No normal birth occurs spontaneously. In addition to the constantly changing hormonal levels, many more changes occur in a woman’s body. For example, changes in the cervix are noted several weeks before the expected date of delivery. It is this process that ensures the birth of a child, and how severe it will be depends on how well it goes.

The anatomical changes that occur to the cervix in connection with preparation for an early delivery begin somewhere from 32-34 weeks of pregnancy. They are expressed in the fact that this anatomical structure softens significantly along the periphery, but near the cervical canal it is still possible to palpate fairly dense tissue. In those women who are about to undergo their first pregnancy, during a vaginal examination, you may find that the tip of the finger can penetrate the external pharynx. In those giving birth, the patency of the canal allows one finger to penetrate up to the internal pharynx. At approximately 36-38 weeks, almost complete softening of the cervix is ​​observed. Further dilation is also stimulated by the fact that the fetus presses on the cervix with its own weight (during this gestational period, the fetus descends into the pelvis).

The process of opening the cervix begins with the internal pharynx. In primigravidas, the canal becomes similar to a truncated cone, the base of which will face upward. Due to the gradual movement of the fetus forward, its further expansion is observed. In multiparous women, the process of opening the cervix is ​​much easier and faster, due to the fact that already at the end of the gestational period the external os is open by 1 finger. This category of women in labor is characterized by simultaneous opening of the external and internal pharynx.

The ideal cervix before childbirth - what is it like?

A common feature of the cervix of both first and multiparous women is that it sharply shortens (smoothes), becomes thinner, and the canal allows 2 or more fingers to pass through. Over time, the cervix becomes fully dilated to 10-12 cm. This makes it possible for the fetal head and torso to pass through the birth canal.

The period of contractions - what happens to the cervix?

This period is the longest - it lasts until the uterus opens to a size that allows the fetus to pass through. The most pressing question for expectant mothers is how much should the cervix open (how many fingers to let through) in order for the birth process to begin?

Dilatation of 2 fingers - when to give birth?

In principle, it can be indicated that before the start of the delivery process, the uterus will be dilated by at least 2 fingers, and at the same time it will be smoothed. But it is very difficult to say anything about whether a woman will begin to dilate to 2 fingers upon reaching the cervix - first, it will be necessary to find out how intensively the dilation occurs during the contractile activity of the myometrium.

Characteristics of different periods of contractions. Anatomical features of the uterus before childbirth

The period of contractions is divided into a slow period, otherwise called the latent period, and a fast period (otherwise known as the active phase of contractions). The duration of contractions lasts about 10-12 hours in primiparous women, and 6-8 hours in women giving birth.

The latent phase begins from the moment contractions acquire a certain rhythm - as a rule, they occur at intervals of 1-2 in 10 minutes, the duration of this phase is about 6 hours and there is no pronounced pain syndrome during it. The duration of this phase in primiparous women is always an order of magnitude longer.

The use of medications at this stage is not indicated, but the need to prescribe tocolytics for women in labor whose age is less than 20 or more than 35 years cannot be ruled out. At this time, a dilation of about 3 cm is already observed, but the exact time of the onset of labor cannot yet be indicated, since the alternating contraction of the uterine myometrium with its subsequent relaxation is just beginning. The result of these processes is a shortening of the length of the cervix. Taking into account the fact that the baby’s head is adjacent to the entrance to the small pelvis, the amniotic sac begins to put pressure on the internal os, resulting in its opening.

Is it possible to tell when labor will occur by the size of the cervical dilatation?

The doctor can tell you after what time period the process of delivery begins when the cervix reaches 4 cm dilatation. It is complete effacement and such dilatation that clearly indicate that the active phase of contractions is starting. Regardless of what kind of birth is expected, the duration of this phase does not exceed four hours. Further disclosure is carried out in record time. The speed of this process is about 2 cm per hour for first-time mothers, and 2.5 cm for repeat births. Once the cervical dilation reaches 5 cm, delivery can be expected within 2 hours, since for normal passage of the fetal head and its body, the dilation must be about 10, and sometimes 12 cm.

What sensations does a woman experience when the cervix dilates?

The pain syndrome during contractions becomes most pronounced after five centimeters of opening. In order to alleviate the condition of the pregnant woman, the following measures are taken:

1. Non-medicinal: massage; warm bath, relaxing music.
2. Drug pain relief - the drug can only be chosen by the attending physician.

In the event that, when the cervix is ​​fully opened, the waters do not drain spontaneously, an opening of the amniotic sac is indicated. At the same time, full dilation is possible only with a sufficient level of contractile activity of the myometrium - weak labor activity is an indication for its stimulation. When performing this intervention, extreme caution must be taken, since if the lumen of the cervix is ​​not opened, stimulation cannot be carried out at all - this can lead to serious consequences, including the occurrence of obstetric hemorrhage.

What changes does the uterus undergo before childbirth?

With increasing gestational age, partial replacement of the muscle tissue of the cervix with connective tissue occurs. “Young” collagen fibers appear, characterized by more pronounced flexibility and extensibility than their counterparts outside pregnancy. A certain percentage of them is absorbed, resulting in the formation of the main substance, leading to an increase in the hydrophilicity of the tissue. For the clinical course, this is of great importance, since this process ensures loosening and shortening of the cervix, as well as gaping of the cervical canal. It is thanks to this feature that the so-called smoothing of the cervix occurs.

What problems may be associated with the process of cervical dilatation?

From approximately 37-38 weeks of the gestational period, the physiological dominant of pregnancy gives way to the dominant of childbirth, and the uterus becomes not a womb, but an organ that is entrusted with the main function of expelling the fetus. In this situation, the possibility of a certain psychological barrier cannot be excluded, which, without appropriate preparation, can lead to hormonal imbalance. Because of this, the cervix does not undergo any changes, and the process of preparation for the upcoming birth is disrupted.

In order for the uterus to open fully, regular labor will be required. If labor contractions become weak, the process of cervical dilatation automatically stops. Often, the picture under consideration must be noted with polyhydramnios (overstretching of the uterus is observed, resulting in a deterioration in its ability to contract) or oligohydramnios (there is a flaccid or flat amniotic sac that cannot affect the cervix with the proper intensity).

Similar problems can most often be found in women over 35 years of age. In this case, the so-called tissue rigidity (low elasticity) contributes to the development of pathology. This feature is one of the most unfavorable reasons that often necessitate a cesarean section in women in labor in this age category.

How is the preparation of the cervix for childbirth stimulated?

It often turns out that just before the date of the expected birth it turns out that the pregnant uterus is “not ready” and its artificial preparation for the upcoming process is necessary. This issue becomes much more relevant after the 40th week of pregnancy. This is explained by the fact that it is during this period that the functionality of the placenta is extremely depleted, which can cause fetal hypoxia.

In this case, the issue can be resolved in two ways - with or without the use of medications:

1. Medication method is quite effective and helps to achieve the desired result in the shortest possible time, however, it can only be implemented in a hospital setting, since its implementation requires medical training.
2. Introduction of kelp sticks into the cervical canal. They are placed along the entire length of the cervical canal, and after 4-5 hours, under the influence of moisture, they swell, which contributes to mechanical opening. In addition, another useful property of kelp in this situation is its ability to secrete endogenous prostaglandins, which also contribute to the process of cervical ripening. This method ensures the fastest and gentle preparation of the cervix for the process of delivery, which will happen in the near future;
3. Introduction of synthetic prostaglandin into the lumen of the cervix in the form of suppositories or gel. Provides the necessary clinical effect within 1-2 hours;
4. In stationary conditions it is carried out amniotomy(violation of the integrity of the amniotic sac). After the water is released, the fetal head descends, which leads to increased pressure on the cervix, due to which dilation occurs faster.

