Childbirth should be carried out conservatively, through the natural birth canal.
First stage of labor:
During the first stage of labor, you should monitor general condition women in labor, count pulse, blood pressure (required on both arms). Watch your character labor activity- frequency, strength, duration of contractions, rhythm. Monitor the fetal cardiac activity using a stethoscope or cardiac monitor while simultaneously recording the contractile activity of the uterus.
Vaginal examinations should be carried out no more than once every 4 hours, in other cases strictly according to indications (rupture of amniotic fluid, bleeding during childbirth, signs of intrauterine fetal hypoxia, the appearance of pushing).
Provide adequate labor pain relief. Pain relief for childbirth medications start in the 1st stage of labor if labor is regular and the cervix is dilated by 3-4 cm. Use analgesics for pain relief. During labor, bladder and bowel function should be monitored. Empty bladder every 3-4 hours.
Second stage of labor:
During the period of expulsion, you should monitor the general condition of the woman in labor, coloring skin and visible mucous membranes, frequency and character of pulse and blood pressure. Continue recording the nature of labor: frequency, strength and duration of contractions, pushing, movement of the head along the birth canal. In this woman in labor, the head should not be allowed to stand in one plane for a long time in a large segment for more than 2 hours.
Listen to fetal heart sounds at the beginning of the 2nd stage of labor after 15 minutes, and then after each effort, pay attention to the frequency, rhythm and sonority of the tones.
From the moment the head erupts, begin providing manual assistance for cephalic presentation.
The first point is to create an obstacle to premature extension of the head.
The second point is to remove the head from the genital slit, without pushing.
The third point is to reduce the tension in the perineum (preventing the threat of perineal rupture)
The fourth point is the regulation of pushing.
Fifth point - liberation shoulder girdle and birth of the fetal body.
If, when providing manual assistance, there is a threat of perineal rupture, it is necessary to perform a perineotomy or episiotomy.
After the baby is born, evaluate it on the Apgar scale at 1 and after 5 minutes. Start toileting your newborn.
Third stage of labor:
The succession period should be conducted actively and expectantly. Prevention of bleeding in 3 and early postpartum period childbirth by administering Sol. Oxytocini 10 units IM). Acceptable blood loss 3500. Watch for signs of separation of the placenta.
A very important and exciting moment in the life of every expectant mother is childbirth. In order not to forget anything and not get confused at the most fussy moment, make a birth plan. In addition, it will help you tune in to the fact that the baby's arrival is close.
In this article, we will help expectant mothers create a birth plan and explain what mandatory items should be included in your plan.
Preparing for childbirth requires a special plan that will help you understand how you manage your birth, what your needs are, what you are afraid of, etc. With the help of a plan, you can compare your needs with the capabilities of the maternity hospital that you have chosen. A birth plan can organize not only you, but also your family members.
So how and when should you make a birth plan?
If the pregnancy is progressing normally, you can safely start working on a birth plan at 6-7 months of pregnancy, or when you feel the need to sort everything out.The birth plan must include all the procedures and things that you think need to be done at the birth of the child. Consider each point carefully, if the need arises, consult with a friend who has already given birth, and best of all, with a midwife or doctor.
Such a plan is very useful when labor begins, because it will not be easy to gather your thoughts at this moment, but every woman wants childbirth to go as smoothly as possible. in the best possible way.
You shouldn't leave your birth plan in such a way that the obstetrician thinks her hands are tied. Remember that your plan will be considered in case of a normal birth, but if there are any complications, it will no longer be relevant.
What must-have items should you consider in your birth plan?
First, write down all the necessary information about yourself, starting with your first and last name and medical indicators, - it is very important.If you decide that someone will be present with you during the birth, be sure to enter the details of this person. Also, you can note at what stages of the birth this person will be present. Indicate all the nuances.
Write down the position you would like to take during the first and second stages of labor; you can discuss these positions in advance with your doctor and midwife. And if you also write down these positions, then no one will forget about your preferences.
Probably the most important point in your birth plan will be the point about medical intervention. Think about what you agree to and what you don't agree to. Write down why you would like to avoid certain procedures.
If you have special preferences, such as using alternative forms of care - massage, aromatherapy, bath or birthing pool, exercise ball - please indicate this as well.
Sometimes it is possible that interns will be present during childbirth; if you do not want to see them, you can safely refuse them. By the way, sometimes they are very useful as additional moral support, not only for you, but also for your birth partner.
If everything goes well, you can even prescribe a condition that the child’s father, for example, will cut the umbilical cord.
