The preliminary date of delivery calculated by the doctor during registration coincides with reality in 25% of cases. Therefore, for some women, contractions come as a surprise, for others - a long-awaited harbinger. Obstetricians allow natural stimulation of childbirth for a period of 38 weeks, in the absence of pregnancy pathologies. But medical intervention in the hospital is prescribed only with the established maturity of the fetus and the simultaneous absence of signs of labor activity.

PDR is not the basis for making a decision on stimulation. A justified reason exists for a period of 40 obstetric weeks, after the conclusion of a gynecologist, based on the results of examinations. Can you safely induce labor? naturally. A special menu is used (spicy, herbs, oils), stimulation of sex hormones (sex, orgasm). The main thing is not to overdo it and inform the baby.

At the first birth, 69% of babies are not born at term due to the immaturity of the cervix. Therefore, during pregnancy, in the absence of a risk of miscarriage, stimulation of the muscles of the reproductive system with Kegel exercises is recommended. Training technique reduces the risk of injury for mom and baby.

To make a decision on stimulation, it is necessary to undergo an examination for pregnant women before childbirth: ultrasound, CTG, OAM, OAC. The results will assess the condition of the fetus, the readiness of the placenta, and identify risks. The formal diagnosis of postmaturity is established only after 42 weeks, but doctors do not take risks and act on the uterus earlier.

What week is labor induction? More often, stimulation is allowed for a period of 38 weeks for boys, at 39 weeks for girls. During this period, the formation of the fetus is completed, the lungs are ready for direct oxygen consumption.

In half of the cases, stimulation is prescribed a week after the PDR. Only 3% of women carry the fetus to 42 weeks, according to the doctor. During this period, the risks of infection, fetal hypoxia are increased.

Indications for stimulation:

pregnancy from 40 weeks;
fruit weighing from 4500 g;
multiple pregnancy;
kidney failure;
endocrine disorders;
gestational diabetes;
polyhydramnios.

It is allowed to accelerate the approach of childbirth at home, if no pathology of pregnancy and the fetus is detected. For example, when amniotic fluid leaks, the impact on the uterus is carried out only in a hospital. If you stimulate the start of labor at home for a natural birth of a child after caesarean section, the risks increase birth trauma, fetal hypoxia and uterine rupture.

Contraindications

It is not allowed to cause contractions for up to 38 weeks, without evidence. Light and vascular system the baby is finally formed in the last 3 weeks of pregnancy, when every day counts. Premature interruption of the gestation process ahead of time threatens with serious complications, up to death.

Minus the stimulation of childbirth - the lack of natural readiness of the uterus, muscle failure. If the tissues have not matured as a result of the natural preparation of the body, pressure on the channels will cause painful symptoms, contractions up to 12 hours, ruptures, fetal injuries.

Contraindications:

previous caesarean section;
wrong position fetus;
discrepancy between the pelvic bone ring and the diameter of the fetal head;
signs of the onset of labor normal condition fetus.

If there are scars on the uterus, stimulation is excluded due to the risk of ruptures. In 65% of cases it is prescribed reoperation, others are allowed natural childbirth after 5-7 years (with a wealthy scar). At the same time, obstetricians categorically prohibit the stimulation of a third birth after a cesarean section, the risk of rupture of the suture is 50%.

An incorrect position or discrepancy between the circumference of the fetal skull and the pelvis also excludes natural way. The head will not be inserted into the cervical canal, will not be able to advance in attempts.
If the cervix is open, the fetus is ripe, from the 40th week, stimulation with drugs in a hospital is recommended. Droppers, injections and tablets are not allowed at home.

Induced labor is more painful than natural, since the birth canals are not yet ripe, and the uterus is already pushing the fetus out. As a result - ruptures, fetal hypoxia, bleeding.

You should not bring contractions closer, with a normal CTG baby. Preparation time for each organism individually. Only 4% of women give birth on the pre-delivery date (with an error of 1-3 days), and only 7% really need to stimulate labor.

Natural stimulation methods

To approach contractions, it is necessary to accelerate the opening of the cervical canal so that the fetal head, under the pressure of water, moves down, stretching the amniotic bladder. This scenario is preceded by softening of the walls of the uterus. The stronger the blood flow and the more intense the production of the hormones prostaglandin and oxytocin, the earlier labor will begin. But if nature is slow at 38-39 weeks, the mother, with the permission of the doctor, can begin natural stimulation of labor.

How to speed up your due date naturally:

nipple stimulation;
sex with orgasm;
acupressure;
hot bath, steam room;
gymnastics;
manual inspection;
nervous stress.

Nipple stimulation. The impact on the chest helps the neck to open. You need to press on the nipples, twist for 10-15 minutes, every hour, pre-apply a moisturizer. Mild arousal promotes the production of oxytocin, which stimulates labor naturally.

