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

For successful childbirth, it is necessary that the body of the woman in labor 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. As soon as delivery begins, the cervix opens and softens. Softening the cervix is necessary in order to ensure that the baby moves 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 woman in labor with ruptures and injuries during childbirth. In addition, this 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 help 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:

Medical;
Mechanical;
Non-drug.

And, despite the fact that quite a lot of folk methods are known to help soften at home, doctors still do not recommend using any of them without prior consultation, so as not to harm yourself and your child.

Softening occurs under the influence of prostaglandins - complex hormones that affect uterine contractility, pain sensation and the immune system. These hormones can be obtained naturally, that is, the woman's body produces them on its own in sufficient quantities, or they can be introduced from the outside. And if the doctor during the examination found that the cervix is not yet quite ready for childbirth, then you can use one of the ways to soften it, described below.

Non-drug softening methods

Softening of the cervix contributes well to sunflower oil, which contains vitamin E, which makes it more extensible during childbirth. In addition, the oil has a positive effect on the circulatory system. In addition to sunflower oil, you can use 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.

Also with oil, you can do perineal massages, which later during childbirth will help prevent its rupture. And you need to start doing such massages early: around the 2nd trimester.

Medical softening methods

The drug method is the use of various antispasmodic drugs. It can be tablets, gel or candles. One of the most common drugs is Buscopan, which softens the cervix before childbirth and promotes its opening. On sale are tablets, injections or Buscopan suppositories.

Cervical softening medication

If the cervix is not yet open, and the contractions have already begun, then the doctor introduces Buscopan suppositories. It should be noted that Buscopan is prescribed mainly before childbirth, and its appointment in the 1st trimester is not recommended. Buscopan is used both for post-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 an 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 referred to as mechanical methods of softening. Most often it can be kelp algae or a special gel. Seaweed, kelp, grows in the Sea of Japan and some cold northern seas. Dried kelp are thin sticks that have the ability to increase many times under the influence of moisture. Enter kelp on the 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, pain in the lower abdomen.

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

Early pregnancy and the risk of softening of the cervix

Throughout the entire period of pregnancy, the cervix should be under special control, because it is she who 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 only becomes so 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 for the life and health of the child?

In this video you will learn what such a concept as the uterus in "uterus in good shape" means:

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

medication;
suturing the cervix;
Installation of a pessary.

Medical treatment of softening in the early stages

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

If uterine hypertonicity also joins the soft neck, then the expectant mother will most likely be admitted to the hospital and prescribed the necessary treatment: drugs, pills, intramuscular injections that will strengthen the cervix.

Suturing the cervix

If the cervix softens in the second trimester, a surgical operation can be performed to pull 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.

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

Operative method of pulling 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 for a period of twenty to thirty weeks. In cases where a soft neck is found, doctors suggest installing a pessary - a special medical ring that tightens the neck and prevents it from opening ahead of time.

Installing a pessary is a fairly quick and painless procedure. Removal of the pessary should only take place in the maternity hospital, at the end of pregnancy, since the removal of the pessary may 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 to endure the pregnancy until the end of the term and safely give birth to a healthy baby. And what option can be applied to a woman is a question for discussion by the woman herself and her gynecologist.

By the time childbirth occurs, the cervix, imperceptibly to the woman herself, has completely changed. And this makes it possible for the baby to be born in a completely natural way. But not always the cervix can change itself to the extent that is necessary for independent childbirth. In this case, medical intervention is simply necessary.

How to check the dilatation of the cervix during childbirth

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

Also, these changes are confirmed by such a process as the discharge of the mucous plug. The cork can move away long before the appointed time, and this indicates that contractions will soon begin. Also, before childbirth, the neck should be shortened and its length should be within one centimeter. And when it comes to her position, the most optimal position is in the middle of the small pelvis.

Although during pregnancy, the cervix is slightly tilted back. Based on the indicators of these parameters, doctors put an estimate, the maximum can be equal to five. According to the same assessment, it is possible to 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 unprepared. Then stimulation will be used to open it. If you do not resort to this method, then the child will soon begin to experience a lack of oxygen due to the fact that the placenta ages very quickly before childbirth, and the functions that it should perform become beyond its power.

How to help dilate the cervix during childbirth

Today, in order to stimulate the opening of the cervix, doctors use four methods.

