What to do to make the opening go faster. Before childbirth: Basic medical terms of childbirth

So, let’s start “deciphering” medical language.

Start of labor

Upon admission to the maternity hospital, and then several more times during childbirth, the doctor will say: “Now we’ll do a vaginal examination” or: “Let’s see how the cervix is, how the baby is progressing.” We are talking about an internal obstetric examination, which allows you to determine the condition of the birth canal and monitor the dynamics cervical dilatation during childbirth, how the presenting part of the fetus (head, buttocks) advances. The initial examination upon admission of a woman in labor to the maternity hospital is carried out on a gynecological chair, and during the birth process - on the birth bed. The frequency of vaginal examinations depends on the characteristics of the course of labor. During the normal course of labor, they are carried out no more often than after 4 hours, and if indications arise (rupture of amniotic fluid, changes in the nature of contractions, the appearance of bloody discharge, changes in the fetal heartbeat) - as necessary.
During a vaginal examination, the shape of the cervix, its size, consistency, its maturity, the degree of its dilatation, etc. are determined. Then the cervix is ​​examined in a speculum, but this is not always done, but only when there is bleeding and it is necessary to exclude the cervix as the source of this problem. If a vaginal examination is carried out on the eve or at the very beginning of labor, then the doctor says that the cervix is ​​mature or, conversely, immature (synonyms: ready or not ready for childbirth).
Cervical maturity determined on a special scale, taking into account how strongly the following four signs are expressed:

1. Consistency of the cervix (a soft cervix is ​​favorable for childbirth): dense – 0 points; softened, but hardened in the area of ​​the internal pharynx – 1 point; soft – 2 points.
2. Length of the cervix (before birth, the length of the cervix is ​​more than 2 cm, before birth it is shortened to 1 cm or less): more than 2 cm - 0 points; 1–2 cm – 1 point; less than 1 cm, smoothed – 2 points.
3. Patency of the cervical canal (this is a canal inside the cervix, before childbirth one or two fingers of the doctor should freely pass through it): the cervical canal is closed, the tip of the finger can pass through - 0 points; the cervical canal allows one finger through – 1 point; more than one finger, with a smoothed neck more than 2 cm - 2 points.
4. The location of the cervix in relation to the wire axis of the pelvis (before childbirth, the cervix should be located in the center of the small pelvis): posterior – 0 points; anteriorly – 1 point; median – 2 points.

Each sign on this scale is scored from 0 to 2 points. Score: 0–2 – immature neck, 3–4 – not mature enough, 5–6 – mature.
Opening of the cervix the doctor determines during a vaginal examination. The opening size is measured in centimeters. Full opening corresponds to 10 cm. Sometimes you can hear the expression “ opening of the cervix 2-3 fingers.” Indeed, obstetricians used to measure the opening in the fingers. One obstetric finger is conventionally equal to 1.5–2 cm. However, the thickness of the fingers is different for everyone, so measurement in centimeters is more accurate and objective.
During a vaginal examination, the doctor also makes a conclusion about the condition of the amniotic sac and amniotic fluid. Then a woman may hear the term “flat amniotic sac” - a situation in which there is little amniotic fluid in front of the fetal head. Normally, during each contraction, pressure inside the uterus increases and is transferred to the fertilized egg (membrane, amniotic fluid and fetus). Amniotic fluid, under the influence of intrauterine pressure, moves down to the exit from the uterus, as a result of which the fetal bladder in the form of a wedge protrudes into the canal of the cervix and promotes its opening. If there is little water in front of the head, then the fetal bladder does not function as a wedge and slows down cervical dilatation, the doctor says that such a bladder needs to be opened or an amniotomy performed.
Another term associated with the amniotic sac is “high lateral rupture of the amniotic sac” - a situation in which the amniotic sac ruptures not in its lower part, but much higher, tightly clasping and holding the fetal head, preventing it from descending and moving into the cavity pelvis, and amniotic fluid is poured out in small portions or drops. In this case, the obstetrician performs instrumental dilution of the membranes, i.e. there is already a hole in the amniotic sac, but the amniotic membranes need to be spread wider. After the water has poured out, the doctor evaluates its nature. “The water is good, light or just normal,” the doctor will say if the amniotic fluid is clear or has a slight yellowish tint, without an unpleasant odor.
It’s worse if the doctor says “green waters.” Cloudy, green or brown color, with an unpleasant odor may indicate hypoxia (oxygen starvation of the fetus). One of the early signs of this condition is the entry of meconium (original feces) into the amniotic fluid. This happens because due to a lack of oxygen, the fetal rectal terminal opening relaxes and feces come out of the intestines. The intensity of the color of the water (from green to dirty brown) depends on the severity and duration of hypoxia in the baby.