Muzheterapiya. Similar but more strong action comes after having sex. Under the pressure of the penis, blood flow in the tissues increases, the walls of the vagina contract, transmitting an impulse to the uterus. Orgasm will enhance the effect.

Obstetricians do not deny the effect of inducing labor with sperm due to the content of prostaglandins in it. The substance enhances secretion, dilates blood vessels, stimulates uterine contractions. After sex, the birch pose is recommended, then the sperm will penetrate deeper.

Acupuncture. Natural way to induce labor - technique acupressure. between big and index finger, on the membrane, you need to grope for the connecting part and massage the central point for 60 seconds, with a break of 1 minute, 3 times per procedure. Repeat 5-6 times a day.

water procedures. Hot water and steam increase blood circulation in the pelvic organs. But the air temperature in the bath before childbirth should not exceed 60 C. The procedure is permissible only if the pregnancy proceeds without deviations. Sauna is not allowed in violation of blood pressure. But a bath with water heated to 37.7 C is acceptable for stimulating labor. You can add 5-7 drops lavender oil, which softens the neck and anesthetizes.

Gymnastics. According to most mothers, physical activity brings contractions closer. If you walk for a long time at a period of 37-38 weeks, the likelihood of an early onset of labor is doubled. Therefore, in maternity hospitals, visitors often observe pregnant women who “wind up” mileage by walking up and down the stairs.

An alternative to walking is recognized exercise to stimulate childbirth. Fitball exercises are recommended - while sitting, raise straightened legs alternately, hold each for 10-15 seconds. The way for the lazy is to lie on your back, placing a pillow under the pelvis, above the level of the head. Lie down for 15 minutes, 3 times a day. A popular method is the squatting position, keeping your back straight (3 minutes). Pregnant on later dates swimming is allowed and useful, 30 minutes daily. Recommended for fetal misalignment.

Labor induction with fingers carried out only by an obstetrician. The doctor inserts a hand deep into the vagina and makes circular movements. Cervical massage will bring the opening of the birth canals closer. Manual stimulation of labor is not performed after the outflow of water, due to the risk of infection.

Can coughing cause preterm labor? Yes, if the symptom is severe and prolonged. Walls are involved in the cough reflex abdominal cavity. Due to excessive tension of the abdomen, during dry severe cough, rises uterine tone, provoking the risk of miscarriage. The symptom is especially dangerous in the first and third trimester.

Can stress trigger labor? Yes, in 17% of cases the cause of prematurity is jar of Hearts, sudden jump cortisol levels. The stress hormone stimulates the immune response, awakens the reaction to eliminate additional burdens on the body, get rid of the fetus. preterm birth from stress in half of the cases pass with complications for the woman.

nutritional stimulation

The method is based, firstly, on the use of foods rich in prostaglandins or analogues. Due to the low concentration of the substance, stimulation has a cumulative effect and works in conjunction with motor and drug therapy. Laxative products contribute to labor activity, as they irritate the intestinal walls. Spasms are transmitted to the uterus, causing contractions.

How to induce labor naturally:

spicy food;
herbs;
beet;
a pineapple;
water from boiled eggs.

Chili pepper, garlic, cumin, spicy seasonings increase gastrointestinal motility. When food is processed, the intestines are irritated, as more intense contractions are required, the reflex is transmitted neighboring body- mother. Such a folk method is prohibited for pregnant women with stomach diseases. The consumption of baked beets or beetroot juice works similarly.

The most common types of herbs for inducing labor folk remedies- raspberry, nettle, barberry, ergot. Dry leaves are brewed with boiling water, infused for 20 minutes, taken half a glass, 2 times a day. It is useful to drink warm tea with raspberry leaves, with a slice of lemon and mint. The drink relaxes and stimulates the contraction of the walls of the uterus. There is a diuretic effect.

Decoctions are effective for bleeding to stimulate the uterus after childbirth. Due to the activation of contractions, dead endometrial cells are pushed out, accelerating healing.

Can raspberry jam induce labor? No, they only work fresh leaves raspberries. Even if you cook jam without getting rid of the leaves, the substances synthesizing the production of prostaglandin will not be preserved.

The substance bromelain contained in pineapple is similar in action to prostaglandin. It is believed that the use of 500-600 g of fruit per day will help the cervix to open.

It is believed that the water boiled eggs stimulates labor due to the production of calcium. The secreted substance envelops the walls of the uterus, nourishes the tissues, increasing their elasticity. Contractions are less painful, after childbirth the vagina retains its elasticity.

