

The doctor looks at such signs: a decrease in the thickness of the placenta, relative oligohydramnios, thickening of the bones of the skull. In such cases, it is recommended to carry out labor induction. Labor induction is done not only with overwearing, but also with preeclampsia, fetoplacental insufficiency. And only after all these studies is it concluded that need whether to call artificial stimulationchildbirth.

So what are the ways stimulationchildbirth do doctors have in their arsenal? To stimulate labor, doctors use:

• amniotomy - artificial rupture of the fetal bladder. They make a puncture in the fetal bladder with a tool that looks like a hook. This procedure is almost painless, since the fetal bladder has no nerve endings, the painlessness of the procedure depends on the professionalism of the doctor who performs the amniotomy. As a result of amniotomy, amniotic fluid begins to drain, after 2-3 hours the birth process starts
• The use of a special gel, which includes prostaglandins in its composition. The obstetrician inserts it into the cervical canal. Prostaglandins contribute to the fact that the cervix "ripens" faster, these hormones stimulate the process of uterine contraction. The procedure is painless, the procedure takes no more than 5 minutes. Childbirth begins after 9-10 hours after the procedure.

Medical stimulationchildbirth carried out strictly according to indications, in the presence of a threat to the life of the fetus or mother.

Stimulation of childbirth - why is it needed?

Stimulation of labor is needed when labor is weak, when labor has already begun, there are contractions, but they are weak, the cervix opens slowly.

12 hours - the time spent by those who give birth for the first time; in the second - 8 hours. If the birth is delayed, the child may suffer, then they resort to stimulation.

There are main drugs that are used to stimulate labor - prostaglandins and oxytocin.
Prostaglandins are used when the weakness of labor is observed when the cervix is ​​dilated up to 4 cm. Oxytocin is used at the stage of uterine dilatation from 5 cm to 10-12 cm, during the period of attempts. Prostaglandins and oxytocin are administered intravenously. Oxytocin begins to act, pain intensifies, it should be used in combination with antispasmodics (drugs that relax the muscles of the uterus). There are no standard schemes for the use of oxytocin, different women react to the same dose in different ways, doses must be selected individually.

Note that the condition of the child should be assessed more often than usual (in the 2nd period after each attempt) using cardiotocography or a conventional obstetric tube.

Within 4-6 hours after the administration of stimulant substances, doctors evaluate whether the drugs are useful, if not, then they consider the option of a caesarean section.

In some cases, doctors do not use stimulants, but sedatives, which are required in cases where a woman is physically tired from prolonged contractions. There is still a period of pushing ahead, when a woman pushes to give birth to a child. In such situations, doctors administer sedatives to the woman so that she can rest a little, gain strength before the upcoming attempts.

Is labor induction necessary?

Labor induction is an emergency option for obstetrics, it is necessary that the woman give birth herself and she does not need serious medical intervention. The expectant mother needs to know how to act correctly during childbirth, how to breathe during contractions and attempts. It is desirable that the expectant mother has been trained in a school for pregnant women and knows what childbirth is. Then it is likely that she will not need stimulation.

It is better for the child if the birth takes place without stimulation. When childbirth occurs naturally and the process is not accelerated, the baby experiences less stress when passing through the birth canal. During labor stimulation, a child may experience hypoxia - a lack of oxygen, which is very bad for the baby.

Contractions may not occur, the cervix may not “ripen”, and these means of stimulation are guaranteed to provide hypoxia to the child. The child's brain suffers from hypoxia, but how severe the damage is visible only after birth. The consequences may be disorders of the central nervous system: regurgitation, delayed speech development, autism syndrome, ADHD, cerebral palsy, visual impairment, hearing impairment, epileptic syndrome

Children who are born as a result of stimulation of labor activity have a yellowish skin color. This is neonatal jaundice, which resolves within 2-3 weeks. The cause of jaundice is an increase in the blood substance bilirubin, which enters into a chemical reaction with oxytocin.

