Only at first glance, the second birth seems easier than the first. If during pregnancy with the firstborn in women there are a lot of questions about the signs, duration and characteristics of the birth process, then with repeated pregnancy everything seems already familiar and understandable. In fact, second births require no less detailed explanation, because they have specific features that women may not even know about. In this article, we will talk about the differences between second births, when they begin and how long they last.
When to give birth?
Most Russian families today decide on a second child. In the USSR, the second child was considered, if not a luxury, then the maximum number of children per family. Today, the attitude towards having many children has changed, and more and more parents decide not only about the need to give birth to a second baby, but also a third and fourth.
The second child is a more conscious parental choice than the firstborn. It is no secret that the first baby is often given birth due to "it happened", among those who come to the hospital for the second baby, there are not so many "unplanned" ones. Parents already know what they are going for, what difficulties and responsibilities they will face.
The second pregnancy usually proceeds more smoothly, unless, of course, it is associated with complications and pathologies. In the process of carrying crumbs, mom knows and understands a lot. She already knows what tests and why she passes, why it is necessary to visit a gynecologist on time. But regarding the timing of childbirth, there is more incomprehensible to a pregnant woman than when carrying a first child.
Popular rumor has it that the second child is usually born before the first child. There is some truth in this. Term delivery in obstetrics is considered to be childbirth that occurs in the period as close as possible to the PDD - the estimated date of birth. But the date indicated in the exchange card is only an approximate guideline. No more than 5% of babies are born within the specified period. Delivery is considered timely if it occurs from week 37 of pregnancy to 42 inclusive.
The second children are rarely worn up to 42 weeks, not every baby "sits" in the mother's tummy even up to 40 weeks. The cervix of a woman who has already given birth is weaker, it softens and opens faster, and therefore the pressure of the head of the crumbs on it from the inside ultimately leads to the fact that labor begins before 40 weeks. The most common second birth occurs between 38 and 39.5 weeks of gestation.
But the maternal factor (the condition of the cervix and the birth canal) is not the only one that affects the term of labor. There is also a fruitful factor. If the baby is not ready for birth for some reason, labor will not start.
In order for regular reflex labor to begin, it is necessary that a sufficient amount of oxytocin, estrogen is produced in the woman's body, and the concentration of progesterone decreases, so that the cervix becomes soft and smoothed, so that the uterine tissues are prepared for contractile activity, so that the fetus gains the required mass and the placenta is sufficiently ripe ... The starting process is very complex from a chemical, biochemical and physiological point of view.
Surprising fact: second births are often "ordered" by women. If a pregnant woman initially tunes in to give birth to a baby by a certain date - by her husband's birthday, by the beginning of his vacation, then with a probability of up to 80% this is exactly what happens. It is difficult to give this clear explanation from the point of view of medicine and science, it is possible that there is an auto-training effect.
Duration
Another common popular opinion regarding second births is duration. It is argued that childbirth lasts less than in the first case. There is also a great deal of truth in this. If in primiparous women the entire period of childbirth from the first contraction to the release of the placenta can take from 9 to 14 hours or even more (labor is considered protracted, which lasts more than 18 hours), then women in labor who come to the hospital for the second time usually give birth during the period from 6 to 8 hours (rarely - 10 hours). Obstetricians talk about a fast and rapid second birth, if the whole process ends in 2 hours. In primiparous, the criterion for the rapidity of labor is 4 hours.
Reducing the time of childbirth is primarily associated with the better preparedness of the female body for contractions, attempts. The muscles are more stretched, the genital tract and cervix "remember" what should happen and in what sequence. The genital tract is more elastic, whereas at the first birth, the child encounters serious resistance when passing through them.
All stages of labor for the second time are faster, and this is a fact. Contractions are shortened due to faster neck opening, pushing due to muscle elasticity. The only stage at which a woman can stay longer than during the first birth is the stage of birth of the placenta. It is the elongation of the uterine tissues that leads to a tighter adherence of the placenta, so its birth is difficult, but not for everyone.
The duration of labor is shortened not only for anatomical and physiological reasons. An experienced woman in labor already knows how to breathe, when to push, how to relax, how to follow the obstetrician's commands, and this is an important skill.
Do all women have a second birth faster than the first? Unfortunately, it is impossible to give an unambiguous answer to this question. Any childbirth, regardless of what they are in the account, is individual and unique in its own way. Therefore, there are those who gave birth to their second child as much in time as the first, and even those who spent more time in the second birth than the first time.