Medical stimulation

Today from ways traditional medicine women go to medicines. Moreover, the main active substance more often natural ingredient. Effective way to hasten childbirth by taking oils (castor oil, primrose, flax) with a laxative effect. The product is added to food, one teaspoon per day. Stimulants are purchased at a pharmacy or are used only in the hospital.

candles;
enema;
seaweed;
acupuncture;
artificial hormones.

Under influence glycerin suppositories, pelvic organs are stimulated. The drug of a special consistency dissolves inside, irritates the intestinal wall. An affordable inexpensive option is Glycerin, Microlax. Antispasmodic suppositories Buxopan, NoShpa anesthetize, soften the tissues of the uterus. Increased elasticity helps to avoid trauma during childbirth.

Enema as a stimulant effective only in a hospital when a large volume container is used. It is used in combination with other methods: droppers, injections.

Algae to open the cervix are called kelp. Elastic sticks, similar to a tampon, roll down from the stems and leaves of the plant. The agent is introduced into the vagina, dissolves (it is better to take a horizontal position). Under the action of secretion, the substance in tampons is synthesized into prostaglandin. Algae induce labor within 48 hours, effective for weak opening of the cervix.

Acupuncture - Eastern Medical equipment. The specialist uses acupuncture to target specific points responsible for transmitting impulses to certain areas of the brain. This includes the stimulation of the segment that generates the right hormone contractions start naturally.

From artificial hormones in the hospital, Dinoprost, Desaminooxytocin, Oxytocin (intravenously, drip) are more often prescribed. Doctors do not recommend Sinestrol to induce labor due to side effects. The cervix opens, but the substances in the composition of the drug irritate the inner walls of the uterus, provoke inflammation of the endometrium.

Efficiency folk methods denied by every second obstetrician-gynecologist. But forums and blogs are filled with arguments of established mothers about the effectiveness own ways stimulation. The main thing is not to rush to check the veracity of these stories and remember that the key to a successful birth is naturalness.

Most births begin naturally after 37 weeks and progress until the baby is born. In some cases this is not observed. Labor may not start when expected, or there may be medical indications for earlier removal of the child into the world. On the other hand, spontaneous labor may progress slowly and even stop. Contractions may stop or be insufficient to dilate the cervix and release the baby (called weakness of labor).

Sometimes slow labor can be spurred on by walking or changing position. Be patient, do not lose control of yourself. If you are tired or the baby is suffering, they will help you speed up the birth. If labor does not begin within 12 hours of rupture amniotic sac, the doctor may suggest artificial induction of labor activity - stimulation.

Stimulation is carried out very carefully. Doctors try to achieve the result of 1 contraction in 3-5 minutes, no more. During this procedure, doctors monitor the condition of the mother and child. If 3-4 hours pass after stimulation, but there is no result or there are contraindications to stimulation, then a caesarean section is performed. Problems with contractions and dilation of the cervix are most common in women with menstrual cycle, With endocrine problems, with inflammation. Before inducing labor, doctors must weigh the pros and cons.
Ways to induce labor
All methods of stimulation can be formally divided into those that stimulate the contractility of the uterus, and those that affect the opening of the cervix.

Methods affecting the cervix

In some women, the reason for the slow course of labor is the unpreparedness of the cervix for disclosure - in the language of doctors, its resistance or immaturity. The most common method to help the uterus "ripen" is the use of prostaglandins.

Prostaglandins are hormones that have a pronounced effect on reproductive function. In small quantities, they are found in almost all tissues of the body, but most of them in seminal fluid and amniotic fluid. Currently, the method of introducing a viscous gel or suppositories containing prostaglandins into the vagina or cervical canal is widely used.

With this method of administration, unlike others, side effects are minimal, and the effect on cervical dilatation is significant. Prostaglandin does not penetrate into amniotic sac in which the child is located. They are inserted deep into the vagina in order to accelerate and then open the cervix, which, in fact, is initial stage the birth itself. Prostaglandin suppositories also stimulate the production of prostaglandin in your body, which causes the uterus to contract. Gels and suppositories are completely safe, do not hinder your movements until their action begins (after 30 minutes). In the meantime, you can move freely around the room, waiting for the medicine to take effect.

Methods affecting the contractile activity of the uterus

In this group, the most popular among obstetricians are amniotomy and synthetically obtained analogs of natural hormones, in particular oxytocin.

Opening of the fetal bladder
This method has another name amniotomy. It consists in the fact that the doctor inserts a small plastic instrument that resembles a long hook into your vagina. The instrument is passed through the cervix, the fetal bladder is captured and then opened, which causes the outflow of amniotic fluid. This procedure is painless because the bladder has no nerve endings, but may not be entirely pleasant. After the water breaks, the pressure inside the uterus drops sharply. The baby's head begins to press on the pelvic bones and open the cervix, which provokes childbirth.

