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 dilation 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 dilation 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. At the moments of smoothing of the cervix, it expands its space for entry; 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, 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 muscle, 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 resist 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 bear 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 that 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 away 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 seamless sports tops throughout my pregnancy and after giving birth (without taking them off!). 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 bowels due to weakening 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 go back 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.”

Why don't you be the first to know about everything? Subscribe to blog updates right now!

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 period 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 dilation 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 is formed 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

The main organ in a woman’s body, without which it would be impossible to bear and give birth to a baby, is the uterus. The uterus is a hollow muscular organ. It has 3 main parts: bottom, body and neck. As you can see, the cervix is ​​an integral part of the main organ during pregnancy; accordingly, the normal course of gestation and natural childbirth will also directly depend on its condition. How? Let's figure it out.

Cervix during pregnancy

The cervix is ​​a tube connecting the uterus and vagina, the ends of which end with openings (the internal os opens into the uterus, the external os opens into the vagina), and the cervical canal runs inside. Normally, throughout almost the entire period of pregnancy, it should have a dense consistency with the cervical canal “tightly” closed, which allows keeping the fetus in the uterine cavity, as well as protecting it from the penetration of infections from the vagina.

information Only a few weeks before the expected date of birth, the cervix begins to undergo changes that will subsequently allow the baby to move freely through the woman’s birth canal and be born unhindered.

Sometimes these changes can begin ahead of schedule. Dilatation of the cervix during pregnancy is a poor diagnostic sign that threatens the loss of the child or premature birth. The causes of this condition are often:

• Complicated obstetric history (abortions, early and late miscarriages);
• Cervical injuries (surgeries, large fetus births, ruptures in previous births);
• Cervical erosion;
• Hormonal disorders (progesterone deficiency).

Softening and dilation of the cervix should occur immediately before childbirth!

Disclosure

As pregnancy progresses, the cervix undergoes partial replacement of muscle tissue with connective tissue. “Young” collagen fibers are formed, which have increased flexibility and extensibility than similar ones outside pregnancy. Some of them are absorbed, forming the main substance, which leads to an increase in the hydrophilicity of the tissue. Clinically, this is manifested by loosening and shortening of the cervix and gaping of the cervical canal.

Preparation of the cervix for childbirth begins at approximately 32-34 weeks of pregnancy. It begins to soften along the periphery, but a section of dense tissue along the cervical canal still remains. In primiparous women, during a vaginal examination, the external pharynx may allow the tip of a finger to pass through; in multiparous women, the canal becomes passable to the internal pharynx for 1 finger. By 36-38 weeks, the cervix is ​​almost completely softened. The fetus begins to descend into the pelvis, with its weight it creates a certain pressure on the neck, which helps its further opening.

The opening of the cervix begins with the internal pharynx. In primigravidas, the canal takes the shape of a truncated cone with the base facing the top. The fruit, gradually moving forward, stretches the external pharynx. In multiparous women, the opening of the cervix occurs easier and faster, due to the fact that by the end of pregnancy the external os is most often already open by 1 finger. In them, the opening of the external and internal pharynx occurs almost simultaneously.

Immediately before the onset of labor, the cervix of the uterus, both in primiparous and multiparous women, is sharply shortened (smoothed), exhausted, the canal extends 2 fingers or more. Gradually, the cervix is ​​fully dilated to 10-12 cm, which allows the fetal head and torso to pass through the birth canal.

Possible problems

Starting from the 37-38th week of pregnancy, the dominant of pregnancy is replaced by the dominant of childbirth, and the uterus turns from a receptacle for the fetus into an expelling organ. Some pregnant women are very afraid of the due date, building a psychological barrier to the formation of that very necessary dominant. Against the background of nervous overstrain and the lack of proper psychoprophylactic preparation for childbirth, a woman’s production of necessary hormones is inhibited. The cervix remains unchanged, and the body’s preparation for childbirth is delayed.

For complete and normal dilatation of the cervix, the development of regular labor is necessary. If labor contractions become weak, the process of opening the cervix also stops. This often happens with polyhydramnios (overstretching of the uterus occurs and, as a result, a decrease in its contractility) or oligohydramnios (a flaccid or flat amniotic sac does not allow proper action on the cervix).

Women who have crossed the age of 35 are at risk of encountering this problem. In their case, the cause may be rigidity (decreased elasticity) of the tissues.

remember The general condition of a woman’s body before childbirth plays an important role. The presence of extragenital endocrine diseases (diabetes mellitus, hypothyroidism, obesity) often leads to the development of complications during childbirth.

Stimulation of the preparation of the cervix for childbirth

Often, just before the expected date of birth, after visiting a doctor, a woman may find out that her cervix is ​​“not mature” and there is a need to artificially prepare it for childbirth. This issue becomes especially relevant after the 40th week of pregnancy, since at these times the placenta depletes its functionality, which leads to fetal hypoxia.

Stimulation of this process can be carried out using two methods: medicinal and non-medicinal.

Medication method allows you to achieve the desired result with the help of medications and only in a hospital setting.

• Introduction of kelp sticks into the cervical canal. Laminaria (seaweed) sticks are placed into the cervical canal along its entire length. Under the influence of moisture, after about 4-5 hours they begin to swell, mechanically opening the canal. Laminaria also secrete endogenous prostaglandins necessary for cervical maturation. The gradual mechanical and biochemical effect of kelp sticks leads to rapid and gentle preparation of the cervix for childbirth;
• Introduction of synthetic prostaglandin into the cervical canal in the form of suppositories or gel. Allows you to achieve the desired effect within a few hours;
• Carried out in a hospital setting amniotomy(piercing the amniotic sac). After this procedure, the anterior waters recede, the fetal head descends, the pressure on the cervix increases, and dilatation begins to occur faster.