Condition and heartbeat of the fetus

During childbirth the expectant mother usually listens very closely to what doctors say about the child’s condition. Listening to the fetal heartbeat, the doctor pays attention to the rhythm, heart rate, clarity of tones, and the presence or absence of noise. Normally, the heart rate is 120–160 beats per minute, the tones are rhythmic, clear, and there are no extraneous noises. In obese women, tones are heard worse due to the thickness of the abdominal wall (muffled heartbeat). The doctor may rate the heartbeat as “rhythmic, clear,” or “muffled, rhythmic,” or “arrhythmic, dull.” The noise can appear when the umbilical cord is entwined around the neck and body of the fetus, the presence of umbilical cord knots, fetal hypoxia, placental insufficiency (a condition when the placenta, which supplies the fetus with oxygen and nutrients, ceases to cope with its work). During the initial examination, the doctor uses a conventional obstetric stethoscope (a special tube), however, to clarify the condition of the fetus, as well as for dynamic monitoring during childbirth, a more detailed study using cardiotocography (CTG) is required.
To do this, an external sensor is placed on the woman's abdomen at the point of best audibility of fetal heart sounds. The second sensor is located in the area of ​​the right corner of the uterus. This sensor records the tone of the uterus, the frequency and strength of contractions. Information about cardiac and labor activity is immediately reflected on the monitor. Doctors often talk about the “Fisher score”, citing certain numbers.
What do these points mean? This is a special scale on which all of the above indicators of the baby’s condition are assessed in a point system.

• A score of 8–10 points characterizes the good condition of the fetus,
• 6–7 points – there are initial signs of oxygen starvation of the fetus (hypoxia). In this case, the fetus experiences a slight deficiency of nutrients and oxygen, but with timely treatment, the prognosis for the baby is favorable.
• Less than 6 points – a serious condition of the fetus, which requires an emergency cesarean section due to the threat of intrauterine death.

Childbirth

After the amniotic fluid breaks, the doctor must check Vasten's sign, which shows the correspondence of the size of the fetal head to the mother’s pelvis (i.e., whether the baby’s head can pass through the mother’s pelvis). The woman lies on her back. The doctor places one palm on the surface of the symphysis pubis (the place where the pubic bones meet), the other determines where the fetal head is located. If all is well then Vasten's sign negative.
If the doctor says that Vasten's sign flush, this means that there is a slight discrepancy in size, but vaginal birth is possible if certain conditions are met: good labor; average fruit size; no signs of post-maturity; good fetal condition during childbirth; presence of light waters; good configuration of the head (i.e. reducing its size due to the fact that the bones of the skull are on top of each other) and its correct insertion when passing through the mother’s pelvis.