How to help dilate the cervix at home?

1. Non-drug method in principle, it can be used at home, but before that you need to carefully analyze all its pros and cons:
2. Cleansing enema. The use of this method leads to irritation of the posterior wall of the uterus, which provokes contraction of the myometrium. In addition, a relationship has been established between the discharge of the mucous membrane and the proposed procedure - a cleansing enema promotes its rapid discharge, which provokes dilatation of the cervix. However, it is indicated only for those women who are due today or have already passed, but the child does not want to be born;
3. Sex. This is the most natural stimulant for the onset of labor. Firstly, intimacy promotes contraction of the muscles of the uterus, increasing the intensity of blood circulation in it. Secondly, male seminal fluid contains prostaglandins, which are activators of the contractile activity of the myometrium. This method of stimulation is contraindicated if the mucus plug has already come off, as the likelihood of infection increases significantly;
4. Moderate physical activity. Long walks in the fresh air, cleaning the house, walking up the stairs. Not allowed for preeclampsia and placenta previa.

After reviewing the information provided, you have learned the reasons for the disruption in the process of preparing the cervix for labor, so you can take preventive measures to prevent such an undesirable phenomenon. In any case, you must remember that first of all you need to take into account the recommendations of your attending physician, since only he knows best the individual characteristics of your body and can decide on the advisability of following one or another management tactics.

The birth of a child is the most exciting event for every pregnant woman. In order for the birth to be easy and painless, and for the baby to be born completely healthy, the expectant mother must know the main stages of this process. Often, when women hear from their gynecologist that the cervix is ​​2 cm dilated, they are filled with anticipation. What does this mean and how soon will labor begin?

Periods of labor

In order to properly prepare for childbirth, a woman must have a clear understanding of the anatomical features of the process. The most important organ of the reproductive system in the female body is the uterus, which is a muscular organ consisting of several elements - the body itself, the fundus and the cervix.

The uterine cervix plays an extremely important role in the process of childbirth, since it is responsible for holding it securely, keeping the fetus inside, and opening the uterus at the right time. The cervix has a cervical canal that connects the uterus to the vagina. Additional protection for the child is the mucous plug, which protects him from various infections.

Childbirth is the opening of the pharynx and the expulsion of the fetus from the uterine cavity. This process consists of several periods:

1. – dilatation of the cervix;
2. attempts - expulsion of the fetus;
3. postpartum period - birth of placenta.

The longest stage is considered to be the stage of contractions, during which the formation of the amniotic sac occurs and the fetus moves along the birth canal. With the necessary dilatation of the cervix, the baby is born. That is why it is very important to know how many centimeters the uterine cervix has dilated.

Cervical dilatation

The opening of the cervix is ​​the long-awaited moment that ends pregnancy. Already from 33-34 weeks, the uterine os begins to prepare for the upcoming birth, most often the process is completed by 38 weeks.

The dilatation itself can last up to 10-12 hours in primiparous girls and 6-7 hours in multiparous girls. This period is divided into 2 stages:

1. Latent.
2. Active.

The latent phase lasts several hours, most often 6-8. In some cases – up to a day. At the same time, the woman does not feel painful spasms at all or they are insignificant. 1 contraction occurs every 8-10 minutes. At this time, the amniotic sac forms and the baby begins to move through the birth canal.

The active phase of dilatation is accompanied by intense labor, full dilatation of the cervix and the birth of the baby.

ATTENTION! The 37th week of pregnancy is characterized by dilation of the uterus by one cm - this stage in most cases does not cause pain or discomfort. This indicator does not indicate an imminent birth, but indicates that the female body is ready for active labor.

It is impossible to determine dilation on your own; this can only be done by a specialist during a gynecological examination.

Opening of the uterine cervix into 2 fingers most often occurs after 36-37 weeks of pregnancy. But the period may vary slightly, depending on whether the woman is primiparous or multiparous.

This condition can be observed during a gynecological examination, when the doctor has the opportunity to insert two fingers into the cervical canal - the middle and index. Having heard from the gynecologist that the cervix is ​​dilated, expectant mothers are interested in when labor will begin and how soon will they see their baby?

How soon is the due date?

After the cervix dilates two fingers, a woman can give birth either within a few hours or after a few weeks. For multiparous women, this condition indicates that in the very next few hours a period of active labor will begin.

This is due to the fact that after the first birth the body is able to instantly respond to any changes in the pelvis; the opening of the uterine cervix occurs very quickly and is not accompanied by severe pain. As a rule, a woman giving birth for the second time can see her baby within a few hours.

In primiparous girls, dilation of the cervix by 2 fingers is not a sign that the female body is immediately before childbirth. In most cases, the proper period occurs only after 2-3 weeks.

A woman can spend the remaining time of pregnancy at home or in a hospital setting. If nothing bothers the expectant mother, she feels well, does not have any pathologies, and remains at home until the birth.

If the woman is not feeling well, the pregnancy is too short or there is a risk of premature birth, the woman is kept in hospital. If necessary, she is prescribed medications whose action is aimed at slowing down the premature expansion of the cervical canal.

Early cervical dilatation

If the cervix is ​​dilated by 2 fingers at 35 weeks of pregnancy or even earlier, there is a high risk of premature birth. This pathology develops against the background of the fact that the uterine cervix cannot fully function and fulfill its purpose, to protect and hold the fetus inside the cavity of the reproductive organ.

The child is growing rapidly and puts pressure on the cervix; a woman may experience various injuries to the pelvic organs - all this can cause premature dilation to 2 fingers. In some cases, the provoking factor is a hormonal imbalance in the female body.

A gynecologist or obstetrician prescribes emergency measures:

• suturing the cervical canal;
• overlay - a plastic or silicone obstetric device designed to reliably support the pelvic organs.

ATTENTION! Retracting the cervix and its cervical canal using an obstetric pessary is recommended only in the most severe and complex cases. After these obstetric procedures, the expectant mother is advised to remain completely at rest; if necessary, she is prescribed special medications. This allows a woman to carry her pregnancy to the required term.

In this case, a pregnant woman is diagnosed with isthmic-cervical insufficiency. The main task of doctors and the expectant mother herself is to make every possible effort to

Lack of dilatation at 40 weeks

An equally dangerous situation develops if a woman has reached 40-41 weeks of pregnancy, and there are no symptoms of imminent labor. The uterine tissue is dense, the cervix is ​​dilated only 2 fingers or less.

ATTENTION! In such cases, obstetricians and gynecologists resort to emergency methods of softening and stretching the cervix using medications - hormonal gels, suppositories. In some cases, the method of mechanical stretching of the reproductive organ is used.

To stimulate the opening of the uterine cervix, non-drug methods can also be used - for example, kelp sticks. They must be inserted into the cavity of the cervical canal along the entire length. This process is accompanied by unpleasant, painful sensations. Some time after the insertion of the stick, the kelp begins to increase and swell, expanding the cervical canal.

How long do you need to wait? In most cases, swelling of the sticks is observed 5-6 hours after administration. After this, the cervical canal and labor begins.

The opening of the uterine cervix by 2 fingers is a condition that in no case should be ignored, because it indicates the birth process in the very near future. A woman must report any changes in her health to her gynecologist.

Video: the beginning of labor - dilatation of the cervix

Video: pushing. It's contraction time. Cervical dilatation. Time of birth

Video: inserting a finger into the cervix

As pregnancy progresses, processes begin to occur in the uterus that involve partial replacement of muscle tissue with connective tissue. As a result, new collagen fibers are formed, which are more extensible and flexible than before pregnancy. Clinically, this process manifests itself in loosening and shortening of the cervix, as a result of which the cervical canal begins to gape in the later stages. It is in this way that the uterus is gradually prepared for the upcoming birth.

