Natural childbirth – preparation, course, advantages, complications. Natural childbirth after caesarean section

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Women who gave birth by force of nature often say that it was the most beautiful day of their lives. There are many films about natural births circulating on the Internet – the vast majority of them evoke tears of emotion, although the visions of painful contractions, pressure and incision of the perineum that last several hours can make you shiver. One thing is for sure – pain is an individual matter for every future mother, so the most important thing is not to expect the worst.

Natural childbirth – definition

According to statistical data, natural births constitute 60 percent. all births in Poland. Natural childbirth is one in which there is no pharmacological or medical interference at all. These are the administration of drugs that enhance contractile functions (mainly oxytocin) and anesthetics, incision of the perineum, the use of obstetric forceps and vacuum lifting, or piercing the fetal bladder. Natural childbirth is a model of natural delivery.

If during a planned vaginal delivery a staff intervention in the form of an episiotomy or the administration of oxytocin is needed, it is called an assisted delivery. On the other hand, the use of obstetric tools qualifies the act of giving birth as forceps or vacuum delivery. The last type is delivery by caesarean section with the use of general or regional anesthesia and surgical intervention.

Natural childbirth – symptoms

The symptoms of upcoming delivery are completely individual. Some women, as they approach the due date, will feel the next typical symptoms of imminent labor, while others will not feel any unusual signs until the waters are gone.

It is possible to distinguish several symptoms of the upcoming natural birth:

1. lowering the abdomen when the baby turns its head down and slowly places it in the birth canal,
2. pain in the thighs and back in the sacro-lumbar region, also associated with a change in the position of the child,
3. less mobility of the child – after changing the position for natural delivery, it is more difficult for the child to move,
4. first contractions, the so-called Braxton-Hicks – rarely very painful, they may appear several weeks before delivery and mistakenly suggest the commencement of labor,
5. departure of the mucus plug, which is associated with the appearance of a pinkish vaginal discharge, i.e. amniotic fluid (so far chop protects the fetus against external infections),
6. diarrhea and nausea – this results from the secretion of hormones, including the stress hormone.

Also read: “Hormones after childbirth – concentration, lactation, first menstruation”

Natural childbirth – how to prepare?

Contrary to cesarean delivery, natural delivery is difficult to plan. Sometimes long hours pass from the first contractions to the actual labor, other women start labor within several dozen minutes. However, there are things that can be done well in advance of a possible natural delivery date.

The first is to make a hospital layette for you and your baby. After natural childbirth, you will have to spend some time in the hospital, so day and night underwear (including disposable panties), hygienic accessories such as postpartum inserts, baby bodysuits and diapers, towels and shower slippers will be useful.

In addition, before natural childbirth, it is worth packing all the necessary documents, including:

1. ID card,
2. original document containing the blood group and PESEL number,
3. pregnancy card,
4. the latest ultrasound results with a note about the weight of the fetus,
5. test results: morphology, serological test (WR), as well as for the presence of HIV, HBV and HCV.

Before natural childbirth, and in fact every childbirth, you should also wash off the nail polish or hybrid polish from your fingernails. A woman giving birth has a heart rate monitor on her finger. It is such a clip placed just at the height of the nail, which measures the pulse and the level of arterial blood oxygenation during childbirth. The operation of this device is based on the assessment of the color of the blood by the nail plate, and the colored varnish effectively makes it difficult. If a woman complains of brittle nails before vaginal delivery, she can apply a conditioner in the form of a colorless varnish.

Another issue when it comes to natural delivery – shaving. Unshaved intimate areas are not a problem in the delivery room. If there is a need for medical intervention, such as an episiotomy, staff will certainly have a razor or undercutter. However, it is not recommended to shave the genitals to zero at least 7 days before delivery, especially the hairs growing on the labia. During natural childbirth, irritated skin may be injured when the baby squeezes through the birth canals. Shaving hairs in the groin and on the pubic mound is much less important. The hair is best trimmed a few millimeters.

What about an enema? Many women associate natural labor with the risk of having a bowel movement when pushing. Admittedly, this is a common occurrence, but that’s why it’s not unusual, so it’s not worth stressing out. Performing an enema before natural birth is not a routine procedure today, it is decided by the woman in labor herself. You can buy special kits at the pharmacy. An enema can be painful in some women, but is usually just unpleasant. To sum up, in the eyes of obstetricians, an enema before vaginal delivery is neither necessary nor harmful.

Also read: «Layette for the hospital. What should be in it? »

Natural childbirth – when for delivery?