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

Laminaria 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 in 2-3 hours.

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

There are cases when women prefer to stimulate their body on their own. The most common way is an enema, which promotes the discharge of the cork. But this can be done only for those pregnant women who have reached the appointed term of delivery, and the child is fully full-term.

If there are no contractions, but the water and the cork have already departed, then in this case stimulation with a warm bath is strictly prohibited. So, as there is a risk of catching some kind of infection. You can also use a variety of physical activities. The best thing for the body will be walking. But you can also clean up. 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 opening during childbirth is called slow, because in 4-6 hours the opening will be no more than 10 cm. At this time, the contractions are not too frequent - every 6-7 minutes. The second stage is called fast because the opening is 1 cm per hour. At this stage, contractions come every minute and so on until the opening is 10 cm. The third period is full disclosure, which indicates complete readiness for labor.

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

This question is very important for expectant mothers and greatly worries them closer to the end of pregnancy. Many women are interested in why everyone used to give birth easily, without even knowing that you need to somehow definitely prepare for this? The fact is that absolutely healthy representatives of the weaker sex really do not need it. However, in today's world these can be counted on the fingers. Therefore, many often find out that the cervix is not ready for childbirth, shortly before them, or even in the process, and doctors have to do this urgently and artificially.

How the uterus is arranged, its functions

To know how to prepare the cervix for childbirth, you need to have information about what it is for and what role its cervix plays. The uterus is an organ that is a hollow sac. Before pregnancy, it looks like a deflated ball with dimensions 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 the 38-39th week, the uterus becomes completely ready for childbirth and is able to push the fetus out with its contractions. The first barrier 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 childbirth. In order not to urgently wonder how to prepare the cervix for childbirth, when they are already taking place, it is necessary to do this in advance.

Determining the maturity of the cervix and what it depends on

How ripe the cervix is, doctors measure on a special scale, taking into account the extent to which the following signs are expressed: the length of the cervix, its consistency and location in relation to the axis of the pelvis, as well as how much we pass

Each of these signs is evaluated 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, are used to artificially prepare the cervix for childbirth.

How to prepare your cervix for childbirth

You can start preparing the cervix from the 34th or 36th week of pregnancy as directed by your doctor. You can do this with medications with the intervention of doctors or on your own. Let's consider both of these options in more detail.

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

For these purposes, the use of synthetic prostaglandins - Cytotec (E1 misoprostol) or Prepidil gel (E2 dinoprostone) is common. 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 prescribe a caesarean section;
a large number of contraindications;
the possibility of excessive stimulation, leading to ruptures and hypertonicity of the uterus. Therefore, a woman must constantly be under the monitor, which excludes the adoption of comfortable positions during contractions.

How to prepare your cervix for childbirth

For self-preparation of the cervix, you can use the following methods:

eating foods containing Namely: blackcurrant, borage, oily fish, linseed oil. You should also exclude the intake of such food in which there is margarine;
the 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 carrying and giving birth to a child. In essence, it is a muscular organ, a container for the fetus. 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 the fact that it does not occur. First, it helps to hold the fetus, prevents descent and premature birth. Then the cervix opens before childbirth, which helps to move through the birth canal. This determines whether the birth 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 action. A lot also depends on the actions of a woman - if you inform your doctor about suspicions in a timely manner, point out pathological signs, you can provide measures to prevent many pathologies. At a later date, you can take an active part in the preparatory process.

The 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 channel is completely freed and provides the exit of the fetus. The reason for this is changes in the neck, 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, the tissues acquire a greater ability to stretch.

The reason for the disclosure is a decrease in the length and other parameters of the neck, as a result of which the structure becomes loose, a gap is formed. Preparation is an advance process that begins at week 33. The uterus becomes looser and softer, there is a decrease in the position of the fetus. 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 the disclosure occurs before the allotted time, there is a risk of premature birth, in which the baby is absolutely not mature.

How to prepare the cervix for dilatation?

In everyday practice, specialists are increasingly faced with the immaturity of the uterus. Therefore, preparations are needed. This issue becomes especially important at the 40th week, when childbirth should already begin, and the placenta is gradually dying off. The risk of hypoxia increases sharply. With this turn of events, artificial stimulation is resorted to.