What features does the uterus have in late pregnancy?

Already from 32-34 weeks, the cervix begins to prepare for childbirth. This is manifested in its softening along the periphery, but the area of ​​​​dense tissue lining the canal is still preserved.

In first-time women, the cervix at this stage can only allow the tip of a finger to pass through, but in those women who give birth repeatedly, 1 finger can freely pass through the internal pharynx. So by 37-38 weeks the cervix is ​​almost completely softened. In this case, a woman may hear from a gynecologist that the cervix is ​​dilated by 2 fingers. At the same time, the fetus itself gradually begins to descend into the small pelvis, putting pressure on the neck with its weight, which contributes to its further opening.

How does the cervix dilate?

It starts directly from its inner pharynx. Moreover, in primiparous women it takes the shape of a truncated cone, the base of which faces the top. Upon examination, the gynecologist says that the cervix is ​​short and the dilatation is 2 fingers. As the fetus moves into the pelvis, the external os of the uterus also stretches.

In women giving birth repeatedly, cervical dilatation usually occurs faster and easier. This happens because the external pharynx in such women by the end of pregnancy is already slightly open by 1 finger. That is why, often, the opening of the external and internal pharynx occurs almost simultaneously.

Immediately before a woman is about to give birth (3-5 days), the dilatation is 2 fingers, and the cervix is ​​smoothed and exhausted.

In cases where a doctor, when examining a pregnant woman in a gynecological chair, says that the cervix is ​​too long, despite the dilation of 2 transverse fingers, one cannot count on childbirth in the next 3 days.

In what cases does the cervix need stimulation?

A week before the expected date of birth, a woman, once again visiting a gynecologist, may find out that her cervix is ​​“immature” and needs artificial preparation for the birth process. This can also occur after the 40th week of pregnancy, i.e. when walking. Often the neck is slightly open (2 fingers wide), but not soft, i.e. fingers pass through the channel tightly.

The process itself can be carried out in 2 ways: medicinal and non-medicinal. As the name suggests, When implementing the first, various medications are used.

The second involves the use of various auxiliary means. So, quite often kelp sticks are used. They are inserted directly into the cervical canal, along its entire length. At the same time, the woman experiences painful sensations. After 4-5 hours from the moment of installation, they begin to swell and increase in size, thereby mechanically opening the canal. Also, in order to increase the dilation of the cervix, special tubes can be used, similar in appearance to a catheter, with a ball at the end. By pumping air, it inflates, thereby expanding the cervical canal, stimulating the onset of the birth process.

Normal and timely labor never begins suddenly and violently. On the eve of childbirth, a woman experiences their precursors, and the uterus and its cervix are prepared for the birth process. In particular, the cervix begins to “ripen” and expand, that is, it enters the stage of opening of the uterine pharynx. Childbirth is a complex and lengthy process and largely depends on the interaction of the uterus, cervix and hormonal levels, which determines its successful completion.

The cervix is...

The lower part of the uterus is called its cervix, which looks like a narrow cylinder and connects the uterine cavity to the vagina. Directly in the cervix, the vaginal part is distinguished - the visible part, which protrudes into the vagina below its fornix. There is also a supravaginal part - the upper part located above the arches. The cervical (cervical) canal passes through the cervix, its upper end is called the internal os, and the lower end is called the external os. During pregnancy, there is a mucus plug in the cervical canal, the function of which is to prevent infection from entering the uterine cavity from the vagina.

The uterus is a female reproductive organ, the main purpose of which is to bear a fetus (fetal receptacle). The uterus consists of 3 layers: the inner one is represented by the endometrium, the middle one is muscle tissue and the outer one is the serosa. The bulk of the uterus is the muscular layer, which hypertrophies and grows during gestation. The myometrium of the uterus has a contractile function, due to which contractions occur, the cervix (uterine os) opens and the fetus is expelled from the uterine cavity during labor.

Periods of labor

The labor process lasts quite a long time, and normally in primiparous women it lasts 10–12 hours, while in multiparous women it lasts approximately 6–8 hours. Childbirth itself includes three periods:

• I period – the period of contractions (opening of the uterine pharynx);
• The second period is called the period of pushing (the period of expulsion of the fetus);
• The third period is the period of separation and discharge of the child's place (placeholder), therefore it is called the afterbirth period.

The longest stage of labor is the period of opening of the uterine pharynx. It is caused by uterine contractions, during which the amniotic sac is formed, the fetal head moves along the pelvic ring and cervical dilatation is ensured.

Period of contractions

First, contractions arise and become established - no more than 2 in 10 minutes. Moreover, the duration of uterine contraction reaches 30–40 seconds, and uterine relaxation reaches 80–120 seconds. Long-term relaxation of the uterine muscles after each contraction ensures the transition of the cervical tissues into the structure of the lower segment of the uterus, as a result of which the length of the visible part of the cervix decreases (it shortens), and the lower uterine segment itself stretches and lengthens.

As a result of the ongoing processes, the presenting part of the fetus (usually the head) is fixed at the entrance to the pelvis, separating the amniotic fluid, and as a result, anterior and posterior waters are formed. The amniotic sac is formed (contains anterior waters), which acts like a hydraulic wedge, wedges into the internal os, opening it.

In first-time mothers, the latent phase of dilatation is always longer than in women giving birth for the second time, which determines the longer total duration of labor. The completion of the latent phase is marked by complete or almost complete effacement of the cervix.

The active phase begins with 4 cm of cervical dilation and continues up to 8 cm. At the same time, contractions become more frequent and their number reaches 3 - 5 in 10 minutes, periods of contraction and relaxation of the uterus are equalized and amount to 60 - 90 seconds. The active phase lasts for primiparous and multiparous women for 3–4 hours. It is during the active phase that labor becomes intense, and the cervix dilates quickly. The fetal head moves along the birth canal, the cervix has completely moved into the lower uterine segment (merged with it), and by the end of the active phase the opening of the uterine pharynx is complete or almost complete (within 8 - 10 cm).

At the end of the active phase, the amniotic sac is opened and the water is released. If the cervical opening has reached 8 - 10 cm and the waters have broken, this is called timely rupture of water, the release of water when the opening is up to 7 cm is called early, with 10 or more cm of opening of the pharynx, amniotomy is indicated (the procedure for opening the amniotic sac), which is called delayed rupture of water.

Terminology

Dilatation of the cervix does not have any symptoms; only a doctor can determine it by conducting a vaginal examination.

To understand how the process of softening, shortening and smoothing of the cervix progresses, you should define obstetric terms. In the recent past, obstetricians determined the opening of the uterine pharynx in the fingers. Roughly speaking, how many fingers the uterine os allows through, so is the opening. On average, the width of the “obstetric finger” is 2 cm, but, as you know, everyone’s fingers are different, so measuring the opening in cm is considered more accurate. So:

• if the cervix is ​​dilated by 1 finger, then they speak of an opening of 2 - 3 cm;
• if the opening of the uterine pharynx has reached 3–4 cm, this is equivalent to the dilation of the cervix by 2 fingers, which, as a rule, is diagnosed already at the beginning of regular labor (at least 3 contractions in 10 minutes);
• almost complete opening is indicated by the opening of the cervix by 8 cm or 4 fingers;
• full dilatation is recorded when the cervix is ​​completely smoothed (thin edges) and is passable for 5 fingers or 10 cm (the head drops to the pelvic floor, turning with an arrow-shaped suture to a straight size, an irresistible desire to push appears - it’s time to go to the delivery room for the birth of the baby - the beginning of the second period childbirth).