Everything you want to do after giving birth should also be included in your plan. Write what the baby should wear after he is bathed.
If you refuse vaccinations for your baby in the first days of his life, also write this down.
Take care of a special statement refusing vaccination - this is necessary for your wish to be fulfilled.
The plan you create will help the maternity hospital staff understand what you want and what you don’t want. It will become an assistant for you; a birth plan will help you focus on the process and not think that you might have forgotten something. This is additional peace of mind for you at such an important and exciting moment.
- important points that I have compiled to follow during the birth of our son and which can help you in drawing up your plan.
I dreamed and dreamed of natural childbirth. But when I was diagnosed with ICN and stitches were placed on my cervix, I realized that giving birth at home was out of the question. At that time, we attended courses for pregnant women and there they explained to us how important it is, not only for the pregnant woman herself, but also for her team, to have a clear Childbirth Plan. It is clear that childbirth is an unpredictable thing and you need to be prepared for anything. That’s why we need this plan, which will clearly describe what and how to do if something happens.
These people should have an idea of what you want from your Childbirth. Let me give you an example. When I got stitches, the doctor who did it asked where I planned to give birth. I said that I wanted a natural birth as much as possible, to which he said that, of course, it could happen here too. Then I asked one question - how much time do you give before cutting the umbilical cord. The answer put everything in its place - “well, 2-3 minutes is enough.” Therefore, it is very important to know in advance and let the doctor understand what you expect and want from your Childbirth.
I drew up the plan for a long time, based on my wishes. It was compiled 2 months before the birth.
I printed it out in 5 copies and put it in a ready-made bag for the maternity hospital. Before that, of course, I let my husband read it :)
So here it is.
Childbirth
1. I can move freely and walk around the room
I didn't want to be tied to the bed and lie on my back during contractions and pushing. For me, as well as for the process itself, it is very important to be in motion.
2. There should be dim, dim light in my room.
That is, natural light from a window during the day or, as in my case, candles at night.
3. My music inside the ward
This aspect was very important to me. I initially planned to listen to traditional Celtic music, but ended up listening to relaxing yoga music. We even bought a special speaker, but since everything was not planned, we forgot it at home. We ended up playing music from our midwife's iPad (which was great that she had it!).
4. Giving birth in your own clothes
I wanted as few associations with the hospital as possible, so it was important for me to give birth in my own personal clothes. I was wearing a simple elastic bandeau dress. In the end, of course, I took it off.
5. Do not offer painkillers/epidurals
I wanted the most natural birth so I only considered non-drug methods pain relief. During childbirth, there comes a time when you begin to feel that you cannot cope and many begin to require anesthesia. It is very important at this time to have someone next to you who can bring you to your senses.
6. Do not puncture the amniotic sac
That is, wait until it bursts on its own. Piercing stimulates very strong and painful contractions - this is considered stimulation of the birth process. In addition, sometimes babies are born “in a shirt” - that is, in a bubble. In my case, we went to the maternity hospital because my bladder burst, so it was irrelevant.
7. Minimum gynecological examinations
Watching the disclosure every time the bubble has already burst can at least introduce an infection, and does not carry much information. I was watched 4 times during the entire Childbirth period.
8. IV only for medical reasons
I was against installing a catheter on my arm. Again, because I wanted to minimize the hospital mood. In the end, of course, they put a catheter in me only because it was necessary for medical reasons - bleeding began.
9. Offer me food and water between contractions.
Yes, I ate and drank during Childbirth. And I think everyone should do this. It takes so much strength and energy to bring a baby into the world. In general, all the fuss about the ban on food and drink came from the fact that surgical intervention could potentially be required. I drank red wine (with doctor's approval) and water. I ate bananas, apples, cheese, dark chocolate.
10. Offer me new positions
During childbirth, there always comes a time when you have to change positions in order to find the right one, in which it seems to be easier for you. For example, I couldn’t lie on my back at all. I was in unbearable pain. During contractions, I walked, lay in the bathtub, and sat on the birthing chair. While pushing, she hung on the bed handle. And she gave birth on a birthing chair.
11. Massage my lower back during contractions
This helped a lot with the pain. When a contraction came, I would first tell my doula “contraction” and she would begin to massage my lower back. Then even words were no longer required. My husband was also a great help with the massage.
12. Lying in the bathtub during contractions
When labor was in full progress, I climbed into the bathtub. Warm water relaxes and helps to experience contractions easier.
12. Use natural methods of stimulation if labor stops
Sometimes they stop. And I did not want to resume the Labor process medicinally with the help of the synthetic hormone Pitocin. Natural methods include nipple stimulation, walking, changing positions, and so on.
