Labor induction: natural and medical. How is the process of labor stimulation in the maternity hospital and at home in the last weeks of pregnancy, what are its pros and cons

They do not come on their own, and medical indications force doctors to stimulate their onset. Stimulation of labor is a phrase that all pregnant women are afraid of. Let's see if it's scary.

Stimulation of labor in the maternity hospital

The most common scenario for the development of events in the stimulation of labor is the hospitalization of a woman in the department of pathology of pregnancy. It is there, after examination and examination, that a decision is made on the indications, timing and methods of stimulation.

Indications for labor induction

The reasons why obstetricians are forced to provoke the onset of labor are divided into maternal and fetal.

Mother's reasons:

The presence of complications of pregnancy, in which its continuation is dangerous for the life and health of a woman: preeclampsia, eclampsia, severe gestational diabetes mellitus, liver damage, coagulopathy caused by pregnancy;
Exacerbation of chronic diseases in severe form: bronchial asthma, diabetes mellitus, arterial hypertension, kidney disease, cardiovascular pathology;
Increasing polyhydramnios;
Pathological preliminary period, when the general condition of the woman, her sleep is disturbed;
Acute situations: acute appendicitis, cholecystitis, cerebral aneurysm, trauma, bleeding. Although in this case such stimulation of labor does not occur. Doctors in such situations go for early delivery by caesarean section, as sometimes the bill goes not for hours, but for minutes;
Postponed pregnancy over 42 weeks by the date of the last menstruation.

There are fewer fetal causes:

Hemolytic disease of the newborn with Rhesus conflict;
Intrauterine infection of the fetus and amniotic membranes;
Fetal growth retardation with good CTG and fetal biophysical profile.

If the child, for one reason or another, suffers in utero, it is preferable not to have an excessive load of artificially provoked childbirth, but to have an operative delivery. Labor is stimulated in the interests of the fetus only after a thorough examination by ultrasound, dopplerometry and CTG.

Methods of stimulation of labor activity

Initially, one or another method of labor stimulation is chosen based on the readiness of the pregnant woman's body for childbirth. With good readiness of the birth canal, "mature" cervix, you can use:

Laminaria sticks. This is a fairly ancient method in obstetrics. Laminaria are seaweed dried and pressed into sticks. Several of these sticks are inserted into the ajar cervix. In a humid environment, the algae swell and mechanically open the cervix, stimulating the onset of labor;
Balloon dilatation of the cervix is similar to the previous method. Instead of laminaria, special balloons are used for mechanical stimulation, gradually filling them with air or liquid;
Amniotomy or artificial opening of the fetal bladder. With the discharge of amniotic fluid, the volume of the uterine cavity decreases, the fetal head descends and presses on the lower segment of the uterus. These factors provoke the onset of labor.

Preparations for stimulating labor

If the woman's body is not ready for childbirth, the cervix is immature, it is impossible and even dangerous to use non-drug methods. In such cases, more thorough preparation of the woman and the use of special preparations are necessary:

Oxytocin is a hormone produced by the pituitary gland and is directly responsible for uterine contractions during childbirth. The introduction of oxytocin intravenously or in the form of tablets will provoke the onset of labor. However, with an immature cervix, the use of this drug is unjustified. More about;
Preparations of the prostaglandin group (Prostin, Prepidil and others). These are biologically active substances that help soften, open and ripen the cervix. This group of drugs is the best for the preparation and stimulation of labor. Prostaglandins are available as injections, tablets, vaginal and cervical gels;
Mifepristone is a relatively new drug for inducing labor. Its action is to block progesterone receptors. Progesterone, whose main function is to maintain pregnancy, stops working. Pregnancy is left without hormonal support, and labor begins.

Labor induction at home

In cases where the term of childbirth has already passed, but both mother and child feel good, there is no need for active action. The doctor lets the pregnant woman go home, where she immediately rushes in search of folk methods to speed up the onset of the cherished day. There are many of these methods, some of them have medical roots and common sense, while some of them are completely devoid of them and even dangerous.

Dangerous methods include hot baths, drinking alcoholic beverages, lifting weights, jumping, taking decoctions of unknown herbs and dietary supplements, any vaginal manipulations at home.