Amniotomy is considered safe method, it does not affect the child's condition in any way, any complications are quite rare. To avoid complications, if possible, try to carry out an amniotomy after the fetal head enters the small pelvis, squeezing the fetal bladder and the vessels passing along its surface. This prevents bleeding and prolapse of the umbilical cord. If contractions still do not start, you may need some kind of drug to stimulate contractions, since after the water breaks there is a high risk that any infection penetrates the cervix to the baby through the cervix.

Oxytocin
This is a synthesized analogue of the hormone produced by the pituitary gland. The action of oxytocin is based on its ability to stimulate contractions. muscle fibers uterus. Oxytocin is used in the form of tablets, but more often in the form of a solution for intramuscular and subcutaneous injection and especially - intravenous administration. The last use of the drug is the most common. True, he has a significant drawback: a woman with a connected drip system (“dropper”) is very limited in her movements.

Oxytocin does not affect the readiness of the cervix to dilate. In addition, in most women, after oxytocin begins to act, labor pain intensifies, therefore, as a rule, it is used in combination with antispasmodics (drugs that relax the muscles of the uterus). different women respond differently to the same doses of oxytocin, so there are no standard schemes for using this drug. Doses are selected individually.

Oxytocin is not used for: the impossibility of having a baby through natural birth canal, abnormal position of the fetus, hypersensitivity to the drug, placenta previa, the presence of scars on the uterus, etc.

The most common side effect of oxytocin is excessive contractile activity uterus, which can lead to impaired blood circulation in this organ, and, as a result, to a lack of oxygen in the fetus.
When is labor induction warranted?

Overwearing

The most common reason for inducing labor is if the pregnancy is longer than 40 weeks. This can lead to complications of pregnancy, when the placenta is less efficient at nourishing the baby. Some doctors prefer to artificially induce labor when the gestation lasts 10 days, others wait two weeks. During the waiting period, the child will be observed to check if he has any complications (lack of oxygen), if his development has slowed down. Samples of amniotic fluid are also taken.
Multiple pregnancy after 38 weeks

If you have multiple pregnancies, then labor is induced after 38 weeks because the babies are already mature and allowing them to continue growing in the womb can cause problems. Also, if an ultrasound done at 37 or 38 weeks shows that the baby is very large, you may be offered induction of labor to avoid the need for a caesarean section in the future. This is a difficult decision because the baby's weight is difficult to accurately determine.
Medical indicators of the condition of the pregnant woman or fetus

Some medical indicators of your condition or your baby may also speak in favor of stimulation. Rh incompatibility and some heart complications that require surgery may require a doctor to induce labor. Stimulation is also recommended if you suffer from preeclampsia, high blood pressure or diabetes, which worsen your condition or the condition of your baby.
Failure during childbirth
Premature discharge of amniotic fluid (since the likelihood of infection through the cervix increases);
The cervix does not open;
Weak, rare, short, unstable, irregular contractions for a long time;
Contractions suddenly stop;
The uterus is too distended due to polyhydramnios, a large baby or twins;
If a woman is tired and completely exhausted from contractions.
Is there a risk?

Induction of labor should only take place on medical grounds for the well-being of the baby or mother. Induction of labor carries some risks: artificially induced labor may be more painful than natural labor; stimulation may not work, labor will not progress, and this will lead to a caesarean section that would not otherwise be needed.

The decision to stimulate is made after it is decided which is more dangerous: to stimulate labor or to continue waiting. Your doctor needs to be sure that the baby will be better off outside the uterus, or if stimulation is due to your medical condition, that it is really necessary.

Even if everything goes smoothly, stimulation still brings discomfort. Artificially induced contractions are almost always stronger than spontaneous ones, the breaks between them are shorter, and the woman in labor does not have time to get used to their gradual increase. In labor that began spontaneously and then was accelerated, the contractions are also stronger. Their strength can be shocking. If you're on a drip, you can't move. You may need more pain medication.

There is a risk and negative consequences for a child. The child and the introduction of hormones should be carefully monitored. If the contractions caused by the administration of oxytocin are stronger than necessary for the progress of labor, they can reduce the supply of oxygen to the baby. All contractions reduce the supply of oxygen, but artificially induced contractions are more frequent and the child has little time to recover from them. Complications in a child usually occur precisely with this method of stimulating childbirth.
Stimulation is not carried out if:
The size of the baby's head does not correspond to the size of the mother's pelvis;
The child feels unwell according to the indications of the heart monitor;
Incorrect position of the child;
Maternal health problems (such as a uterine stitch or hypertension)

Medical procedures

Who needs labor induction and why?