Non-drug method can be used at home, but you should be extremely careful and take into account all the pros and cons.

• Cleansing enema. Its use irritates the back wall of the uterus, causing it to contract. It was also noticed that after this procedure, the mucous plug is released and the cervix begins to dilate. But it can only be done for those women whose expected due date has already arrived or passed;
• Sex. Natural stimulant of labor. Firstly, it causes contraction of the muscles of the uterus, increasing blood flow to it. Secondly, semen contains prostaglandins, the “birth hormone.” Contraindication: detached (high probability of infection);
• Physical activity. Long walks, cleaning the house, climbing the stairs to the upper floors. Contraindicated for hypertension, placenta previa.

Now you know how, when and why the cervix is ​​prepared for childbirth. You know the reasons why this may not happen and how you can fix it. Having information, you can correct or prevent possible problems. Don’t forget one thing: it’s best to do this in consultation with your doctor!

Upon admission to the maternity hospital, and then several more times during childbirth, the doctor will say: “Now we’ll do a vaginal examination” or: “Let’s see how the cervix is, how the baby is progressing.” We are talking about an internal obstetric examination, which allows us to determine the condition of the birth canal, observe the dynamics of cervical dilatation during childbirth, the mechanism of insertion and advancement of the presenting part of the fetus (head, buttocks). The initial examination upon admission of a woman in labor to the maternity hospital is carried out on a gynecological chair, and during childbirth - on the birth bed. The frequency of vaginal examinations depends on the characteristics of the course of labor. In the physiological (normal) course of labor, they are carried out no more often than after 4 hours, and if indications arise (rupture of amniotic fluid, changes in the nature of contractions, the appearance of bleeding, changes in the fetal heartbeat) - as necessary.

During vaginal examination during childbirth, the shape of the cervix, its size, consistency, and degree of maturity are determined; the condition of the external opening of the cervix, the edges of the pharynx and the degree of its opening, one of the dimensions of the pelvis is measured - the diagonal conjugate - between the lower part of the pubis and the promontory of the sacrum protruding into the pelvic cavity. Then the cervix is ​​examined in a mirror, but this is not always done, but only when there is bleeding and it is necessary to exclude the cervix as the source of this bleeding (this can be with extensive erosions, cervical cysts, vaginal varicose veins).

If a vaginal examination is carried out on the eve or at the very beginning of labor, then the doctor says that the cervix is ​​mature or, conversely, immature, synonyms - ready or not ready for childbirth.

The maturity of the cervix is ​​determined using a special scale (Bishop’s scale), taking into account the severity of four signs:

1. Consistency of the cervix (a soft cervix is ​​favorable for childbirth):

• dense - 0 points;
• softened, but hardened in the area of ​​the internal pharynx - 1 point;
• soft - 2 points.

Cervical length (before birth, the length of the cervix is ​​more than 2 cm, before birth the cervix is ​​shortened to 1 cm or less):

• more than 2 cm - 0 points;
• 1-2 cm - 1 point;
• less than 1 cm, smoothed - 2 points.

Patency of the cervical canal (before childbirth, the cervix should be freely passable for one or two fingers):

• external pharynx is closed, allows the tip of the finger to pass through - 0 points;
• the cervical canal allows one finger to pass through, but a seal is detected in the area of ​​the internal pharynx - 1 point;
• more than one finger, with a smoothed neck more than 2 cm - 2 points.

The location of the cervix in relation to the pelvic axis (before childbirth, the cervix should be located in the center of the pelvis):

• posterior – 0 points;
• anterior - 1 point;
• median - 2 points.

Each sign is scored from 0 to 2 points.

Score: 0-2 - immature neck, 3-4 - not mature enough, 5-6 - mature.

The doctor determines the opening of the cervix during a vaginal examination. The size of the opening of the uterine pharynx is measured in centimeters. Full opening corresponds to 10 cm. Sometimes you can hear the expression “opening of the cervix 2-3 fingers.” Indeed, old obstetricians measured the opening in their fingers. One obstetric finger is conventionally equal to 1.5-2 cm. However, the thickness of the fingers is different for everyone, so measurement in centimeters is more accurate and objective.

During a gynecological examination, the doctor also makes a conclusion about the condition of the amniotic fluid. Then a woman may hear the term “flat amniotic sac” - a situation in which there is little amniotic fluid in front of the fetal head. Normally, during each contraction, an increase in intrauterine pressure is transmitted to the fertilized egg (membrane, amniotic fluid and fetus). Amniotic fluid, under the influence of intrauterine pressure, moves down to the exit from the uterus, as a result of which the fetal bladder in the form of a wedge protrudes into the canal of the cervix and promotes its opening. There is little water in front of the head due to low or polyhydramnios, the presence of a large fetus, and weakness of labor. In this case, it does not function as a wedge and inhibits the opening of the cervix; the doctor says that such a bladder needs to be opened or an amniotomy performed.

Another term associated with the amniotic sac is “high lateral rupture of the amniotic sac” - a situation in which the amniotic sac ruptures not at its lower pole, but much higher, tightly grasping and holding the fetal head, preventing it from descending and moving into the cavity pelvis, and amniotic fluid is poured out in small portions or drops. In this case, the obstetrician performs instrumental dilution of the membranes, that is, there is already a hole in the membranes, but the amniotic membranes must be diluted.