13. No Episiotomy
I am opposed to episio - or perineal incision, which is practiced in almost all childbirths. And without any meaning. Many doctors say this is necessary to prevent rupture. But even studies already say that natural tears heal much faster and more painlessly than incisions.
14. Physiological birth of the placenta
This means that the placenta should be delivered on its own, without prescribed Pitocin or tugging on the umbilical cord. The exception is the placenta not expelling within 60 minutes or bleeding!
15. Natural relaxation methods
This includes breathing, acupuncture, massage, rebozo, pressure. For example, it helped me a lot when they breathed through each contraction with me and massaged my lower back.
After childbirth
1. No Pitocin
This synthetic hormone oxytocin is often given immediately to prevent bleeding. I see no reason to do this without strict medical indications. That is, if the birth was normal and physiological.
2. Immediate skin-to-skin contact
Place the baby on my stomach immediately after he is born. This is important not only from a psychological point of view, but also from a physiological one. Children should receive microflora from the skin of their mother (or father), and not from the hospital table. Plus, it stimulates the separation of the placenta! Well, the “plus” is that it even helps children breathe, as they feel your breathing and heartbeat.
3. Clamp the umbilical cord only after the birth of the placenta
Or at least let it pulsate. Blood and oxygen are still supplied to the baby, so it is important to let him get enough of it. In our case, unfortunately, this did not work out because I started bleeding.
4. The husband cuts the umbilical cord
It was important for me from an emotional point of view.
5. Save the placenta for encapsulation
This requires a separate post. But the point is to dry the placenta, chop it up and then consume it. Yes, you heard correctly - eat your placenta. All females in the animal kingdom do this. The placenta contains numerous hormones and bioactive substances. Its use improves milk flow and reduces the risk of developing postpartum depression, gives more energy. Unfortunately, we were unable to use this service because I had partial placenta accreta. But next time, if possible, I’ll definitely use it!
6. Examine the baby on my chest
This is where he should be. And all manipulations (of course, if everything is fine) can be carried out on my chest. Or wait a few hours - for example, measuring weight and height. They examined Emelya and listened to me on my chest and only then measured his height and weight.
7. Avoiding eye drops
It is still standard practice in many maternity hospitals to instill antibiotics into children's eyes. This is done to prevent infections that can be transmitted to them from their mother. I’m completely clear about this, so I didn’t see the point in completely unnecessary antibiotic therapy.
8. Refusal of vaccinations
We wrote a refusal of all vaccinations. It would take a long time to explain; I have already written my point of view on this matter.
9. Don't bathe your baby
Babies are born covered with a special protective lubricant, which, in my opinion, is simply unnatural to wash off. Moreover, with the use of all kinds of chemical agents. We didn’t bathe Emelya, we just dried him off.
10. Consultation with a breastfeeding specialist
No matter how rich the theory is breastfeeding I didn’t, I still had no idea how to breastfeed. That's why knowledgeable person, which showed how to apply to the breast correctly, came in very handy. But my husband also helped me a lot. It was he who helped put Emelyan to the chest and insisted on trying new positions if Emelyan refused to take the breast.
11. The baby is always with me or with dad
My labor is over heavy bleeding, where I lost 1.5 liters of blood. It’s clear that I spent the first 12 hours in intensive care. At this time, our baby was with his dad. It lay on his bare chest and was “enriched” with his microflora. In addition, my husband brought Emelya to me for feeding until I was transferred to our shared ward. If this point had not been in my plan, Emelyan would have gone to the nursery and lay there alone, which in my opinion is absolutely unnatural.
Just in case
1. Do not accelerate/provoke labor
Only if exists real threat my life or the baby's life.
2. Explain any interference to me first and then give time to discuss it with your team
In my case, the moment came when the progress of labor stopped. The baby was premature (I gave birth at 35 weeks) and he was not lying as it should, so I could not relax and the dilation was 8 cm, but during contractions no more than 6. In a normal “full-term” case, I would have been given Pitocin, but since it was a premature birth - there were two ways out. Either a cesarean section or try an epidural, which will help dilate up to 10 cm, and then give birth without it. When the doctor told me about this, I couldn't believe it. In my eyes, this was the collapse of my dream of natural Childbirth. But my midwife and doula agreed with the epidural as a necessary part of my Labor and helped me understand and accept it. As a result, she helped me dilate to 10 cm, and I was already experiencing all the delights of the birth process!
C-section
1. Only strictly for medical reasons
In cases of threat to my life or the life of the baby.