Positive Vasten's sign indicates that the mother’s pelvis is an obstacle to the passage of the fetus and natural childbirth is impossible in this case. During a vaginal examination, the doctor evaluates how the fetal head is positioned. If everything goes well, then most likely you will not hear anything from the doctor on this score, but perhaps, wanting to emphasize that everything is fine, he will say that the fetus is occipital presented. Normally, the baby’s head begins to move along the mother’s birth canal, while it is bent, i.e. the chin is pressed to the chest, and the baby moves forward with the back of his head. This is the most favorable case, since the head passes through the birth canal with its smallest circumference quite easily. However, there are also “wrong” situations when the head is straightened and either the forehead or the face of the fetus comes first, and the doctor can note this by saying that the presentation is frontal or facial.
In these cases childbirth often end with a cesarean section to avoid injury to the fetus and mother. But with a small degree of extension of the head, good labor activity, and a small size of the fetus, a woman may well give birth herself.
The expectant mother may hear the expressions “front view”, “rear view”. No need to worry. With a cephalic presentation, this means that in the anterior view the occiput of the fetus is facing the anterior wall of the uterus, and in the posterior view - towards the back.
Both options are normal, but in the latter case the pushing lasts longer. After an external vaginal examination, the doctor can say that the head is pressed against the entrance to the pelvis. Two weeks before the onset of labor, in women expecting their first baby, the fetal head begins to descend and press against the entrance to the pelvis. Due to this, pressure increases on the lower part of the uterus and its cervix, which promotes the maturation of the latter. But with repeated pregnancy, the head drops 1-3 days or even a few hours before the onset of labor.

Childbirth: completion

With each push, the head gradually passes through the pelvic cavity and begins to appear from the genital slit; doctors call this cutting in - when it becomes visible only during the push, and eruption, when it is visible constantly. This means that the baby will be born very soon. If there is a threat of perineal rupture, obstetricians often resort to dissection of the perineum - then they warn that they will do a perineotomy or episiotomy. This is nothing more than an incision in the perineum, which helps prevent injury to mother and baby. In the first case, the perineum will be cut in the middle, and in the second, diagonally.
Immediately after the baby is born, doctors assess his condition using the Apgar scale (at 1 and 5 minutes). The following signs are taken into account: heartbeat, breathing, skin color, reflexes, muscle tone. The severity of each of the five signs is determined in points from 0 to 2.
If the sum of points for all signs is from 7 to 10, then the condition of the newborn is satisfactory, 4–6 points – a condition of moderate severity, 1–3 points – severe.
After the baby is born, the obstetrician-gynecologist monitors for signs of placental separation. “It has separated, we are giving birth to an afterbirth,” the doctor will say something like this when he determines that the placenta has successfully separated from the wall of the uterus and is about to come out.
Certainly, during childbirth and then, after the birth of your baby, you will have to deal with a large number of new words and concepts, and the more you learn about them from reliable sources, the more reliably you will rid yourself of unreasonable fears.

The successful outcome of a normal birth depends on the functioning of the cervix, which in turn depends on the level of hormones in the blood of the mother. Throughout pregnancy, changes occur in the cervix, but before the onset of labor, it must be tightly closed, otherwise the pregnancy may be terminated prematurely.

Cervix before childbirth

Before childbirth, under the influence of prostaglandin hormones, processes called ripening occur in the cervix. There is a certain scale that allows you to evaluate the cervix before childbirth, and 3 criteria are assessed: consistency, length of the cervix, patency of the cervical canal and its location to the pelvic axis. Each criterion is scored during a cervical examination from 0 to 2 points:

• a score of 0-2 points corresponds to an immature cervix before birth;
• a score of 3-4 points corresponds to an insufficiently mature cervix;
• score 5-6 points – mature cervix.

During a normal pregnancy, the cervix should ripen by 38-39 weeks. Under the influence of hormones, the cervix softens before childbirth, its centering in relation to the wire axis of the pelvis. The length of the cervix before birth is reduced to 10-15 mm and the external pharynx opens by 1-2 cm, that is, it becomes passable for 1 finger of the obstetrician.

Dilatation of the cervix before childbirth

The opening of the cervix before childbirth occurs gradually and reaches 10 cm (the cervical canal must allow 5 fingers of the obstetrician to pass through). Dilation of the cervix during labor is divided into 2 phases: latent (dilation up to 4 cm) and active (from 4 cm to 10 cm). The latent phase in primiparous women lasts 6-9 hours, in multiparous women 3-5 hours. From the moment the active phase begins, the rate of opening of the cervix becomes 1 cm per hour. The soft cervix easily opens under the influence of pressure from the fetal head and wedging of the lower pole of the fetal bladder into its canal.

How to help dilate the cervix?

