Soft uterus before birth. What changes occur in the cervix before childbirth

For a successful birth, it is necessary that the mother's body is absolutely ready for this complex process. In the last weeks of pregnancy, changes occur in the cervix that make it possible to determine its “maturity” and readiness for childbirth. Once labor begins, the cervix opens and softens. Softening the cervix is necessary in order to ensure that the baby can move freely through the birth canal without injury to himself and the expectant mother. However, there are situations in which the cervix is not softened properly, which threatens the mother with ruptures and injuries during childbirth. In addition, such a situation will not have a very good effect on the general condition of the baby. In such cases, additional intervention and procedures are required to soften the cervix.

Methods for softening the cervix

There are quite a few methods for softening the cervix. They are divided into the following groups:

Medication;
Mechanical;
Non-medicinal.

And, despite the fact that quite a few folk methods are known to promote softening at home, doctors still do not advise using any of them without prior consultation, so as not to harm yourself and the child.

Softening occurs under the influence of prostaglandins - complex hormones that affect the contractility of the uterus, the sensation of pain and the immune system. These hormones can be obtained naturally, that is, the woman’s body produces them independently in sufficient quantities, or they can be introduced externally. And if, upon examination, the doctor determines that the cervix is not yet completely ready for childbirth, then you can use one of the methods for softening it, described below.

Non-drug softening methods

Sunflower oil, which contains vitamin E, helps soften the cervix, making it more distensible during childbirth. In addition, the oil has a positive effect on the circulatory system. In addition to sunflower oil, you can consume olive oil, which also increases the elasticity of muscle tissue. You need to start drinking oil in the last trimester of pregnancy (from 36 to 38 weeks). It is recommended to use 1 tablespoon (tablespoon) of oil per day or simply season salads with it.

You can also massage the perineum with oil, which will later help prevent its rupture during childbirth. And you need to start doing such massages early: approximately in the 2nd trimester.

Medicinal methods of softening

The medical method is the use of various antispasmodic drugs. These can be tablets, gel or suppositories. One of the most common drugs is Buscopan, which softens the cervix before childbirth and promotes its dilatation. Buscopan tablets, injection solution or suppositories are available for sale.

Medication to soften the cervix

If the cervix is not yet dilated, but contractions have already begun, then the doctor administers Buscopan suppositories. It should be noted that Buscopan is prescribed mainly before childbirth, and its use in the 1st trimester is not recommended. Buscopan is used both during postterm pregnancy and ten to twelve days before the planned date of birth. It is important to know that when taking Buscopan, you should fully adhere to the recommendations given by your doctor. In case of overdose, the following undesirable consequences may occur:

Dry mouth;
Dyspnea;
Dizziness;
Tachycardia, etc.

Therefore, in no case should you take Buscopan, like any other drugs, on your own, because only a gynecologist can prescribe the dosage, based on the results of the examination. It is noted that Buscopan should also not be taken by women suffering from constipation.

Mechanical softening methods

The introduction of prostaglandins into the cervical canal is considered a mechanical softening method. Most often it can be kelp algae or a special gel. The seaweed, kelp, grows in the Sea of Japan and some cold northern seas. Dried kelp are thin sticks that have the ability to expand many times when exposed to moisture. Kelp is administered on a gynecological chair. Rapidly increasing in volume, kelp puts more and more pressure on the cervix, which softens. Softening of the uterus is accompanied by contractions and pain in the lower abdomen.

The use of kelp is a fairly effective and relatively inexpensive remedy, which, moreover, rarely causes complications or side effects. But it should be noted that it takes time to achieve the desired effect when using kelp. But how many sticks need to be administered and for how long is determined by the doctor.

Early pregnancy and the risk of cervical softening

Throughout the entire period of pregnancy, the cervix should be under special control, because it is the one that holds the fetus growing inside the uterus. Normally, during the first - second trimester, it should be dense and closed. The uterus should not be soft throughout pregnancy; it becomes so only before childbirth.

However, many women, having visited a gynecologist, hear the conclusion “the uterus is in good shape.” What does this phrase mean and what threats exist to the life and health of the child?