After the water has poured out, the doctor evaluates its nature. “The waters are good, light, normal” - this is what the doctor will say if the waters are clear or with a slight yellowish tint, without an unpleasant odor. It’s worse if the doctor says: “green waters”; cloudy, green or brown water with an unpleasant odor may indicate hypoxia (intrauterine oxygen deprivation of the fetus). When fetal hypoxia develops, one of its early signs is the entry of meconium (original feces) into the amniotic fluid. This occurs as a result of relaxation of the fetal rectal sphincter due to oxygen starvation. First, lumps of meconium appear in the waters in the form of a suspension, and then the waters turn green. The intensity of the color of the water (from green to dirty brown) depends on the severity and duration of the hypoxic state in the fetus.

Fetal assessment

During childbirth, the expectant mother usually listens very closely to what they say about the baby's condition. While listening, the doctor pays attention to the rhythm, heart rate, clarity of tones, and the presence or absence of noise. Normally, the heart rate is 120-160 beats per minute, the tones are rhythmic, clear, and there are no extraneous noises. In obese women, the clarity of tones is reduced due to the thickness of the abdominal wall (muffled heartbeat). The doctor may rate the heartbeat as "rhythmic, clear," or "muffled, rhythmic," or "arrhythmic, dull." The presence of noise during auscultation can be around the neck and torso of the fetus, the presence of umbilical cord nodes, fetal hypoxia, placental insufficiency. The clarity of tones is affected by the thickness of the abdominal wall, the degree of expression of subcutaneous fat, the location of the placenta on the anterior wall of the uterus, the presence of myomatous nodes, and polyhydramnios. During the initial examination, the doctor uses a conventional obstetric stethoscope, but to clarify the condition of the fetus, as well as for dynamic monitoring during childbirth, a more detailed study using cardiotocography (CTG) is required. Modern cardiac monitors are based on the Doppler principle, the use of which makes it possible to record changes in the intervals between individual cycles of fetal cardiac activity; they are displayed in the form of sound and light signals and graphic images on the cardiotocograph monitor. To do this, an external sensor is placed on the woman's anterior abdominal wall at the point of best audibility of fetal heart sounds. The second sensor is located in the area of ​​the right corner of the uterus (the corner of the uterus is located in its upper part at the origin of the fallopian tube). This sensor records the frequency and strength of contractions during labor. Information about cardiac and labor activity is immediately reflected on the monitor in the form of two curves, respectively.

The frequency of vaginal examinations depends on the characteristics of the course of labor.

For diagnostic use, a special scale has been developed on which all of the above indicators are assessed in a point system. Doctors often talk about the “Fisher score,” i.e., a score on a scale developed by W. Fisher. A score of 8-10 points characterizes the good condition of the fetus, 6-7 points - there are initial signs of oxygen starvation of the fetus - hypoxia (compensated state). In this case, the fetus experiences a slight deficiency of nutrients and oxygen, but with timely treatment and an adequate method of delivery, the prognosis for the baby is favorable. Less than 6 points - severe (decompensated) condition of the fetus, which requires emergency delivery due to the threat of intrauterine fetal death.

How is the birth process going?

After the water breaks and the head is inserted, to assess the correspondence of the size of the fetal head to the mother’s pelvis during labor, the doctor must check Vasten’s sign and can inform the expectant mother about the results. The woman lies on her back. The doctor places one palm on the surface of the symphysis pubis, the other on the area of ​​the presenting head. If the sizes of the mother's pelvis and the fetal head correspond, the anterior surface of the head is located below the plane of the symphysis (pubic symphysis), i.e., the head extends under the pubic bone (Vasten's sign is negative). If the anterior surface of the head is flush with the symphysis (flush Vasten's sign), there is a slight size discrepancy. If there is a discrepancy between the sizes of the mother's pelvis and the fetal head, the anterior surface of the head is located above the plane of the symphysis (Vasten's sign is positive). A negative Vasten sign indicates a good match between the sizes of the woman’s head and pelvis. With the second option, a favorable outcome of birth through the natural birth canal is possible, subject to certain conditions:

• good labor activity;
• average fruit size;
• no signs of post-maturity;
• good fetal condition during childbirth;
• presence of light waters;
• good configuration of the head and its correct insertion when passing through the pelvic cavity.

A positive sign indicates that the mother’s pelvis is an obstacle to the passage of the fetus and natural childbirth is impossible in this case.

During a vaginal examination, the doctor evaluates how the fetal head is positioned. If everything goes well, then most likely you will not hear anything from the doctor on this score; if he wants to emphasize that everything is normal, he will say that the fetus is occipital in presentation. Normally, the fetal head descends into the pelvic cavity in a state of flexion, that is, the baby’s chin is pressed to the sternum, and the point in front of the birth canal is the back of the fetal head. In this case, it passes through all the planes of the pelvis with its smallest circumference quite easily. There are incorrect types of cephalic presentation, when the head is extended and either the forehead or the face of the fetus enters the pelvic cavity first. These types of cephalic presentation are called frontal and facial. In these cases, childbirth often ends with a cesarean section in order to reduce trauma to the fetus and mother. But with a small degree of extension of the head, good labor activity, and small size of the fetus, natural delivery is possible.

A woman may hear the expressions “front view”, “rear view”. No worries. With a cephalic presentation, this means that in the anterior view, the back of the fetal head faces the anterior wall of the uterus, and in the posterior view, it faces backward. Both options are normal, but in the latter case the pushing lasts longer.

After an external vaginal examination, the doctor can tell you how the head is moving through the birth canal.

The head is pressed against the entrance to the pelvis. Two weeks before the onset of labor in primiparous women, the fetal head begins to descend and press against the entrance to the pelvis. Due to this, pressure on the lower segment and cervix increases, which contributes to the ripening of the latter. In multiparous women, the head drops 1-3 days or even several hours before the onset of labor.