In many ways, the success of preparing for disclosure depends on the woman herself. She must maintain a high level of activity, be sure to exercise. The load must be dosed. There are many programs for pregnant women that contribute to both physical and psychological preparation for childbirth. Physical exercises, specially designed complexes, stimulate the activity of the muscles of the uterus, 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, breathing with your stomach, work out 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. Also, special means are used that promote disclosure, for example, candles, tablets. Their action is aimed at softening tissues, the formation of connective tissue layers.

You can also prepare the uterus for childbirth with medication or non-pharmacological 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 medicines, resort to the use of a stimulating catheter, kelp sticks.

Symptoms

Once the disclosure process has started, it can go completely unnoticed. Often, women enter the maternity hospital already having a dilation of 1-2 cm. It happens so imperceptibly that the woman does not even suspect it. This is a sign of physiological maturity. Sipping, tingling, feeling of heaviness are rarely observed.

A sign that most accurately and reliably indicates the presence of an opening, the secretion of a mucous plug.

A dangerous symptom may be the discharge of amniotic fluid, which indicates the need for urgent hospitalization, delivery to the hospital. If childbirth does not begin in 6-8 hours, it is necessary to stimulate disclosure, since a long stay of the fetus without amniotic fluid is fraught with serious consequences for both the baby and the mother. Possible infection, hypoxia, death.

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

The initial stages are completely invisible. Only if the mucous plug has moved away is this considered an indicator that indicates the opening as accurately as possible.

How long does the cervix dilate?

It is determined by whether a woman gives birth for the first time or again. In primiparas, disclosure can be achieved after 8-10 hours. In re-children, this process is reduced to 6-7 hours.

Periods and phases of cervical dilatation

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

At this time, you can not listen to the sensations. Waiting for contractions is also not recommended. It is necessary to try not to notice them, but at the same time it is already better to be under the supervision of medical personnel. At this time, you need to try to relax as much as possible. You can do meditation, breathing exercises, listen to soothing music, or just take a nap. There is no need to waste forces in vain, you need to try to preserve and increase them, since a lot of them will still be needed. There is no need for medical assistance yet. But the doctor can take action if there is a risk of complications. Most often resort to artificial stimulation of childbirth.

The second period is called the phase of active disclosure, accompanied by the swiftness 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 amniotic fluid should pour out and the bubble should burst. The opening is 4-8 cm.

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

Feelings when opening the cervix

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

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

pain

Disclosure is divided into 2 phases: latent and active. Usually the latent phase occurs painlessly, while the second - active phase already passes with a sensation of pain. In fact, this pain is of a natural nature, but at present, not every woman can endure it, so doctors are forced to resort to anesthesia. Usually, intense pain occurs when the opening is more than 5 cm.

Allocations

First the cork comes off. Yellow mucus discharge is also possible. At the end of the active phase, amniotic fluid is poured out. If the cervix is open by about 8-10 cm, this is a timely outpouring. If the opening is approximately 7 cm, the outpouring is early. When the neck is opened by 10 cm or more and there is no outflow of water, it is necessary to carry out an amniotomy, at the entrance of which the wall of the bladder is pierced.

Nausea

Nausea is rarely observed: as a reaction to a hormonal shift. When opening the neck, nausea rarely occurs. Sometimes it can be observed as a reaction to pain, or as a side effect of drug exposure.

Blood

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

Opening the cervix without pain and contractions

Painlessness is observed in the latent phase. When the disclosure goes into the next stage, there are painful sensations. Pathological disclosure is usually painless, so it is necessary to undergo examinations in a timely manner. The cervix can open without contractions, especially during the latent period.

Opening of the cervix in nulliparous

The duration is determined by whether the woman is primiparous, multiparous. Primiparas have no such experience, the body only adapts to new and unknown conditions for it. Change of activity and new conditions cause additional stress in the body, like any other new and unexpected activity. The body spends part of the resources to adapt to new conditions. The muscular system and connective tissue are not trained, nerve impulses enter the uterus more intensively, stimulating its contractile activity. This slightly increases the sensitivity and soreness.

Psychological readiness and self-regulation are at a lower level than in multiparous. In addition, the lack of experience, ignorance of what actions to perform affects. Therefore, you need to relax as much as possible and follow the recommendations of the doctor. In primiparas, it takes up to 8-10 hours.