Labor induction points

Stimulation, or stimulationchildbirth at home is a procedure that induces contractions (uterine contractions) during pregnancy, but before the natural onset of labor.

Stimulate a point between the thumb and forefinger, a point at a height of 4 fingers from the ankle and a point in the corner of the little finger on the leg. Each point for 20 seconds, 2 minutes break and so on 3 times.

Methods for approaching childbirth with folk remedies at home:

If the due date set by the doctors is behind you, and labor has not begun, you can try to take the following actions.

• Take 3 times a day for 1 tablespoon of vegetable oil: it contains semi-saturated fatty acids, which contribute to the production of its own prostaglandins in the body. These substances help prepare the cervix for the upcoming process and start the birth mechanism.
• Drink any vegetable oils (olive, linseed, wheat germ, and so on) that are rich in vitamin E and omega 3 and 6 acids. Start with 1 tablespoon and work up to 3 tablespoons per day. It is better to drink on an empty stomach, but you can drink it in salads and with bread. The oil helps tissues and muscles to be elastic, prevents ruptures.
• It is necessary to drink tea from raspberry leaves. Brew 1 tbsp per 0.5 l. Start drinking no earlier than 36 weeks, because. can provoke childbirth. Start drinking 1 glass a day, from 38 weeks to 2 glasses, from 39 weeks to 3 glasses. Drink instead of tea and always drink warm or hot.
• Have sex: during intercourse, the nerve cells of the cervix are irritated, a signal is sent to the pituitary gland, which “gives the command” for the body to produce oxytocin, the hormone that starts childbirth. manual or oral stimulation clitoris, even without orgasm, can also be effective to start childbirth. Semen contains prostaglandins that cause uterine contractions.
• Increase physical activity: you can walk up the stairs, wash the floors - all this helps to bring the birth closer. Excessive stress should be avoided, otherwise it can lead to placental abruption.

Remember that it is undesirable to give birth and stimulate labor at home if you want to give birth to a healthy child.

Childbirth is a complex physiological process of expulsion of the fetus from the uterine cavity. After the opening of the cervix in the first stage of labor, the baby begins to move through the birth canal due to uterine contractions - contractions. In the second period, contractions (contractions of the abdominal and diaphragm muscles) join the contractions, as a result of which the baby is born into the world. After that, the placenta quickly separates and the placenta comes out. Here it is, the happy ending!

To start normal labor, two basic conditions are needed: a mature cervix and sufficient strength and duration of contractions. Typically, the cervix "ripens" (i.e., becomes soft, shortens to 1 cm or less, and dilates by more than 1 finger) by the 38th to 39th week of pregnancy. With the onset of labor, the cervix continues to open and smooth out. This is due to contractions, as well as pressure on her fetus. An important role is played by the fetal bladder, which "weds" into the opening of the cervix, contributing to its opening. For the successful completion of the first stage of labor, uterine contractions must be sufficiently strong, long-lasting and occur at regular intervals.

In cases where the contractions are not intense enough, short or rare, they speak of the weakness of labor activity. This condition is also indicated by a low rate of cervical dilatation (normally 1 cm per hour). Also, this condition is diagnosed through observation, CTG (cardiotocography) and vaginal examination.

There are primary and secondary weakness of labor activity. The primary is manifested by contractions of weak strength, a violation of their rhythm and duration from the very beginning of childbirth. The second option is characterized by the appearance of the same changes, but not immediately, but after a certain period of time after the development of normal labor activity.

What is the danger of weakness of labor activity?

Many expectant mothers are perplexed - is labor stimulation really necessary? After all, you can often hear arguments about how they gave birth in the old days for several days, and nothing - everyone treated this normally. But it is important to understand that such a situation is not at all the norm and threatens the development of serious complications. For a baby, the danger of weak labor activity is to increase the risk of developing severe oxygen starvation, which is fraught with neurological disorders and cerebral circulation disorders in the newborn. In addition, during prolonged labor, amniotic fluid may enter the lungs of the fetus, leading to inflammation of the lungs and impaired breathing of the child after birth. These consequences often require long-term observation and treatment of the baby in the future.