Of the permitted ways to speed up the onset of childbirth:

Exercises, which include the notorious climbing stairs and washing floors. Neither harm nor benefit any moderate physical activity can bring. But systematic yoga, swimming or aerobics for pregnant women are very useful for muscle development, proper breathing, weight control and the development of a generic dominant.
Castor oil or the well-known castor oil is considered a panacea for inducing labor. There is a grain of common sense in this. Castor oil has a hormone-like effect and can help ripen the cervix when used regularly, such as in suppositories. The laxative effect of castor oil can have the effect of rhodostimulation only when the birth canal is ready. A cleansing enema has a similar effect.
Sex life is perhaps the most scientifically based way to induce labor. The semen contains the same prostaglandins that were discussed. With regular sexual activity, the action of these substances on the cervix and its mechanical irritation contribute to the onset of labor.

Before using any of these "grandmother's" methods, be sure to check with your doctor if he allows such experiments in your particular case.

Alexandra Pechkovskaya, obstetrician-gynecologist, specially for website

Useful video:

Nature has programmed the body so that the birth of a woman occurs spontaneously, without any outside interference. In the normal course of pregnancy, the birth of a child occurs between 37 and 41 weeks. But there are times when the process does not start on time, then the pregnant woman has to induce labor. In what cases it is necessary to resort to stimulation, is it dangerous, what methods exist - we will consider these and other questions that concern women in labor in the article.

What is labor induction?

For some indications, doctors are forced to resort to labor induction.

Labor induction is called the artificial induction of the birth process by various methods. The action can be applied at any stage of pregnancy after 27 weeks, if there are indications for this. It is from 27 weeks that the baby can survive outside the womb. But most often, stimulation is done when a woman overwears the fetus.

Before deciding whether a woman's body is ready for stimulation, the doctor checks the cervix. If it shortened, became soft, it means that the readiness for an important process has already come.

Otherwise, the pregnant woman is first prescribed drugs that accelerate the "maturation" of the uterine pharynx, and only then choose the appropriate method of inducing contractions.

If a woman does not have any pathologies, the mother and fetus feel good, then the artificial induction of childbirth can only be advisory. The expectant mother herself has the right to choose whether to take this step or wait until the process begins spontaneously.

When is stimulation used?

There are a lot of reasons for artificially calling the generic process:

The decision on the need to stimulate labor is made only by the doctor, he also chooses the most appropriate method, depending on the situation and the condition of the patient.

Ways to induce labor

All methods of artificial induction of labor activity are divided into two types:

Medical.
Natural.

Let's consider each in detail.

Ways to induce labor.

Medical methods

This type includes methods involving pharmacological preparations and medical equipment. Methods are carried out in a hospital, in a maternity hospital, under the close supervision of a doctor.

Amniotomy (puncture)

When the woman in labor has been having contractions for a long time, and the fetal bladder has not yet burst on its own, the uterine os opens very slowly, the doctor does an amniotomy (bladder puncture). The procedure is quick and painless, after it the waters leave, and the baby's head begins to move along the birth canal. The opening of the cervix is faster, and labor begins soon enough.

Amniotomy process.

Pills

Today, pharmacology offers artificially synthesized antigestogens in the form of tablets that effectively stimulate labor. The drugs cause the release of the hormone progesterone, which is responsible for the opening of the cervix and its contraction.

Any medication during pregnancy can be taken only after consulting a doctor.

Doctors prescribe the same pills to women for early termination of pregnancy. In the late they act as stimulants.

Such drugs have a minimum of side effects and do not harm the health of the mother and baby. In addition, they greatly facilitate the birth process, contributing to the rapid and complete disclosure of the uterine os. The percentage of emergency caesarean sections in women in labor when taking such pills is very low.

The medicine is taken strictly in a hospital under the supervision of a doctor.

Oxytocin is a synthetic analogue of the hormone involved in uterine contractions and expulsion of the fetus. The drug is administered as an injection intravenously or drip. The obstetrician-gynecologist uses the method only as a last resort, when the waters of the woman in labor have already departed, but the contractions have begun to fade, the opening of the cervix is slow or has stopped completely.

The introduction of oxytocin is carried out with the simultaneous control of the baby's heartbeat. The drug acts very quickly and there is a risk that hypercontraction of the uterus will begin, and the fetus will experience oxygen starvation.

Oxytocin has serious side effects and can cause uterine bleeding. It is not done to women with a very narrow pelvis and in the case when the fetus is in the wrong position.

Before introducing this drug to the expectant mother, the doctor carefully weighs all the risks.

Oxytocin has a number of contraindications and is administered only as a last resort.