In this video you will learn what the concept of a uterus means in “toned uterus”:

A woman can most often hear such conclusions in the second trimester, since during this period the tummy begins to round and the pelvic bones diverge. And if, during a routine examination by a gynecologist, it turns out that the cervix is soft, bleeding has appeared, and the uterus is toned, then the expectant mother will most likely be hospitalized. When the cervix softens in the second trimester, doctors strongly recommend stopping sexual activity to avoid uterine spasms, and sports activities are also undesirable. For existing problems, doctors offer the following treatment options:

Medication;
Stitching the cervix;
Installation of a pessary.

Drug treatment of softening in the early stages

The fact that only softening of the cervix is detected, without any accompanying signs, does not mean at all that a woman will not be able to safely carry a pregnancy. With such a conclusion, a woman needs absolute rest, bed rest and a complete absence of nervous stress.

If uterine hypertonicity is also associated with a soft cervix, then the expectant mother will most likely be admitted to a hospital and prescribed the necessary treatment: medications, pills, intramuscular injections that will strengthen the cervix.

Stitching the cervix

If the cervix softens in the second trimester, a surgical operation can be performed to tighten it with sutures, which are removed at the end of the third trimester. Such an operation is performed only under anesthesia and in a hospital setting.

Like any surgical intervention in the body, this procedure may have its consequences, but this will help avoid the threat of early onset of labor.

Surgical method of tightening the uterus in a woman

Installation of a pessary for softening of the cervix

The softness of the cervix in the 2nd trimester is fraught with miscarriages at a period of twenty to thirty weeks. In cases where a soft neck is detected, doctors suggest installing a pessary - a special medical ring that tightens the neck and prevents it from opening earlier than expected.

Installing a pessary is a fairly quick and painless procedure. Removal of the pessary should only occur in the maternity hospital, at the end of pregnancy, since removal of the pessary can stimulate the onset of labor.

You can learn more about the pessary and its installation after watching this video:

The use of all of the above methods will help the expectant mother carry the pregnancy to term and safely give birth to a healthy child. Which option can be used for a woman is a question for discussion between the woman herself and her gynecologist.

By the time childbirth occurs, the cervix, unnoticed by the woman herself, has completely changed. And this makes it possible for the baby to be born completely naturally. But the cervix itself cannot always change to the extent necessary for spontaneous childbirth. In this case, medical intervention is simply necessary.

How to check cervical dilatation during childbirth

There are several parameters by which doctors determine the readiness of the cervix for childbirth. This is its placement in the pelvis, its length and how soft it has become. If its softness allows you to pass 1-2 fingers inside, then this is a completely ripe cervix and ready for childbirth.

Also, these changes are confirmed by a process such as the removal of the mucus plug. The plug may move away long after the appointed time, and this indicates that contractions will soon begin. Also, before giving birth, the cervix should shorten and its length should be within one centimeter. And when it comes to its position, the most optimal position will be in the middle of the small pelvis.

Although during pregnancy the cervix is slightly tilted back. Based on the indicators of these parameters, doctors give a rating; the maximum can be five. Using the same assessment, you can determine the readiness of the cervix for labor. If the score is five, then they say that the cervix is ripe.

But quite often it happens that labor should begin soon, but the cervix is still completely unready. Then stimulation will be used to open it. If you do not resort to this method, the child will soon begin to experience a lack of oxygen due to the fact that the placenta ages very quickly before birth, and the functions that it must perform become beyond its ability.

How to help the cervix dilate during childbirth

Today, doctors use four methods to stimulate cervical dilatation.

Injections of Sinestrol into the muscles. Thanks to this drug, you can make the cervix ripe, but it has nothing to do with contractions.

Kelp sticks. The doctor places these 5 cm sticks into the cervical canal. As moisture acts on them, they swell and mechanically open the cervix.

Gel with prostaglandins. This is one of the most effective methods. Under its influence, the cervix will open within 2-3 hours.

Enzaprost intravenously. This drug also contains prostaglandins. Therefore, using it can also reduce the duration of contractions.

There are cases when women prefer to stimulate their body on their own. The most common method is an enema, which helps remove the plug. But this can only be done for pregnant women whose due date has approached and the baby is full term.