On the part of the mother, there is a threat of birth injuries, and as a result of insufficient contraction of the uterus in the postpartum period, bleeding may begin.

Therefore, in all cases of development of weakness of labor activity, it is necessary to stimulate it - to increase the strength, duration and frequency of contractions.

Stimulation in childbirth: let's try without drugs

Most often, the concept of "rodostimulation" in expectant mothers is associated with the use of special medications, but, in addition to this, there are a number of non-drug ways to normalize labor activity:

• The active behavior of the woman in labor contributes to the strengthening of labor activity.
• Stimulation of the areolas (nipple circles) and nipples of the mammary glands leads to the release of the hormone oxytocin, which enhances uterine contractions.
• Labor activity is enhanced when the position of the woman on her side, the same name as the position of the fetus.
• Amniotomy (opening the membranes) is an effective measure to activate contractions. This is explained by the fact that after the discharge of amniotic fluid, the volume of the uterus decreases, which allows it to contract more efficiently. In addition, amniotomy activates the formation of prostaglandins - substances that are powerful stimulants of uterine contractions. This manipulation is painless, since there are no pain receptors on the surface of the membranes.

Medical stimulation during childbirth

Before starting medical stimulation in childbirth, it is very important to assess the condition of the woman in labor. When she is tired, a drug sleep is prescribed, which lasts about 2 hours. The positive effect is due to the fact that during this period, childbirth does not stop, and the cervix continues to open. Often, after a rested woman in labor wakes up, labor activity returns to normal, and the need for labor stimulation may disappear. If this measure did not help, then, as a rule, the doctor decides on drug stimulation during childbirth.

To date, drugs of the prostaglandin group and oxytocin are used for this purpose.

Prostaglandins are biologically active substances that trigger regular labor activity. They contribute to the opening of the cervix and increase its contractions. Prostaglandins are used with the development of primary weakness of labor or with the development of secondary weakness of labor, if the cervical dilatation is not more than 6 cm. These drugs also have side effects - nausea, vomiting, increased blood pressure, increased heart rate, bronchospasm (difficulty respiration due to a decrease in the lumen of the bronchi). Given this, contraindications for the appointment of such drugs are bronchial asthma, increased blood and intraocular pressure (glaucoma), severe liver and kidney diseases. These drugs are administered intravenously.

Oxytocin (from the Greek oxys - fast, tokos - childbirth) is a synthetic analogue of the hormone oxytocin, which is responsible for the contractility of the uterus. Since the most common cause of the development of weakness in labor is the insufficient production of one's own oxytocin, the introduction of this substance helps to correct the situation and normalize the process of childbirth. Sensitivity to oxytocin increases towards the end of the first stage of labor, so it is most effective for secondary weakness of labor and weakness of attempts. It is also administered intravenously.

The introduction of these drugs requires constant supervision of an obstetrician-gynecologist and midwife. Careful monitoring of the contractile activity of the uterus and the condition of the fetus is necessary. It is important to prevent an overdose of prostaglandins and oxytocin, which causes uterine hypertonicity, which, in turn, leads to impaired uteroplacental circulation and intrauterine suffering of the baby, premature detachment of the placenta.

Along with the stimulation of labor, antispasmodic drugs are usually administered to relieve spasm of the cervix during contractions and soften it. Strengthening contractions with a dense cervix leads to its rupture. To prevent fetal oxygen starvation, drugs are prescribed that improve uteroplacental blood flow and increase the resistance of fetal brain cells to oxygen deficiency.

With persistent weakness of labor, combined with other diseases, and with the impossibility of natural childbirth, a caesarean section is indicated.