The head is a small segment at the entrance to the small pelvis. In this obstetric situation, the head is motionless, its largest part is located above the plane of the entrance to the pelvis, it can still be palpated through the anterior abdominal wall. This happens in the first stage of labor - during contractions.

The head is a large segment at the entrance to the small pelvis. In this case, it is located with its large circumference in the plane of the entrance to the small pelvis; it can hardly be felt through the anterior abdominal wall, but during a vaginal examination the doctor can clearly identify it, as well as all the sutures and fontanelles. This is how the head is positioned at the end of the first stage of labor before pushing begins.

The head in the pelvic cavity is not detected during external examination; during vaginal examination, the doctor sees that it fills the entire pelvic cavity. This obstetric situation is observed during the pushing period.

Birth of a baby

With each push, the head gradually passes through the pelvic cavity and begins to appear from the genital slit; doctors call this cutting in - the head appears from the genital slit only during pushing and through the eruption of the head (the head is constantly visible in the genital slit). This means the baby will be born soon. If there is a threat of perineal rupture, obstetricians often resort to dissection of the perineum - then they warn that they will do a perineotomy or episiotomy. This necessary measure helps prevent injuries to mother and baby. The perineotomy operation is a dissection of the perineum in the direction from the posterior perineum to the rectal sphincter. Thus, the incision passes along the midline of the perineum. For an episiotomy, the incision is made on one side, through the labia majora (at an angle of 45° from the midline).

Immediately after birth, mucus is sucked out of the baby's nose and mouth using a rubber balloon so that it does not enter the lungs during his first breath. The condition of a newborn baby is assessed using a scale at the 1st and 5th minutes. The following signs are taken into account: heartbeat, breathing, skin color, reflexes, muscle tone. The severity of each of the five signs is determined in points from 0 to 2. If the sum of points for all signs is from 7 to 10, then the condition of the newborn is satisfactory, 4-6 points - a condition of moderate severity, 1-3 points - severe.

After the baby is born, the obstetrician-gynecologist monitors for signs of placental separation. “It has separated, we are giving birth to the placenta” - this is what the doctor will say if, when pressing with the edge of the palm above the womb, the umbilical cord does not retract inward, if the clamp previously applied to the umbilical cord near the genital slit has dropped slightly.

Of course, during childbirth and then after the baby is born, you will have to deal with a lot of new words and concepts. And the more you learn about them from reliable sources, the more reliably you will rid yourself of unreasonable fears.

Natalya Bulakh, obstetrician-gynecologist of the first category,
Ph.D. honey. Sciences, MUZ Clinical Maternity Hospital, Astrakhan

The uterus is the most important organ in the female body, which is responsible for bearing and giving birth to a child. In essence, it is a muscular organ, a receptacle for the fetus. It is represented by three parts - bottom, body, neck. The cervix is ​​the part of the uterus that is responsible for both the onset of labor and its prevention. First, it helps to retain the fetus, prevents descent and premature birth. Then the cervix dilates before labor, which facilitates movement through the birth canal. This determines whether childbirth will proceed normally or pathologically. The uterus must be mature.

It is important for every woman to know and understand the causes, signs and mechanism of uterine dilatation, which will make it possible to distinguish the pathological process from the natural one. With at least minimal knowledge, a woman can take timely measures. A lot also depends on a woman’s actions - if you promptly inform your doctor about suspicions and point out pathological signs, you can take measures to prevent many pathologies. At a later date, you can take an active part in the preparatory process.

, , , , , ,

Reasons

Traditionally, there is a division of all possible causes into natural and pathological. The normal course of pregnancy is accompanied by a closed state of the uterus, which contributes to the reliable retention of the fetus, ensures full development, and protection of the effects. Later, the canal is completely freed and allows the fetus to emerge. The reason for this is changes in the cervix, leading to a partial replacement of muscle tissue with connective tissue. Collagen fibers are also actively formed, due to which the passage becomes softer and more elastic, as a result of which the tissues acquire greater stretchability.

The reason for the opening is a decrease in the length and other parameters of the neck, as a result of which the structure becomes loose and a gap is formed. Preparation is an advance process that begins at week 33. The uterus becomes looser and softer, and the position of the fetus decreases. From the inside there is constant pressure on the uterus, it begins to gradually open.

But there are many reasons that contribute to the pathological process. If dilation occurs ahead of schedule, there is a risk of premature birth, in which the baby is completely immature.

, , , , , ,

How to prepare the cervix for dilatation?

In everyday practice, specialists are increasingly faced with uterine immaturity. Therefore, preparatory measures are needed. This issue becomes especially important at 40 weeks, when labor should begin and the placenta gradually dies. The risk of hypoxia increases sharply. With this turn of events, artificial stimulation is resorted to.

In many ways, the success of preparation for disclosure depends on the woman herself. She must maintain a high level of activity and be sure to exercise. The load must be dosed. There are many programs for pregnant women that promote both physical and psychological preparation for childbirth. Physical exercises, specially designed complexes, stimulate the activity of the uterine muscles and receptors.

The effectiveness of physical activity is explained by the fact that the uterus is a muscular organ, which also requires training. You need to practice breathing exercises, belly breathing, practice relaxation and meditative techniques that make it possible to relax and concentrate. With the help of exercises, you can learn to control the relaxation of some muscles and the relaxation of others. Special means are also used that promote opening, for example suppositories, tablets. Their action is aimed at softening tissues and forming connective tissue layers.

You can also prepare the uterus for childbirth using medicinal or non-medicinal methods. In the first case, drugs are administered in various ways. Most often, local agents are used, the action of which is based on irritation and stimulation of receptors. For example, they use special medications, resort to the use of a stimulating catheter, and kelp sticks.