If there are no contractions, but the water and the plug have already broken, then stimulation with a warm bath is strictly prohibited. Because there is a risk of catching some kind of infection. You can also use a variety of physical activities. Walking is best for the body. But you can also do some cleaning. But in such cases, you need to monitor your well-being, because the consequences will not always be the most pleasant.

Stages of cervical dilatation

The cervix does not open immediately during childbirth. Doctors distinguish several periods. The first period of cervical dilation during childbirth is called slow, because in 4-6 hours the dilation will be no more than 10 cm. At this time, contractions are not too frequent - every 6-7 minutes. The second stage is called fast because the dilatation is 1 cm per hour. At this stage, contractions occur every minute and so on until the dilation is 10 cm. The third period is full dilation, which indicates full readiness for labor.

But sometimes there are cases when the cervix can open ahead of schedule. Therefore, in the last trimester, a woman should be ready for absolutely anything.

This issue is very important for expectant mothers and worries them greatly towards the end of pregnancy. Many women are interested in why everyone used to give birth easily, without even knowing that they needed to somehow definitely prepare for this? The fact is that absolutely healthy representatives of the fairer sex really do not need this. However, in the modern world such people can be counted on one hand. Therefore, many often find out that the cervix is not ready for childbirth, shortly before it, or even during the process, and doctors have to do it urgently and artificially.

How the uterus works and its functions

To know how to prepare the cervix for childbirth, you need to have information about what it is needed for and what role its cervix plays. The uterus is an organ that is a hollow sac. Before pregnancy, it looks like a deflated balloon measuring up to 10 cm. During pregnancy, an embryo develops in it, and the uterus stretches as it grows. Special collagen fibers that appear during pregnancy make it elastic. At 38-39 weeks, the uterus becomes completely ready for childbirth and is able to push out the fetus with its contractions. The first obstacle to the exit of the fetus is the cervix. And if it is not soft and elastic, it will interfere with the normal course of labor. In order not to urgently ask the question of how to prepare the cervix for childbirth when it is already happening, it is necessary to do this in advance.

Determination of cervical maturity and what it depends on

Doctors measure how ripe the cervix is using a special scale, taking into account the degree to which the following signs are expressed: the length of the cervix, its consistency and location in relation to the pelvic axis, as well as how passable

Each of these signs is assessed on a scale of 0-2 points. Hormones called prostaglandins are responsible for preparing the cervix. They affect the contraction of hormones, analogues of natural ones, and are used to artificially prepare the cervix for childbirth.

How to prepare the cervix for childbirth

You can start preparing the cervix from the 34th or 36th week of pregnancy as prescribed by your doctor. This can be done with medications with the intervention of doctors or independently. Let's look at both of these options in more detail.

How to prepare the cervix for childbirth with medications. Pros and cons

For these purposes, the use of synthetic prostaglandins is common - Cytotec (E1 misoprostol) or Prepidil gel (E2 dinoprostone). These are highly effective drugs that can prepare the uterus within a few hours. However, they have the following disadvantages and side effects:

relatively high cost. Therefore, their use is possible only if the birth is paid for, and in a paid clinic. In a simple maternity hospital, they will prepare the cervix manually or schedule a caesarean section;
a large number of contraindications;
the possibility of excessive stimulation leading to uterine rupture and hypertonicity. Therefore, a woman must constantly be under the monitor, which prevents her from adopting comfortable positions during contractions.

How to prepare your cervix for childbirth yourself

To prepare the cervix yourself, you can use the following methods:

eating foods containing: black currants, borage, fatty fish, flaxseed oil. You should also avoid eating foods that contain margarine;
use of capsules with;
sex in the last weeks of pregnancy without a condom. Sperm contains natural prostaglandins, which softens and prepares the cervix for childbirth.

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 exit. 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 dilatation 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 that 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, such as suppositories and 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 meditate, 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 an expectant tactic, which makes it possible to wait for the fetus to mature and to 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 gain 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. At home, you can train 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 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 such a position 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 for opening 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 subsides, 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 maintains and nourishes 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.