Doctors have been studying the technology of stimulating labor and its effect on the body of the mother and child for a century. Today, there are many ways and drugs that can speed up and facilitate the process of childbirth. But no matter what cutting-edge medicines they give you, no matter how you are assured that the stimulation procedure is absolutely safe - remember that any interference with birth process can both positively and negatively affect childbirth.

Since the female body is designed by nature in such a way that a child can be born practically without outside help, groundless interference in childbirth can only do harm. True, today complications even in primiparous mothers are recorded more often. It's all because of the bad environment. late age the birth of the first child and, accordingly, large quantity chronic diseases in women giving birth.

In addition, doctors, having believed too much in miraculous devices and medicines, are now increasingly relying on average birth rates than on their own experience. According to statistics, in every Russian maternity hospital, labor induction is used in 7% of cases of childbirth, but this is only according to official data. And what is actually happening, one can only guess, because in many maternity hospitals this procedure is put on stream.

Most women who are offered induction of labor simply do not know, and doctors do not consider it necessary to inform them, that the introduction of medications can either speed up or slow down, or completely stop the natural process of childbirth. And this leads to additional medical intervention and increasingly to caesarean section.

After the operation is done, the doctors "calm" the woman with the words that this was the only possible variant, and that if it were not for her (the operation), the result could have been much sadder. The only thing they do not talk about is that the very stimulation of childbirth becomes the causative agent of surgical intervention.

Often women without complete information about the pros and cons of stimulation, and with the tacit consent of doctors, they very easily agree to “push” the birth process. They do not realize that childbirth may be faster, but the pain will not decrease from this, but will only increase, and the child will increase the risk of developing oxygen starvation, and, as a consequence, it may decrease blood pressure(and this is already an indicator that the child is suffering in utero, and you need surgery).

Of course, doctors must be trusted, and there are times when stimulation is really necessary and justified. But do not forget that any actions that the obstetrician decides on must be agreed with you or your authorized representative. Therefore, if you have such an opportunity, let your husband or one of the relatives whom you trust be present at the birth with you. And even if you are not able to make an adequate decision, they will be able to assess the situation more calmly.

And most importantly, you need to prepare yourself psychologically and physically for childbirth from the moment you found out about your pregnancy and decided to give birth. If you have no contraindications for health reasons, then walks on fresh air, swimming, sports - the most the best helpers in preparing your body and internal organs to such important point in the life of any woman, like childbirth.

Why is it necessary to induce labor?

In cases where childbirth does not begin naturally or does not progress, when there are medical indications for the birth of a child prematurely, doctors resort to stimulation of labor to open the cervix.

Stimulation of labor activity is necessary:

in case of post-term pregnancy (more than 42 weeks);

to reduce the risk of caesarean section in multiple pregnancies, or large size child;

to avoid birth complications in cases where there are medical indications for the health of the mother or fetus: kidney disease, thyroid gland, high blood pressure, gestational diabetes, umbilical cord prolapse.

The main disadvantages of labor stimulation:

the main disadvantage of stimulation is too strong an effect of drugs on the body of the mother and child. Hence the very painful contractions, the suffering of the fetus and, as a result, a caesarean section;

when a dropper is used in childbirth, a woman is forced to be in the most uncomfortable and ineffective position for the birth of a child - lying on her back. This increases the pain of contractions and interferes with progress in childbirth;

stimulation can cause the development of oxygen starvation of the fetus, and in some cases lead to disruption of the functioning of the child's cardiac system;

stimulation of labor can cause too long, very intense and painful contractions that require the introduction of an additional portion of painkillers;

the likelihood of uterine rupture along the scar, in the case of repeated vaginal delivery after caesarean section;

fetal distress. It is believed that childbirth occurs after the child releases a special hormone into the mother's body, which starts the birth process. If the birth is stimulated artificially, then the child is not yet ready to be born;

stimulation increases the risk premature detachment placenta, as well as the use of forceps or a vacuum extractor.

Types of artificial stimulation

The following methods are most often used to stimulate labor:

The introduction of analogues of natural hormones that trigger labor and enhance the contractile activity of the uterus

To prepare the uterus for disclosure, a drug such as oxytocin is used.

Oxytocin- refers to synthesized analogues of the hormone produced by the pituitary gland. Oxytocin is administered in the main form of intramuscular or subcutaneous injections. This drug has more minuses than pluses, and, in addition, there is a high probability of its overdose:

oxytocin causes non-physiological contractions and increases labor pain(therefore should be used in combination with painkillers);

the drug may increase the suffering of the fetus. Too long and intense contractions cause a decrease in the amount of oxygen supplied to the child. And children born with the help of stimulation adapt worse and more often have infantile jaundice;

the dose of the drug should be selected individually due to the identified increased sensitivity to it in many patients;

oxytocin should not be used if there is a scar on the uterus, placenta previa, an abnormal position of the fetus, or the inability to have a baby through the birth canal.