Symptoms

Once the process of disclosure has begun, it can proceed completely unnoticed. Often, women end up in the maternity hospital already having a dilation of 1-2 cm. It happens so unnoticed that the woman does not even suspect it. This is a sign of physiological maturity. Stretching, tingling, and a feeling of heaviness are rarely observed.

The sign that most accurately and reliably indicates the presence of an opening is the release of a mucus plug.

A dangerous symptom may be the rupture of amniotic fluid, which indicates the need for urgent hospitalization and delivery to the maternity hospital. If labor does not begin within 6-8 hours, dilatation must be stimulated, since a prolonged stay of the fetus without amniotic fluid is fraught with serious consequences for both the baby and the mother. Possible infection, hypoxia, and death.

If the dilatation is pathological and occurs long before birth, symptoms may also not be noticed. Therefore, it is important to consult a doctor in a timely manner so that he can identify possible pathology and prevent it.

The initial stages are completely invisible. Only if the mucus plug has come away is this considered an indicator that most accurately indicates dilation.

How long does it take for the cervix to dilate?

It is determined by whether a woman is giving birth for the first time or repeatedly. In primigravidas, dilation can be achieved after 8-10 hours. For repeat mothers, this process is reduced to 6-7 hours.

Periods and phases of cervical dilatation

Three periods are known. The initial stage is latent. Contractions begin. They are usually irregular and not strong. Contractions are not painful, and no significant sensations occur. Often women who are not in the maternity hospital endure this period on their feet, going about their usual activities and not noticing contractions. The latent period can last from several hours to several days.

At this time, you cannot listen to your feelings. It is also not recommended to wait for contractions. You should try not to notice them, but it is better to be under the supervision of medical personnel. During this time, you should try to relax as much as possible. You can do meditation, do breathing exercises, listen to soothing music, or just sleep. There is no need to waste energy in vain, you need to try to preserve and increase it, since a lot of it will still be needed. There is no need for medication yet. But your doctor can take action if there is a risk of complications. Most often they resort to artificial stimulation of labor.

The second period is called the phase of active disclosure, accompanied by the rapidity of the process. Characterized by an increase in the intensity of contractions and a reduction in the interval between them. It is at this stage that the amniotic fluid should pour out and the bladder should burst. The dilatation is 4-8 cm.

Gradually, and sometimes rapidly and quickly, the third stage begins, and the uterus opens to its fullest extent. There should be a doctor nearby who will supervise.

Sensations when the cervix dilates

Changes begin around 38-40 weeks. Aging of the placenta is observed, accompanied by the release of hormones, which stimulate the cervix to open. Significant transformations occur in the body, but no new sensations are experienced. Sometimes there may be pain, a feeling of pressure indicating descent. Sometimes women experience hormonal imbalance, which manifests itself in the form of sudden mood swings, irritability, anxiety, or vice versa, euphoria. But these sensations pass very quickly.

Later, after the fetus has descended sufficiently, painful sensations in the lower abdomen and false contractions may be observed, which represent prenatal hypertonicity of the uterus. During this period, the uterus begins to contract intensively and gradually opens. First, the latent period of opening usually passes without pain. In the second, active period, pain occurs.

Pain

Opening is divided into 2 phases: latent and active. Usually the latent phase occurs painlessly, while the second, active phase, already passes with a feeling of pain. In fact, this pain is natural, but nowadays not every woman can endure it, so doctors are forced to resort to pain relief. Typically, intense pain occurs when dilation exceeds 5 cm.

Discharge

First the plug comes off. Yellow mucous discharge is also possible. At the end of the active phase, amniotic fluid is released. If the cervix is ​​dilated by about 8-10 cm, this is a timely effusion. If the dilation is approximately 7 cm, the effusion is early. If the cervix is ​​opened by 10 cm or more and there is no rupture of water, it is necessary to perform an amniotomy, at the entrance of which the wall of the bladder is pierced.

Nausea

Nausea is rare: as a reaction to hormonal shifts. Nausea rarely occurs when the cervix is ​​dilated. It can sometimes occur as a reaction to pain, or as a side effect of medications.

Blood

There is no blood when it opens. The appearance of blood indicates a pathological process, a rupture of the perineum, other injuries, bleeding.

, , , , , , , , ,

Cervical dilatation without pain or contractions

Painlessness is observed in the latent phase. When the opening moves into the next stage, painful sensations arise. Pathological disclosure is usually painless, so you need to undergo timely examinations. The cervix can open without contractions, especially during the latent period.

, , , , ,

Dilatation of the cervix in primiparas

The duration is determined by whether the woman is primiparous or multiparous. Primiparas do not have such experience; the body only adapts to new and unknown conditions. Changes in activity and new conditions cause additional stress in the body, like any other new and unexpected type of activity. The body spends part of its resources on adapting to new conditions. The muscular system and connective tissue are not trained; nerve impulses enter the uterus more intensely, stimulating its contractile activity. This slightly increases sensitivity and pain.

Psychological readiness and self-regulation are at a lower level than in multiparous women. In addition, the lack of experience and lack of knowledge of what actions to perform take their toll. Therefore, you need to relax as much as possible and follow the doctor’s recommendations. For first-time mothers, it lasts up to 8-10 hours.

, , , , , , ,

Dilatation of the cervix in multiparous women

For those who have given birth before, the uterus is more prepared, stretched, and activated. In addition, muscle memory is preserved, which reproduces the process of pushing out the fetus, similar to the previous experience. Contractile activity is better regulated by nerve impulses, since the reflex arc has already been laid out and there is experience on which the nervous system can rely to produce reflexes. The process becomes more regulated and automatic with the simultaneous activation of the body’s self-regulation mechanisms. The muscles of the uterus and pelvic area are also more prepared, developed and activated. Therefore, in multiparous women, it takes approximately 6-7 hours to fully dilate, of which the latent phase accounts for 5-6 hours, and the active phase lasts only 1-2 hours. The process is less painful, also due to physical and psychological readiness for the upcoming pain.