Some time after the first contractions, they become more intense – they last longer, more often and are more painful. In the absence of contraindications to natural childbirth, it is a good time to go to the delivery room. The final moment is the departure of the amniotic fluid. What will happen in the delivery room before natural birth?

First, you need to take a line in the emergency room of the gynecology and obstetrics ward. The queue is obligatory for all women who do not suffer from any side effects, such as vaginal haemorrhage or severe pain or advanced stage of labor. After that, all necessary documents should be handed over to create hospital documentation.

The next stage is gynecological examinations. Before natural birth, in addition to examining the dilation, the doctor will interview the patient. Questions will be asked about the strength, duration and frequency of contractions, the perceptibility of the baby’s movements and the departure of the amniotic fluid. Then a woman qualified for natural childbirth will be connected to CTG equipment, thanks to which the doctor will check the uterine contractions and the baby’s heart rate. It will also be necessary to measure the blood pressure and body temperature of the woman.

What does natural childbirth look like?

Natural childbirth is one that takes place without both pharmacological and medical intervention, i.e. without administration of anesthesia, oxytocin or cesarean section. Most often it takes place in three stages:

1. The first, longest stage of labor is associated with the initial labor contractions that occur every 10-30 minutes and last from 30 to 45 seconds. The amniotic fluid may depart from this point on. In a non-life-threatening situation, their color is transparent, slightly cloudy. If the water is green or brown it is absolutely necessary to go to the hospital. This is because there are serious complications. Stage one of labor continues until your cervix has expanded to ten centimeters. Usually it takes several to several hours. During this time, the expectant mother should remain in motion, e.g. lightly bounce on the ball, walk. The position of a supported kneeling or other position that relieves the spine is effective in relieving labor pain. Deep breathing must not be forgotten.
2. The second stage is the birth of the baby – this is when the fetal bladder usually bursts. Otherwise, the doctor has to puncture him. There are frequent, strong contractions (approximately every two minutes) accompanied by pain, especially in the lower back. This is a sign that the baby is being pushed out through the birth canal. The woman in labor feels the need to push, she may shiver, feel cold or hot. Sometimes there is also vomiting. In primiparous women, the second stage of natural labor may take up to two hours, and in women who gave birth earlier – about 30 minutes.
3. The third stage is the shortest. Within 15 minutes of a baby’s birth, the placenta is delivered.

Natural childbirth – how to speed it up?

The best way to speed up natural labor is to move. You can choose from several forms: gently bouncing on a pilates ball or a short, slow walk. Sometimes a warm (but not hot!) Bath is recommended. In the second stage of labor, when the labor is already underway, the woman should help herself with synchronized, regular breathing and pushing. This, among other things, is taught by childbirth schools.

Natural childbirth after caesarean section (VBAC)

After Caesarean section, many women would like their next children to be born through nature. It is possible, but depends on several factors. The first is the reason for a cesarean section in your first delivery – for example, a narrow pelvis or a chronic disease. In this case, subsequent solutions should be performed through the cesarean for the safety of the mother and child.

When it comes to abnormalities in the first delivery, e.g. incorrect positioning of the newborn, natural delivery the second time is not excluded. The greatest danger with VBAC is the possibility of uterine rupture and hemorrhage. Especially for women who are going to give birth around two years after their caesarean section. If the scar is well overgrown, there are usually no contraindications to natural childbirth.

Also read: «The most common ailments after childbirth»

Natural childbirth – advantages

Natural childbirth is a process developed by nature by choosing optimal mechanisms for the health and condition of both mother and baby. Therefore, it is a method of delivery recommended by obstetricians, unless of course there are any medical contraindications. The most important advantages of natural childbirth are:

1. quick recovery of the woman,
2. natural start of breast milk production,
3. the child acquires natural immunity – during the passage through the birth canal, the child comes into contact with the bacterial flora, which builds defensive reactions not only for the first months, but also for life,
4. less breathing problems in the newborn – natural birth is characterized by the fact that the baby’s chest is pressed during contractions, thanks to which amniotic fluid can escape from the lungs; additionally, the “pressure” of the birthing action increases the production of adrenaline in the child, which motivates to gasp quickly,
5. probably less frequent occurrence of sensory integration disorders due to intensive contact of the child’s body with the walls of the genital tract during natural childbirth.

Contraindications to natural childbirth

Although natural childbirth is the best solution for women and newborns, sometimes natural delivery is impossible. What determines the decision to make a decision about Caesarean section?