Currently, few modern women can boast of excellent health. An accelerated pace of life, frequent stress, poor nutrition and poor ecology can disrupt the production of prostaglandins in the female body, on which the processes of cervical ripening and its opening directly depend. In order to accelerate the ripening of the cervix and its opening during childbirth, therapeutic drugs based on prostaglandins have been developed. A synthetic analogue of prostaglandin E1 (Cytotec) or an analogue of prostaglandin E2 in gel form (Prepidil) promotes cervical ripening within a few hours. But they are used very rarely due to their high cost. Narcotic and non-narcotic analgesics (promedol, fentanyl, nalbuphine) can be used during childbirth, but they can cause respiratory depression in the fetus after birth and necessitate the administration of an antidote. An effective and relatively safe method for dilating the cervix is ​​epidural anesthesia. It is performed by an anesthesiologist under sterile conditions. It does not have a negative effect on the fetus, since the administered drugs do not enter the bloodstream, and not only accelerates the dilatation of the cervix, but also makes this process painless.

Cervical rupture

The better the cervix matures before childbirth, the less likely it is to rupture during the birth of the child. Also the cause of the breakup there may be a large fetus, rapid labor, incorrect insertion of the fetus and the application of obstetric forceps or vacuum extraction of the fetus. A cervical rupture may be accompanied by heavy bleeding, since the cervix is ​​well supplied with blood. In case of ruptures, the cervix is ​​sutured with absorbable threads; the woman does not feel these stitches, so healing is painless.

Thus, cervical ripening is disrupted for reasons that depend and do not depend on the woman herself. Therefore, a woman herself can help prepare her body for childbirth by following a daily routine, eating right and not thinking about troubles.

In order for the baby to be born, the birth canal needs to be prepared for this. The pelvic bones move apart, the cervical canal smoothes out and becomes shorter. Drugs and non-traditional techniques will help speed up the dilation of the cervix before childbirth.

The cervix is ​​a connecting tube that runs from the vagina to the uterus. At the gestation stage, it is completely closed because it has a protective function for the baby (it stops all infections and bacteria). Before childbirth, the cervix opens, and with it the birth canal.

Indications for stimulating uterine dilatation:

1. post-term pregnancy (after 41 weeks);
2. lack of development of labor;
3. deterioration of the condition of the mother or baby;
4. placental abruption;
5. breaking of water;
6. severe illness of the expectant mother (diabetes mellitus);
7. multiple pregnancy.

There are also situations when the use of drugs to dilate the cervix is ​​prohibited. You need to familiarize yourself with the main contraindications.

• the fetus is too large in relation to the woman’s pelvis;
• there are difficulties with the child’s heartbeat (frequent or, on the contrary, very rare);
• the baby is positioned incorrectly;
• poor health of the mother, temporary or permanent (high blood pressure, dizziness, difficulty in heart function).

It is necessary to consult a doctor in a timely manner and report changes in your condition in order to prevent complications. The child’s well-being is monitored by measuring the baby’s heart rate, as well as by monitoring his motor activity. Depending on the characteristics of the mother's body, the doctor selects stimulating activities that are best suited to a particular case.

Stages of disclosure

Mothers do not always know enough information about the course of the birth process. The uterus opens in three stages, which not every woman in labor will be able to recognize.

First stage (latent). The woman feels light, chaotic contractions, no pain is felt. The duration of the first stage ranges from 2 hours to 2 days. At this time, it is better to abstract yourself and sleep in order to gain strength and vitality. Usually, stimulating procedures are not prescribed at the initial stage. But if there are indications for this, the doctor will definitely take measures and help speed up the opening of the uterus.

Second period (active phase) characterized by intensifying contractions, they become longer and more intense. The opening at this moment is 4-5 cm.

How to speed up the process of cervical dilatation before childbirth:

1. constantly move;
2. do not lie on the bed;
3. walk along the ward or corridor;
4. perform breathing exercises correctly.

Usually, during the second period of dilation, the woman in labor ruptures the membranes and the water breaks. If this does not happen, an amniotomy is performed.

The third period is full dilation of the cervix, labor is already in a fairly active form. A different amount of time may pass between the second and third phases; both rapid and protracted labor are quite likely. That is why at such a moment it is better to be in a hospital so that the doctor has time to correct the condition of both the fetus and the mother.