Opening of the cervix in multiparous

In those who have already given birth before, the uterus is more prepared, stretched, activated. In addition, muscle memory is preserved, which reproduces the process of pushing the fetus, similar to the previous experience. Contractile activity is better regulated by nerve impulses, since the reflex arc is already laid 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 region are also more prepared, developed and activated. Therefore, in multiparous ones, it takes about 6-7 hours for full disclosure, of which 5-6 hours fall on the latent phase, and the active phase lasts only 1-2 hours. The process is less painful, including due to the physical and psychological readiness for the upcoming pain.

Premature opening of the uterus in the early stages

It often happens that the uterus does not cope with its functions, and may open prematurely. This is fraught with premature birth and miscarriage. 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 neck softens and shortens, losing the 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 the failure of the cervix.

In this case, you need to take measures to save the pregnancy. Usually carry out activities aimed at prolonging pregnancy. This is a waiting tactic, which makes it possible to wait for the maturity of the fetus and the possibility of its habitation outside the uterus. Traditional and non-traditional therapies are used.

Opening of the cervix at 30, 40 weeks of pregnancy

The closer the birth, the greater the likelihood that the fetus is ripe. Accordingly, even premature birth carries a lesser danger. The cervix should gradually dilate. The ideal option is when childbirth occurs immediately after disclosure, but in practice it often happens that the cervix opens, while childbirth does not yet occur. Many women are not even aware of disclosure when they enter the hospital. In this case, most births end happily. The extent to which the uterus was opened upon entering the hospital does not affect the birth process itself. It is important that it opens during childbirth. Normally, disclosure occurs at a rate of 1 cm per hour, in multiparous patients, the rate of disclosure is higher. Usually the cervix becomes soft, and is ready for childbirth already at 37 weeks, and the uterus begins to prepare for this from 30-32 weeks.

Degrees of dilatation of the cervix

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

Opening 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; on palpation, the doctor cannot move the finger deeper. Opening to the floor of the finger means the possibility of passing half of the finger of the obstetrician, to 1, 2, 3, 4 fingers - respectively, there is a space for the passage of 1,2,3,4 fingers. In the event that she misses at least one finger, the uterus can be considered mature.

Full dilation of the cervix

Full disclosure is the third phase, which ensures that the baby comes out unhindered. Disclosure from 10 cm can be considered complete. Sometimes tears occur, requiring stitches. If there is a threat, an emergency caesarean section is performed.

Consequences and complications

Disclosure can be complicated by weak contractions, in which the cervix practically does not open, remains at the prenatal stage. This often happens with polyhydramnios and multiple pregnancy. If there is an overstretching of the uterus, its ruptures, a decrease in tone and contractile activity are possible. This also leads to a weakening of labor activity, the risk of fetal hypoxia.

How is cervical dilatation determined and checked?

Since dilatation is asymptomatic, investigation is required. Basically, they are examined by palpation - the obstetrician probes with a finger. Opening is determined by the number of fingers that can pass freely through the cervix. This method is outdated, but is still used today in almost all institutions. The most accurate measurement is in centimeters. Usually, if 1 finger passes freely, this indicates an opening of 2-3 centimeters, respectively, 2 fingers are equated to 3-4 cm. Full disclosure is said when the uterus opens by 4 fingers or 8 cm. Full disclosure is ascertained visually: when neck smoothing, thin edges and free passage of 5 fingers.

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

Opening of the cervix on ultrasound

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

Stimulation of cervical dilatation

This implies the use of various methods that speed up the disclosure process. Distinguish between pharmacological and non-pharmacological methods.

How to speed up the opening of the cervix at home?

Promotes a high level 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, little finger. Sex helps open the cervix as it is a natural stimulant. In addition, semen contains a large amount of prostaglandins, which are also strong stimulants.

Physical exercise is important. Squats make a huge contribution. Classes with special balls, gymnastic accessories have a positive impact. Breathing exercises are very important, which not only stimulate the uterus, improve blood circulation, but also trigger a number of biochemical transformations. The hormonal background and the neuropsychic state are changing. At the same time, tense areas relax, and relaxed ones come into tone. There comes the correct regulation of the contractile activity of the muscles, including the uterine. Breathing, especially in the abdomen, stimulates the production of prostaglandins and nerve impulses that directly affect the activity of the uterus. Smooth muscles are also trained and strengthened.