Prostaglandins

Prostaglandins are lipid substances found in our body. In a concentrated amount, they are in the amniotic fluid. Lipids, along with hormones, provoke the uterus to contract and open. In pharmacology, the drug is presented in the form of vaginal suppositories or gel. Stimulation of labor in this way is very mild, with virtually no side effects and negative effects on the fetus.

The substance is injected into the vagina and after 1-4 hours, the woman begins contractions.

Detachment of amniotic membranes

The technique is used in post-term pregnancy. It is done manually by a gynecologist. The woman lies down on a chair, the doctor begins to move his finger around the cervix. The procedure is not particularly pleasant, but painless. During such a “massage”, the amniotic membrane begins to gradually exfoliate, which causes childbirth. Immediately after the session, bloody spotting may be observed. Nothing wrong with that. If labor does not begin within a day, the doctor repeats the procedure.

Foley catheter

An outdated method that is practically not used in modern clinics. The catheter consists of a long silicone tube with a balloon-shaped tip. The device is mainly used in urology. In gynecology, it was previously used to open the uterine cervix. The process is painful, so today it is resorted to only in extreme cases, when there is nothing else, but it is necessary to cause contractions.

Foley catheter.

natural methods

The doctor may recommend natural methods of stimulation to the pregnant woman, without the use of drugs. Typically, such therapy is prescribed for post-term pregnancy, when the health of the mother and baby is in perfect order, and no threats are observed.

Physical activities

If childbirth has not yet occurred at 40-41 weeks, the woman is advised to increase physical activity, of course, within the permissible range. Walking up the stairs, doing housework, light gymnastics, long walks - all this can positively affect the onset of labor.

Increased physical activity can stimulate the onset of labor.

sexual intercourse

The more sex a lady has at a later date, the better. But only sexual intercourse leading to orgasm counts. At the moment of culmination, the uterus actively begins to contract, which stimulates the onset of labor. Of course, it is worth excluding too violent sex with sudden movements. Male semen contains prostaglandins, which also cause the cervix to dilate. But one dose is not enough, it is desirable to have sex 2-4 times a day.

Bath

A warm bath with essential oils of cinnamon, clove and ginger is a pleasant relaxing method that leads to the opening of the cervix. The bath should not be taken if the water has already departed, or if you feel unwell.

Enema

A cleansing enema causes contraction of the smooth muscles of the intestine. It is highly likely that this will be followed by a contraction of the uterus. To induce labor activity, most likely, one enema will not be enough. The procedure will have to be done for 3-4 days.

laxative food

You can eat for several days foods that cause relaxation of the intestines. Bringing the matter to terrible diarrhea is not worth it, it is enough that defecation occurs 2 times a day. Intestinal spasms can stimulate uterine contractions. The method is not guaranteed, but some ladies claim that this is what helped them.

What Not to Do

When preparing for the arrival of a baby, it is important to remember that some actions can harm.

It is forbidden:

Whatever method of labor induction you choose, it is not recommended to do it without consulting a doctor.

Take any causing drugs without a doctor's prescription.
Resort to natural methods without consulting your doctor.
Induce labor if the due date has not yet reached 37 weeks.
Do the procedures yourself when you feel unwell and being alone.
Violate doctor's orders.
Use risky folk methods. On the Internet you can find a lot of advice on taking oils, decoctions and other potions to induce labor. But all these methods are extremely unpredictable. There is a danger of harming not only yourself, but also the child.

What is the danger of stimulation?

Even under the supervision of a doctor in a clinic and ward, the artificial induction of contractions in a pregnant woman has some negative consequences:

Too painful contractions. The opening of the pharynx after taking the drugs occurs faster than during the natural course, so the pain increases.
Some techniques cause inconvenience to a woman. For example, when you enter oxytocin, you have to lie under a dropper for a long time, and when you enter prostaglandins, lie down for an hour without getting out of bed.
With accelerated delivery, there is always a risk of fetal asphyxia.
Perhaps a violation of the central nervous system in a child.

Contraindications

Artificial provocation of the birth process has a number of contraindications:

Hypertension (most drugs cause an increase in pressure).
Intracranial pressure.
Scars on the uterus.
Chronic oxygen deficiency in the fetus.
Some diseases in a woman in labor.
Incorrect position of the baby in the womb.

How is induced labor going?

Regardless of the way in which labor was caused by the uterus, after the start of contractions, everything goes as usual. Labor with stimulation are the same as spontaneous labor, the only difference is that contractions can be longer in interval and painful. But this doesn't always happen.