Symptoms and sensations when opening

The opening of the cervix is ​​considered to be the first stage of labor. Gynecologists measure this phenomenon with obstetric fingers. Full opening is equal to 5 fingers or 10 cm. This process is easy to recognize, because the onset of labor cannot be confused with anything.

Symptoms:

• pain similar to menstrual pain;
• discharge of a mucus plug (a clot of mucus mixed with blood);
• nagging pain in the lower abdomen.

How does cervical dilation manifest during pregnancy? The main symptom indicating the beginning of the opening is the presence of regular contractions at the same interval. At the first stage, the interval between uterine contractions is 25-30 minutes, but with the progress of dilatation, it decreases to 5-6 minutes. The intensity and duration of labor spasms also depends on the degree of opening of the uterus.

How quickly does the cervix dilate before labor? Everything is individual, because every woman in labor has her own characteristics. On average, the rate of dilatation is 1 cm per hour, counting from the moment when labor enters the active phase. How long before birth the cervix softens depends on the speed of its opening. A pregnant woman is examined every 2-3 hours, provided that she feels well.

The symptoms of dilatation cannot be confused with anything; in fact, this is the beginning of labor. The main thing is to get ready and behave correctly (count contractions).

Non-medicinal methods of dilating the cervix

This process does not always occur naturally. Sometimes a doctor's help is required. In addition to medications, there is alternative therapy that helps eliminate the problem.

How the cervix dilates before childbirth:

1. with the help of physical activity;
2. yoga or meditation;
3. active sex life;
4. breast stimulation;
5. enema;
6. through a Foley catheter;
7. puncture of the amniotic sac;
8. after taking a bath with aromatic oils;
9. administration of prostaglandins;
10. when performing massage on certain areas of the body;
11. by adjusting your diet.

Physical exercise to dilate the cervix before childbirth - one of the simplest methods of stimulation, the essence of which is to maintain motor activity in the last stages. You need to walk more, walk in the fresh air, and do breathing exercises. This promotes rapid dilatation of the cervix, but the method can be used if the expectant mother is in normal health.

What positions help to open the cervix:

• constant change of body position;
• lotus pose, butterfly;
• On knees.

The main thing here is to remain calm and relax. Then the opening process will go on its own.

Yoga or meditation are also gaining popularity among pregnant women who need stimulation to open. The point is to positively visualize the process of opening the cervical canal. That is, you need to try to set yourself up for a positive result. Meditation to open the cervix will only help those who believe and delve into it.

Husband therapy.

Some obstetricians advise pregnant women to have an active sex life after 40 weeks. This can promote dilation, because the sperm softens the cervix, and it ripens faster. Having sex is allowed in the absence of medical contraindications to it. Nipple stimulation

also belongs to the means for opening the cervix. The principle of action is to produce oxytocin (the hormone that causes contractions) naturally. You can perform breast massage yourself or ask your husband, which will be more pleasant for both. Stimulating the nipples with water from the shower will also work. Foley catheter placement

- insertion of the balloon into the cervical cavity. This is a quick and painless procedure. First, the pregnant woman is examined, then the obstetrician inserts a tube with a balloon at the end into the cervix and injects 10 ml of liquid. The reservoir fills and expands the channel walls to the sides. If this is not enough, saline is injected through a catheter directly into the amniotic sac. The Foley catheter can remain inside for about a day, after which it must be removed.

An enema helps to open the cervix faster, stimulating its back wall, thereby accelerating the process of softening and smoothing. The downside of the procedure is discomfort. But on the other hand, it is also a cleansing of the intestines before childbirth, to ensure against unforeseen situations during childbirth

Amniotomy is a puncture of the amniotic sac. This is an absolutely painless procedure, after which the opening occurs much faster. And in general, labor activity decreases by 2-3 hours. There are, of course, negative nuances - amniotomy leaves the fetus without a cushion of water, which softens its passage through the birth canal. Taking a bath with aroma oils

Kelp is widely used by obstetricians. After inserting the seaweed stick, the uterus quickly opens, and the birth process constantly progresses. The essence of the method is to insert a tampon of algae into the neck. After they swell in the moist environment of the vagina, the canal expands and matures.

