The expected due date is approaching or has already expired, and the baby is in no hurry to be born. Many women face this situation, especially primiparas. At the same time, it is becoming more and more difficult to carry a large child, and all the wishes of a pregnant woman come down to making everything happen faster.
Late terms are exhausting, a woman gets tired, and therefore the question arises quite logically: "Is it possible to accelerate childbirth, to promote their beginning on their own at home?" In search of an answer to this question, women can meet with different advice, and not all of them are equally useful, and some are frankly harmful and dangerous.
The beginning of labor - how does it work?
The female body prepares for childbirth not only in the later stages, but practically throughout the entire pregnancy. This physiological process requires multifaceted preparatory measures. And childbirth as a culmination is just a logical conclusion of amazing processes and transformations in the organisms of the mother and fetus. The onset of labor is indicated by the onset of regular contractions or the passage of water. Childbirth, if it is not premature (pathological by default), begins when everything is ready for it.
Let's start with the uterus. The female reproductive organ during pregnancy is a reliable "house" for the baby. So that nothing threatens the baby while it grows and develops, the cervix is tightly closed. With the onset of labor, she has to gradually open up and give the baby the opportunity to leave the womb. Contractions contribute to this. But the uterus itself cannot contract - it is a muscular organ that is incapable of strong rhythmic long-term contractions if a number of conditions are not met.
For example, in late pregnancy, cells of the uterine tissue (myocytes) accumulate a special substance - actomyosin, and it is this substance that gives the cells a temporary ability to vigorously contract.
For contractions (contractions) to begin, in a woman's body, a hormonal generic dominant with a predominance of the hormone oxytocin should form. If progesterone during the entire period of gestation of the baby "took care" of maintaining the "interesting position" and the continuation of gestation, then before childbirth its concentrations decrease and decrease to such a level that estrogen begins to predominate. The mechanism of menstruation is exactly the same: a drop in progesterone and an increase in estrogen lead to endometrial rejection, menstruation begins. Before childbirth, the same hormonal change occurs, but additionally supported by oxytocin, produced by the pituitary gland and the placenta.
The approach of labor is also assessed by the condition of the cervix. This round muscle is prepared for opening in advance, softening and somewhat smoothening, due to which it becomes shorter and opens slightly before delivery. From the inside, the head of the fetus presses on the cervix (the baby sank and with all its weight, plus the weight of the waters, the placenta, tries to "lay down" on the cervix from the side of the internal pharynx). At the same time, the cervical canal begins to produce new specific enzymes, which gradually thin the membranes. When the time is right, the shells can burst, and water will begin to drain.
Preparations are underway in the child's body. The lung tissue matures, the baby gains weight, as this will help him breathe on his own after birth and maintain body heat. The nervous system is reformed, reflexes are trained.
Only when all the conditions we have listed coincide, full-fledged, normal labor activity begins. During contractions, the cervix gradually opens until it reaches its maximum full (10-12 centimeters, depending on the size of the pelvis). At the second stage of labor, attempts begin, and the baby is expelled through the birth canal outward. At the final stage, the afterbirth is born, after which the recovery period begins, during which the uterus contracts to its previous size for quite a long time.
No one can say when a particular woman will be ready for childbirth, when it all starts.
As soon as all internal preparation processes are completed, this will definitely happen. Much depends on the characteristics of pregnancy and women's health. For example, first-borns are in no hurry to be born, like large babies, but twins are not in a hurry to "sit out" until the PDD. The term, which is indicated in the card as intended, is therefore called the alleged what no one guarantees that labor should begin on this day. According to medical statistics, no more than 5% of babies are born during this period, and all the rest choose the time before and after the PDD.
Normal (urgent, that is, on time) delivery is considered from 38 to 42 obstetric week. Your PDD is the end of Week 40. therefore the absence of labor during this period is not considered a pathology.
Do you need stimulation?
If your week is 39, 40–41, or even 42, there is nothing to worry about. It is not worth asking a doctor to stimulate labor or to advise something effective for this purpose. Until all stages of internal preparation are completed, labor will not begin. The need to induce childbirth is spoken about only when the woman is clearly postponing the child.