The use of prostaglandins

Studies show that it is much safer to use prostaglandins (prosten, enzaprost, dinoprostone, prostiv) to prepare the uterus for dilatation, causing milder contractions. Often the reason for the lack of progress in childbirth is the immaturity of the cervix. In order to "soften" it and cause contractions, doctors inject prostaglandins in the form of a special gel or suppositories deep into the vagina and cervical canal.

The benefits of using prostaglandins are that this drug does not penetrate the amniotic sac and does not restrict the movement of a woman during childbirth. At the same time, prostaglandins can slow down the transition to active stage childbirth. In some women in labor, the use of these drugs causes the development of headaches or vomiting.

Amniotomy

Amniotomy- this is the opening of the fetal bladder with a special hook that is inserted into the vagina, the fetal bladder is captured and opened, which causes the outpouring of amniotic fluid. This operation should be carried out by an experienced obstetrician and only according to indications.

To avoid possible complications, amniotomy is carried out, as a rule, after the baby's head has passed into the small pelvis, squeezing the fetal bladder and the vessels on its surface, which prevents the risk of bleeding and prolapse of the umbilical cord.

The main indications for amniotomy, according to gynecologists and obstetricians, are pregnancy overdose, and as a result, deterioration of the placenta, as well as the risk of oxygen starvation of the fetus.

One more important reason to the use of amniotomy may become preeclampsia.

Preeclampsia- this is a complication during pregnancy, the main symptom of which is the appearance of edema ("dropsy of pregnancy"), as well as, in more severe cases, increased arterial pressure and the presence of protein in the urine. Opening the fetal bladder during preeclampsia can help a woman in labor and prevent complications during childbirth.

Another indicator for this operation, which is much less common, is the Rhesus conflict.

But we must not forget that this manipulation can be unsafe. In Russian maternity hospitals, sometimes they do not even warn about amniotomy. And the consequences of such an operation can be very sad. Contractions may never come, which will require the use of other medical preparations- oxytocin, and rare cases can lead to infection of the fetus or prolapse of the umbilical cord.

Despite the fact that the stimulation of labor is used everywhere today, in some cases it is forbidden to do it.

Contraindications for artificial stimulation:

maternal health problems (endocrine disorders, diabetes, suture on the uterus, etc.);

incorrect position of the child;

discrepancy between the size of the child's head and the size of the mother's pelvis;

deterioration in the child's health (according to the indications of a heart monitor).

As well as medical methods labor induction, there are natural ways that help speed up or start childbirth. The only thing to keep in mind is if you decide to use one of the methods natural stimulation please consult with your physician first. No matter how safe or pleasant this or that method seems to you, it is better to coordinate your actions with a specialist.

Natural methods of labor induction:

Xclothes

During a long walk, the baby presses on the cervix, which causes it to begin to open. This method only works if the cervix has already begun to flatten in anticipation of labor.

sexual intercourse

Semen contains the natural hormones prostaglandins, which soften the cervix and promote uterine contractions.

Orgasm

Promotes muscle contractions uterus.

Nipple massage

Increases the content of the hormone oxytocin in the blood. True, such a procedure requires more time than the use of artificial drugs. Massage should be done three times a day for ten to twenty minutes. Some doctors recommend performing this procedure only while in a hospital where it is possible to monitor the condition of the mother and child.

For example, a long walk and any active actions.

Acupuncture

There are several points, the impact on which contributes to the natural stimulation of childbirth. These dots are between the index and thumbs, in the upper part of the shoulder, in the sacrum, near the ankle, on the outer part of the little finger at the base of the nail (information can be found in books on acupuncture) and, according to experts, are associated with the uterus. Their stimulation helps the woman relax, which relieves pain and starts the birth process.

Any normal labor activity begins at 38-40 weeks of pregnancy. But some women even at this time do not have any urge to give birth, in which case you have to resort to a qualified medical assistance. In the maternity hospital, doctors conduct labor stimulation so that the child is born safely. In this article we will talk about what methods are used in this case.

Labor induction is a challenge to the onset of labor in women who have reached a period at which this process does not begin naturally, which increases the risks to the health of the child and mother. Based on the foregoing, it becomes clear that stimulation is not carried out for all women in labor, but only for those who have indications for it:

If a woman has already carried the baby significantly in time, that is, she has not begun childbirth even after the period has reached 42 weeks. If this happens, then the probability increases:

that the placenta will grow old and will not fully perform the functions assigned to it;
change the color of amniotic fluid - they accumulate toxic substances that can harm the fetus;
the child suffers in the womb from a lack of oxygen.