Meditation, relaxing practices, silence, concentration and inner contemplation are important. These are the main techniques of hatha yoga, which allow you to control your own body, consciously regulate your feelings and sensations. Breathing and relaxation practices relieve excessive tension and stress. As a result, muscle tension is also removed, pain sensations go away. Mental attitude plays an important role. Many women are afraid of pain and consciously or unconsciously slow down the process of childbirth. Breathing and relaxation make it possible to get rid of internal blocks, block fear and reduce the threshold of pain sensitivity.

Aromatherapy sessions, taking a warm bath with essential oils, color therapy, water procedures, music therapy, sound-vibration therapy are also shown.

Methods of dilating the cervix

There are conservative methods in which pharmaceutical agents are used to stimulate. Radical methods can be used in emergency cases: amniotomy, perineal incision. There are also non-drugs: kelp sticks, special catheters, gels and oils, suppositories. Physical exercises, sex, meditation, breathing techniques, local candles work well.

Catheter and Foley balloon for cervical dilatation

A special catheter, which is presented in the form of a tube with a balloon. Enter into the neck for 24 hours. The balloon is gradually filled with air, it 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, while gradual opening occurs due to the expansion of the neck wall. Significantly increases the likelihood of infection.

Gel for opening the cervix

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

Physical exercises

Of the physical exercises, squats are effective. Twisting and jumping are contraindicated. At the same time, during the practice, you need to strive for maximum relaxation, control your breathing. It is necessary to perform static exercises that train willpower and endurance. It is better to perform exercises in a calm environment, with relaxing music. There are many video tutorials for pregnant women, where all the exercises are shown clearly, selected in the optimal sequence, smoothly transitioning from one to another. In such video lessons, static and dynamic complexes, breathing exercises and meditation practices are effectively combined.

The best option is yoga, pranayama (breathing exercises and inner contemplation), qigong, meditation, swimming, water aerobics. You can sign up for special preparatory courses for pregnant women, where expectant mothers are physically and psychologically prepared, training is supervised by experienced specialists who can choose an individual pace and exercise routine. Special gymnastic balls, fitballs are used. At home, you can train even with the help of a regular ladder, making frequent ascents and descents.

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

Fitball for opening the cervix

In modern clinics, it has long been recommended to take not the traditional position on the horizontal plane, but the vertical one. A sitting position is also recommended. But the surface should not be hard. The ideal fitball is a large inflatable ball that is used in sports, gymnastics. If you sit on it and perform special exercises, you can relax tense areas and strain those areas that will be in good shape. It is better to spread your legs apart. There is an activation of nervous and hormonal activity, the uterus is more stimulated. At the preparatory courses, you can get special training in exercises and positions on the 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 scheme. The time is gradually increasing. First you need to complete each step for 10 seconds. Then bring 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 must completely lower ourselves in 10 seconds. Then we sit in this position for another 10 seconds, we begin to relax as much as possible. Then we rise partially. You need to stop in such a position that the thighs are parallel to the floor. We are in this position for 10 seconds, then slowly, over the next 10 seconds, we go 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 start 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, be sure to sit down at a fast pace. The speed should reach 50 squats per minute. If it doesn’t work out, it’s better not to squat completely, you can only partially lower. Gradually, you need to increase the depth of the squats.

Meditation to open the cervix

Effective is the pose "Shavasana", used in yoga. You need to lie in a position on your back, legs and arms slightly apart. The eyes are covered. You can turn on relaxing music, an aroma lamp. The sounds of nature are well suited, especially the sound of the sea wave, the sounds of rain, a waterfall. Birdsong, animal sounds, instrumental music may be suitable. You need to try to relax as much as possible, not to think about anything. Muscles should be relaxed consciously, directing attention to them. First, let's focus on the legs. We feel how the muscles of the legs relax, become soft, heavy. Relaxation covers the fingertips, is understood along the lower leg, along the thigh. The kneecap descends. Relaxes the pelvic region, perineum, uterus. Both legs are relaxed, the pelvic region is relaxed, gradually relaxation covers the stomach, back, the lower back relaxes, the muscles along the spine relax. Relaxes chest and arms. The relaxation of the hands rises from the fingertips, slides along the cyst, elbows, forearm, the elbow, shoulder, and collarbones relax.