How does the cervix ripen?

The appearing harbingers of labor indicate the imminent onset of labor (approximately from 2 weeks to 2 hours):

• the fundus of the uterus descends (for 2 - 3 weeks before the onset of contractions), which is explained by the pressing of the presenting part of the fetus to the pelvis, a woman feels this sign by easier breathing;
• the pressed head of the fetus puts pressure on the pelvic organs (bladder, intestines), which leads to increased urination and constipation;
• increased excitability of the uterus (the uterus “turns to stone” when the fetus moves, the woman moves suddenly, or when the abdomen is stroked/pinched);
• possible appearance - they are irregular and sparse, drawn-out and short;
• The cervix begins to “ripen” - it softens, allows the tip of the finger to pass through, shortens and “centers.”

Dilatation of the cervix before childbirth occurs very slowly and gradually over the course of a month, and intensifies on the last day or two before birth. In primiparous women, the opening of the cervical canal is about 2 cm, while in multiparous women the opening exceeds 2 cm.

To establish cervical maturity, a scale developed by Bishop is used, which includes assessment of the following criteria:

• consistency (density) of the neck: if it is dense - this is regarded as 0 points, if it is softened along the periphery, but the internal pharynx is dense - 1 point, soft both inside and outside - 2 points;
• length of the neck (the process of its shortening) - if it exceeds 2 cm - 0 points, the length reaches 1 - 2 cm - score 1 point, the neck is shortened and does not reach 1 cm in length - 2 points;
• patency of the cervical canal: a closed external pharynx or the tip of a finger passes through - score 0 points, the cervical canal is passed to a closed internal pharynx - this is scored as 1 point, and if the canal allows one or 2 fingers to pass beyond the internal pharynx - scored at 2 points;
• how the neck is located tangentially to the wire axis of the pelvis: directed posteriorly - 0 points, displaced anteriorly - 1 point, located in the middle or “centered” - 2 points.

When summing up the points, the maturity of the cervix is ​​assessed. An immature cervix is ​​considered with a score of 0 - 2 points, 3 - 4 points are regarded as an insufficiently mature or ripening cervix, and with 5 - 8 points they speak of a mature cervix.

Vaginal examination

To determine the degree of readiness of the cervix and not only, the doctor conducts a mandatory vaginal examination (upon admission to the maternity hospital and at 38–39 weeks at an appointment at the antenatal clinic).

If the woman is already in the maternity ward, a vaginal examination to determine the process of opening of the uterine pharynx every 4 to 6 hours or for emergency indications:

• discharge of amniotic fluid;
• carrying out a possible amniotomy (weakness of labor, or flat amniotic sac);
• with the development of anomalies of labor forces (clinically narrow pelvis, excessive labor, incoordination);
• before performing regional anesthesia (EDA, SMA) to determine the cause of painful contractions;
• the occurrence of bloody discharge from the genital tract;
• in the case of established regular labor (preliminary period, turning into contractions).

When conducting a vaginal examination, the obstetrician assesses the condition of the cervix: its degree of dilation, smoothing, thickness and extensibility of the cervical edges, as well as the presence of scars on the soft tissues of the genital tract. In addition, the capacity of the pelvis is assessed, the presenting part of the fetus and its insertion are palpated (localization of the sagittal suture on the head and fontanelles), the advancement of the presenting part, the presence of bone deformities and exostoses. The amniotic sac must be assessed (integrity, functionality).

Based on subjective signs of dilatation and vaginal examination data, a partogram of labor is compiled and maintained. Contractions are considered subjective signs of labor, in particular the opening of the uterine pharynx. The criteria for assessing contractions include their duration and frequency, severity and uterine activity (the latter is determined instrumentally). The partogram of labor allows you to visually record the dynamics of the opening of the uterine pharynx. A graph is drawn up, the horizontal length of which indicates the duration of labor in hours, and the vertical dilatation of the cervix in cm. Based on the partogram, the latent and active phases of labor can be distinguished. A steep rise in the curve indicates the effectiveness of the birth act.

If the cervix dilates prematurely

Dilation of the cervix during pregnancy, that is, long before childbirth, is called isthmic-cervical insufficiency. This pathology is characterized by the fact that both the cervix and the isthmus do not perform their main function during gestation - obturator. In this case, the cervix softens, shortens and smoothes, which does not allow keeping the fetus in the sac and leads to spontaneous abortion. Termination of pregnancy usually occurs in the 2nd – 3rd trimesters. The incompetence of the cervix is ​​indicated by the fact that it shortens to 25 mm or less at 20–30 weeks of gestation.

Isthmic-cervical insufficiency can be organic and functional. The organic form of pathology develops as a result of various cervical injuries - induced abortions (see), cervical ruptures during childbirth, surgical methods for treating cervical diseases. The functional form of the disease is caused either by a hormonal imbalance or by an increased load on the cervix and isthmus during pregnancy (multiple pregnancy, excess water or a large fetus).

How to maintain pregnancy when the cervix is ​​dilated

But even with cervical dilatation by 1 - 2 fingers at a period of 28 weeks or more, it is quite possible to maintain the pregnancy, or at least prolong it until the birth of a completely viable fetus. In such cases, the following are prescribed:

• bed rest;
• emotional peace;
• sedatives;
• antispasmodics (magne-B6, no-spa,);
• tocolytics (ginipral, partusisten).

Treatment is mandatory aimed at producing surfactant in the fetal lungs (glucocorticoids are prescribed), which accelerates their maturation.

In addition, treatment and prevention of further premature dilatation of the cervix is ​​carried out surgically - sutures are placed on the cervix, which are removed at 37 weeks.

The cervix is ​​immature - what then?

The opposite situation is possible, when the cervix is ​​“not ready” for childbirth. That is, hour X has arrived (the expected date of birth), and even several days or weeks have passed, but no structural changes are observed in the cervix, it remains long, dense, deviated posteriorly or anteriorly, and the internal pharynx is impassable or allows the tip of the finger to pass through. What do doctors do in this case?

All methods of influencing the cervix, leading to its maturation, are divided into medicinal and non-medicinal. Medication methods include the introduction of special gels and suppositories with prostaglandins into the vagina or cervix. Prostaglandins are hormones that accelerate the process of cervical ripening, increase the excitability of the uterus, and during childbirth their intravenous administration is practiced in case of weakness of labor forces. Local administration of prostaglandins has no systemic effect (no side effects) and contributes to the shortening and smoothing of the cervix.

Non-medicinal methods of stimulating cervical dilatation include:

Sticks – kelp

The sticks are made from dried kelp seaweed, which are highly hygroscopic (they absorb water well). A number of sticks are inserted into the cervical canal so that they fill it tightly. As the sticks absorb liquid, they swell and stretch the cervix, causing it to dilate.

Foley catheter

The catheter for dilating the cervix is ​​represented by a flexible tube with a balloon attached to one end. A catheter with a balloon at the end is inserted by the doctor into the cervical canal, the balloon is filled with air and left in the cervix for 24 hours. Mechanical action on the cervix stimulates its opening, as well as the production of prostaglandins. The method is very painful and increases the risk of infection of the birth canal.

Cleansing enema

Unfortunately, some maternity hospitals have refused to perform a cleansing enema for a woman admitted to give birth, but in vain. Free intestines, as well as its peristalsis during defecation, increase the excitability of the uterus, increase its tone, and, consequently, accelerate the process of cervical dilatation.

Question - answer

How can you speed up cervical dilatation at home?