Conditions for labor stimulation are:

• Correspondence of the size of the fetal head to the mother's pelvis, which shows the possibility of the fetus moving through the pelvic cavity during childbirth;
• Satisfactory condition of the baby (according to cardiotocography, ultrasound, Doppler uteroplacental blood flow). With oxygen starvation of the fetus, it is impossible to perform rhodostimulation, as this can lead to vasospasm, disruption of the uteroplacental circulation and deterioration of the child's condition.
• Absence of a fetal bladder. Rhodostimulation is not carried out with a whole fetal bladder. This threatens with a serious complication - placental abruption due to an excessive increase in intrauterine pressure. Usually, with the development of weakness in labor, an amniotomy is first performed (puncture of the fetal bladder), and then the woman in labor is observed for 2 hours. If during this time labor activity has not returned to normal, drug stimulation is prescribed.

Is it possible to avoid stimulation in childbirth?

Prevention of the development of weakness of labor activity is largely a normal pregnancy. For the expectant mother, a full-fledged sleep is necessary - at least 8 hours a day, a rational balanced diet, favorable conditions for psychological comfort. An important role is played by the absence of chronic foci of infection, good physical shape, training at school for pregnant women and support from relatives. Gymnastics for pregnant women, breathing exercises, swimming in the pool, yoga, outdoor walks are recommended. Also, the expectant mother needs to take vitamins (B6, ascorbic and folic acid), which have the ability to increase the energy potential of the uterus.

Such different concepts

It is important to understand that labor stimulation and labor induction are two completely different procedures. Rhodostimulation is always an intensification of already existing contractions, when labor activity began on its own, but then there was a failure in its normal development, and it began to weaken. Labor induction is carried out if it is necessary to induce labor, when there are no contractions yet.

Causes of weakness of labor activity:

• previous abortions, miscarriages, curettage of the uterus, inflammatory diseases of the female genital organs, uterine fibroids, hormonal disorders and chronic diseases;
• the age of the primipara is less than 18 and more than 35 years;
• a large number of births (4 or more);
• causes leading to overstretching of the uterus (large fetus, polyhydramnios, multiple pregnancy), preventing the full contraction of the myometrium - the muscles of the uterus;
• hereditary predisposition, which can be traced through the female line;
• complications of the course of pregnancy - postmaturity, fetoplacental insufficiency (i.e., the inability of the placenta to meet the needs of the developing fetus);
• woman's fear of pain, lack of psychological attitude to childbirth.

When is it not possible to induce labor?

Contraindications for labor stimulation are the presence of a scar on the uterus, incorrect position of the fetus, its oxygen starvation, a clinically narrow pelvis (a situation where the size of the fetal head does not correspond to the size of the mother's pelvis), placenta previa (when the placenta blocks the exit from the uterus), severe preeclampsia, fatigue women in labor.

After the 37th week of pregnancy, the moment of the natural birth of the child comes. However, this does not always go smoothly. Sometimes it is necessary to induce contractions with the help of surgical or medical intervention. Labor induction is carried out only by a doctor when labor begins spontaneously and then stops: the woman can no longer give birth. This article describes methods and techniques for safely inducing labor in a hospital or at home.

What is labor induction

The procedure of labor stimulation is the birth of a child as a result of contractions caused by an artificial method. It is carried out to stimulate the labor activity of a pregnant woman according to the doctor's indications. It is aimed at ensuring the opening of the cervix of the woman in labor. If the birth canal is closed or not completely ready before the start of delivery, then such labor activity is called weak. For this procedure, both medicines and natural methods can be used, which are described below.

Artificial Methods

There are several artificial methods of labor induction. The first is transcervical. The essence of the method is that a catheter with a solid rod is inserted into the cervical canal. Then it is replaced with a needle. It is used to pierce the amniotic membrane to remove some of the amniotic fluid. After that, a highly concentrated sodium chloride solution or a 20% glucose solution is injected inside. This method is not used on women who suffer from high blood pressure or kidney disease.

The next way is transabdominal. It is not used if the placenta is attached to the anterior wall of the uterus. The method consists in the fact that doctors inject saline solutions with ultrasound determination of the location of the placenta. It is used in case of injury or bleeding. A saline solution is injected into the amnion (inner part of the placenta) after a certain amount of amniotic fluid has been taken. Unfortunately, in this case, the child does not survive, as the saline solution kills him. After a couple of days, artificial labor is performed.