To understand the criteria for the need for stimulation, it is worth familiarizing yourself with the basic requirements and provisions of the protocol of clinical recommendations of the Ministry of Health of the Russian Federation on induction of labor. This document for doctors and obstetricians describes all the ways and situations in which stimulation is needed.
So, A post-term pregnancy is considered a direct indication for induction, and this is 42 full weeks of pregnancy. It is also recommended to stimulate childbirth if there is a suspicion of fetal distress, as well as for certain diseases of the mother, which in the later stages can pose a danger to the baby's life, for example: diabetes mellitus, glomerulonephritis, pulmonary ailments, severe hypertension and gestosis. It may be necessary to stimulate labor if a woman is suspected of infection of the membranes (chorionamnionitis), as well as in case of proven fetal death in utero.
In some situations, stimulation is performed without medical indication, but in this case, there must be weighty social ones, for example, a woman's residence at a great distance from the hospital, when it is quite obvious that she will not be able to get to the medical facility quickly in case of labor.
Important! It is considered advisable to stimulate labor only when the risks from prolongation of pregnancy significantly exceed the risks of the stimulation itself.
If such risks exist, the doctor must necessarily discuss them with the patient and her relatives. Without written consent, women in labor will not stimulate labor.
The stimulation itself is carried out exclusively in a hospital. At home, this is impossible and dangerous. Do not think that induction of labor is safe and painless - it always comes with risks:
- an immature baby may be born (ultrasound and gestational age are not yet an indicator of the biological and physiological maturity of the fetus);
- surgery may be required (episiotomy, caesarean section);
- stimulation can cause disturbances in labor (weakness of labor forces or rapid labor, which in both cases is dangerous for the life of the mother and fetus);
- there may be problems with the life of the baby (pathological CTG, hypoxia, ischemia, hemorrhage);
- there is a risk of uterine rupture;
- increased risks of prolapse of the umbilical cord and parts of the fetus.
The document provides mandatory assessment of all indications and contraindications. It is very important that the cervix is ripe not less than 6 points on the Bishop scale. It means that it should be softened, ajar, shortened. If the cervix is not ripe, obstetric response measures are needed first to ripen it.
To prepare the cervix in the maternity hospital, prostaglandin preparations are used. They are injected in the form of a gel into the cervical canal, into the vagina. Mechanical methods are also used, for example: kelp sticks, occasionally a Foley catheter. The challenge at this stage is to achieve maximum softening and shortening of the cervix in order to facilitate its opening after the initiation of induction.
As soon as the cervix is recognized as mature, the doctor can choose, according to the protocol of the Ministry of Health, any of the accepted modern methods of stimulation. The most widespread method is in which amniotomy and oxytocin. The woman is transferred to the birth ward in the early morning, a puncture of the membranes (amniotomy) is performed. The discharge of water is controlled by an obstetrician, their color, transparency, quantity are assessed. The woman is then left alone for three hours. It is believed that during this time, most women in labor begin labor.
If after 3 hours they have not begun, oxytocin is injected intravenously, the fetus is monitored by CTG.
A woman should not be alone. An obstetrician or doctor is present next to her. They add the dosage of oxytocin as needed until the contractions are intense.
Sometimes misopristol (Mifepristone) is used to stimulate labor. Vaginal tablets are inserted into the birth block, placed in the posterior fornix of the vagina. If necessary, the introduction is repeated after 6 hours. Also, tablets can be administered orally under the supervision of a physician.
Stimulation of labor is a serious medical measure. It is extremely dangerous to carry it out on your own. therefore women who are thinking about finding methods and causing childbirth at home on their own need to think carefully about whether they are ready for possible serious complications, the death of a baby, his disability, if something goes wrong... Even in a hospital, doctors cannot guarantee that the stimulation will go smoothly, let alone home "experiments"!
therefore Trying to induce labor on your own is a big and unjustified risk. And you need to be afraid not that the attempts will not be crowned with success, but that they will be successful, in which case complications are possible at any stage of childbirth.