1. Problems with the hip joints.
2. Inflammation of the urinary tract or reproductive organs.
3. Incorrect positioning of the baby in the uterus – natural delivery with pelvic or gluteal positioning is difficult, the best position is the head position of the newborn.
4. Multiple pregnancy – natural childbirth of twins may also take place in a hybrid manner, because the first child is born through nature, and the second, due to complications, will be born as a result of a caesarean section.
5. Threat to the mother’s life.
6. Maternal gynecological diseases, incl. fibroids.
7. Natural childbirth and vision defect – advanced myopia, abnormal pressure of the eyeball or detachment of the retina disqualify the possibility of childbirth.
8. Hypertension and heart defects in a woman.
9. Big baby – natural childbirth with a high birth weight is impossible and requires medical intervention.
10. The width of the pelvis also affects natural birth – a narrow pelvis prevents the baby from passing through the birth canal.

Natural childbirth – perineal hygiene

Immediately after giving birth, the puerperium begins, which may last from 6 weeks to even 3 months. During this time, the body regenerates after 9 months of pregnancy. Uterine contractions may be felt for up to 6-7 days after vaginal delivery. The vagina is shrinking slowly but it has problems passing both urine and stools. Sometimes it becomes unexpected, sometimes elimination is stopped, sometimes it is painful.

Particular attention should be paid to intimate hygiene. Natural childbirth may be associated with a tear in the perineum, which is then sutured by the doctor. A wound is formed which is exposed to infections and injuries. How to take care of her hygiene?

1. Hygiene should start as soon as possible.
2. You should change your postpartum pads or pads frequently, and always keep your hands clean.
3. You should rinse your perineum with lukewarm water after using the toilet.
4. When washing the perineum after natural childbirth, you can additionally use special intimate hygiene cosmetics, the most delicate preparations for children or gray soap. Sponges and washcloths should not be used due to the willingly growing bacteria and fungi there. After washing, the perineum must always be thoroughly dried. A delicate disposable towel is best. 
5. It is good to use creams that accelerate the healing of the skin and mucous membranes, with fungicidal, antibacterial and antiviral properties.
6. Choose light, cotton, breathable underwear, avoid tight pants.
7. When the wound in the crotch after natural childbirth hurts, it is best to sit on cushions with an opening in the center.

Natural childbirth – complications

Although nature knows what is best for humans, all sorts of undesirable situations can arise in a woman in connection with natural childbirth.

1. The most common undesirable ailment is uterine prolapse, or in fact its significant reduction. It is caused by a lot of effort during labor, which leads to too much stretching of the uterine muscles. The red light should be lit by symptoms such as pain during intercourse and movement, problem with urinary incontinence and defecation, a feeling of pressure in the uterus.
2. Difficulty walking, pain radiating to the thighs and back, as well as swelling at the symphysis site, may be a sign of disruption of the symphysis after vaginal delivery.
3. Postpartum bacterial or fungal infection is systemic in nature. They are characterized by high fever, chills after natural childbirth, weakness and pain in the lower abdomen.
4. Uterine paresis, which occurs when the uterus does not contract properly and blood begins to pool. The most important symptoms include pale skin, fainting, increased heart rate, drop in blood pressure, a large amount of blood in the faeces, softness and laxity of the uterus.
5. Amniotic fluid embolism is quite a rare ailment undesirable after natural childbirth. It occurs when there are microtraumas to the cervix, for example, when the veins are broken. Inflammation, hypotension, slowing circulation and respiratory disorders appear.

This will interest you: «Almost 5 kg newborn born by forces of nature in water!»

Natural childbirth or Caesarean?

Natural childbirth causes fear in many women, while caesarean section is associated with safety and full control. And it really is. Unlike natural delivery, a cesarean section can be scheduled for a specific day and time. The woman is given anesthesia and does not need to push and regulate her breathing. There is also no deformation of the perineum and he has problems with excretory functions much less frequently.

However, it is worth remembering that a caesarean is a surgical procedure and therefore has certain dangers. There may be intrauterine haemorrhage, postoperative adhesions in the abdominal cavity, bladder injuries or wound infections. In addition, the mother’s body reacts differently to natural childbirth. There are difficulties with lactation or contracting the uterus.

A caesarean section is the ideal solution when natural delivery is impossible or risky. It saved millions of mothers and newborns, both in terms of health and life. However, whenever giving birth through nature is possible, it is always a better choice, because it is designed by nature so that it works and serves a woman and a child.

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