Artificial childbirth is also carried out by expanding the cervical canal, after which the fetal bladder is opened. Stimulation of labor can occur if the woman in labor has contraindications to hypertonic solutions. There are also medical methods that contribute to the opening of the cervix and contraction of its muscles. However, the stimulation of labor with drugs is used in extreme cases, when other manipulations are contraindicated for the mother. After such a procedure, there is a risk of consequences.

natural stimulation

If artificial induction of labor is not suitable for a woman, the doctor or obstetrician suggests breaking through the membranes. This is the manual separation of the amnion from the uterine wall. The doctor inserts a finger into the cervix and with the help of gentle movements separates the membrane from the wall. There is also a rupture of the water bladder with the help of an amniotic hook. There are options for natural stimulation of labor at home, but more on that later.

Why is labor induction dangerous?

By itself, the stimulation of childbirth can not only harm the child, but also the woman. Any type of stimulation is carried out only with the permission of a doctor who is familiar with the medical indications of the patient. Complications occur frequently. In the following sections, you will learn about the dangers of induction during childbirth in the clinic, how it can harm the mother or newborn baby, and why such a procedure can be dangerous.

Pain during contractions

In order to stimulate delivery, a woman can be injected with synthetic hormones, which cause severe pain than during natural labor. Such pain passes quickly, does not cause the release of painkillers into the blood. During normal labor activity, they are produced by the female body. At the first stage of stimulation, gels or balloons can be injected that cause painful contractions. Painful discomfort is also caused by vaginal examinations. Read on to find out how to stimulate contractions on your own.

Uncomfortable body position

In the case of using droppers, doctors put the woman in the most uncomfortable and ineffective positions that prevent the birth of a child - lying on her back, on her side or standing on all fours. In such positions, unpleasant discomfort occurs, which can intensify. This interferes with the process of labor, and the pain of contractions increases markedly.

Oxygen starvation of the fetus

Stimulation of labor can lead to the development of oxygen starvation of the fetus (fetal hypoxia). This is a violation of the intensity of blood supply. Such a problem does not sum up in the development of the child. The diagnosis is “removed” after 3 months, when the child develops as it should, no deviations are observed. In some cases, labor with stimulation can lead to disruption of the functioning of the baby's heart system. However, we can fix that.

Indications for labor induction

Labor is stimulated in several medical indications. The most common reason for the use of stimulants is the gestational age (more than 41 weeks). In such cases, natural stimulants can be used, which can also be used at home. This procedure is done to reduce the risk of a caesarean section. It is used if the child is large.

With multiple pregnancies, when babies simply cannot appear in the usual way, stimulation is also prescribed. If the mother has kidney disease, thyroid disease, gestational diabetes, high blood pressure, then doctors prescribe stimulation. This method is also used for prolapse of the umbilical cord. Doctors want to avoid complications during and after the birth process.

How to stimulate labor in the hospital

In the maternity ward, obstetricians and doctors stimulate labor in various ways. Doctors determine the methods of stimulation for certain indications and situations. They may use pills, injections, opening the membranes, injecting oxytocin or prostaglandin. Such methods have advantages and disadvantages, which you will learn about in the following sections.

Preparations for stimulating labor

Drugs in our time have become increasingly used to speed up labor in certain cases. They are used in order to cause a minimum of physical damage to the fetus during the process. If you want to use drugs during childbirth rather than other more dangerous methods, then this can be discussed with your attending gynecologist.

Oxytocin

The substance oxytocin is a synthesized analogue of the hormone that the pituitary gland produces. It stimulates the contraction of the muscle fibers of the uterus, which helps with weak labor, postpartum bleeding and to stimulate lactation. Available as a solution for subcutaneous and intramuscular injections. The disadvantage of this drug is that a woman cannot move normally while under the connected drip system.