Home methods: efficiency, pros and cons
For a long time, women have been puzzled by the question of how to bring an important day closer, because fatigue in the last weeks reaches its peak - both psychologically and physically a woman is exhausted. And therefore, popular rumor and alternative medicine know several dozen ways that they recommend to expectant mothers as self-help measures in matters of approaching childbirth. How effective they are, whether it is worth using them, should be considered in more detail.
Movement, gravity, and stair climbing
This group of tips is the most common. A woman is advised to move more at home in order to bring childbirth closer, to speed up the process of cervical maturation - advice that makes sense. With adequate movement, exercise, walking, walking, the processes of cervical ripening really proceed somewhat faster. That is why doctors advise not to lie on the couch at a later date, but to walk and move.
But traditional medicine has gone further - it recommends squats, lifting weights and strenuous activities, such as walking repeatedly up and down stairs. It is believed that this is what can provoke generic activity and bring closer the onset of such a long-awaited birth. And such advice is very dangerous.
First of all, there is no scientific data that would confirm that physical activity in any way brings childbirth. There are only observations of gynecologists, who say that mobile women rarely alter babies, and those leading a sofa lifestyle often overdue. Secondly, physical activity does not in any way affect the endocrine background, and we remember that hormonal levels are one of the decisive factors in the onset of labor. And finally, intense loads, lifting weights and squats with a huge belly can lead to placental abruption, bleeding, and premature discharge of water.
If contractions do not begin 3 hours after the outpouring, you will still have to go through medication stimulation. If placental abruption occurs, doctors will have no choice - to save the woman and the baby, they will have to give the woman in labor a cesarean section.
Adequate loads and walks, light exercises (without jumping, lifting dumbbells and squats) are useful exclusively from the point of view of muscle training... The condition of muscle tissue is important for the progress of labor. The better their tone, the easier it is to give birth. Walking improves blood circulation and is an excellent prevention of hypoxia.
Based on these facts, do not take the advice too literally and bluntly. Moving furniture, jumping and squatting with dumbbells is risky, do not jeopardize the well-being of the child, because you have worn it for nine long months.
Adequate load includes morning exercises, walks in the park (away from gas-polluted highways), yoga for pregnant women (if you have done it before, of course). While cleaning the apartment bends and squats should be avoided... And if you really want to walk up the stairs, do it very carefully. As soon as shortness of breath appears, heart rate increases, it is worth stopping the exercise so as not to cause a pressure surge.
Remember, neither cleaning nor the ladder will bring your birth closer, they only help you to keep your muscles in good shape, and this will help to give birth to a baby more easily.
Hot tub, steam bath, sauna and swimming
As with exercise, swimming helps prepare muscles and ligaments for the difficult process of childbirth, In addition, water treatments allow you to relieve stress, improve mood, appetite and sleep - but what else does an expectant mother need before giving birth? But neither swimming nor showering will help speed up the internal processes of preparing the female body for childbirth. Anyway, while there is no direct evidence of the effect of swimming on the timing of labor in medicine.
The hot tub, steam bath and sauna deserve a separate discussion.
Exposure to high temperatures increases blood circulation - this is an indisputable fact, which is why we come out of hot water reddened and ruddy. But in the later stages, increased blood flow in the vessels can be very dangerous - primarily for the state of the placenta. A hot bath and a hot bath can lead to her heart attack, detachment and the development of bleeding. At the same time, the child will experience severe acute hypoxia, which is fraught with death or disability for the rest of his life, since the lack of oxygen primarily negatively affects the tissues and blood vessels of the brain.
Additionally, there are risks of a sharp jump in pressure, loss of consciousness, and the development of preeclampsia. And therefore pregnant women in the third trimester are not recommended to go to the bathhouse and wash themselves in a hot bath. To keep the body clean warm enough shower, which is not dangerous for mom and baby.
If your mucous plug has already departed or is just leaving (jelly-like discharge, with or without blood streaks), then the bath and the pool are also prohibited due to possible intrauterine infection - the water is non-sterile, and the cervical canal is no longer reliably protected by a mucous plug. From the vagina, germs, bacteria and viruses can easily penetrate into the uterine cavity, which is dangerous for the life of a woman, and especially for the life and health of the baby.
