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Which women find it harder to give birth: an explanation of the gynecologist
Someone recalls the birth of a child with a soft smile, someone with horror. On what it may depend, who will find it more difficult, and what to do to facilitate the course of childbirth, we learned from a specialist.
From the words “come back for the second”, which the nurses say, seeing off the young mother to the discharge, some women openly cringe. It’s no joke, only five days, or even less, have passed since the moment when I had to endure unreal, indescribable pain. Come back again? No, thank you. And even the stories of girlfriends who are lucky to give birth quickly and almost painlessly cause irritation: brag somewhere else. Why is that?
gynecologist of the highest category, ultrasound diagnostician Major Clinic
“Whether the labor is difficult or not depends on the readiness of the birth canal, how soft the cervix is, shortened, and passable for one or two obstetric fingers. The softer the cervix, the cervical canal is passable, the cervix is shorter, the faster the birth process. Therefore, preparation for childbirth is important, so that everything is normal. “
What makes childbirth difficult
Polycystic ovary syndrome, hormonal disorders
PCOS is a disease that affects 5-10 percent of women. Many small cysts form in the ovaries, and this entails many problems, including infertility. And if it is still possible to conceive, then the excess of androgens affects the course of childbirth: in women with hormonal disorders, the uterus is usually dense, the cervix is small. Usually, specialists prepare expectant mothers with such problems for childbirth in advance: from the 36th to 37th week of pregnancy, they need special therapy.
Dimensions of the pelvis
The width of the hips has nothing to do with it – we are talking about the size of the inner pelvis. If it is a uniformly narrowed or narrow pelvis of the first degree, then the birth process, naturally, is delayed: the configuration of the fetal head in this case takes longer than in a woman with normal pelvic dimensions, it is more difficult for a child to squeeze through the birth canal.
Fruit size
The larger the fetus, the more difficult childbirth is. Especially if a large baby is born to a mother with a narrow pelvis: with the size of the fetus, for example, 3900 grams, childbirth is likely to be long and painful.
The degree of maturity of the baby
Pregnancy can be full-term and post-term. In the second case, the bones of the baby’s head become dense, and this is fraught with injuries for both the mother and the fetus. Therefore, now they are trying to allow childbirth when the pregnancy is full-term up to 40 weeks. At this time, the large fontanelle on the baby’s head is not yet closed. The bones of the baby’s head become denser by the 42nd week of pregnancy.
Premature birth is a separate topic, which has its own nuances. They, too, can be fraught with tears in the perineum and vagina during childbirth. But, as a rule, due to premature birth, the fetus suffers more, birth traumatism is more common in the baby. And mothers, due to the fact that children are born small, rarely suffer from injuries and complications during childbirth.
When the head of a fetus with a large diameter passes through the birth canal, injuries can occur. Hence, intracranial hypertension in a baby, injuries of the cervical spine, cerebral palsy. It happens that women come and tell that the child has cerebral palsy, thinking that it is congenital, but in fact it is often incorrect management of childbirth. Therefore, it is necessary to predict the likelihood of such situations, to calculate in advance the risks in the patient: this is the age, the size of the pelvis, the size of the fetus, how the pregnancy proceeds, what are the initial diseases of the woman, including chronic ones. And depending on this, prepare a woman for childbirth.
Unexpected risks
In addition to problems that can be predicted – such as the size of the pelvis and the fetus – there are also unpredictable complications. For example, in the third trimester, a woman’s blood pressure rises, protein may appear in the urine, plus edema. It also happens that two symptoms are observed together, for example, high blood pressure and swelling. These are all very disturbing symptoms.
When blood pressure rises during childbirth, there can be complications: the child may develop acute hypoxia up to placental abruption during childbirth, if the pressure is really high. Therefore, the situation must be constantly monitored.
It also happens that a woman who has not been prepared for childbirth suddenly enters the department with high blood pressure. In this case, there is a risk of acute fetal hypoxia and detachment of the normally located placenta. If an operative delivery is carried out on time, then everything will be fine, but if it is acute hypoxia, this can lead to antenatal (fetal death during pregnancy) fetal death. And placental abruption, if you do not have time to operate on a woman in labor, is one hundred percent antenatal fetal death.
How to protect yourself from harm
To prevent all this from happening, you need to regularly check the following components:
arterial pressure;
regularly take a general urine test so as not to miss the protein in the urine;
monitor the weight gain during pregnancy – so that there is no excess;
monitor diuresis so that the amount of fluid that a woman drinks and excretes is approximately the same;
so that there is no swelling in the legs and arms.
It is necessary to teach a woman in advance to push correctly, to listen to the midwife who takes delivery. Because if a woman behaves spontaneously, does not obey, then severe perineal ruptures can occur. And it is very useful to conduct psychological trainings before childbirth.
Also, for the process of childbirth to go well, it is necessary that the vagina be scanned before childbirth. There should be no inflammatory processes, all tests and smears should be normal – and after all, pregnant women often have thrush. If left unaddressed, the risk of tearing the perineum, vaginal walls and cervix during labor increases dramatically. A smear test is usually taken at about 36 weeks and is usually treated or not prescribed if everything is in order.
By the way, complications in childbirth can happen to anyone, even the richest and most famous woman. Below is a photo gallery of stars who almost died in childbirth.