Doses are selected for each woman individually - each body reacts differently. The drug does not affect the readiness of the cervix to dilate, so when oxytocin acts, labor pain appears. Can be taken with antispasmodics. This drug is not used if it is undesirable to have a child through normal childbirth, if the baby is in the wrong position, if the components are intolerant, if there are scars on the uterus, and others. Side effect - can lead to hypoxia.

Miropriston

The drug Miropristone is a medical preparation that is used to terminate a uterine pregnancy in the early stages (up to 42 days) and to artificially induce labor. An analogue of this tool is Pencrofton. Both drugs are used in confirmed ectopic pregnancy, a pregnancy that occurs when using intrauterine or hormonal contraceptives. It is contraindicated in:

• individual intolerance to the components of the drug;
• porphyria;
• anemia;
• violation of hemostasis;
• adrenal insufficiency;
• uterine fibroids;
• smoking;
• acute inflammatory pathology of the female reproductive system.

birth control pills

A popular method by which the uterus "ripens" is the use of prostaglandin hormones. They stimulate delivery by acting on the cervix, causing structural changes. They are used in the slow course of labor, the reason for which lies in the immaturity of the uterus, its resistance. Next, consider the pros and cons of such hormones.

Prostaglandins

Hormones have a beneficial effect on the female reproductive system. They stimulate smooth muscles, fallopian tubes, uterus and cervix. The drug causes painful contractions that help a woman give birth faster. Available in the form of tablets that have side effects. The tool works in much the same way as Oxytocin. Side effects include nausea, fever, vomiting, diarrhea, and more. They cost a little more. Tablets are used for artificial termination of pregnancy in the early stages.

Detachment of amniotic membranes

Prenatal stimulation detachment of the membranes is performed only by a gynecologist or midwife during a gynecological examination. From the lower sections of the uterus near the internal pharynx of the cervix, the amniotic membranes are carefully peeled off. This procedure is used several times until the woman's labor activity begins. It is rarely used, only in extreme cases and as prescribed by a doctor.

Puncture of the amniotic sac

Amniotomy is performed exclusively in the process of delivery. It is not used today, because there is a risk of infection of the child with various infections. Rarely, when other methods cannot be used, a puncture of the amniotic sac is used. At the same time, it is used when the cervix is ​​softened, using a special tool to puncture the fetal bladder.

Foley catheter

To use this method, you need to consult a specialist. Upon inspection, the size that suits you is determined. Please note that the caterer is introduced in the hospital by doctors, it is forbidden to do this at home. It will harm the baby and the mother. It is rarely used and only when there is a medical indication for use. Foley catheter is contraindicated in:

• inflammatory process in the cervix (cervitis);
• inflammation of the vaginal mucosa (vaginitis);
• rupture of the fetal bladder;
• low placenta previa.

Stimulation of labor activity at home

Not infrequently, girls do not want to use different medications, lie down on the operating table, so they discuss possible ways of stimulation during childbirth at home with their gynecologist. Such an independent solution comes to mind the fastest. If you also do not want to use traditional methods, you can choose one of such methods as late sex, gymnastics for pregnant women, nipple massage and castor oil. If you don't know how to induce labor yourself at home, the following sections will help you.

Sex in late pregnancy

During sex, oxytocin is produced, which helps speed up labor. Male sperm contains prostaglandins, which promote maturation and expansion of the uterus. Unfortunately, this method is used only when the water has not broken, because this can infect the placenta. Sexual contact is prohibited if you have a low placenta previa.

Labor induction exercises

A little exercise is also a natural labor stimulant. Walking slowly down the street every day will help you bring on contractions as soon as possible. We recommend that you climb the stairs over the step, dance and slowly rotate your hips. It is forbidden to lift weights, use strength exercises on simulators. Another option would be mopping without a mop.

The advantage of using such methods is that the cervix softens and smoothes faster, which causes a quick delivery in a woman. However, this method will be harmful to women with preeclampsia, indications for caesarean section, for up to 40 weeks, chronic diseases that are not related to pregnancy in any way. Before using this method, consult your gynecologist.