• long walks in the fresh air increase the excitability of the uterus and the production of prostaglandins, and the presenting part of the baby is fixed at the entrance to the pelvis, further stimulating the opening of the cervix;
• take care of your bladder and intestines, avoid constipation and prolonged abstinence from urination;
• eat more salads made from fresh vegetables dressed with vegetable oil;
• take a decoction of raspberry leaves;
• stimulate the nipples (when they are irritated, oxytocin is released, which causes uterine contractions).
• Are there any special exercises for opening the cervix?

At home, cervical ripening is accelerated by walking up stairs, swimming and diving, bending and turning the body. It is also recommended to take a warm bath, massage the ear and little finger, breathing exercises and exercises to strengthen the perineal muscles, and do yoga. In maternity hospitals there are special gymnastic balls, the seat and bounces on which during labor accelerate the opening of the uterine pharynx.

Does sex really help prepare your cervix for childbirth?

Yes, having sex in the last days and weeks of pregnancy (provided the amniotic sac is intact and there is a mucus plug in the cervical canal) contributes to the ripening of the cervix. First, during orgasm, oxytocin is released, which stimulates uterine activity. And, secondly, sperm contains prostaglandins, which have a beneficial effect on the process of cervical maturation.

At what opening does pushing begin?

Pushing is a voluntary contraction of the abdominal muscles. The desire to push arises in women in labor already at 8 cm. But until the cervix is ​​fully dilated (10 cm) and the head drops to the bottom of the pelvis (that is, it can be felt by a doctor by pressing on the labia), you cannot push.

Before childbirth, a number of processes occur in a woman’s body that are aimed at the successful resolution of the burden and the birth of a viable fetus. The birth process itself is divided into three stages, each of which is characterized by certain characteristics.

Throughout pregnancy, and especially in the first stage of labor, the cervix plays an important role. This part of the uterus is the “lock” that locks the fetus in for nine months and then releases it. Proper functioning of the cervix and its adequate condition during pregnancy is the key to full gestation.

If the cervix is ​​unable to close tightly, this can lead to miscarriages at any stage of pregnancy and premature birth. Then it’s worth talking about isthmic-cervical insufficiency. This process is controlled by a leading gynecologist, who monitors the condition of the female genital area throughout pregnancy. When examined on a gynecological chair, it is not difficult to diagnose slight dilatation or softening of the cervix. This pathology is a threat to normal pregnancy. And if in the first months, while the fetus is small, a miscarriage does not occur, since the pressure on the cervix is ​​still small, then already during the period of active growth of the child, the cervix may not withstand such pressure. In such cases, miscarriages occur most often from 20 to 30 weeks.

It is very important for a woman to visit a gynecologist in a timely manner, because Symptoms of cervical dilatation may not appear for the woman herself, due to the fact that the opening did not occur under the influence of the hormonal system. Often, a pregnant woman does not feel any symptoms of dilatation at all and learns about this trouble only during an examination. And in some cases, a woman may experience tingling pain in the vaginal area, which requires consultation. The sooner the pathology is diagnosed, the faster doctors will take the necessary measures to preserve the pregnancy. In this case, the process of maintaining pregnancy will be controlled in other ways (suturing the cervix, applying a pessary, wearing a bandage).

The cervix, as one of the most important organs in the entire pregnancy process, undergoes changes throughout the entire period of gestation. The processes that take place in the cervix at the very end of pregnancy are important for the woman and the child - they signal that labor will soon begin. Every expectant mother needs to know the symptoms of cervical dilatation in order to seek help from a medical facility in time - perhaps to maintain the pregnancy, and perhaps for childbirth (depending on at what stage these signs appear).

Changes affecting the dilatation of the cervix occur at 38-40 weeks. At this time, the placenta begins to age, which secretes hormones that serve for the normal course of pregnancy. At this time, the uterus and its cervix have such a tone that does not allow the child to grow, but, nevertheless, does not yet allow it to be born. After the placenta stops producing hormones aimed at maintaining the uterus, antagonist hormones appear in the woman’s body, the task of which is to help the cervix open and the uterus itself to contract. Thus, the level of estrogen increases and the level of progesterone decreases, oxytocin, prostaglandins, acetylcholine, and serotonin accumulate. All these hormones will affect the progress of labor and directly the dilatation of the cervix.

Recently, while in the mother’s belly, the child, under the influence of the slightly infantile uterus, descends down into the pelvic cavity. As a result of pressure on the cervix, the body receives signals that labor is approaching. The uterus becomes slightly more toned to facilitate labor. Thus, we are talking about the harbingers of labor - false contractions due to short-term prenatal hypertonicity. During this period, despite the pressure on the cervix, it does not open, although the uterus may contract.

The main feature of the cervix during the labor period is its smoothing (shortening) and softening. When the cervix effaces, it expands its entry space; this does not happen immediately, but gradually, over several hours. In fact, the entire first stage of labor consists of preparing the uterus and its cervix for subsequent active actions.

10 cm is the norm for a baby to be born

Throughout the nine months, the cervix is ​​called immature. At this time, it is closed, does not allow a finger to enter, and is about two centimeters long. In the first few hours of the birth process, the uterus opens quite a bit - only one centimeter, which is determined by the free passage of one finger.

Briefly about cervical dilatation before childbirth in the video.

The neck is slightly softened and shortened. This condition of the cervix is ​​called underripe. After several hours, the cervix opens so much that it can no longer hold the mucus plug - it quickly comes out, which signals the imminent beginning of the second stage. In the process of its opening, the cervix changes its location - in relation to the body of the uterus, it becomes larger in the center, and during pregnancy it can be displaced all the time. We can talk about the maturity of the cervix when it allows more than one finger inside, its length is less than one centimeter, and the cervix itself is soft. Typically, this condition of the cervix is ​​determined by thirty-nine weeks, and with repeated births a little earlier. Physiologically, a woman is ready for childbirth, but in practice, most often pregnant women walk with their cervix dilated for a couple of weeks and give birth at forty to forty-one weeks without any pathologies. Symptoms of cervical dilatation are practically not noticeable for a woman. Only sometimes can the lower abdomen stretch, which indicates pressure from the fetus on the softened neck.

A completely reliable sign of cervical dilation is release of mucus plug. But leakage of amniotic fluid is a signal that hospitalization is necessary - either labor is approaching, or they will be stimulated so as not to leave the baby without amniotic fluid. Signs of cervical dilatation are more clearly determined by gynecologists.

Cervical dilatation begins shortly before birth, as the cervix of the hollow organ matures. When it is ready, it will completely soften and smooth out, and during a vaginal examination, the opening of 1 finger will be determined, that is, the doctor will be able to freely pass his index finger over the internal pharynx.

Labor does not always begin in such conditions; you may go through several more days, despite the fact that your uterus is already in a state of readiness.

Cervical dilatation during pregnancy

A premature indicator of the body’s readiness occurs with its pathology, the so-called isthmic-cervical insufficiency. It occurs as a result of damage to the cervix during abortion, ruptures during childbirth. This can begin to occur as early as 16 weeks of pregnancy and, without treatment, results in late miscarriage or premature birth.

If a woman is healthy, the hollow organ can remain closed until the final date, but for many, 2-3 weeks before this joyful event, the cervix undergoes serious changes, leading to a gradual process of readiness of the body.

The smoothing and opening of the cervix is ​​called ripening. Its symptoms are obvious: training contractions are disturbing and the mucus plug is coming off. Of course, there is no exact method for expectant mothers; a vaginal examination performed by a doctor is necessary.

Using this indicator, the doctor can judge how soon your labor will begin. As a rule, changes in the cervix in primiparous women begin earlier; in multiparous women, this process can go much faster and therefore can begin immediately before childbirth.