During contractions, the cervix gradually dilates. When the pharynx is opened by 10-12 cm, the contractions turn into attempts. This means that the child is actively moving along the birth canal and will be born very soon.

Childbirth with stimulation is not much different from the usual.

Is stimulation harmful?

Any intervention in the processes of the body, which should occur naturally, is risky. Is artificial stimulation of labor harmful? Physicians do not have a definite answer to this question. Certainly, when there is a threat to a child or his mother, such a step can save a life.

There is also a risk of an unfavorable outcome of childbirth with a spontaneous course, in the case of a stimulated process, it increases slightly.

If you look objectively at the statistics, then in 95% of cases, women after defiant methods give birth safely, and children are born completely healthy. Therefore, there is no need to panic about such an appointment. It is very important to trust your doctor. If the doctor has appointed a call for childbirth, then it is really necessary.

Finally

Doctors and psychologists have long established that the course of pregnancy and its outcome largely depend on the psycho-emotional state of a woman. The happier, calmer and more confident the mother feels, the more likely it is that the birth will take place as expected: on time, easily, quickly. Stress, fears, anxiety and other negative emotions create strong blocks in the muscular system. This is reflected in the uterus, and the more tense the body, the more difficult it is for the uterine tissue to start a natural contraction. Therefore, the most important thing is to remain calm, relaxed, joyful, in harmony and simply trust nature, because it is perfect.

In this article:

When the pregnancy has come to an end in time, and childbirth has not yet occurred or labor is too weak, there is a need for stimulation of labor. Induction of labor is a natural or artificial acceleration of the activation of labor activity through the administration of medications or certain procedures.

Indications for labor induction

Labor induction is used in the case when a woman cannot give birth on her own due to the presence of such factors: overweight of the fetus or mother, the presence of some serious diseases in history (diabetes mellitus), placental abruption, early discharge of amniotic fluid, etc.

Mandatory stimulation of labor is carried out with placental abruption, when there is a possibility of bleeding and the life of the fetus is at risk. They stimulate labor activity when the pregnancy is overdue, and childbirth does not occur. Rare irregular contractions or their complete cessation, cases when a woman is completely exhausted after contractions are also a reason to induce labor. Large-term and polyhydramnios is an indication for artificial stimulation, since in this case the birth may be delayed, and there is a possibility of hypoxia in the fetus.

Artificial methods of labor induction

During childbirth, the doctor monitors how the labor activity is progressing: he palpates the woman's abdomen, determines the frequency and number of contractions, their duration. The most accurate indicator is the disclosure of the cervix. If the cervix opens too slowly or the opening has stopped, then, if necessary, labor is stimulated.

Induction of labor can be carried out with the help of:

oxytocin;
prostaglandins (gel, suppositories);
amniotomy;
mifepristone, pencrofton, miropriston.

Oxytocin

To open the cervix, hormonal analogs are used to promote the opening and maturation of the cervix. The most effective and common drug is oxytocin. It refers to the method of artificial stimulation of labor by intravenous administration. It is used for weak labor, as a stimulation of lactation, as a remedy for postpartum hemorrhage.

There are some contraindications against the use of oxytocin. So, it cannot be prescribed if the woman has a very narrow pelvis or there is an anomaly in the position of the fetus. There is also the possibility of overdose or side effects due to inaccuracies in dosage. As a side effect, excessive contractions of the cervix may appear, which leads to impaired blood circulation and fetal hypoxia. Bleeding may develop.

Prostaglandins

Prostaglandins are used in medical practice as a means to stimulate labor. They are prescribed in cases where the cervix is not ready to dilate. Normally, prostaglandins are found in the amniotic fluid, and in small amounts in the tissues of the body.

The safest is the use of a labor-stimulating agent in the form of a gel or suppositories - this method is the most gentle and effective. Labor induction gel, which contains prostaglandins, helps to improve hormonal levels and prepare the cervix for dilation and childbirth. Labor activity occurs within 4 hours after the introduction of the gel. Under the action of oxytocin, contraction of the cervix is stimulated, pain is softened.
The gel is injected vaginally with a sterile syringe into the back wall of the vagina. After that, the woman needs to lie down to avoid the gel leaking out. If you enter the gel directly into the cervix, there is a possibility of hyperstimulation of labor. In the absence of the desired effect after 6 hours, the gel is reapplied. The maximum dose of the injected gel is no more than 3 ml in total.

Although the gel, as a labor accelerating agent, has good reviews, there are still a number of contraindications to the use of this gel. These include the presentation of the fetus, a clinically narrow pelvis in a woman, the presence of indications for a caesarean section.