Nipple massage

A special nipple massage helps the female body produce the hormone oxytocin. It stimulates the contraction of the uterus, which helps to start labor faster. It also helps a woman get used to the discomfort, because after birth, the baby will “bite” your breasts. When massaging the nipples, the same feeling is felt. Massage is done several times a day for 15 minutes. Nipples need to be lightly pinched and stroked.

Castor oil to speed up labor

Castor oil has been used in the past to induce bowel movements, since castor oil has a laxative effect. Today it is sold in the form of candles. Castor oil stimulates the contraction of the intestines and uterus. However, if you use a dose a little higher, diarrhea sets in, which can lead to dehydration. Such an action can lead to real danger. It is better to put a couple of drops of castor oil on bread and eat it with tea.

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Maria Sokolova

Reading time: 8 minutes

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The 41st week is already underway, and the little one is still in no hurry to enter the light of God ... This situation is familiar to every 10th woman. And passively waiting for future fights is not always the ideal solution.

When labor stimulation is really needed, whether it is dangerous, and how it is carried out - we understand the nuances.

Indications for labor induction - who decides to induce labor and when?

The term "induction of labor" is used when labor has to be induced artificially at some point in the pregnancy.

It is worth noting that in the period from the 37th to the week, labor induction is not required if there is no indication for it.

Also, it is not needed in the case of a normal birth.

Experts consider indications for the stimulation of labor activity ...

• True.
• Identification of pathological changes in the placenta.
• Symptoms of any disorders that are dangerous to the health and life of the fetus.
• Late toxicosis (not always).
• Early broken water (given the high risk of infection through the cervix).
• Placental abruption.
• Certain chronic diseases of the mother. In particular, diabetes, hypertension, etc.

Naturally, the decision to induce labor is made by only a doctor and only after a full examination , which will establish that further pregnancy can harm the baby or mother.

It is worth noting that a post-term pregnancy is not just an extra week or two of discomfort for the mother, it is, first of all, the risk of bleeding in the mother, hypoxia in the baby, as well as weak labor, etc. Therefore, if the doctor decides to stimulate labor need strictly follow the instructions!

• If you have any doubts whether it is worth doing stimulation, you can contact another specialist to make sure that the decision was made correctly.
• It is impossible to rely solely on the date of the birth expected by the doctor (or on your own date) when making a decision. That's why this date is "estimated". That is, the decision is made only after 40 obstetric weeks - and only according to indications.

Possible complications and consequences of labor stimulation - why is it dangerous for the mother and baby?

Stimulation of childbirth is far from an “ordinary” phenomenon. This is an extremely emergency option for childbirth, which, in fact, should be natural and without medical intervention.

Of course, any interference with the natural process cannot be beneficial - but, in most cases, stimulation does not cause significant harm.

However, it is worth mentioning the possible risks for the baby from using this procedure:

• Hypoxia.
• CNS disorders in the baby after birth.

Risks for mom:

• Painful childbirth: stimulated contractions are always stronger than usual - and with shorter breaks.
• It is impossible to move under a dropper, which complicates the general condition of the woman in labor.
• Stimulation does not work in all cases, and then a caesarean section is indispensable.

3 methods of stimulating labor in the maternity hospital

The conclusion - whether there is a gestation - is made by specialists at a certain time (closer to the expected date of birth) and solely on the basis of research:

1. Cardiotocography.
2. Assessment of all parameters (fetal size, fluid composition, placenta condition, etc.).

If, according to the results of the examination, a thickening of the bones of the fetal skull, oligohydramnios, aging of the placenta or other signs indicating overmaturity are revealed, then an appropriate decision is made on artificial stimulation of labor.

All methods are classified into 2 groups:

• Methods and means that accelerate the opening of the cervix.
• Methods and means for stimulating uterine contractions.

