How successful and easy the birth will be depends not only on the qualifications of the chosen doctor and the conditions of the maternity hospital, not only on psychological and emotional preparation, but also on how easy and fast the process of cervical dilation will take place. It is worth taking care of its preparation in advance.
Why is this needed and when to start?
The cervix is a universal female organ, or rather, part of the uterus. While a woman is carrying a baby, the cervix ensures a tight closure so that the fetus does not leave her cavity ahead of time. When the time comes to give birth, the cervix begins to open, and when its opening becomes full, the fetal head can leave the womb and begin to move along the birth canal.
A normal full-term pregnancy ends in labor between weeks 38 and 42. Approximately one and a half months before that, numerous preparatory processes begin to take place in the cervix., because opening the neck is a very responsible process, which is not subject to the will of a woman, it occurs reflexively. In many ways, the state of the cervix depends on hormonal levels, muscle readiness, and the characteristics of a particular pregnancy.
But to all women starting at 38 weeks, a gynecological examination is performed to determine whether the cervix is ready for the upcoming birth.
The cervix is a round muscle, inside it is the cervical canal, which connects the uterine cavity and the vagina. But nothing from the genital tract can get into the uterus during pregnancy, since the cervical canal is reliably closed with a mucous plug.
A month before giving birth, the cervix during normal pregnancy begins to shorten. From the original 4 centimeters, it decreases in length to one centimeter.
In these last weeks before childbirth, everything is very important - from the hormonal background to the psychological state, since the fears, anxiety and anxieties that the expectant mother may experience increase muscle clamps, which not only interferes with the preparation of the cervix, but can also cause a lot of complications in the process childbirth.
The process begins from the moment the abdomen drops. The fetus begins to press the head against the inner ring of the neck. Under this pressure, a slow and systematic opening of the internal pharynx occurs. The process involves hormones and enzymes.
As soon as the cervix becomes mature, reaches a shortening of 1-0.5 centimeters, it is believed that labor can start at any time.
Women who are waiting for the birth of their first child have a longer disclosure, the process starts in advance, the internal pharynx gradually opens first, and the external one begins to open last. In those giving birth repeatedly, both the inner ring and the outer one open almost simultaneously, with a slight difference in time, and therefore childbirth in the second or third pregnancy proceeds faster. Cervical preparation also begins very shortly before childbirth and proceeds much faster.
Preparation of the cervix for dilatation is carried out in a hospital if there are no signs of maturation after 38 weeks... This parameter is estimated in points on the Bishop scale. The cervix is considered to be mature if it scored, according to the gynecologist, from 5 to 8 points... Anything less than these values is considered an insufficiently mature or immature cervix and requires medical attention if the due date has already approached.
If there are still 1-2 weeks ahead, there is no reason to stimulate the cervix. It is quite possible to get by with methods that are transmitted from generation to generation through the female line and are considered quite effective.
Home preparation
It is believed that one of the most effective ways help the cervix to ripen and soften by the right time - sex without a condom... The ejaculate contains natural prostaglandins that soften the round muscle before childbirth.
But this method is not shown to everyone: if there is placenta previa, if a woman is pregnant with twins, if she has an obstetric pessary or other complications of pregnancy, sex is contraindicated.
Also, they do not have sex after the passage of even a small part of the mucous plug from the cervical canal or with leakage of amniotic fluid - this will increase the likelihood of the onset of labor with an unprepared cervix, which is fraught with ruptures, and also increases the risk of infection entering the uterine cavity.
It is worth adding oil to the diet about a month before giving birth - olive, sunflower, linseed... They help increase the elasticity of muscle tissue. Foods that help soften the cervix are fish and dairy products, chicken breast, fresh vegetables and fruits rich in vegetable fiber.
Raspberry leaves in the form of a decoction or as part of a cup of green tea are allowed to be taken from the 37th week of pregnancy... A drink in the amount of a glass per day will help soften the neck, if the gestation period is 37 weeks, two glasses, if the period is 38 weeks, at 39 weeks you can take three, and at 40 weeks up to a liter of decoction of raspberry leaves per day.
Softening at home should always be agreed with the attending physician... In some cases, medications are prescribed - "No-Shpa" and candles "Buscopan", "Papaverin" also contribute to the preparation of muscle tissue, since they are antispasmodics.
According to the reviews of women in labor, massage of the external genitalia with sterilized vegetable oil has an excellent effect... Evening primrose oil also works, but before using it, be sure to consult a doctor.
It is useful to move more, to do housework, naturally, reasonable and feasible. Walks are important.
You need to understand that any home preparation should not go beyond reasonable boundaries, otherwise childbirth may begin earlier than the date marked for the baby.
How is it prepared in the hospital?
There are two types of medical preparation of the cervix, for which there are indications and contraindications:
mechanical methods - sticks of kelp, Foley catheter;
drug methods - hormonal drugs - tablets, suppositories, gel for application directly to the cervix.
Stimulation of the maturation of the cervix in the hospital is carried out at 40-41 weeks, if the cervix in terms of maturity "does not reach" the norm. It can be softened by the introduction of a Foley catheter. To soften the neck, this method is used less and less today, since more effective and less unpleasant methods have appeared.
The catheter is a thin silicone-coated latex tube. The lower end is equipped with a small balloon. The tube is inserted into the cervical canal and the balloon is filled with saline or water. The balloon presses on the cervix, which causes it to expand. The result is evaluated within a day. But practice shows that in about half of women with a post-term pregnancy, the Foley catheter brought nothing but pain.
Kelp sticks are dried algae about 6 centimeters long. Their width is different, and which sticks to choose, the doctor decides, depending on how the cervix itself is ready for the birth process and what is the width of the cervical canal. It is there that sticks are introduced, which, under the influence of moisture, begin to swell and expand the canal mechanically.
Algae additionally produce a certain type of prostaglandin, which also helps to soften and open the neck. After a day, the signs are assessed and a decision is made - to go to give birth or to introduce more kelp. The effectiveness of the sticks is marginally higher than that of the Foley catheter.
Medicines ("Mifepristone", "Miropriston") show better results, since they affect the hormonal background, sharply lowering the level of progesterone. The drugs are also controversial. In world medical practice, they are used to terminate early pregnancy (medabort). I have to take two tablets with a difference per day. Labor usually begins within 24-72 hours.
Sometimes women mistakenly refer to these drugs as labor stimulation. "Mifepristone" stimulates nothing, does not affect contractions. It affects the cervix and changes hormonal levels.
If the contractions do not start in the indicated period, it is possible to stimulate the administration of oxytocin preparations, but only on the condition that the agent has worked and the neck has matured (the effectiveness of "Mifepristone" reaches 98%).
Useful Tips
On the Internet, you can find many useful tips on how to bring the day of birth closer if you are already unbearable to wait, but experts do not recommend blindly following them, since even herbal and folk remedies that are advised to use for cervical ripening can be dangerous for the mother and fetus.
Any impulse of the expectant mother to contribute to softening and opening the cervix must be coordinated by her with the attending physician, otherwise the consequences can be very tragic. Only a doctor can accurately assess the condition of the birth canal and answer the question of whether a particular remedy can be used.