If the pregnancy has come to an end, and the cervix is ​​still not ready for childbirth, in order to speed it up, you may be prescribed auxiliary measures. There are medicinal and non-medicinal ways to accelerate the maturation of a hollow organ.

So, physical activity, squats and walking contribute to this, sex in the last weeks of pregnancy also helps, and the point here is not only the physical impact on the cervix itself, but the fact that male sperm contains a large amount of prostaglandins, substances that accelerate maturation. Of course, no special exercises have been invented to open the cervix, but still many women note that their labor began precisely after physical exertion. It is worth warning that active walking on stairs, long walks that leave you exhausted, and moving furniture around the house is not the right and even dangerous way. You should not test your strength before the most crucial moment in your life; instead of accelerating the onset of labor, you may end up with complications, for example, premature rupture of water or placental abruption.

If all the deadlines have passed, or the child’s condition requires accelerating labor, and the body is not yet ready, drug stimulation is possible.

How is cervical dilatation checked?

A doctor examines a pregnant woman on a gynecological chair. He inserts 2 fingers of his right hand into the woman’s vagina and assesses the condition of the hollow organ by simple palpation. During pregnancy, the cervix is ​​normally turned backwards, and it is very difficult to reach it during examination. By the time the mother gives permission, the cervix unfolds in front, along the axis of the pelvis, and becomes easily accessible and soft. Its canal gradually expands and when it matures completely, it easily passes the doctor’s index finger inside the uterus, to the child. Of course, it is separated from the baby by the amniotic sac, but this degree of maturity of the uterus indicates that labor is about to begin.

If it is necessary to speed up ripening, different methods are used. For example, you can act on it locally; a gel containing prostaglandins causes a fairly rapid softening.

Some methods force the body to produce these substances itself. For example, you can use non-medicinal effects, special sticks made from dried seaweed (kelp). They are introduced into the canal, and here they swell under the influence of moisture, significantly increasing in volume; under their pressure, they open both mechanically and due to increased production of prostaglandins in its tissues. In any case, suppositories, tablets and other medications are prescribed by the doctor; do not try to speed up labor on your own.

Childbirth, cervical dilatation

The dilation of the cervix before childbirth barely reaches 1 finger, the uterine os resembles a dense elastic ring, but with the onset of labor, amazing changes occur. The first period of labor lasts a matter of hours, during which time it becomes thinner, spreading out into a wide ring, until it practically disappears altogether, merging with the walls of the birth canal, and now no longer interferes with the birth of the baby.

How does the cervix dilate?

The wall of a hollow organ consists of two powerful layers of muscles, longitudinal and circular. The circular layer resembles rings and is concentrated mainly in the lower segment of the uterus, including the cervix. Throughout pregnancy, the circular layer in the cervical area is tense and holds it in place like a lock, while the longitudinal layer is relaxed so that the baby is comfortable and gets everything he needs.

The onset of labor changes muscle function to the opposite. Now, strong contractions of the longitudinal muscles at each contraction stretch the lower segment of the woman’s hollow organ, pull the neck in different directions, and the circular layer relaxes, not resisting this pull. As a result, the cervix opens more and more and becomes thinner. The opening of the cervix by 2 fingers, which is usually present in the first hours of labor, progresses to the final result when the cervix freely passes all 5 fingers (10 cm).

Throughout the birth, doctors monitor the progress of labor using these indicators. Many women describe vaginal examination during labor as extremely unpleasant and painful. When the doctor checks the dilation of the cervix, the sensations are really not pleasant, because the uterus reacts to this with another contraction.

Sometimes there is a violation of the coordination of contractions of the hollow organ for one reason or another, and, despite the fact that the contractions are strong, the cervix does not react. Stimulation, in such cases, is carried out using labor anesthesia and the use of antispasmodics. Manual dilatation of the cervix, when in the last stages the midwife stretches and tucks the cervix with her hand behind the head of the baby quickly moving along the birth canal, is rarely used, mainly in cases where the woman in labor cannot overcome the pushing, although it is too early to push, and this the measure helps prevent ruptures.

The function of a hollow organ during pregnancy allows a woman to carry and give birth to her baby. The uterus, damaged by abortion, may subsequently become incompetent and begin to open long before birth, or due to scarring it will not respond properly. Take care of yourself, do not allow abortions that could damage her, so that nothing will interfere with your motherhood in the future.

Hi all!

I will break this review down point by point, because... There are many points that I would like to highlight. PLEASE DO NOT READ FOR THE WEAK NERVOUS - I will describe all the intimate details!

PREFACE.

I am 26 years old, my first pregnancy, it proceeded without complications, there was not even toxicosis. But, as they say, not a single pregnancy passes without a trace for a woman. My surprises were hemorrhoids and uterine fibroids (rare for my age). There were still minor inconveniences, but now we are talking about the final stage of pregnancy - childbirth.

DISCHARGEMENT OF THE MUCOUS PLUG.

It all started at 36 weeks and 6 days. In the morning, I discovered scanty mucous discharge of a pinkish tint (sorry for the details, but not long ago I myself was looking for such a detailed description). Naturally, I was scared, and the first thing I did was go online. (Now I’m scolding myself for this. You shouldn’t be shy and call your treating gynecologist right away!) In general, I read that in the later stages this happens after sexual intercourse due to an abundant flow of blood to the causative site. At the courses for young parents, we were told that after 35 weeks it is better to abstain, but who remembers this... After a couple of hours, everything passed and I calmed down.

The next morning the mucus plug was completely gone. This cannot be confused with anything else: a viscous mucous substance with small red veins about the size of a tablespoon. That’s when I called the gynecologist and described the situation. She replied that she needed to monitor her future condition, more carefully monitor the cleanliness of her intimate area and not walk a lot. She also reassured me that after the plug comes out, labor can begin in two weeks; the plug comes out is not the beginning of labor.

LEAKING OF AMBIENT WATER.

At 37 weeks and 2 days after my lunch nap, I began to notice that the discharge (usual for this period) became a little thinner (to notice this, it is better to use paper napkins rather than panty liners), but the volume did not increase much. After 20 minutes the situation repeated itself, a new portion of liquid was released. I called the doctor again with suspicion of leaking amniotic fluid. She said to watch for a couple more hours to see if other symptoms appear and call to report.

I ate a lot (I know it’s impossible, but until the very end I didn’t want to believe that the process had already started. By the way, I didn’t have an enema before giving birth and nothing unnecessary came out). Two hours later (once!) I felt a slight pull in my lower back for half a minute. Portions of liquid continued to be released approximately every 20 minutes, 0.5 - 1 tablespoon. No other symptoms increased.

Three hours later I reported to the gynecologist. She said to collect the bags and call an ambulance. I was so worried that I had to call the doctors for my husband. The ambulance arrived and they took the blood pressure – 150/100! Apparently the excitement made itself felt. They offered to inject magnesium, I agreed (I thought that I would have to remain in conservancy for another couple of weeks). They took me to the maternity hospital.

PAINLESS CONTRACTIONS OR IMPOSSIBLE DILATION OF THE CERVIX.

At the sanitary inspection room, we filled out the necessary papers, took blood for analysis, measured our pelvis and weight upon admission, and took us to the department. There I also had to fill out a bunch of paperwork, fortunately the nurse did it. I was assigned to the prenatal ward, where I changed clothes and headed to the examination room. During the examination, the obstetrician confirmed leakage of amniotic fluid and shocked me with the news: “YOU ARE 5 CM OPENED!!!” But I don’t feel any contractions! How can this be? It turned out that it can! If I had delayed, I would have had to give birth at home!