The second reason why labor is stimulated in the maternity hospital is a multiple pregnancy or polyhydramnios, which can stretch the uterus too much, and this can be a direct threat to the life of a pregnant woman.
If a woman suffers from chronic diseases that complicate the course of pregnancy and negatively affect the health of the child. It's about about diseases such as diabetes, heart or kidney failure.
Women whose waters have broken, and the birth process has not begun (contractions do not occur), must be stimulated, because the child becomes very vulnerable to different kind infections.
If the cervix does not open during labor or in general, if labor is weak.

In what cases it is impossible to stimulate labor in the maternity hospital?

women whose first birth ended in a caesarean section, and the second time she is going to give birth on her own (if stimulation is carried out in this case, the old suture on the uterus may break);
pregnant women who, according to ultrasound, have been diagnosed with an abnormal position of the fetus in the uterus or some health problems have been identified in the child, because of which he simply may not survive the passage through the birth canal.

Consequences of stimulation of labor in the maternity hospital

Labor after stimulation can begin quickly and pass without dangerous consequences for many women. However, there are other situations when stimulation ends sadly for the woman in labor and complicates the birth process. Let's take a closer look at what complications threatens to stimulate labor:

Contractions will be much more painful. Because of this, it may be necessary additional reception painkillers.
A woman can experience a lot of discomfort due to stimulation, especially if a drip is given. She can not take the position in which she is comfortable to be.
The child may suffer from hypoxia, which will negatively affect his development and health.
Stimulation may simply not give any results, which is why you have to resort to surgical intervention.

In general, a doctor must weigh the pros and cons a lot of times before prescribing a woman to stimulate labor, because she can not only help a woman give birth, but also harm her and her child.

Medical methods of labor induction in the maternity hospital

First, let's figure out how mechanical stimulation of labor occurs, that is, medical. Depending on the situation, in each case, the doctor may resort to different methods stimulation of labor activity. Which ones exactly:

The very first and most common procedure, which is absolutely painless for a woman in labor, is the detachment of the amniotic membranes. It should be noted that this procedure, although painless, is not very effective. It may not give any results.
If labor activity does not begin, then prostaglandins are introduced to the woman in labor, which contribute to the opening of the cervix, because under their action (like sperm, in which there are a lot of these biologically active substances) it softens. Of course, in the hospital, prostaglandins are injected into the vagina like suppositories to induce labor. They dissolve, while the woman does not experience any discomfort. Instead of suppositories, a gel can be used to stimulate labor, which is also based on prostaglandins. It can be administered every half hour until the cervix begins to actively open.
If there is no noticeable result even after the above drugs for stimulating labor, then doctors stimulate labor by puncturing the amniotic sac. But this is only permissible if the baby's head has already sunk to the bottom of the uterus, otherwise serious complications, for example, with an amino hook, a gynecologist can hook not only the amniotic sac, but also blood vessel which will cause bleeding.
After the bladder is punctured, the doctor can put a drop with oxytocin to the woman, which stimulates the contractile activity of the uterus. However, oxytocin can make these contractions so painful that a woman cannot endure them for long. Together with oxytocin, a woman needs to be given pain medication, which will slightly alleviate her condition.
Lately, many maternity give birthing pills to induce labor. These pills women drink on early dates pregnancy to terminate it artificially. Modern gynecologists believe that the use this method stimulation of labor activity is the most acceptable of all existing. Usually, best pills to stimulate labor - Miropriston. Due to the fact that these pills have contraindications, which include, for example, diabetes, other birth control pills, Pencrofton, can also be used.
Very rarely, gynecologists use Foley to stimulate labor. This is a tool that has the form of a canister with a tube inserted into the cervix. This catheter to stimulate labor increases the tone and motility of the uterus. The doctor will need to inject a special saline solution into the cervix through a balloon to stimulate labor.

Natural induction of labor

Of course, it is most correct that the stimulation of labor activity takes place under the strict supervision of doctors. But some procedures that can provoke childbirth can be done independently at home. What is one of them:

First of all, it is sexual intercourse, which among women is called “muzheterapiya”. Why is sex one of the effective ways stimulation? At the moment of orgasm, the uterus contracts intensively under the influence of oxytocin and prostaglandins produced by the female body, which are contained in male sperm which can induce natural childbirth. In other words, sexual intercourse is a complex stimulation of labor activity. By the way, the usual foreplay before intercourse can also provoke tribal activity. For example, nipple massage is a great way to induce labor. His woman can do it herself.
Castor oil is often used by women to induce labor. Actually Castor oil does not directly affect labor induction. It promotes enhanced digestion, acts as a laxative, and it is intestinal motility that helps the uterus to start naturally shrink.
Can be performed special exercises to stimulate labor or simply perform some kind of active physical exercise- wash floors, wash, clean. But, of course, all this should be done only at the time when it is already possible to give birth.
Sometimes labor is stimulated with gynecological massage. Held this procedure in the hospital and contributes to the onset of labor.
A woman at home can use kelp to stimulate labor. These are ordinary algae, which are sold in pharmacies in the form of sticks. They soften the cervix 16 hours after they are inserted into the vagina.