, , , , , , ,

Premature dilatation of the uterus in the early stages

It often happens that the uterus cannot cope with its functions and may open prematurely. This is fraught with premature birth and miscarriages. This pathology is called isthmic-cervical insufficiency, in which the functional activity of the cervix and isthmus of the uterus is impaired. The obturator function is not performed, as a result of which the cervix softens and shortens, losing its ability to support the fetus. Most often, this phenomenon is observed in the 2-3 trimester. If at 20-30 weeks the cervix is ​​shortened to 25 mm, we are talking about cervical incompetence.

In this case, measures must be taken to maintain the pregnancy. Usually, measures are taken to prolong pregnancy. This is a wait-and-see strategy, which makes it possible to wait for the fetus to mature and be able to live outside the uterus. Traditional and non-traditional therapy is used.

Cervical dilatation at 30, 40 weeks of pregnancy

The closer the birth is, the greater the likelihood that the fetus is ripe. Accordingly, even premature birth carries less danger. The cervix should gradually dilate. The ideal option is when labor begins immediately after dilatation, but in practice it often happens that the cervix dilates without labor occurring yet. Many women do not even know about dilatation when they get to the maternity hospital. However, most births end successfully. The degree to which the uterus was dilated when entering the maternity hospital does not in any way affect the birth process itself. It is important that it opens during childbirth. Typically, normal dilation occurs at a rate of 1 cm per hour; in multiparous women, the dilation rate is higher. Usually the cervix becomes soft and ready for childbirth at 37 weeks, and the uterus begins to prepare for this at 30-32 weeks.

, , ,

Degree of cervical dilatation

The initial stage is painless, with contractions. The second stage - the degree of disclosure is approximately 6-8 cm. Lasts 4-5 hours, ends with a gradual transition to the third stage, during which complete rapid disclosure occurs. This stage symbolizes the beginning of labor. Accordingly, there are 3 degrees of disclosure - initial (1-4 cm), medium (4-8 cm), full disclosure (8-10). Sometimes a dilation of up to 12 cm is required.

, , , , , ,

Dilation of the cervix to half a finger, 1, 2, 3, 4 fingers

Indicators of 10 cm are considered normal for childbirth, which corresponds to 5 fingers. If the uterus is closed, there is no lumen, and during palpation the doctor cannot move the finger deeper. Opening to half a finger means the possibility of passing half of the obstetrician's finger, to 1, 2, 3, 4 fingers - accordingly, there is space for passing 1,2,3,4 fingers. If she misses at least one finger, the uterus can be considered mature.

, , , , ,

Full dilatation of the cervix

Full dilation is the third phase, which ensures the baby's unhindered exit. Dilation from 10 cm can be considered complete. Sometimes ruptures occur, requiring stitches. If there is a threat, an emergency caesarean section is performed.

Consequences and complications

Dilation may be complicated by weak contractions, during which the cervix practically does not dilate and remains at the prenatal stage. This often happens with polyhydramnios and multiple births. If the uterus is overstretched, its ruptures, decreased tone and contractile activity are possible. This also leads to a weakening of labor and the risk of fetal hypoxia.

How is cervical dilatation determined and checked?

Since the dilatation is asymptomatic, investigation is required. They are mainly examined by palpation - the obstetrician probes with his finger. Dilation is determined by the number of fingers that can freely pass through the cervix. This method is outdated, but is still used today in almost all institutions. Measurements in centimeters are considered more accurate. Usually, if 1 finger passes freely, this indicates a dilation of 2-3 centimeters, respectively, 2 fingers are equated to 3-4 cm. Full dilation is indicated when the uterus dilates by 4 fingers or 8 cm. Full dilation is determined visually: when smoothing the neck, thin edges and free passage of 5 fingers.

To assess dilation, the Bishop scale is used, a gynecological examination, during which measurements are taken. Then the data obtained is presented in the form of a graph on which the birth process is visualized. The graph is called a birth partogram. It clearly demonstrates changes; a sharp rise indicates the effectiveness of childbirth.

Cervical dilatation on ultrasound

The dilatation may be noticeable on ultrasound. It is necessary to attend scheduled examinations, which will make it possible to identify pathology and take the necessary measures.

, , , , ,

Stimulation of cervical dilatation

This involves the use of various methods that speed up the opening process. There are medicinal and non-medicinal methods.

How to speed up cervical dilatation at home?

Promotes high levels of physical activity. Food should contain plenty of fresh vegetables and fruits. You need to take a decoction of raspberry leaves or tea with the addition of raspberry leaves. It is important to stimulate the nipples, massage the earlobe and little finger. Sex helps open the cervix because it is a natural stimulant. In addition, semen contains large amounts of prostaglandins, which are also strong stimulants.

Exercise is important. Squats make a huge contribution. Exercises with special balls and gymnastics equipment have a positive effect. Breathing exercises are very important, as they not only stimulate the uterus and improve blood circulation, but also trigger a number of biochemical transformations. Hormonal levels and neuropsychic state change. At the same time, tense areas relax, and relaxed areas become toned. Correct regulation of contractile activity of muscles, including uterine muscles, occurs. Breathing, especially with the stomach, stimulates the production of prostaglandins and nerve impulses, which directly affect the activity of the uterus. Smooth muscles are also trained and strengthened.

