The childbirth process is always very complex and individual in many ways. The sequence of stages described in the medical literature, as well as explained to women in the courses of expectant mothers, is not always the case in practice, and therefore a pregnant woman needs to be mentally prepared for a variety of scenarios.
In this article, we will talk about the features of childbirth, which begin not with contractions, but with a sudden outpouring of water or a mechanical puncture of the fetal bladder.
Anhydrous childbirth
From the point of view of obstetrics, childbirth is considered ideal, which begins with the gradual development of contractions. The cervix gradually smoothes out, opens, and only after the opening of the internal pharynx, the pressure on the fetal bladder becomes large enough, it opens, and the water leaves. Attempts begin, and soon the baby is born.
In fact, childbirth often begins with the discharge of water. The baby stays in the mother's womb in a sterile environment - the amniotic fluid, which is enclosed with the baby in the amniotic sac. If the walls of the fetal bladder have become thinner due to diseases suffered by a woman during the period of bearing a baby, if they are simply thin in themselves, if the expectant mother has been diagnosed with polyhydramnios, then the outpouring of water can happen before the contractions begin.
Often, an outpouring occurs when falling, it is especially dangerous for a pregnant woman in the later stages to fall on her stomach, on her ass, on her back.
If the waters have receded, it is very important that the contractions begin quickly enough, the cervix opens, and attempts begin. If labor activity is weak, slow, then the baby is at great risk.
In the absence of a sterile environment, which was water, he can become infected with viruses, bacteria, fungi, which can be fatal for him or have irreparable consequences.
A long anhydrous period, if the contractions do not come on time, threatens with acute hypoxia, the development of post-hypoxic brain lesions. The consequences can be the most unpleasant: cerebral palsy, traumatic deformity of the child's limbs, and even the death of a baby.
Infectious pathogens that can enter a woman's uterus during an anhydrous period can lead to complete amputation of the genital organ and the inability to have children in the future.
In this regard, the question arises when the contractions begin after the discharge of water.
The answer is ambiguous. In obstetrics, it is believed that the prognosis will be favorable if the contractions begin no later than 3-4 hours after the waters leave. If a child is in an anhydrous period for more than 12 hours, the development of severe consequences is possible. If the anhydrous period lasts longer than 48 hours, fetal death and infection of the woman's uterus is likely.
The task of a woman who has lost water is to immediately call an ambulance and go to the hospital as soon as possible. There is no point in sitting at home and waiting for contractions to begin.
If the cervix is not at all ready for childbirth, in such situations, a cesarean section is often performed in order to eliminate the risks for the baby.
But a specific decision should be made as soon as possible by qualified doctors after examination and assessment of all the circumstances. The outpouring of waters is the beginning of labor. There can be no two opinions.
What's next?
The outpouring itself can be complete or partial. If the water only leaks a little, the development of contractions can be delayed for a long time. If at least 150-200 ml of water has left at once, we are talking about a complete rupture of the bubble.
An outpouring is considered premature if the cervix is not yet ready for childbirth, there is no disclosure and smoothing. If the outpouring occurs against the background of disclosure, contractions, then the early discharge of amniotic fluid is considered when the cervix is open by only 4 cm. Normally, the water should leave when opening up to 5-6 centimeters. They say about the delayed departure of waters if the bubble does not open when fully opened.
The place of perforation of the fetal sac is also important - cervical or lateral. There can be quite a few factors influencing the contractile activity of the uterus. If time passes, contractions do not start in 4-6 hours, the question of stimulating labor is decided.
Recently, doctors have somewhat revised the approach, which for a long time was the only generally accepted one - to wait until the last. Previously, regulations instructed doctors not to induce labor, even in an anhydrous period, for 12 hours.
After the shocking statistics of the Ministry of Health in recent years on the number of birth complications in children and women in labor with a long anhydrous period, it is recommended to provide stimulating assistance earlier.
Stimulation is carried out in the case of a full-term pregnancy, not complicated by an umbilical cord entanglement, when the child is in the correct head presentation, with a medium-sized fetus. In order for a woman to start giving birth, she is injected with the hormone oxytocin, which causes contractions of the smooth muscles of the uterus.
If labor remains sluggish after stimulation, dilation is slow, a decision is made to perform an emergency caesarean section.
Surgically, a woman is delivered without waiting for the onset of contractions if:
- the released water had a green, dark color, an unpleasant odor, an admixture of meconium (feces) is possible, this often signals a state of fetal hypoxia;
- there were blood impurities in the waters - pathological processes in the placenta were not excluded;
- the outpouring of water was rapid, as a result of which parts of the child's body or umbilical cord loops fell out with the water into the genital tract (with partial opening), if they cannot be adjusted, a cesarean section can be performed.
The unnatural color of the amniotic fluid and their unpleasant odor may indicate an intrauterine infection, and therefore the child, for health reasons, needs to leave the mother's womb as soon as possible.
Be sure to inform the doctor upon arrival at the hospital about the color of the drained water. This will help you choose the right tactics.
You will learn what to do if the waters broke away without contractions in the following video.