2. “Soft” CS
In Russia, this type of operation has only recently begun to be practiced. I will definitely write a separate post about this. It is called “soft” for many reasons. Below are some of them:
- Before the operation, insert a sterile bandage into the vagina and then wipe the baby’s mouth, face and body with this bandage in the first 2 minutes after Birth (when he lies on my chest). This is necessary in order to give the baby the mother’s microflora, which he is deprived of because he did not pass through the birth canal.
- My team (husband, doula and midwife) with me in the operating room
- I want to see the birth of my baby (that is, not put up a barrier)
- If possible, let the umbilical cord pulsate
- Husband cuts the umbilical cord
- Leave my one hand free so I can hold the baby
- Immediately put the baby to my chest, if not, then to my husband
All points were fulfilled in my situation. Because I knew what I wanted. Because I had a plan. And of course, because we gave birth under a contract with the “right” doctor in the “right” maternity hospital, who shared our views on natural childbirth. And most importantly, we gave birth with the “correct” midwife, not a hospital one, but her own, who taught courses for us. Which we knew personally. And I know that I would give birth again there, with these same people!
* I am now actively mastering Instagram, my thoughts about pressing problems and more are on evgenia_happynatural
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No one can know how the birth will go. Will they be quick or long, will pain relief be required or will the sensations be tolerable? One of my friends arrived at the maternity hospital and almost immediately went to give birth, the other lay there for several more days before the baby decided to be born. And despite this, the practice of drawing up a birth plan is becoming increasingly widespread. Why is it needed if everything is so uncertain? And how to use it in our country, where most maternity hospitals are not ready to discuss such issues with the patient?
The birth plan is increasingly common abroad. In Europe, the USA, and Israel, a pregnant woman, together with her doctor, describes how she sees the birth of her unborn child. Are you planning to invite your husband and other accompanying people to the birth? Will she need pain relief or does she want as much pain as possible? natural childbirth? Does she want to use items that she brings with her from home to soften the sensations during contractions: a fitball, massagers, pillows, a player with pleasant music, scented candles? Or maybe she liked it water birth? The plan also includes the woman’s desire to use the position in childbirth that will be convenient for her, consent or disagreement to carry out hygiene procedures upon admission to the maternity hospital (enema, shaving), readiness to breastfeed, joint or separate stay with the baby and even the time that she is ready to spend in the hospital after a joyful event.
The woman makes decisions about how she sees her childbirth, and the doctor helps her look at things realistically and warns her in advance against demands that cannot be met without risk to the health of the mother or baby. The doctor will also inform the expectant mother about the rules of a particular maternity hospital and how they relate to what she wants.
Drawing up a birth plan allows you to approach the birth of your baby as responsibly as possible: make key decisions not in a stressful situation, but calmly, when there is still time to think and read relevant literature. The plan will also allow to the expectant mother take off nervous tension before childbirth, which, to one degree or another, is present in every woman. Thought is material, which means that such a plan can be a kind of request to fate, which can turn into reality.
When making a plan, be sure to think about not only what you would like to receive (a calm, painless birth, healthy baby, breastfeeding in the first minutes after the baby is born), but also what you are ready to do for this (the ability to breathe correctly, knowledge of what actions bring you relief during contractions, the ability to control relaxation and tension, choosing a competent accompanying person and a doctor you trust, etc.).
However, you should not take your birth plan as something set in stone. Childbirth is a kind of lottery, and even the most experienced obstetrician-gynecologist cannot tell you how it will go for you. A cloudless pregnancy does not guarantee the same easy birth, just as a difficult waiting period does not mean anything. Therefore, having written a plan and prepared mentally for what is, from your point of view, an ideal birth, it is important to have the strength to refuse it at any time, understanding that doctors are interested, first of all, in ensuring that the mother and her newborn remain alive and healthy.
I have read many birth plans that our compatriots offer as samples on the Internet. However, I found that these plans are rather similar to some instructions for doctors called: “What should I do with me when I get to your family?” Girls are asked not to use certain medications: droppers, injections, infusions; do not force a woman in labor to shave or do an enema; do not do epidural anesthesia, episiotomy (perineal incision), and in general, do not do medical procedures without compelling evidence. Excuse me, but isn't medical intervention carried out only when there is evidence for it? By the way, the woman with whom I was lying in the postpartum ward was just unhappy that her labor was induced late, forcing the baby to suffer from hypoxia for too long. Thank God everything ended well! I propose to leave the issues that require medical education to the doctors, and let us do what we can actually do.