Amniotomy

Folk methods of stimulation

Folk methods of stimulating labor include such remedies as castor oil (castor oil), champagne, the use of kelp, etc.

Castor oil

Induction of labor at home can be carried out with the help of an oil such as castor oil. Castor oil, due to its relaxing effect, can lead to the opening of the cervix and hasten childbirth, if taken in large quantities. To stimulate labor, you need to drink 1 tablespoon of castor oil. But still, modern medicine is against such a drug as castor oil, because castor oil can cause diarrhea and lead to dehydration (castor oil is also used as a laxative).

Castor oil is not considered a good and suitable remedy for inducing labor. You can use more gentle and more effective methods to stimulate labor than castor oil or castor oil.

Laminaria

You can bring the process of childbirth closer in a natural way at home with the help of a special diet, which includes foods rich in fiber. In this sense, seaweed (or, in other words, kelp) is very good. Laminaria contains a large amount of iodine. And the vitamins and elements contained in kelp are in no way inferior to expensive vitamin preparations. To have a relaxing effect, it is enough to eat a little kelp, and it will have a stimulating effect on the body.

Laminaria in obstetrics is used not only at home in official medicine. In order to make it convenient to use kelp, they are formed into sticks 6-9 cm long. Laminaria absorb moisture well, therefore, when placed in the vagina, they expand the cervical canal. In addition, it is believed that kelp contributes to the production of prostaglandin, which expands and softens the cervical canal.

Laminaria is used in two stages: first, 6 sticks are introduced for 16 hours, and if childbirth has not begun, then these sticks are removed and another 6-12 sticks are introduced for the next 16 hours.

Alcohol

It is believed that taking a small dose of alcohol has a relaxing effect on the body and leads to a natural acceleration of labor. Partly it is. For example, if you drink a little red wine, it will not harm the baby and will help bring contractions closer. Champagne is not recommended. Champagne does not have the necessary effect on the body and can only harm. Therefore, doctors are against this method.

Useful video

Childbirth is a complex physiological process of expulsion of the fetus from the uterine cavity. After the opening of the cervix in the first stage of labor, the baby begins to move through the birth canal due to uterine contractions - contractions. In the second period, contractions (contractions of the abdominal and diaphragm muscles) join the contractions, as a result of which the baby is born into the world. After that, the placenta quickly separates and the placenta exits. Here it is, the happy ending!

To start normal labor, two basic conditions are needed: a mature cervix and sufficient strength and duration of contractions. Typically, the cervix "ripens" (i.e., becomes soft, shortens to 1 cm or less, and dilates by more than 1 finger) by the 38th to 39th week of pregnancy. With the onset of labor, the cervix continues to open and smooth out. This is due to contractions, as well as pressure on her fetus. An important role is played by the fetal bladder, which "weds" into the opening of the cervix, contributing to its opening. For the successful completion of the first stage of labor, uterine contractions must be sufficiently strong, long-lasting and occur at regular intervals.

In cases where the contractions are not intense enough, short or rare, they speak of the weakness of labor activity. This condition is also indicated by a low rate of cervical dilatation (normally 1 cm per hour). Also, this condition is diagnosed through observation, CTG (cardiotocography) and vaginal examination.

There are primary and secondary weakness of labor activity. The primary is manifested by contractions of weak strength, a violation of their rhythm and duration from the very beginning of childbirth. The second option is characterized by the appearance of the same changes, but not immediately, but after a certain period of time after the development of normal labor activity.

What is the danger of weakness of labor activity?

Many expectant mothers are perplexed - is labor stimulation really necessary? After all, you can often hear arguments about how they gave birth in the old days for several days, and nothing - everyone treated this normally. But it is important to understand that such a situation is not at all the norm and threatens the development of serious complications. For a baby, the danger of weak labor activity is to increase the risk of developing severe oxygen starvation, which is fraught with neurological disorders and cerebral circulation disorders in the newborn. In addition, during prolonged labor, amniotic fluid may enter the lungs of the fetus, leading to inflammation of the lungs and impaired breathing of the child after birth. These consequences often require long-term observation and treatment of the baby in the future.

On the part of the mother, there is a threat of birth injuries, and as a result of insufficient contraction of the uterus in the postpartum period, bleeding may begin.

Therefore, in all cases of development of weakness of labor activity, it is necessary to stimulate it - to increase the strength, duration and frequency of contractions.