But still, for most women in labor, the repeated process is more intense, more energetic and less painful. Correct behavior, psychologically higher readiness for the process, understanding of what is happening and the absence of alarming uncertainty that torments primiparous, in this case, they do their job - natural mechanisms of pain relief work, as a result of which the woman notes that childbirth was not associated with acute and intolerant pain reactions ...
How is it going?
All stages of childbirth will be exactly the same as the first time, but they will proceed with some peculiarities. Even if the first child was born difficult and painfully, you should not immediately recall the horrors and nightmares with the first contractions in the second childbirth (painting them in darker colors than it was in reality), since the second birth will feel different.
The first stage of labor is labor, unless, of course, labor begins with the outpouring of water (this happens in about 10% of cases). The first contractions are latent. They are not associated with acute pain even during the first birth, and during the second very often they go unnoticed at all. Slightly pulls the lower back, the lower abdomen aches slightly. Over the last month of bearing a fetus, a woman gets used to such sensations, and therefore cannot always identify the onset of labor. In addition, the multiparous is tuned to about the same beginning as the first time, and this is the main mistake.
As a result, when the expectant mother begins to realize that she has begun regular labor pains, the cervical dilatation is already sufficient to go to the hospital. The latent period, which in primiparous lasts up to 8 hours, in women during the second birth is reduced to 5-6 hours, after which quite frequent contractions occur - once every 5 minutes and the disclosure reaches 3-4 centimeters.
Active contractions that follow latent contractions last no more than 3 hours in multiparous (during the first birth - up to 5-6 hours). This period should no longer be spent at home, but in a hospital. This is where comfortable poses that come to mind in time will come in handy, in which it is easier to wait out the fight. At the first birth, a woman tries different options, selects a comfortable body position. At the second, she already remembers in which position she felt good the last time, and immediately does what will be easier and more comfortable. This greatly facilitates the second stage of contractions.
The third stage - transitional contractions, usually lasts about half an hour in the second birth. The uterus reaches its maximum opening and during a vaginal examination its boundaries are no longer determined - the baby's head is ready for birth.
When there is a desire to push hard, with increased downward pressure, the second-birth usually clearly knows - it's time to call the doctors and go to the delivery room, as the attempts begin. If the birth is not the first, usually by this time the outpouring of water has already occurred.
The second stage of labor begins. At this time, it is important for a woman to breathe correctly in order to help the baby to be born faster. The head is born first, if the fetus is in the cephalic presentation, then the shoulders. Then the baby leaves the genital tract entirely. If the woman in labor does everything in accordance with the requirements of the obstetrician - pushing when the appropriate command follows, resting when required, then the likelihood of rupture and injury to the fetus during childbirth is reduced.
The need to protect the perineum from rupture by surgical dissection (episiotomy or parineotomy) in the second birth occurs less often than in the first. The exception is cases when a woman in the perineum has scars from ruptures in the first birth, since the likelihood of repetition of the rupture, if the first was serious and deep, is quite high.
After the birth of the baby (the second period, usually during the second birth, takes no more than half an hour - forty minutes), the baby is applied to the breast and transferred to neonatologists for examination, weighing, Apgar assessment. Obstetricians continue to deliver - the third period begins, in which the placenta and the remnants of the membranes must leave the uterus.
The afterbirth ("baby's place") should detach from the wall of the uterus, and therefore be born in 1-2 attempts. Uterine contractions usually resume, but they no longer have such a pronounced intensity and are not perceived as painful by a woman. Quite often, during the second birth, there is a need for manual assistance to a weakened uterus - the obstetrician can facilitate the separation and exit using one of the existing methods of exposure, or manually separate the placenta.
Then the woman enters the early postpartum period, which will last up to 4 hours. In general, the recovery period from the point of view of obstetricians lasts 42 hours. It has been noticed that those giving birth again quickly restore strength, get out of bed earlier. They have fewer difficulties and difficulties in establishing full lactation, with the attachment of the baby to the breast.
If the wards in the maternity hospital are intended for the joint stay of a mother and a child, then such women are better at caring for a newborn from the first hours of his life.
Psychological nuances
Separately, it is necessary to dwell on the psychological readiness for repeated childbirth. It is only at first glance that it is easier and easier for a woman, everything that happens is clearer. In practice, and female psychologists working in consultations are forced to state this, a woman going to a second birth experiences no less than the first time, and sometimes even more.
Indeed, it is much easier for women who had their first births relatively easy and successful to have repeated ones. There is no negative and difficult psychological experience. In this case, the confidence, calmness, balance of the woman in labor really have a positive effect on reducing pain, and on reducing the duration of the stages and periods of childbirth.