Meditation, relaxation practices, staying in silence, concentration and internal contemplation are important. These are the basic techniques of hatha yoga, which allow you to ensure control over your own body and consciously regulate your feelings and sensations. Breathing and relaxation practices relieve excess tension and stress. As a result, muscle tension is relieved and pain goes away. Mental attitude plays a vital role. Many women are afraid of pain and consciously or unconsciously slow down the birth process. Breathing and relaxation make it possible to get rid of internal blocks, block fear and reduce the threshold of pain sensitivity.

Also shown are aromatherapy sessions, taking a warm bath with essential oils, color therapy, water treatments, music therapy, and sound-vibration therapy.

Cervical dilatation methods

There are conservative methods that use pharmaceutical agents aimed at stimulation. Radical methods can be used in emergency cases: amniotomy, perineal incision. There are also non-medicinal products: kelp sticks, special catheters, gels and oils, suppositories. Physical exercise, sex, meditation, breathing techniques, and local candles work well.

Catheter and foley balloon to dilate the cervix

A special catheter, which is presented in the form of a tube with a balloon. Injected into the cervix for 24 hours. The balloon is gradually filled with air, which expands the walls of the uterus. Has many disadvantages.

Can be described as a catheter containing a balloon. It is filled with air. It is inserted for a day, and gradual opening occurs due to the expansion of the cervical wall. The likelihood of developing an infection increases significantly.

Cervical dilation gel

A special gel containing prostaglandins is injected into the cervical canal. Hormonal stimulation occurs, the effect can be achieved after 2-3 hours.

Exercise

Squats are effective exercises. Twisting and jumping are contraindicated. At the same time, during practice you need to strive for maximum relaxation and control your breathing. You need to perform static exercises that train willpower and endurance. It is better to perform the exercises in a calm environment, with relaxing music. There are many video lessons for pregnant women, where all the exercises are shown clearly, selected in the optimal sequence, and smoothly transition from one to another. Such video lessons effectively combine static and dynamic complexes, breathing exercises and meditative practices.

The best option is yoga, pranayama (breathing exercises and internal contemplation), qigong, meditation, swimming, and water aerobics. You can sign up for special preparatory courses for pregnant women, where physical and psychological preparation of expectant mothers is carried out; training is carried out under the supervision of experienced specialists who can choose an individual pace and exercise regimen. Special gymnastic balls and fitballs are used. You can train at home even with the help of a regular staircase, making frequent ascents and descents.

Physical exercises will be more effective if you start preparing early. And even better - long before pregnancy. Trained muscles are the key to quick and successful opening of the uterus, since it is also essentially a muscle. But if preparations were not started when planning the pregnancy, it’s okay. It is better to start late than not to exercise at all. They are beneficial even if you start regular practice in the last weeks.

Fitball for dilation of the cervix

In modern clinics, it has long been recommended to take not the traditional position on a horizontal plane, but a vertical one. A sitting position is also recommended. But the surface should not be hard. The ideal fitball is a large inflatable ball, which is used in sports and gymnastics. If you sit on it and perform special exercises, you can relax tense areas and tighten those areas that will be in good shape. It is better to spread your legs apart. Nervous and hormonal activity is activated, and the uterus is more stimulated. At the preparatory courses you can receive special training in exercises and positions on a fitball.

, , ,

Squats to open the cervix

Squats stimulate the neck, both by activating nervous activity and mechanically. You need to perform regular squats, or squats according to a special pattern. The time gradually increases. First, you need to perform each stage for 10 seconds. Then increase the time to 1 minute for each stage. At the first stage, we slowly squat. The duration of the squat should be 10 seconds, that is, we should completely lower ourselves in 10 seconds. Then we sit in this position for another 10 seconds, and begin to relax as much as possible. Then we rise partially. You need to stop in a position so that your thighs are parallel to the floor. We remain in this position for 10 seconds, then slowly, over the next 10 seconds, lower ourselves down. We rest, relax in a squat for another 10 seconds. We begin a slow rise for 10 seconds. Then rest for 10 seconds and begin squatting again. After we managed to complete 10 such squats in one approach, we move on to the next stage - the duration of each stage increases to 20 seconds, then to 30, 40, 50 seconds and one minute. After squatting 10 times at a slow pace, you definitely need to squat at a fast pace. The speed should reach 50 squats per minute. If this doesn’t work, it’s better not to squat completely; you can only lower yourself partially. Gradually you need to increase the depth of the squats.

Meditation to open the cervix

The “Shavasana” pose used in yoga is effective. You need to lie on your back, legs and arms slightly apart. Eyes closed. You can turn on relaxing music and an aroma lamp. The sounds of nature are good, especially the sound of a sea wave, the sounds of rain, and a waterfall. Birdsong, animal sounds, and instrumental music may be suitable. You need to try to relax as much as possible, not think about anything. Muscles should be relaxed consciously, directing attention to them. First, let's focus on the legs. We feel how the leg muscles relax, become soft and heavy. Relaxation covers the tips of the fingers, is understood along the shin, along the thigh. The kneecap drops. The pelvic area, perineum, and uterus relax. Both legs are relaxed, the pelvic area is relaxed, gradually relaxation covers the stomach, back, the lower back, and the muscles along the spine relax. The chest and arms relax. Relaxation of the hands rises from the fingertips, glides along the wrist, elbows, forearm, relaxes the elbow, shoulder, collarbone.

Once again, walk your attention throughout your body, feel the relaxation in every area. Particular attention should be paid to the face: feel how your forehead, nose, eyes, ears, cheeks relax. The chin is relaxed, the lower jaw is relaxed and may be slightly open. Eyes closed. You are motionless and relaxed, your whole body is heavy. There are no thoughts in my head. There is only silence. If thoughts come, you need to let them go, not delay them. This meditation should last at least 30 minutes. There is no maximum limit. Ideally, it should be up to three hours. After this, you need to lie down and do not rush to get up. You can drink tea or herbal decoction. Raspberry leaf tea is ideal.