By the way, during pregnancy I read a bunch of horror stories about pain during examination before childbirth and when the bladder was punctured. Nothing of the kind! At least in my case, everything happened neatly and painlessly.

So, they pierced my bladder, or rather, they pierced it for about 10 minutes (the child tried to get out quickly and constantly covered the puncture site). Looking ahead, I’ll debunk the common myth that a piercing hook can scratch a child’s head. Nothing of the kind! After so many punctures, my child didn't have a scratch! Doctors know what they are doing and do not want to harm your baby in any way!

PAINFUL CONTRACTIONS AFTER PUNCTURE OF THE AMERIOUS BLADDER.

Five minutes after my water broke, I finally felt the first contractions (in fact, I had been having them for several hours, but I did not feel any pain or tension in my abdomen). There were obvious contractions, they gradually but quickly intensified. The sensations are not like acute pain, but like pain during a spasm. At this moment, correct breathing is very helpful: a short, deep breath in through the nose just before the contraction and exhale as long as possible during the contraction.

PUSHING AND WHAT HELPED REDUCE THE PAIN.

An hour later I was already fully dilated. I felt the baby trying to move through the birth canal (pressure on the pelvic bones during contractions). From that moment on, I began to move actively, trying different positions to help the baby. The main thing during this period is to MONITOR YOUR BREATHING and LISTEN TO THE DOCTOR. The following helped me: I hung on my husband’s neck (we had a partner birth) so that my legs relaxed as much as possible, and as I exhaled I made a sound reminiscent of a moo. For some reason, this is how I didn’t feel pain. In addition, during contractions, on the advice of the obstetrician, I tensed my abs to strengthen the contractions of the uterus. But nothing worked. Possibly due to magnesium (see above).

NARROW PELVIS AND TRIPLE TIGHT UMBRICAL CORD.

CTG showed that the child was beginning to choke (ultrasound revealed double entanglement at 33 weeks). Therefore, the decision was made to stimulate with oxytocin. I was injected with it twice during the birth process. I did not feel any noticeable intensification or acceleration of contractions (although everywhere they write about the opposite). There was always time to rest between contractions.

Because of my narrow pelvis, I couldn’t start giving birth until the baby’s head adjusted to the required diameter. I think everyone knows that the skull bones of a newborn are mobile? The situation was also delayed by the fact that the umbilical cord wrapped around her neck did not allow the baby to move towards the “exit”. Only 2.5 hours after the full opening I was allowed to push. It was no longer possible to wait.

APPEARANCE OF THE HEAD AND REMOVAL OF THE LOOP.

I lay down on a special bed and began to remember everything I had read and watched about childbirth. And this only bothered me! Bottom line: I missed precious minutes of the birth of my child. You only need to listen to doctors! At this moment, you need to push the child out through “I can’t.” It will seem as if the stretched skin is about to crack, but in reality there will most likely not be any tears. If there is any concern, the doctor will suggest making an incision.

After 6 attempts, a miracle happened - the head appeared! The umbilical cord loops were immediately removed from the neck. There were three of them! After which they gave me a little rest, allowed me to pat the baby on the head (which I did not do) and showed this intermediate process to my husband! I don’t understand why?! I tried to express my dissatisfaction, but I had to continue pushing.

APPEARANCE OF A CHILD.

This stage was the most difficult for me. The head had already appeared, the baby turned around, stretched out her legs, and it was not so easy to push her out. It’s much easier to put pressure on the “ball” than on the “string”, if you understand what we’re talking about?)) Then the midwife came to the rescue and put her hand on my stomach, placing support for my legs. After all, a child also puts a lot of effort into being born: it is drilled by its head, pushed off by its legs...

After the head appeared there was no pain at all. The removal of the placenta generally seemed like a pleasant process!

Due to hypoxia after the entanglement, the neonatologist immediately took the child away. They didn’t even wait for the blood to pulse through the umbilical cord. At that moment I was very afraid that the child would not survive. The baby didn’t scream, and the doctors didn’t say anything...

CONDITION OF THE CHILD AFTER BIRTH.

The ultrasound and the height of the uterine fundus predicted a large fetus. These were the results at week 33:

But the baby was born at 37 weeks and 3 days with a weight of 2.390 kg and a height of 49 cm, 7-7b on the Apgar scale. The head was severely deformed (elongated occiput). But by three months the appearance returned to normal. So if anyone encounters a similar problem, don’t worry!

The baby did not cry immediately after birth. Because of this, the oval window in her heart did not completely close. This is a fairly common pathology in children. In principle, there is no need to be afraid yet; it may drag on on its own. All internal organs were in order, and the brain had already developed by the month.

Protracted jaundice was also a complication. This was the reaction to oxytocin in the child. Therefore, we sunbathed under the lamp for another two weeks.

INSPECTION AFTER DELIVERY, RIPS AND CUT, SUITURING.

In my memory, this is the most unpleasant part of childbirth. I had only one tear, but not on the perineum, but on the labia minora. The obstetricians stretched the “causal site” with their hands to help the baby be born faster and slightly overdid it. I had to get a couple of stitches. Here a sharp pain was already felt. But I heroically endured it!)))

Since the gap was in a non-standard place, it did not bother me. It didn't even hurt to go to the toilet. I could sit immediately after giving birth.

Tip: Don't ignore Kegel exercises before or after giving birth! They will greatly help you avoid unnecessary damage and contribute to a speedy recovery!

HAEMORRHOIDS.

Hemorrhoids that appeared during pregnancy, alas, did not go away after childbirth, although there was a chance. So after finishing breastfeeding I will go for a consultation with a surgeon.

CHILDREN AFTER TREATMENT OF EROSION WITH SOLKOVAGIN.

Before planning a child, I successfully got rid of cervical erosion with the help of the drug Solkovagin. This is a kind of acid peeling that renews the cells of the affected area. During the birth process, a small area with erosion appeared again, but after sea buckthorn suppositories (a horror, not a cure!) it healed almost completely.

BIRTH WITH UTERINE FIBROID.

Also, during the process of bearing a child, I developed a myomatous node in the uterus measuring 53x30 mm (at 33 weeks). In this regard, I was injected with Ceftriaxone (an antibiotic, but I didn’t know about it!) and Oxytocin while I was in the maternity hospital. During childbirth, a change in hormonal levels occurs and, theoretically, the fibroid should have decreased to a minimum, but two months have passed, and its dimensions are still 39x35 mm - too large. Let's see what happens in six months... most likely I will have to put in a uterine device.

STRETCH STRETCHES AND WEIGHT AFTER BIRTH.

During pregnancy, I gained 11.5 kg (from 53.7 kg to 65.2 kg), tried to control my weight and monitor my calorie intake. Immediately after giving birth, I lost 5.5 kg, the remaining 6 kg went away in 3 months without much effort or training. A month later, another cologram went away. All that remains is to pump up the muscles.

I didn’t have a single stretch mark, either before or after the birth of the child (although in my teens I got a few on my hips, which means I’m still prone to this problem).

What helped me? First of all, genes! Stretch marks occur when the adrenal glands produce too much cortisol. This is inherent in the body. If you have a problem with this, then no cream will save you! But I still additionally helped the skin stay toned: a daily light massage using olive oil (the most common unrefined food oil), a contrast shower after bathing, exercises and light exercises for pregnant women.

It also saved me that my breasts were small. When poured with milk, it does not stretch so much under its own weight. In addition, I wore (without taking off!) sports seamless tops throughout my pregnancy and after giving birth. I highly recommend it! Let's see what happens after breastfeeding ends.