Massage of bioactive points- a way to stimulate the cervix before childbirth with your fingers. Massage sessions are carried out on certain areas of the skin. Palm massage is considered the most effective for opening the cervix. The idea is to stimulate special areas that are responsible for the birth process. Massaging the little finger to open the cervix is ​​also effective if you know how to stimulate and where to apply pressure.

Eating certain foods influences opening. It is recommended to include in your diet foods that cause cervical dilatation, such as olive oil, strawberries (in season), dried fruits, and prunes. Tea made from raspberry leaves helps well; it promotes the production of estrogen. Some expectant mothers drink alcoholic beverages as a method of influencing the uterus. An excellent stimulant is eating chili peppers.

You should stimulate cervical dilatation at home only after discussing the method of influencing the cervical canal with the obstetrician leading the birth. This will help keep the baby and his mother calm and healthy.

Drug stimulation

Sometimes gynecologists decide to soften the cervix and open it with the help of medications. This is a large number of drugs that have an effect on labor.

Gel for dilating the cervix before childbirth is widely used in medical practice; it is based on prostaglandins. This method has almost no side effects, and the channel opens quickly. After using the gel, rapid labor rarely occurs.

Suppositories for dilating the cervix also contain prostaglandins. A positive quality of the stimulation method is the freedom of movement of the woman in labor. A significant disadvantage is the cost of the medicine.

Homeopathic medicines- Another option is to cause the opening of the cervix. This medicine is based on herbal ingredients.

What pills are given to dilate the cervix before childbirth? Various medications are prescribed, but Caulophyllum 30 is one of the most prominent representatives of such medications, which helps the uterus to ripen faster. The result is not long in coming, but the price for it is not small. The use of pills for cervical ripening before childbirth is allowed only after a certain medicine has been prescribed by a doctor.

Administration of oxytocin– the prevailing option in obstetric practice for influencing the connecting canal. With this drug, an IV is placed to dilate the cervix or injections are prescribed. A significant disadvantage of the stimulation procedure is the constant restriction of the woman’s movement, because she is tied to the system and the tripod on which the medicine is held.

Manual dilatation of the cervix carried out by an obstetrician during an examination if the pregnant woman is post-term. Then the doctor tries to insert his fingers into the cervical cavity to open the path to the uterus.

Complications

Starting from 37 weeks, the female body prepares for the childbearing process. Most expectant mothers, due to fear of the unknown, panic. This leads to a slowdown in the production of hormones necessary for childbirth and the cervix takes a long time to open.

Reasons for lack of disclosure:

1. polyhydramnios;
2. oligohydramnios;
3. age after 35;
4. thyroid diseases.

When the cervix is ​​ready for labor, it opens dynamically. When the process of divergence of the walls of the cervical canal is pathologically slow, stimulation is resorted to. In a hospital setting, an injection is given to dilate the cervix or an IV is given. At home, you can try starting with non-drug therapy.

Fast opening– this is also not normal, but it is impossible to influence the mechanism that has started. The pregnant woman’s body does not have time to prepare for delivery and tears and cracks appear. The child also experiences enormous stress and finds it difficult to adapt to the new environment.

After stimulation, which is carried out to speed up the opening of the cervix during contractions, pathologies also occur. This is both a slowdown in labor activity and its rapid development. Therefore, when starting therapy to influence the cervical canal, it is better for a woman in labor to stay in the maternity hospital.

A hard cervix is ​​also an anomaly that occurs as a result of regular pregnancy. Therapy based on strengthening drugs exacerbates the opening process. The only way out of the situation is a caesarean section.

Cervical dilatation is an important period of labor, without which the baby will not be born naturally. You can use medications or alternative techniques. Both options are quite productive. Before proceeding with stimulation, you need to discuss all the nuances with the obstetrician who is responsible for childbirth.

Just before childbirth, the cervix changes dramatically. A pregnant woman does not feel these changes, but the unborn child gets a chance to be born naturally. So how exactly does this reproductive organ change and when is medical attention needed to improve the dilatation of the uterus? We are looking for answers to these and other similar questions.