It is much more difficult to accept the upcoming childbirth for women who were "unlucky" in the first childbirth - childbirth was difficult, complicated, accompanied by ruptures, postpartum pathologies. They involuntarily transfer the existing experience to the idea of the upcoming birth process and mentally prepare for the repetition of the negative scenario. Fear is deeply rooted in them, which does not contribute to either reducing pain, or shortening the duration of labor, or easy opening of the cervix, since at the physical level, fear causes muscle tension, "clamps" and blocks.
That is why the correct psychological preparation before the second birth is needed no less than before the first, and sometimes to a greater extent. A psychologist can help a pregnant woman with a consultation, his appointment is free. You just need to inform the obstetrician-gynecologist who monitors the pregnancy about your desire to talk to a psychologist.
Such classes with a specialist will not be superfluous for women who had a cesarean section for the first time, and the doctors allowed to give birth to their second child on their own. Their fear is even stronger, because each of the expectant mothers is afraid not only of pain and for the health of the baby, but also for the condition of the stitches on the uterus - they can disperse already during the contractions, the uterus can rupture. Such women are explained that the likelihood of rupture is small, childbirth with a scar on the uterus is taken with special attention and care, moreover, a surgical team is always ready, which at any time can carry out an emergency caesarean section if the physiological delivery goes according to an unplanned scenario.
It is imperative to seek help from women who are in difficult social or personal circumstances. The second pregnancy is not always desirable, the spouse does not always support the wife's desire to have a second baby, the family does not always have sufficient financial support. And therefore, disturbing thoughts about how and what to feed the baby after birth, how to raise him, at what means, sometimes bring the pregnant woman again to a real nervous breakdown.
In general, the second pregnancy pleases women more than the first. These happy and difficult nine months are rethought in a new way, with a different mood the woman collects the dowry for the baby, everything is filled with a deeper meaning. The expectant mother has almost no time to discuss possible terrible agony and serious consequences with her friends, because the first child requires care, attention, and education.
Doctors note that multiparous are more efficient - they do not have to be persuaded to take an analysis or visit an ultrasound office. Understanding the essence of the process and knowledge of the characteristics of one's own body have a positive effect on both bearing and the process of giving birth to a baby.
Possible complications
The likelihood of complications after the second birth in women is at the same level as after the first. The only caveat lies in the fact that the likelihood of developing postpartum bleeding in patients who have become mothers twice is slightly higher than in those who have given birth to their first child. This is due to the greater elongation of the walls of the uterus, weakness of the uterine muscles and cervix. It is these two factors that create a certain threat of hypotension and uterine atony in the postpartum period.
The reproductive organ needs to shrink to its previous size, the process of reverse development begins, the so-called involution of the uterus. It is this process in a woman who has given birth twice may be weaker, and therefore the contraction will proceed slowly, abnormally. Doctors undoubtedly know about the increased risk, therefore, from the very first hours, they will monitor the contractile ability of the uterus in the postpartum women with special attention. If necessary, she will be injected with contraction drugs that will intensify spasms and will facilitate the discharge of blood lochia and a decrease in myometrial fibers.
It should be noted that with the modern development of medicine, inflammatory and stagnant phenomena associated with uterine hypotonia, postpartum hemorrhages due to a weak uterine tone are not as common as before. In multiparous, according to statistics, this happens in 0.5% of cases. In almost 100% of cases, a woman, if this happens, is provided with competent and timely medical care, so nothing threatens her life.
The likelihood of infection in the uterus, the development of endometritis or endometriosis after the second birth is at the level of statistics for the first birth - 1.7-2.5%. The likelihood of inflammation of the sutures in the perineum, if there were spontaneous tears or surgical incision, does not exceed 3-5%, provided that the woman adheres to the requirements of hygiene and the rules for caring for the sutures in the intimate area.
A tangible risk after the birth of a second baby for a woman is viral and other common diseases that can begin already in the early recovery period. Immunity was undermined by childbirth, there was a certain blood loss, and therefore it is rather difficult for the body of the mother to resist viruses and bacteria. But even this problem can be dealt with by observing preventive requirements. Also, a woman should remember that in the presence of a history of chronic diseases after repeated childbirth, the likelihood of an exacerbation of these ailments is slightly higher.
What affects the nature of the birth process and rehabilitation?
What will be the second birth and the subsequent recovery after them, depends on many reasons and factors. If desired, a woman herself can assess all the possible risks. The doctor in consultation and the medical staff in the hospital will do this without fail. The likelihood of deviations from the classic second birth picture described above and the higher risks of complications depend on several factors.