Do not treat labor induction as a process that will make your condition much easier. It is best for the child and for you that everything happens as naturally as possible. Agree to stimulation only if there is a medical indication for it.

Video: "Stimulation of labor at 38-42 weeks"

If there are indications in the hospital, activities that cause labor can be carried out. labor induction(induction, stimulation of labor) is considered appropriate in cases where the risk of its implementation is lower than the risk of further continuation of the pregnancy and there are no contraindications to natural childbirth.

Often used to induce labor full readiness for childbirth from the cervix.

Mature cervix- soft, shortened, with a disclosure of 1.5-2 cm. In addition, the duration of pregnancy, the location of the placenta, the number of births in a woman are taken into account. With an immature cervix, labor induction methods are used to promote its maturation.

To check the readiness for childbirth of the body of a woman can be used special tests, for example, oxytocin or mammary, which assess the degree of excitability of the uterus and the reaction of the fetus to such artificial contractions.

Indications for labor induction

Many are wondering, is it possible to induce labor? If there is a reason for that, then it is even necessary. Indications can be general, as well as on the part of the mother or fetus.

Are common: gestational age of 41 weeks or more with signs of postmaturity of the fetus, premature rupture of amniotic fluid in the absence of labor, severe polyhydramnios, pathological preparatory period with irregular exhausting contractions.

Mother: diabetes, severe forms gestosis and preeclampsia, others common diseases, complicated or progressing as a result of pregnancy, threatening life and health during its prolongation.

Child: intrauterine growth retardation, severe malformations, hemolytic disease fetus, antenatal fetal death. Among relative readings mention should be made of a presumably large fetus and twins at 37-38 weeks.

Contraindications

Along with indications for labor induction, there are contraindications:

narrow pelvis;
abnormal position of the fetus;
scar on the uterus;
full presentation placenta or umbilical cord;
primary acute illness genital herpes;
severe fetal distress;
some serious illnesses pregnant;
cervical myomatous node.

With some other contraindications, the situation is considered by doctors on an individual basis, during which a conclusion is made on the admissibility or refusal to induce labor.

Possible complications may be as follows:

placental abruption;
hyperstimulation of the uterus up to rupture;
prolapse of the umbilical cord;
fetal disorders varying degrees;
infection;
increased risk of caesarean section and other interventions in the birth process;
postpartum hemorrhage.

Methods of initiation of labor in a hospital

Pharmacological methods consist in stimulating the start of the birth process with the help of various medicines. These include drugs inducing labor, with content synthetic analogues oxytocin or prostaglandins.

Prostaglandins - special hormones that affect the change in the structure of the cervix, stimulating its maturation and, to some extent, relaxing lower section uterus. In addition, prostaglandins stimulate the production of natural oxytocin in female body which also enhances uterine contractility.

Prostaglandin preparations are available in various forms, dosages and with different commercial names. Of the most commonly used form of the drug can be called gel containing prostaglandin E2, which is inserted into the posterior fornix of the vagina or into the cervical canal. It is allowed to use this method only with a whole fetal bladder. The effect can be expected in a few hours, but it may be necessary reintroduction. In total, up to three injections per day are allowed. If there is no effect, then it is considered that further administration is inappropriate.

Also, prostaglandins, like oxytocin, can be administered intravenously as solutions. This method works much faster, while it is possible to influence the frequency and strength of contractions by changing the rate of infusion of the dropper. However, the risk of developing uterine hyperstimulation is higher than with intravaginal administration. Interval between administration of prostaglandin E2 and oxytocin should be at least 6 hours to avoid the development of uterine hyperstimulation. However, simultaneous drip administration of these drugs is also possible with a halving of the dosage of each. The introduction of oxytocin is usually acceptable only when the amniotic sac is opened. The effectiveness of oxytocin is assessed 2.5-3 hours after administration.

Often women are offered a drink birth control pills. Most often this drugs based on antigestagens (mifepristone), which block the action of progesterone, thereby contributing to the onset of uterine contractions.

Non-pharmacological methods :

Opening of the fetal bladder - amniotomy - a fairly often used method in maternity hospitals, indicated for a mature cervix, can be supplemented, if necessary, by the introduction of oxytotic agents, if labor has not begun 2-3 hours after the puncture. In 50% of cases, additional ways labor induction after amniotomy is not necessary.