Ideal cervix before childbirth

The parameters characterizing the state of the uterus before childbirth are its location in the pelvis, state of softness and length. The softening of the cervix to the point where it can allow 1-2 fingers of the doctor inside indicates the readiness of the birth canal for the process of delivery. Such changes are accompanied by the release of the mucus plug. That is, the sooner the cervix begins to dilate, the sooner the woman in labor notices this sign of the onset of contractions.

Before childbirth, the cervix shortens. According to medical statistics, its length is about one centimeter. If we talk about the location, then it becomes in the center of the small pelvis, while during pregnancy the cervix is ​​tilted back.

Doctors evaluate all of the above parameters on a five-point scale. A score of 5 indicates that the uterus is ideally ready for childbirth. This condition is called a mature uterus.

Ways to stimulate cervical dilatation

The above are excellent prenatal parameters. But in practice, this does not always happen, and doctors resort to stimulating the process of cervical dilatation.

If a medical examination shows that the cervix is ​​not mature, and you are due to give birth soon, then it is quite acceptable to perform this process and stimulation. Not using it sometimes means dooming the child, given the fact that before birth the placenta “grows old” and cannot cope with its functions as before.

In practice, stimulation is done in four ways, sometimes with a combination of them:

1. Sinestrol injections intramuscularly. The drug makes the cervix mature, but does not affect contractions.
2. Insertion of kelp sticks into the cervix. Such sticks, 5 cm long, are placed in. After a few hours, they swell under the influence of moisture and thus open the cervical canal.
3. Injection of a gel with prostaglandins into the cervical canal. This gel works quickly - and the neck opens in 2-3 hours.
4. Administration of Enzaprost intravenously. This drug also contains prostaglandins. Thus, the period of contractions is reduced in time.

Sometimes women use self-induction of labor.

Among them:

1. Enema. After it, the mucus plug comes off - and the cervix becomes mature. The procedure can only be used by women who have already reached their due date, that is, the baby is full-term.
2. A warm bath is not recommended for loose plugs and waters. The procedure is also dangerous for women with high blood pressure.
3. Sex acts as a medical stimulant, because sperm contains prostaglandins. That is, it promotes the maturity of the uterus. But pregnant women whose plug has already come out should not have sex. After all, there is a possibility of “catching” an infection in the uterus.
4. Physical activity. This could be a brisk walk, washing the floors, or cleaning. Women with hypertension do not need to overdo these methods.

But such methods can be fraught with dangerous consequences.

Stages of cervical dilatation

The cervix goes through several stages of dilatation before childbirth. The first is called latent or slow. It lasts 4-6 hours with a dilatation of up to 4 cm. In this case, contractions occur every 6-7 minutes.

The second stage is called active or fast. Every hour the cervix dilates by 1 cm. This continues up to 10 cm, and contractions occur every minute.

The third stage is full disclosure. It characterizes the process of the onset of labor. Sometimes the dilation of the cervix is ​​premature. This is evidence of pathology and, without treatment, can cause premature birth or miscarriage.

A pregnant woman should remember that in the period before childbirth she needs to be prepared for the fact that labor will begin earlier. If you feel unwell or have other symptoms, consult a doctor immediately.

Peace of mind and health to you!

Especially for Elena TOLOCHIK

When pregnancy is approaching its natural end, a woman, during an examination in a gynecological chair, may hear from the doctor that her cervix has dilated by 1 finger. What does it mean? Do you need to quickly pack your things because the baby is already “on the way”? How soon will labor begin?

For whatmeasure how dilated the cervix is?

The cervix (cervix) is a kind of cylindrical canal that connects this organ with the vagina. Its length is only 4 cm. In the last stages of pregnancy, it becomes shorter and softens, and then completely smoothes out to allow the baby to pass through.

To determine how ready a woman’s body is for childbirth, the dilation of the cervix is ​​measured. If it is already 1 finger, it means that in a week and a half (if this is the first child) or even much sooner, after a couple of days (if this is a repeat birth), the baby will be born.