Once again, go through the whole body with your attention, feel the relaxation in each area. Particular attention should be paid to the face: feel how the forehead, nose, eyes, ears, cheeks relax. The chin is relaxed, the lower jaw is relaxed and may be slightly open. The eyes are closed. You are motionless and relaxed, the whole body is heavy. There are no thoughts in my head. There is only silence. If thoughts come, they need to be released, not delayed. This meditation should last at least 30 minutes. There are no limits for the maximum. Ideally, you need to bring up to three hours. After that, you need to lie down, do not rush to get up. You can drink tea, herbal decoction. Raspberry leaf tea is ideal.

For meditation, there are also video tutorials and audio materials that describe 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 the entire meditation: it is effectively combined with moments of silence, a special background and musical accompaniment are selected. The rhythm intensifies, subsides, which creates the desired tonality.

Preparations for opening the cervix

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

Tablets

Apply miropriston. It stimulates the contractile activity of the myometrium. It is taken 1 tablet at intervals per day, under the strict supervision of a physician.

Oxytocin-MEZ is often used to stimulate the opening of the uterus, labor induction. It is a solution for intramuscular and intravenous administration.

Opening can be facilitated by no-shpa, which is an antispasmodic drug that relaxes the muscles and makes them more elastic. It is prescribed 1-2 tablets 2-3 times a day or as an injection.

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

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

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

Many women after discharge 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 anesthesia, since it does not affect either contractile activity or the fetus, the drug does not enter the bloodstream. Other types are usually used only if 2-3 hours remain before the birth of the baby, this eliminates the risk of developing hypoxia.

With generic weakness, drugs are used to stimulate. An injection is often taken as an amniotomy - a puncture of the fetal bladder. Depending on the situation, symptomatic agents are used - to reduce swelling, pressure, palpitations, to stimulate the fetus.

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

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

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

Candles for opening the cervix before childbirth

They are used for intravaginal administration with a high content of synthetic prostaglandin. Their effectiveness is high: the result is achieved in 2-3 hours.

Laminaria sticks for opening the cervix before childbirth

They are sticks made from sea kelp. Algae in dried form, small in size, is inserted into the neck. Gradually saturated with moisture and expands, the cervix also expands. Insert as many sticks as required for full filling.

Manual opening of the cervix

It implies artificial opening by inserting and expanding the finger during a gynecological examination.

Pessary and balloon dilatation of the cervix

It is used to prevent early disclosure and maintain pregnancy. The pessary is a plastic device that provides support to the organs. It is formed from several rings connected to each other. Provides reliable support, 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.

For mechanical opening and stimulation of the uterus, a special plastic ball is inserted into the cervix and left for a day.

Raspberry leaf for opening the cervix

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

Opening 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 bottom of the uterus, in centimeters. The obtained indicators are subtracted from 10 cm, the height indicators are obtained. Approximate method.

How to prevent cervical dilatation during pregnancy?

Prolongation agents are used: bed rest. Emotional peace, drugs, especially sedatives. Be sure to carry out treatment aimed at the production of surfactant in the lungs of the fetus, which accelerates their maturation. Surgical methods of treatment are also possible, in particular, suturing the cervix, or using a special obstetric pessary.

Ring on the cervix from disclosure

In order to prevent premature disclosure, a special plastic ring is inserted into the uterus. It reduces the load. The introduction can be done on an outpatient basis, on an empty bladder. To prevent the uterus from contracting, you can drink an antispasmodic before the procedure. The ring is lubricated with glycerin and inserted into the vagina. Then they turn in the right direction. The doctor will do everything necessary. The patient will only need to come to the appointment every 2-3 weeks for a bacteriological examination. You also can't have sex. Opening the cervix before childbirth passes naturally, as the ring is previously removed.

While waiting for a baby, a woman feels anxiety and fear of the upcoming birth. In late pregnancy, this feeling intensifies. Women who have this first pregnancy are most worried. Uncertainty and complex medical terms scare 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 state 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 with 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 the body, fundus and cervix.

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

After the 38th week of pregnancy, the placenta ages. At the same time, the production of special hormones begins in the uterus, which provokes the preparation of the organ before childbirth.