Often women, especially primiparas, do not notice the beginning of the cork discharge, it can come off entirely or be separated in parts, and therefore a woman before being examined by a gynecologist has absolutely no confidence that the cork is in place.
A similar ban on bathing and swimming comes into force from the moment the water flows out, as well as from the moment it starts to leak. If the discharge has become more abundant, thinner, do not take the risk and try to induce labor with hot water. This will most likely fail. But the risk of infection of the baby will be high.
A warm shower is acceptable in all cases, it helps to slightly reduce the discomfort typical of late periods in the lower back, sacrum, back due to effective muscle relaxation.
Water procedures do not affect the term of labor itself.
Intense sex, "muzherapy"
The advice to make more love for the approach of childbirth, which sometimes not only women give to each other on the forums, but also obstetricians, have a certain scientific justification. Semen contains high amounts of naturally occurring prostaglandins. And if a couple has unprotected sex, then these very substances gently contribute to the maturation of the cervix (remember that in the hospital, ripening is also carried out using gels based on prostaglandins!).
There are several "buts", and you should definitely know about them in advance. The obvious effect of "muzherapy" produces not so much on the woman as on the future dad. He usually likes this method of preparing for childbirth. A man's mood, self-esteem rises, he is complacent and positive. The concentration of prostaglandins in semen is ten times less than that contained in pharmaceuticals to accelerate the ripening of the cervix. And therefore sperm does not have a pronounced effect.
In addition, no one promises that prostaglandins will increase the level of oxytocin in the body. They only have a softening effect on the round muscle of the neck itself, but do not affect the generic dominant. What does it mean? This means that sex is very useful in the absence of contraindications for improving blood supply to the genital tract, for the normal psychological and emotional state of the expectant mother (in the later stages, I especially want to feel desired and loved, no doubt about it), but sex cannot bring childbirth as such.
During orgasm, a woman's level of oxytocin slightly increases (which provides small contractions of the muscles of the uterus). And it is clear that with the opening of the cervix, already by 2 fingers, this amount could be enough for the body to receive a signal to start labor, but with this disclosure, sex is usually no longer recommended - all for the same reasons for the safety of the baby. And in other cases, orgasm does not give a significant impetus to the onset of labor, but has other advantages: The rush of blood to the uterus provides a more saturated filling of the placenta, the baby receives more oxygen. And the hormones of joy (serotonin), which are produced at the time of orgasm, enter the baby with the mother's blood - why not please the baby?
"Muzheterapiya" is categorically contraindicated if the woman has begun to discharge or has already come out of the cervical mucous plug, if water is leaking, if the placenta is low (high risk of bleeding).
Doctors also prohibit sex in later stages for women who are pregnant with twins or triplets, as well as during pregnancies after a successful in vitro fertilization protocol.
In these cases, the prohibition applies not only to the sexual act itself, but also to masturbation. In any case, before practicing this method, it is better to ask the opinion of a doctor who observes the pregnant woman and knows the features of her condition. If the doctor does not mind, then remember that sex in the later stages should be gentle, neat, delicate, non-traumatic, you cannot use lubricants and lubricants with different effects (cooling, warming), do douching. This can disrupt the microflora of the vagina, and the normal condition of the birth canal is very important for natural childbirth.
Nipple massage
Among all the popular advice, this is one of the best. The fact is that with light gentle massaging of the nipples of the mammary glands in the woman's body, small doses of oxytocin are produced - the very hormone that forms the generic dominant, giving the brain the command to "start". And if the delay in the onset of labor at 41, 42 weeks of gestation is associated precisely with a small amount of oxytocin in the blood plasma, then the method can indeed be quite effective.
But a low amount of oxytocin is far from the only factor due to which labor can be delayed. And if the real reason lies in something else, for example, in the immaturity of the cervix, then nipple massage is unlikely to be effective.
Should the method be applied? Why not! This is not only useful, but also pleasant, and you can also do it as part of preparing the mammary glands for the upcoming breastfeeding. The nipples will be more "strong", and at the beginning of lactation there will be fewer problems with cracks, soreness when latching the baby to the breast.