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If at 38-39 weeks (when the cervix begins to open) the cervix is ​​still elastic and its length is 3 cm, but it has already opened by one finger, then you can postpone the trip to the maternity hospital for now.
The dilatation is checked to give an approximate idea of ​​what stage the woman in labor is at and whether she needs to be transferred to the maternity ward. If doctors assign her the status of “actively in labor,” such checks will be done every 4 hours, and if the opening of the cervical cervix is ​​delayed, then labor will be stimulated.

Secretthe language of obstetricians: what do doctors talk about during labor?

So, based on the dilation of the cervix, the doctor makes a conclusion about whether it is mature or not, that is, when to expect the onset of labor. Sometimes obstetricians use the number of fingers as a measure of this process, and in other cases they define it in centimeters. How do you understand that one finger and one centimeter are the same thing? And what does this indicator tell the doctor?

Here's what it means:

• if the cervix is ​​dilated by 1 finger, then the dilatation is 2 cm. At this stage, no one will yet be able to name the exact date of birth. But the maximum period that the baby will spend in the mother’s tummy will be no longer than 1.5 weeks. Usually a woman does not feel a couple of centimeters dilated, but for some this process is accompanied by nagging pain in the lower abdomen, which is similar to menstrual pain;
• dilatation of the cervix by 1.5 fingers - this is approximately 3 cm. In this phase, there are also no strong painful sensations, since the active labor process has not yet begun;
• if the cervix is ​​dilated by 2 fingers (up to 4 cm), this indicates the beginning of regular labor - about 3 contractions in 10 minutes. At this stage, the muscles of the uterus smoothly contract, and the cervix is ​​drawn into its cavity;
• if the patency of the cervical canal has reached 4 fingers (8 cm), then the dynamics of labor are rapidly increasing. Muscle contractions are repeated every minute;
• full expansion - 5 fingers (10 cm). The woman in labor begins to feel pressure. The membrane breaks and water pours out. The baby's head descends to the pelvic floor and is felt through the labia. The opening diameter becomes equal to the circumference of the toddler's head. The woman is transferred to the delivery room.

Howlearn about disclosure yourself?

Is it possible and how to determine the dilatation of the cervix at home? There is nothing super complicated or mysterious about this procedure, and you don’t have to be an obstetrician to perform it. But two points must be taken into account. The first is to maintain hygiene (although until your water breaks, it is almost impossible to get an infection). And second: if the scheduled date of birth is still far away, then it is better not to “look” for your cervix, because this can provoke contractions.

Here's how it's done: you need to squat down, spread your legs apart, insert two clean fingers - the index and middle - into the vagina (you can pre-lubricate your hand with oil). You should push them all the way until you feel a rounded bulge with a depression. If the opening has already taken place, then a hole will appear here. You need to very carefully insert a finger into it, and then a second one, and slowly try to move them apart. Then, without changing position, you need to manage to remove them from the vagina. Then everything is simple - attach them to the ruler and measure the distance.

Here's another way, albeit controversial. It is called the violet (red) line method and consists of observing a stripe that forms on the gluteal fold. As the cervix opens, it rises from the anus upward, and when the opening reaches its maximum, the line reaches the place where the gluteal fold begins. But this streak is not noticeable for everyone.

According to experienced midwives, you can go to the maternity hospital at 6-7 cm of dilation.

Howat home, reduce the time of cervical dilatation: practical tips

There are several methods of self-stimulation of uterine activity. How to speed up the dilatation of the cervix at home? To do this, you can take the stairs or just walk, swim, dive, bend and rotate your body. To speed up this process, it is recommended to take a warm bath. Massaging the little finger and earlobe also helps. You can also do exercises to strengthen the muscles of the perineum and breathing exercises. To speed up the results, it is permissible to use a cleansing enema.

When the nipples are stimulated, oxytocin is released, a hormone that causes uterine contractions. Having sex has the same effect. This helps the cervix ripen and also brings the uterus into an active state. In addition, prostaglandin is present in sperm, which has a very positive effect on the maturation of the cervix.

Home methods are quite effective, but, according to doctors, it is better not to interfere with the disclosure process.