While waiting for a baby, a woman feels anxiety and fear of the upcoming birth. In later stages of pregnancy, this feeling intensifies. Women who are experiencing this for the first time are the most worried. The unknown and complex medical terms frighten expectant mothers. To reduce anxiety, a woman needs to understand what awaits her. Minimal knowledge will help prevent serious pathologies, since, knowing atypical symptoms, you can consult a doctor in a timely manner.

Why does the cervix dilate during childbirth?

The uterus itself is a hollow muscular organ. The inner walls are covered with a mucous membrane, the condition of which changes on different days of the menstrual cycle. When pregnancy occurs, the fetus develops in the uterus. It is connected to the vagina by a special tube called the cervix. The inside of the neck is tightly closed. This is necessary to securely hold the baby inside and protect the fetus from the penetration of pathogenic microorganisms. The uterus consists of a body, fundus and cervix.

During childbirth, the cervix dilates (see photo). This process is necessary for the smooth passage of the child through the birth canal. Cervical preparation begins at 32 weeks of pregnancy. At this time, its walls become more loose due to the partial replacement of muscle tissue with connective tissue. In addition, due to the production of the hormones estrogen and collagen, the tissues become softer and more stretchable.

After the 38th week of pregnancy, the placenta begins to age. At the same time, the uterus begins to produce special hormones that provoke the preparation of the organ before childbirth.

How do doctors determine dilation?

Labor activity and the readiness of organs for the birth of a child are determined by the degree of dilatation of the cervix. As a rule, this condition is checked by palpation, when doctors determine how many fingers fit freely into the lumen of the cervix. Currently, the centimeter measurement method is often used. The opening of one finger is equal to two centimeters.

When the cervix is dilated by 3 cm, many pregnant women are concerned with the question, how long will it take for labor to begin? Doctors determine the onset of labor depending on how open the birth canal is. After 4 cm, the cervix opens a centimeter every hour. For birth, the clearance should be 10–12 cm.

Can a pregnant woman check her dilation herself?

Dilation of the cervix by 1–2 centimeters (by 1 finger) occurs without characteristic signs. As a rule, a woman does not feel that changes have begun to occur in her body. In rare cases, pregnant women complain of heaviness in the lower abdomen and minor pain.

If the expectant mother notices thick mucous brownish discharge, it means that the plug has come off. This symptom indicates the onset of labor. The amount of discharge depends on whether the protective plug has come off completely or partially. In any case, if suspicious discharge is detected, you should contact a gynecologist.

Sometimes labor begins with the release of amniotic fluid. They are normally colorless and odorless. You need to remember the time when your water broke. In this case, the cervix may not open. This process requires the presence of a doctor; it is better for a woman to immediately contact the maternity hospital. If the cervix does not allow several fingers through 5–7 hours after the release of fluid, labor should be stimulated, since a long stay of the fetus without amniotic fluid leads to its hypoxia.

It is impossible to determine the exact dilation in centimeters on your own at home. In order to examine the cervix before childbirth, check its readiness and understand the progress of labor, you need special skills and knowledge that only specialists possess. In addition, the woman in labor is physically unable to do this herself.

Stages of cervical dilatation in pregnant women

Disclosure occurs in 3 stages:

Latent. It is characterized by mild contractions that occur without any frequency. There are no painful sensations. If a woman is at home at this time, she rarely notices changes in her condition. During this period, it is recommended not to focus on the contractions, try to be distracted or sleep. Breathing exercises and calm music have a beneficial effect on muscles. Medical intervention in the natural process during the latent period is not required. In rare cases, when pathologies develop, it is possible to use stimulants. The period lasts from several hours to several days.
Fast. At the same time, the duration of contractions increases and the interval between them decreases. Contractions appear periodically, every 2–5 minutes. They become painful; in case of severe unbearable pain, painkillers are used. During this period, the woman needs to be under the supervision of a doctor so that he can correctly assess labor and provide the necessary assistance. It is not recommended to sit or lie down. A pregnant woman needs to stand with her elbows on a stable surface or walk. This way, the greatest pressure from the baby’s weight is achieved, and the cervix should open faster. If it is more convenient for a woman to wait out contractions while sitting, it is better to use a large ball - a fitball. In the rapid period, dilation occurs by 4–6 cm within 8–10 hours for women with their first pregnancy (primiparas) and 5–7 for pregnant women for the second and subsequent times (multiparas).
Full disclosure. At this time, the pregnant woman is under the supervision of doctors. The baby's head drops into the pelvis as the cervix is fully dilated, or, as obstetricians say, effaced. The obstetrician seats the woman in labor on a special chair, conducts an examination and asks her to push. The time of the rapid period and full disclosure depends on the individual characteristics of the expectant mother’s body and the readiness of her birth canal.