- The gap between childbirth - if the first birth was only a year ago, then both pregnancy and the birth of a baby can be associated with great risks, because the woman's body did not have time to sufficiently recover after the first birth. A too long break (more than 8-10 years) can bring unpleasant "surprises". The woman's body “forgets”, the same “muscle memory” is partially lost, which makes repeated childbirth easier and shorter, so childbirth can proceed like the first time with all the ensuing consequences. A break of 2-4 years is considered optimal.
- Age. It is believed that age does not matter for second or third births, it is important only for primiparous. This is not true. Over the years, the quality of oocytes deteriorates in women, and therefore the probability of congenital defects and chromosomal abnormalities in a child is higher. And it doesn't matter what kind of childbirth is coming. Older women, as a rule, already have chronic diseases that aggravate both pregnancy and childbirth. The likelihood of complications is higher in too young women giving birth to a second baby under the age of 19. The optimal age is between 19 and 35 years. But women in 40 and older may well give birth easily and without consequences for the health of the baby. The main thing is pregnancy planning, examinations and timely diagnosis.
- Features of the current pregnancy. A single pregnancy is usually easier than a multiple pregnancy. Carrying a fetus and childbirth, both for the first and second time, is aggravated by factors such as a large fetus, placenta previa, umbilical cord entanglement. In some cases, a woman, even who has successfully given birth for the first time, is asked to complete her second pregnancy with a planned caesarean section so as not to expose her and the baby to unnecessary risk.
Do you need preparation?
A woman who is about to give birth for the second time, along with a primiparous woman, will be asked to enroll in courses for expectant mothers at an antenatal clinic. On them, a woman will be able to remember and refresh in her memory the breathing technique in childbirth and massage techniques for natural pain relief of contractions. During the courses, specialists will answer all questions - about childbirth, pregnancy, and caring for a baby.
There is never too much parenting experience, especially since almost every year new medicines, new methods of providing obstetric care, and new methods of pain relief appear. The woman will be told about all this at the preparatory courses, and there will be much fewer questions directly in the hospital.
Courses for women who decide to give birth to a second baby with a partner will be especially useful. Partnership childbirth requires especially careful joint preparation, because the husband in the hospital is not an outside observer, but a real participant in the process with his responsibilities.
It is important for a woman who is going to become a mother twice during pregnancy to engage in her physical form, to prevent muscle weakness and hypotonia - a lot depends on their condition during childbirth. A complex of Kegel exercises is especially recommended for multiparous. It helps to strengthen the pelvic floor muscles weakened after the birth of the first child. You also need to eat right, take vitamins recommended by your doctor, and avoid stress.
Pain management issues
Repeated labor is advised to pay attention to methods of natural pain relief. The author of one of the most popular is the French obstetrician Fernand Lamaze. This is a complex training, which is based on proper breathing, aromatherapy, special exercises for relaxation, auto-training. Only confidence in success and complete muscle relaxation, according to the French specialist, can guarantee less painful sensations during the birth of a baby.
In any case, a woman giving birth again at any time of childbirth can count on the help of medical personnel. The Ministry of Health recommends giving women pain relievers on demand. A woman is not obliged to suffer and suffer in childbirth, this is contrary to the principles of the doctor's humanity. Therefore, today epidural anesthesia is actively used, in which anesthetics are injected through a lumbar puncture into the epidural space of the spine.
If there are no contraindications to such anesthesia, it may well be applied for the first, and for the second, and for any subsequent childbirth. You can identify contraindications in advance by talking to an obstetrician-gynecologist in consultation or with an anesthesiologist at the hospital.
If for a number of reasons such anesthesia cannot be given to a particular woman, she will be offered other methods - medicines with anesthetic and antispasmodic effect, intravenous administration of drugs - muscle relaxants, etc. It is better to discuss possible methods in advance with the doctors of the selected maternity hospital when signing an exchange card in it ...
Reviews
According to women, second births are completely different from the first. Most often they are lighter and faster, but everything is very individual. Often, at the birth of a second child, women decide on certain experiments - for vertical childbirth, childbirth in water. But most of those with generic experience still prefer the classic option - the maternity hospital. The degree of patient confidence in doctors, according to surveys, also increases in comparison with the first birth. Women in labor are more informed and disciplined.
Only a small percentage of mothers claim that the second birth was much more difficult than the first.
For information on what mistakes need to be considered after the first birth, see the next video.