How do doctors determine dilatation?

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

When opening the cervix by 3 cm, many pregnant women are concerned about the question, after how long will childbirth 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 dilation on her own?

The opening of the cervix by 1-2 centimeters (per 1 finger) passes 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 noticed thick mucous brownish discharge, it means that the cork has come off. This symptom indicates the onset of labor. The amount of discharge depends on whether the protective plug has completely or partially come off. In any case, if suspicious discharge is found, you should contact a gynecologist.

Sometimes childbirth begins with the release of amniotic fluid. They are normally colorless and odorless. It is necessary to remember the time when the waters broke. In this case, the neck 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 pass several fingers 5–7 hours after the release of the fluid, labor should be stimulated, since prolonged exposure of the fetus without amniotic fluid leads to its hypoxia.

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

Stages of cervical dilatation in pregnant women

Disclosure occurs in 3 stages:

Latent. It is characterized by mild contractions that occur without any periodicity. Painful sensations do not occur. 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 contractions, try to get distracted or sleep. Favorably affects the muscles of breathing exercises and calm music. Medical intervention in the natural process during the latent period is not required. In rare cases, with the development of pathologies, the use of stimulants is possible. The period lasts from several hours to several days.
Quick. This increases the duration of contractions and reduces the interval between them. Contractions appear periodically, after 2-5 minutes. They become painful, with severe unbearable pain, painkillers are used. During this period, a woman needs to be under the supervision of a doctor so that he can correctly assess labor activity and provide the necessary assistance. It is not recommended to sit or lie down. A pregnant woman needs to stand, leaning on a stable surface, or walking. Thus, the maximum pressure of the weight of the child is achieved, the cervix should open faster. If it is more convenient for a woman to wait out the time of contractions while sitting, it is better to use a large ball - a fitball. In the fast period, there is an opening of 4–6 cm within 8–10 hours for women with a first pregnancy (primiparous) and 5–7 for pregnant women a second and subsequent times (multiparous).
Full disclosure. At this time, the pregnant woman is under the supervision of doctors. The child's head descends into the small pelvis, as the cervix is completely opened, or, as obstetricians say, smoothed out. The obstetrician sits the woman in labor on a special chair, examines and asks to push. The time of the fast period and full disclosure depends on the individual characteristics of the body of the expectant mother 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? With the approach of the date of childbirth, the excitement of women intensifies. Primiparas are afraid of possible pain and uncertainty, 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 delivery.

Other causes of weak labor activity:

polyhydramnios - with a large amount of amniotic fluid, the walls of the uterus are unnecessarily stretched, which reduces their contractility;
oligohydramnios - with a lack of fluid, it is difficult for a child to pass through the birth canal, since the force of pressure on the neck is provided by the fetal bladder;
pathology of the endocrine system in a pregnant woman - the production of the necessary hormones is necessary for normal labor activity.

If dilatation is not observed after the 40th week of pregnancy, stimulation is applied. At this time, the placenta ages and ceases to perform its functions, as a result, the child receives insufficient nutrients and oxygen. This can cause the development of hypoxia.

If dilatation occurs before due date, it can lead to miscarriage. They try to stop the increase in the lumen from the 28th week of pregnancy. With an increase in the lumen 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 fallen, then the woman is prescribed complete rest and the introduction of special drugs that accelerate the development of the child.

Ways to open the cervix in the hospital

If dilatation does not occur by the 40th week of pregnancy, uterine stimulation is used. The procedure should take place in the hospital under the supervision of doctors. The main methods include drug therapy. The use of various agents can lead to full disclosure in 5-7 hours after application. Most often used:

Miropriston. It helps to increase the contractile activity of the walls of the uterus. It is allowed to use 1 tablet per day.
Oxytocin. It is a solution for intramuscular injections. Stimulates opening.
No-Shpa. It is a strong antispasmodic, relaxes muscles, reduces their tone, which contributes to rapid disclosure. Taken 2-3 tablets per day.
Papaverine. It is 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 hospital:

suppositories and gels with prostaglandin - are inserted into the vagina, childbirth will begin a few hours after the injection (there are contraindications);
kelp sticks (look at the photo) - special sticks are placed in the neck, due to swelling they increase the clearance, in addition, they contain substances that prepare the neck 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:

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