Stimulation in childbirth: let's try without drugs

Most often, the concept of "rodostimulation" in expectant mothers is associated with the use of special medications, but, in addition to this, there are a number of non-drug ways to normalize labor activity:

The active behavior of the woman in labor contributes to the strengthening of labor activity.
Stimulation of the areolas (nipple circles) and nipples of the mammary glands leads to the release of the hormone oxytocin, which enhances uterine contractions.
Labor activity is enhanced when the position of the woman on her side, the same name as the position of the fetus.
Amniotomy (opening the membranes) is an effective measure to activate contractions. This is explained by the fact that after the discharge of amniotic fluid, the volume of the uterus decreases, which allows it to contract more efficiently. In addition, amniotomy activates the formation of prostaglandins - substances that are powerful stimulants of uterine contractions. This manipulation is painless, since there are no pain receptors on the surface of the membranes.

Medical stimulation during childbirth

Before starting medical stimulation in childbirth, it is very important to assess the condition of the woman in labor. When she is tired, a drug sleep is prescribed, which lasts about 2 hours. The positive effect is due to the fact that during this period, childbirth does not stop, and the cervix continues to open. Often, after a rested woman in labor wakes up, labor activity returns to normal, and the need for labor stimulation may disappear. If this measure did not help, then, as a rule, the doctor decides on drug stimulation during childbirth.

To date, drugs of the prostaglandin group and oxytocin are used for this purpose.

Prostaglandins are biologically active substances that trigger regular labor activity. They contribute to the opening of the cervix and increase its contractions. Prostaglandins are used with the development of primary weakness of labor or with the development of secondary weakness of labor, if the cervical dilatation is not more than 6 cm. These drugs also have side effects - nausea, vomiting, increased blood pressure, increased heart rate, bronchospasm (difficulty respiration due to a decrease in the lumen of the bronchi). Given this, contraindications for the appointment of such drugs are bronchial asthma, increased blood and intraocular pressure (glaucoma), severe liver and kidney diseases. These drugs are administered intravenously.

Oxytocin (from the Greek oxys - fast, tokos - childbirth) is a synthetic analogue of the hormone oxytocin, which is responsible for the contractility of the uterus. Since the most common cause of the development of weakness in labor is the insufficient production of one's own oxytocin, the introduction of this substance helps to correct the situation and normalize the process of childbirth. Sensitivity to oxytocin increases towards the end of the first stage of labor, so it is most effective for secondary weakness of labor and weakness of attempts. It is also administered intravenously.

The introduction of these drugs requires constant supervision of an obstetrician-gynecologist and midwife. Careful monitoring of the contractile activity of the uterus and the condition of the fetus is necessary. It is important to prevent an overdose of prostaglandins and oxytocin, which causes uterine hypertonicity, which, in turn, leads to impaired uteroplacental circulation and intrauterine suffering of the baby, premature detachment of the placenta.

Along with the stimulation of labor, antispasmodic drugs are usually administered to relieve spasm of the cervix during contractions and soften it. Strengthening contractions with a dense cervix leads to its rupture. To prevent fetal oxygen starvation, drugs are prescribed that improve uteroplacental blood flow and increase the resistance of fetal brain cells to oxygen deficiency.

With persistent weakness of labor, combined with other diseases, and with the impossibility of natural childbirth, a caesarean section is indicated.

Conditions for labor stimulation are:

Correspondence of the size of the fetal head to the mother's pelvis, which shows the possibility of the fetus moving through the pelvic cavity during childbirth;
Satisfactory condition of the baby (according to cardiotocography, ultrasound, Doppler uteroplacental blood flow). With oxygen starvation of the fetus, it is impossible to perform rhodostimulation, as this can lead to vasospasm, disruption of the uteroplacental circulation and deterioration of the child's condition.
Absence of a fetal bladder. Rhodostimulation is not carried out with a whole fetal bladder. This threatens with a serious complication - placental abruption due to an excessive increase in intrauterine pressure. Usually, with the development of weakness in labor, an amniotomy is first performed (puncture of the fetal bladder), and then the woman in labor is observed for 2 hours. If during this time labor activity has not returned to normal, drug stimulation is prescribed.

Is it possible to avoid stimulation in childbirth?

Prevention of the development of weakness of labor activity is largely a normal pregnancy. For the expectant mother, a full-fledged sleep is necessary - at least 8 hours a day, a rational balanced diet, favorable conditions for psychological comfort. An important role is played by the absence of chronic foci of infection, good physical shape, training at school for pregnant women and support from relatives. Gymnastics for pregnant women, breathing exercises, swimming in the pool, yoga, outdoor walks are recommended. Also, the expectant mother needs to take vitamins (B6, ascorbic and folic acid), which have the ability to increase the energy potential of the uterus.