Possible problems

Why are there no contractions and the cervix is not ready if it’s time to give birth? As the due date approaches, women's anxiety increases. First-time mothers are afraid of possible pain and the unknown; women with a second pregnancy are frightened by previous experience, especially for those who have encountered problems during childbirth. The emotional state affects the functioning of the endocrine system. Due to stress, adrenaline is produced, which leads to the fact that the cervix is closed at the time of birth.

Other reasons for weak labor:

polyhydramnios – when there is a large amount of amniotic fluid, the walls of the uterus stretch excessively, which reduces their contractility;
oligohydramnios – if there is a lack of fluid, it is difficult for the child to pass through the birth canal, since the force of pressure on the cervix is provided by the amniotic sac;
pathologies of the endocrine system in a pregnant woman - the production of necessary hormones is necessary for normal labor.

If dilation is not observed after the 40th week of pregnancy, stimulation is used. At this time, the placenta ages and ceases to perform its functions, as a result, the baby does not receive enough nutrients and oxygen. This can cause the development of hypoxia.

If dilatation occurs before the due date, it can lead to miscarriage. They try to stop the increase in lumen from the 28th week of pregnancy. When the lumen increases by 1–2 cm, the inner edges of the cervix are sutured before delivery, which slows down further opening. If the lumen reaches 3–4 cm and the fetal head has dropped, then the woman is prescribed complete rest and the introduction of special medications that accelerate the development of the child.

Methods for dilating the cervix in the maternity hospital

If dilation does not occur by the 40th week of pregnancy, uterine stimulation is used. The procedure must take place in the maternity hospital under the supervision of doctors. The main methods include drug therapy. The use of various products may result in full dilatation 5-7 hours after application. Most often used:

Miropriston. Helps increase the contractile activity of the uterine walls. Allowed to take 1 tablet per day.
Oxytocin. It is a solution for intramuscular injection. Stimulates opening.
No-Shpa. It is a strong antispasmodic, relaxes muscles, reduces their tone, which promotes rapid opening. Take 2-3 tablets per day.
Papaverine. Used in the form of tablets and injections. The action is aimed at reducing muscle tone. The dosage is determined individually, taking into account the condition of the birth canal.

Other methods of stimulation in the maternity hospital:

suppositories and gels with prostaglandin - inserted into the vagina, labor will begin a few hours after insertion (there are contraindications);
kelp sticks (look at the photo) - special sticks are placed in the cervix, due to swelling they increase the lumen, in addition, they contain substances that prepare the cervix for the passage of the child;
manual exposure - during a gynecological examination, the doctor expands the organ with his fingers;
amniotomy - puncture of the fetal bladder using a special device.

Is it possible to stimulate disclosure at home?

Ways to induce labor at home:

Following a diet and taking special decoctions. A woman's diet should include more fresh vegetables and fruits. A decoction of raspberry leaves and berries helps stimulate the opening of the cervix, as it contains substances that relax muscles and reduce tone.
Cleansing enema. In this case, the posterior wall of the uterus is affected. In addition, this leads to the removal of the plug, which provokes the onset of labor.
Sex. During orgasm, the uterus naturally contracts. Semen contains substances that soften the tissues of the cervix.
Physical activity. Performing exercises should be agreed with a doctor, since muscle tension is contraindicated in gestosis and other pathological conditions. It is better to select a complex with an experienced instructor. Long walks, slow squats and exercise on a fitball have a beneficial effect (see photo). You can't jump. In addition, exercises with high arms raised should be avoided. During gymnastics, you need to monitor your breathing and relax your muscles in a timely manner.