Massage should be combined with obligatory water procedures for the breast: Pay off the breast twice a day with cool water, wipe off with a hard towel. This may not help in getting closer to labor, but it will definitely benefit the comfort of breastfeeding afterwards.
Diet and folk remedies
During the last month before giving birth, a woman is advised to follow a diet. In the diet, the amount of calcium-rich foods should be reduced - the baby's needs for it are no longer so great, but the premature hardening of the baby's skull bones has not yet facilitated labor. Also, do not lean on meat and fatty foods, on sweets. It's better to design the menu in such a way to have more vegetables and fruits rich in fiber.
This is an excellent prevention of constipation in the later stages (and as a result - the prevention of such a common complication as hemorrhoids).
But the benefit of a vegetable diet before childbirth (from about 37-38 weeks) is also that uncrowded intestines will not press on the posterior fornix of the uterus. And this will help reduce the unpleasant sensations that are characteristic of women in the later stages.
Traditional medicine advises expectant mothers to approach labor drink tea with raspberry leaves, eat the fruits themselves. This is a very useful product, but you should not be too zealous: raspberries are a highly allergenic berry. Some recommend using caraway seed oil, as well as evening primrose oil, rubbing these funds into the external genitals. For any use of such funds it is better to consult a gynecologist. There is no scientifically proven, convincing data that at least something of the above somehow affects labor, But there are contraindications for plants and essential oils, and doctors are well aware of them with the relevant competence.
To eat right before childbirth, without harm to health, safe and beneficial for mom and baby, advice to drink wine should be avoided (some recommend stimulating labor this way). Any alcohol is dangerous for a pregnant woman and a child in any quantity and for any period. In addition, knowing about the mechanisms of development of labor, now you understand perfectly well that a glass of wine or brandy cannot affect hormones and start the birth process.
Laxative
This is another popular recommendation for women who want to give birth faster. Someone advises ordinary rectal suppositories, and someone suggests drinking castor oil. Castor oil (castor oil) has a pronounced laxative effect. Magnesia is used similarly. But there is no need to talk about the benefits of such funds, and to say that it is safe, in general, the language does not turn.
Indeed, constipation does not at all contribute to early childbirth, but their absence does not particularly bring the long-awaited moment closer. The fact is that different hormones are responsible for intestinal peristalsis and for contractions of the uterine muscles in a woman's body, and one is not connected with the other.
Cleansing the body occurs naturally. Experienced mothers know that diarrhea usually begins a few days before childbirth - this is how the body cleans itself. We can say that nature itself takes care of the cleanliness of the intestines before the birth of a baby.
If diarrhea is forcibly stimulated with enemas and laxatives, a completely undesirable effect can be achieved. - intestinal dysbiosis, dehydration of the body, washing out of the intestines of all nutrients that simply will not have time to be absorbed.
The state of dehydration is life-threatening, and dysbiosis will not be the best "companion" during recovery in the postpartum period.
What to do?
First of all, a woman should not be ashamed of her desire to give birth faster. After the arguments about the dangers of independent attempts to stimulate labor, many may begin to feel embarrassed - this is unnecessary. The desire to give birth faster is quite natural, and there is no need to hide it. Above all, it does not need to be hidden from your doctor. It is imperative that you share your thoughts and advice with him. If the doctor sees no contraindications, he himself will advise you on sex, a warm shower, and walking, and even raspberry leaves in tea.
But no doctor will ever recommend pills and gels to speed up labor at home. The only thing that's allowed is "No-Shpa". This antispasmodic from 38–39 weeks of pregnancy helps to prepare the cervix, as it relaxes the smooth muscles (and the cervix also belongs to them).
Do not even try to buy oxytocin and inject it yourself intramuscularly (by the way, there are such tips on women's forums!). This may represent mortal danger, since it is impossible to foresee and predict how the female body will react to changes in hormonal levels even in a maternity hospital. If you want to give birth to a healthy, full-term baby, be patient - there is very little time left to wait.