Such different concepts

It is important to understand that labor stimulation and labor induction are two completely different procedures. Rhodostimulation is always an intensification of already existing contractions, when labor activity began on its own, but then there was a failure in its normal development, and it began to weaken. Labor induction is carried out if it is necessary to induce labor, when there are no contractions yet.

Causes of weakness of labor activity:

previous abortions, miscarriages, curettage of the uterus, inflammatory diseases of the female genital organs, uterine fibroids, hormonal disorders and chronic diseases;
the age of the primipara is less than 18 and more than 35 years;
a large number of births (4 or more);
causes leading to overstretching of the uterus (large fetus, polyhydramnios, multiple pregnancy), preventing the full contraction of the myometrium - the muscles of the uterus;
hereditary predisposition, which can be traced through the female line;
complications of the course of pregnancy - postmaturity, fetoplacental insufficiency (i.e., the inability of the placenta to meet the needs of the developing fetus);
woman's fear of pain, lack of psychological attitude to childbirth.

When is it not possible to induce labor?

Contraindications for labor stimulation are the presence of a scar on the uterus, incorrect position of the fetus, its oxygen starvation, clinically narrow pelvis (a situation where the size of the fetal head does not correspond to the size of the mother's pelvis), placenta previa (when the placenta blocks the exit from the uterus), severe preeclampsia, fatigue women in labor.

Maria Sokolova

Reading time: 8 minutes

A A

The 41st week is already underway, and the little one is still in no hurry to enter the light of God ... This situation is familiar to every 10th woman. And passively waiting for future fights is not always the ideal solution.

When labor stimulation is really needed, whether it is dangerous, and how it is carried out - we understand the nuances.

Indications for labor induction - who decides to induce labor and when?

The term "induction of labor" is used when labor has to be induced artificially at some point in the pregnancy.

It is worth noting that in the period from the 37th to the week, labor induction is not required if there is no indication for it.

Also, it is not needed in the case of a normal birth.

Experts consider indications for the stimulation of labor activity ...

True.
Identification of pathological changes in the placenta.
Symptoms of any disorders that are dangerous to the health and life of the fetus.
Late toxicosis (not always).
Early broken water (given the high risk of infection through the cervix).
Placental abruption.
Certain chronic diseases of the mother. In particular, diabetes, hypertension, etc.

Naturally, the decision to induce labor is made by only a doctor and only after a full examination , which will establish that further pregnancy can harm the baby or mother.

It is worth noting that a post-term pregnancy is not just an extra week or two of discomfort for the mother, it is, first of all, the risk of bleeding in the mother, hypoxia in the baby, as well as weak labor, etc. Therefore, if the doctor decides to stimulate labor need to strictly follow the instructions!

If you have any doubts whether it is worth doing stimulation, you can contact another specialist to make sure that the decision was made correctly.
It is impossible to rely solely on the date of the birth expected by the doctor (or on your own date) when making a decision. That's why this date is "estimated". That is, the decision is made only after 40 obstetric weeks - and only according to indications.

Possible complications and consequences of labor stimulation - why is it dangerous for the mother and baby?

Stimulation of childbirth is far from an “ordinary” phenomenon. This is an extremely emergency option for childbirth, which, in fact, should be natural and without medical intervention.

Of course, any interference with the natural process cannot be beneficial - but, in most cases, stimulation does not cause significant harm.

However, it is worth mentioning the possible risks for the baby from using this procedure:

Hypoxia.
CNS disorders in the baby after birth.

Risks for mom:

Painful childbirth: stimulated contractions are always stronger than usual - and with shorter breaks.
It is impossible to move under a dropper, which complicates the general condition of the woman in labor.
Stimulation does not work in all cases, and then a caesarean section is indispensable.

3 methods of stimulating labor in the maternity hospital

The conclusion - whether there is a gestation - is made by specialists at a certain time (closer to the expected date of birth) and solely on the basis of research:

Cardiotocography.
Assessment of all parameters (fetal size, fluid composition, placenta condition, etc.).

If, according to the results of the examination, a thickening of the bones of the fetal skull, oligohydramnios, aging of the placenta or other signs indicating overmaturity are revealed, then an appropriate decision is made on artificial stimulation of labor.