The most popular medical methods of labor induction include the following:

• Amniotomy. In this case, a specialist inserts a special tool-hook through the cervix and, having hooked the amniotic membrane, punctures the bladder, as a result of which water is poured out and contractions begin. The opening of the bladder also stimulates the production of prostaglandins, which enhance labor activity. The method is often used, but it is considered risky due to the possible infection, especially if the method could not start the birth process. Also, possible risks include prolapse of the umbilical cord (here, emergency honey / intervention will not be enough) and damage to blood vessels with subsequent bleeding. The procedure is absolutely painless.
• Oxytocin. An agent that is a synthesized analogue of a hormone produced by the pituitary gland. This drug in the form of tablets or a solution is used to activate the contractile abilities of the muscles of the uterus in various cases - to stimulate labor or lactation, with postpartum hemorrhage, with weak labor activity. In order to avoid complications, the use of the drug is excluded in case of an abnormal position of the fetus, scars on the uterus, placenta previa, as well as in the narrow pelvis of the mother. The dosage is usually selected specifically for each situation, taking into account the individual characteristics of the mother. Side effects and risks: increased labor pains, powerful contraction of the uterus (note - there is a risk of circulatory disorders in it and, as a result, hypoxia of the baby).
• Prostaglandins. This tool is used in the case when the cervix is ​​simply not ready for disclosure, although the process of childbirth is already underway. These hormones contribute to the rapid “ripening” of the uterus, which is immature for childbirth, stimulating smooth muscles, as well as acting stimulant on the cervix, on itself, and so on. When administering the drug, specialists seek to minimize the risk of a side effect of prostaglandins, using them in the form of a gel or suppositories. It is worth noting that tablets and solutions of the drug are often used during abortion, and the risks of using the drug during childbirth orally and intravenously are quite high: excessive stimulation of uterine contractions (note - with all the consequences), nausea and vomiting, and so on.

There are other drugs to stimulate labor, but they are used extremely rarely.

It is worth noting that drug stimulation is prescribed only in exceptional cases, when there is a threat to the life of the mother or baby.

Inducing labor at home is strongly discouraged unless you have an OB/GYN nearby or your doctor has advised you to do so.

Any actions that can lead to the approach of childbirth - only on the recommendation of your gynecologist!

The main "techniques" that are used at home to stimulate childbirth include ...

• Nipple stimulation. Such massage provokes the production of oxytocin, which in turn stimulates childbirth. That is why early attachment of the baby to the breast after childbirth helps to accelerate the birth of a child's place and reduce the risk of bleeding. If you do not plan to give birth ahead of time, then you should be more careful with intimate relationships if they are present at a later date (do not overdo it).
• Enema. Intestinal contraction also promotes the release of prostaglandins.
• Proximity. The most well-known method of approaching childbirth, but very risky in the later stages. It is worth saying that uterine contraction and the production of oxytocin are guaranteed, and in the male seed there are prostaglandins that soften the cervix.
• "Up down" : Walking up and down the stairs can help a mother who is a little late in labor.
• Squats, long walks. Remember that excessive loads lead to placental abruption.
• Spicy dishes. Spicy spices in food are stimulants for intestinal contractions, and after it - for the walls of the uterus.

In addition to these, there are other ways to bring the moment of childbirth closer, including funny, dangerous and downright stupid.

Video: Natural methods of inducing labor

But it is important to remember the main thing:

1. Do not use any means and methods for approaching childbirth if your due date has not yet come, and there are no such doctor's recommendations. You risk harming yourself and your baby, and the consequences can be unpredictable.
2. Pregnancy fatigue is not a reason to induce labor!
3. Any remedy for stimulating labor can turn into a tragedy if there are no qualified doctors nearby, if it takes a long time to get to the hospital, if the mother has a narrow pelvis and cannot give birth on her own (in an emergency), if the baby lies upside down, and in other cases.
4. It is strictly forbidden to stimulate labor on your own at home with medical methods, including candles and acupuncture.

If the results of the examination show that everything is in order with the little one, and the doctor recommends waiting a little longer, do not rush the baby - let him live in the belly. Give him time - he will decide when it is time to be born.