BELLY AFTER BIRTH.

The stomach has become so soft that the fingers just fall in when pressed. Horrible! This condition will continue until the uterus completely contracts - about 1.5 months. The skin, in my case, did not sag (as I read), it was just not in good shape and hurt a little. I continued to use sea buckthorn oil (I took it to the maternity hospital) and do a pinching massage. The dark vertical stripe has not yet gone away after 3 months.

GOING TO THE TOILET AFTER CHILDREN.

I've heard a lot of stories about this. Like, urinary incontinence, the inability to empty the intestines due to weakening of the muscles. Everything was fine! You can take one microenema with you so as not to worry. I personally didn't need it.

SEX AFTER PARTNER BIRTH.

In a word - SCARY! It hurts a little at first, but then the feeling goes away. Lubricants can help you! And it’s better not to rush to resume intimate life as soon as possible, let the body recover properly. Ideally, after a trip to the gynecologist.

When I asked my husband if there was a difference before and after childbirth, he replied that there were no fundamental differences. And the first time he was so afraid of hurting me that he didn’t even notice the difference)).

According to my feelings, it became even more pleasant. But there was one minus. Due to the expansion of the diameter... sometimes air gets inside and, when enough air has accumulated, it comes out with a characteristic sound...)) That's why you need to do Kegel exercises regularly.

As I already wrote above, my husband observed all the “charm” of the process of giving birth to a daughter, although initially we agreed that he would go out into the corridor at this stage. According to the husband, he did not associate the ongoing process with something intimate, so it did not affect his sex life in any way (plus abstinence played into his hands). It is not known what will happen in your case, so do not take risks unless your husband takes the initiative.

HAIRLOSS.

It began three months after the birth of the child. And it's been a month and a half already. Very intense, although during pregnancy my hair also fell out a little.

FIRST EXAMINATION BY A GYNECOLOGIST.

I went to the gynecologist 2 months after giving birth. The inspection was carried out with an individual plastic set with a mirror. Usually this procedure caused me discomfort. And now everything was fine)). Due to slight inflammation, sea buckthorn suppositories and Polygynax (an antibiotic) were prescribed; breastfeeding was continued on the doctor’s recommendation.

_______________________

In general, you can write like this endlessly...))) Every time I reread it, I remember something new. Maybe I'll add something else.

6 months later.

Haemorrhoids.

The condition has not changed. There are some small knots, but they don't bother me. Relief ointment (which is not hormonal) did not give anything, so I abandoned it. I'll go to a specialist after finishing feeding.

Cervical erosion after childbirth.

Still, it didn’t tighten completely. I had to burn it with electric currents (reviews will be a little later, when I pass the control examination). I will say one thing for sure - it hurts, but it only lasts a matter of seconds. For some reason, the current gynecologist recommended in this situation this particular method of eliminating cervical erosion.

Uterine fibroids.

The myomatous node is now 37x32 mm in size (it has shrunk quite a bit from 39x35 mm). And this takes into account lactational amenorrhea (menstruation has not yet begun). Plus, a new myomatous node measuring 8 mm in diameter is formed... Or there will be more... (((The ultrasound specialist said that when the menstrual cycle resumes, the size of the nodes will increase. If it reaches 50 mm, you will have to operate.

Stretch marks and weight .

Not a single stretch mark appeared.

After 4 months of breastfeeding, I abandoned the diet, after which the weight crept up again and I was again at my pre-pregnancy weight of 54 kg. I feel like I’ll soon return to the diet again, I really liked the appearance)).

Abdominal condition.

The pigment line on the abdomen is still visible six months later, but has become much lighter. The skin is no different from other parts of the body. The old pre-pregnancy abs are still there!))

Sex.

Everything is back in place, no more squelching is felt, no excess air gets in. The sensations became more pleasant than about pregnancy!)))))

Hair loss.

It stopped only after 6 months, and even then not completely. Now my hair is falling out as usual. The density has not changed. But the condition of my hair has improved noticeably. But I attribute this to better and more nutritious nutrition than to pregnancy.

Observation by a gynecologist.

Examinations in the chair became a little painful. Now again you have to run around half the city to find a gynecological speculum size C for less discomfort.

After finishing feeding I will do a mammogram just in case. Health comes first!)

_________________________________________

Well, that's all. Thanks for reading! I hope someone finds my article useful. Have an easy birth and happy motherhood!

The first stage of labor is called period of cervical dilatation. The cervix is ​​a long muscular cylinder at the base of the uterus. During childbirth, she will be the channel through which the child will come out into the world from the mother's womb.

To better understand what processes

are happening in the body of a pregnant woman, you need to imagine the uterus in the form of a balloon, inside of which there is a doll. To remove it without damaging the ball, you need to stretch its neck very strongly so that the head passes through. But this must be done slowly and very carefully, otherwise the rubber will simply tear. And when the diameter of the hole becomes equal to the circumference of the head, carefully begin to pull out the doll.

During pregnancy The cervix is ​​very dense, up to 4 centimeters long and completely closed. Its task is to prevent the premature birth of a baby. A few weeks before, under the influence of special hormones, it begins to soften and the fetal head shortens due to pressure on it. By the beginning of labor, due to prenatal contractions in many women, especially those who have previously given birth, it is no longer than 1.5 cm and can already be dilated even up to 4 cm in diameter. This opening, which is called passive, is usually not felt by mommy. There may be small short nagging pains in the lower abdomen, reminiscent of menstrual pain.

Further opening of the birth canal called active, as it requires strong and regular contractions of the uterine muscles. This is it contractions. In order for a child to be born, the diameter of the cervix must be at least 12 cm. With the help of contractions, its dilation occurs on average 1 cm per hour in primiparous women and 2-3 cm per hour in others. That is, labor contractions are felt from 6 to 12 hours.

First stage of labor is the longest and most painful. It is better for a woman to be prepared for this in advance in order to correctly distribute the forces. Ignorance creates suspicion that something is wrong, and fear increases pain. What to expect? At first, contractions are short, painless, with an interval between them of up to 10 minutes. But gradually they become longer, more noticeable, and the time for rest decreases. For the last hour, the uterus has been contracting every 2-3 minutes for 1-2 minutes. The woman feels a bursting, burning pain in the lower abdomen, radiating to the hips and sacrum.

What should I do?

Firstly, you must already be in a maternity hospital (in a nearby one or in the one where you agreed on the management of labor, for example, Maternity Hospital 9) when the interval between contractions becomes less than 10 minutes.

Secondly, if the doctor does not object, you can choose a body position in order to feel less painful contractions of the uterus (standing, walking, sitting on a fitball, standing on all fours or lying down).

Thirdly, it is useful to joke and laugh in the company of your neighbors in the prenatal ward. When the facial muscles relax, the vaginal muscles also relax, the pain becomes less noticeable.

Fourthly, you can take a relaxing warm shower and even take a nap (therapeutic sleep-rest when the cervix is ​​dilated to 8 cm is very welcome).

Fifthly, massage the back in the area of ​​the sacrum and wings of the ilium. At partner birth let an assistant do this - husband, sister, assistant.

Sixth, during the fight, loudly scold the present husband for all his faults (and at the same time for the future) (just don’t overdo it), and when she lets go, listen with a smile to his excuses and declarations of love.

There is no need to despair - there is just a little left.

You need to think that each new contraction brings you closer to freedom from pain, heartburn, shortness of breath, swelling in the legs, duck gait and insomnia. The long-awaited happy moment of meeting your baby is about to come. You can’t give in to your fears - at this time there is always a midwife nearby who will never miss beginning of the second stage of labor, saying with a smile: “Well, it’s time.”

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