All methods are classified into 2 groups:

Methods and means that accelerate the opening of the cervix.
Methods and means for stimulating uterine contractions.

The most popular medical methods of labor induction include the following:

Amniotomy. In this case, a specialist inserts a special tool-hook through the cervix and, having hooked the amniotic membrane, punctures the bladder, as a result of which water is poured out and contractions begin. The opening of the bladder also stimulates the production of prostaglandins, which enhance labor activity. The method is often used, but it is considered risky due to the possible infection, especially if the method could not start the birth process. Also, possible risks include prolapse of the umbilical cord (here, emergency honey / intervention will not be enough) and damage to blood vessels with subsequent bleeding. The procedure is absolutely painless.
Oxytocin. An agent that is a synthesized analogue of a hormone produced by the pituitary gland. This drug in the form of tablets or a solution is used to activate the contractile abilities of the muscles of the uterus in various cases - to stimulate labor or lactation, with postpartum hemorrhage, with weak labor activity. In order to avoid complications, the use of the drug is excluded in case of an abnormal position of the fetus, scars on the uterus, placenta previa, as well as in the narrow pelvis of the mother. The dosage is usually selected specifically for each situation, taking into account the individual characteristics of the mother. Side effects and risks: increased labor pains, powerful contraction of the uterus (note - there is a risk of circulatory disorders in it and, as a result, hypoxia of the baby).
Prostaglandins. This tool is used in the case when the cervix is simply not ready for disclosure, although the process of childbirth is already underway. These hormones contribute to the rapid “ripening” of the uterus, which is immature for childbirth, stimulating smooth muscles, as well as acting stimulant on the cervix, on itself, and so on. When administering the drug, specialists seek to minimize the risk of a side effect of prostaglandins, using them in the form of a gel or suppositories. It is worth noting that tablets and solutions of the drug are often used during abortion, and the risks of using the drug during childbirth orally and intravenously are quite high: excessive stimulation of uterine contractions (note - with all the consequences), nausea and vomiting, and so on.

There are other drugs to stimulate labor, but they are used extremely rarely.

It is worth noting that drug stimulation is prescribed only in exceptional cases, when there is a threat to the life of the mother or baby.

Inducing labor at home is strongly discouraged unless you have an OB/GYN nearby or your doctor has advised you to do so.

Any actions that can lead to the approach of childbirth - only on the recommendation of your gynecologist!

The main "techniques" that are used at home to stimulate childbirth include ...

Nipple stimulation. Such massage provokes the production of oxytocin, which in turn stimulates childbirth. That is why early attachment of the baby to the breast after childbirth helps to accelerate the birth of a child's place and reduce the risk of bleeding. If you do not plan to give birth ahead of time, then you should be more careful with intimate relationships if they are present at a later date (do not overdo it).
Enema. Intestinal contraction also promotes the release of prostaglandins.
Proximity. The most well-known method of approaching childbirth, but very risky in the later stages. It is worth saying that uterine contraction and the production of oxytocin are guaranteed, and in the male seed there are prostaglandins that soften the cervix.
"Up down" : Walking up and down the stairs can help a mom who has a little late delivery.
Squats, long walks. Remember that excessive loads lead to placental abruption.
Spicy dishes. Spicy spices in food are stimulants for intestinal contractions, and after it - for the walls of the uterus.

In addition to these, there are other ways to bring the moment of childbirth closer, including funny, dangerous and downright stupid.

Video: Natural methods of inducing labor

But it is important to remember the main thing:

Do not use any means and methods for approaching childbirth if your due date has not yet come, and there are no such doctor's recommendations. You risk harming yourself and your baby, and the consequences can be unpredictable.
Pregnancy fatigue is not a reason to induce labor!
Any means to stimulate labor can turn into a tragedy if there are no qualified doctors nearby, if it takes a long time to get to the hospital, if the mother has a narrow pelvis and she cannot give birth on her own (in an emergency), if the baby lies upside down, and in other cases.
It is strictly forbidden to stimulate labor on your own at home with medical methods, including candles and acupuncture.

If the results of the examination show that everything is in order with the little one, and the doctor recommends waiting a little longer, do not rush the baby - let him live in the belly. Give him time - he will decide when it is time to be born.

The site site reminds: this article in no way replaces the relationship between a doctor and a patient. It is informative in nature, it cannot be considered as a guide for self-treatment and diagnosis.

Pathological symptoms and some physiological conditions of a pregnant woman require the direct intervention of the attending physician!