There are also video lessons and audio materials for meditation, which explain in detail all the nuances and provide meditation accompaniment. The slow, calm voice of a specialist smoothly guides your attention, directing it to the right areas, reminding you to relax and not think. The voice does not accompany all meditation: it is effectively combined with moments of silence, a special background and musical accompaniment are selected. The rhythm intensifies and fades, which creates the desired tonality.

Drugs for dilation of the cervix

Various drugs are used. Oxytocin, intramuscular administration of sinestrol, and suppositories with prostaglandin have proven themselves well. Enzaprost is also administered intravenously. The use of synthetic prostaglandin is allowed. The dosage and frequency of administration can only be determined by a doctor, since it is strictly individual and determined by the results of the partogram.

Pills

Miropristone is used. It stimulates the contractile activity of the myometrium. Take 1 tablet every day, under the strict supervision of a doctor.

Oxytocin-MEZ is often used to stimulate uterine dilation and induce labor. This is a solution for intramuscular and intravenous administration.

The opening can be facilitated by no-spa, which is an antispasmodic drug, relaxes the muscles and makes them more elastic. Prescribed 1-2 tablets 2-3 times a day or in the form of injections.

Papaverine can be used both in the form of injections and in the form of tablets. The dosage depends on the speed of dilation and the condition of the uterus, and is determined exclusively after palpation and gynecological examination. Helps reduce blood pressure and relax smooth muscles.

Caulophyllum 30 is a homeopathic remedy that is used to induce labor. It makes giving birth much easier and reduces the pain threshold. A remedy of Indian origin that has long been used in Indian medicine. Significantly reduces the risk of cesarean section, the need for oxytocin disappears. Eliminates trembling, fatigue and thirst, gives strength.

Castor oil, when taken orally, promotes rapid expansion. In the early stages it has abortifacient properties.

Many women, after being discharged from the hospital, say that they were given too many injections. And no one knows what drugs are used for this. In order to avoid unnecessary fears, it is better to understand this.

First of all, drugs are administered for pain relief. These are narcotic drugs that are administered in various ways. Most often - intramuscularly, intravenously. Epidural anesthesia (an injection in the back) is also used. It is the safest type of pain relief, since it does not affect either contractile activity or the fetus, the drug does not enter the blood. Other types are usually used only if there are 2-3 hours left before the baby is born, this eliminates the risk of developing hypoxia.

For labor weakness, stimulation medications are used. An amniotomy is often mistaken for an injection - a puncture of the amniotic sac. Depending on the situation, symptomatic remedies are used - to reduce swelling, pressure, heartbeat, and to stimulate the fetus.

If the contractions are long and painful, but unproductive, the woman weakens. She is given a sleep-rest drug, which allows her to quickly regain strength. This type of sleep lasts 2 hours. After it, labor activity intensifies.

Injections are often used to prevent or stop bleeding. In case of surgery, many injections are also used. Injections are also given to remove the placenta and postpartum rest.

A dropper is used to stimulate opening. It is based on saline solution or glucose, which ensures the maintenance and nutrition of the body. If necessary, drugs of various effects are added to the droppers.

Suppositories for dilation of the cervix before childbirth

Used for intravaginal administration with a high content of synthetic prostaglandin. Their effectiveness is high: the result is achieved within 2-3 hours.

Laminaria sticks for dilating the cervix before childbirth

They are sticks made from sea kelp. Dried algae, small in size, is inserted into the neck. Gradually it becomes saturated with moisture and expands, the cervix also expands. As many sticks are inserted as required to completely fill.

Manual dilatation of the cervix

It involves artificial dilatation by inserting and expanding a finger during a gynecological examination.

Pessary and ball dilation of the cervix

It is used to prevent early dilation and maintain pregnancy. The pessary is presented in the form of a plastic device that provides support for the organs. It is formed from several rings connecting to each other. Provides reliable support and can even be performed on an outpatient basis. Duration – several minutes. For insertion, the ring is lubricated with gel and inserted into the vagina. After the procedure, sex is contraindicated. Every 2-3 weeks you need to monitor the state of the vaginal microflora and conduct ultrasonography.

To mechanically open and stimulate the uterus, a special plastic ball is inserted into the cervix and left for a day.

Raspberry leaf for cervical dilatation

Raspberry leaves are very effective in dilating the cervix. Can be used in tea or as a decoction.

Dilatation of the cervix according to Rogovin

The full name is the Rogovin-Zanchenko method. This is an external measurement method that allows you to assess the degree of opening of the external pharynx. At the height of the contraction, measure the distance from the xiphoid process to the fundus of the uterus, in centimeters. The resulting indicators are subtracted from 10 cm to obtain height indicators. The method is approximate.

How to prevent cervical dilatation during pregnancy?

Prolongation means are used: bed rest. Emotional peace, medications, especially sedatives. Treatment is required to produce surfactant in the fetal lungs, which accelerates their maturation. Surgical treatment methods are also possible, in particular, suturing the cervix, or using a special obstetric pessary.

Ring on the cervix to prevent dilatation

In order to prevent premature dilatation, a special plastic ring is inserted into the uterus. It reduces the load. Administration can be done on an outpatient basis, on an empty bladder. To prevent the uterus from contracting, you can take an antispasmodic before the procedure. The ring is lubricated with glycerin and inserted into the vagina. Then they are turned in the desired direction. The doctor will do everything necessary. The patient will only need to attend an appointment every 2-3 weeks for a bacteriological examination. You also can't have sex. Dilatation of the cervix before childbirth occurs naturally, since the ring is first removed.