LECTURE № 8
CHILDBIRTH. BEHAVIOR
OF THE WOMAN IN LABOR.
Dr. Nagayeva S.
FOREWORD
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The outcome of labor
depends from woman's
behavior and
management ability of a
body and breath.
The given lecture
represents brief
instruction to correct
woman's behavior in
childbirth.
WHAT YOU MUST TO DO, WHEN
CONTRCTIONS HAS BEGUN
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STAGE № 1 AT HOME
You are on the 40th week. You began to notice that
an uterus strains more often than before. Listen to
yourselves and to your sensations. The true
contractions are felt as feeling of an increasing
pressure in an uterus. Normally it arises in the
bottom of uterus and spreads to lower parts of it.
At first pauses between contractions are long ,about
30-40 minutes. Then, with each hour the intervals
between contractions decrease, it's intensity
increase. It should not be very painful. It is
necessary to go to maternity home as soon as the
interval between contractions becomes 10 minutes.
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The movement you have felt, that at you this longawaited moment a has come - REJOICE! Collect
things, which will be necessary for you and your
kid at maternity home calmly. Necessary list, you
have to take is in your medical exchange card of
the pregnant woman. It is obligatory to take
medical exchange card of the pregnant woman,
passport and insurance policy.
Cut nails, shave genitals, give an enema to
yourselves by means of Esmarh's mug and 2 litres
of boiled warm water, take a shower. You can get
all just listed procedures at maternity hospital, if
you not sure how to do it.
If you are worry very much , the following
actions can help:
Lie down on a bed , take the control
over breath.
 Stroke a tummy, talk to the baby, calm
him. It is not smaller stress for him,
than for you. Do not do sharp hasty
movements, it can scare your baby.
 Gather to the childbirth as for a holiday.
Give to yourselves positive aim at all
process of the labor.
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STAGE № 2
AT THE MATERNITY HOSPITAL.
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You have got to the maternity hospital. There, at reception
ward, midwife will ask a documents (an exchange card, the
passport and an insurance policy), will measure the blood
pressure, the pulse.
Doctor on duty will familiarize with data of your exchange
card, will talk to you. You must tell him openly, how and
when the contractions has begun, with what interval they
are followed one by one, which intensity and how much
painful it has had, how your baby moves, your complaints).
The doctor will listen and palpate to your baby, will
measure a circle of an abdomen, height of the uterus, the
sizes of a basin. Then he'll examine you, to familiarize with
the changes from maternal passages, to estimate the water
bag
After examination you'll get an enema,
shaving of a genitals, shower , if you
certainly hasn't made it at home .
 During sanitary processing with the
advent of contraction strike the
comfortable attitude, breathe deeply,
correctly.
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Apparently, the muscular effort causes
waste of forces, that's why you should stay
in slackness during the moment of
contraction. But this relaxation - not
passive, but active, it is subordinated to
your will.
 During this period you should use the
formula of autohypnosis : " I am quiet.
Contractions is a parameter of the birth
activity. Gradually it'll become stronger.
Breath is deep and steady. Muscles are
weakened. Contraction comes to the end.
After that there will be a period of rest ".
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After procedures you will be
moved to the prenatal ward. Here
you will spend the time expecting,
when contractions will make their
business and the cervix of the
uterus will opens completely. That
is in obstetrical language - 5
fingers. Getting to the end, the
contractions become stronger and
more often. The interval between
them decreases up to 4-3-2
minutes.
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Between contractions, woman can apply receptions of
relaxation, beginning from face's muscles and finishing
by the muscles of lower extremities. Auto-suggestion
between contractions is carried out by mental repetition
of formulas: " I am quiet. I supervise myself. My breath
is stead and quiet. Muscles of the face are weakened.
Muscles of shoulders, forearms, hands are weakened.
All muscles of my hands are weakened completely and
also warm.
Muscles of the perineum and buttocks are weakened.
Muscles of the hips, shins are weakened completely..
Between contractions my organism has a rest. My
childbirth has been proceeding safely. I am quiet. I feel
movements of the child very well. A condition of the
child is good. I am quiet for him" .
PROCEDURES USED MOSTLY OFTEN IN
THE MATERNITY WARD.
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There may suggest to make a spasmolytics and a metabolic
complex, for the improvement of processes of contractions and
relaxation of muscular fibers of the uterus and preventive
measures of fetal hypoxia during the labor.
Besides, of procedures which may be offered in the maternity
home is amniotomy - artificial laceration of the extraembrionic
membranes. This procedure has been made in the cases, when it
has done his function or it is pathological. The procedure is
absolutely painless.
If you have fears of a procedure, ask your doctor interesting
questions . After the amniotomy contractions become more
intensively and more often than before.
You should breathe during all contractions as you studied during
all pregnancy, mentally tell endearing words to your baby , so as he
can felt your support. Close your eyes between contractions, relax
completely, leave in itself. Feel as heat spreading throughout body,
as though you lay in a warm bath.
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You'll feel pressure on perineum , after the next
series of contractions. Character of contractions
has been changed, you'll want to make an effort.
Inform your doctor about it.
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The doctor will look you and if the cervix of an
uterus has opened completely, you will be
dressed on a sterile shirt, a cap and shoe
covers. Then will suggest to accept convenient
position in Rakhmanov's armchair. The most
important to take the position, which is
convenient for you, thus legs should rest against
special supports, you will find handles, to hold
on , when you will strain.
STAGE OF PUSHING
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So you on the armchair
already, there are a doctor and
a midwife near you. You should
strain in doctor's or the
midwife's order. It is the most
important and responsible
moment, collect all your
forces.
It is necessary to strain 3
times, during the labor
pushing. Therefore you should
forethought your forces and
the air-supply.
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So you feel that the labor pushing begins. Take
a deep breath , bend a head to a breast (your
sight should fall on your navel), press a waist to
a table and strain. Then on a doctor's sign do a
smooth exhalation and take a deep breath ,
bend a head to a breast press a waist to a table
and strain again. You must do it 3 times in that
way. During the moment of labor pushing repeat
following formula: " Breath. To strain the muscles
of an abdomen. To strengthen the pressure to
the bottom smoothly. Pressure is more strongly
and more strongly. The child moves ahead
through maternal passages . A smooth
exhalation ".
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When the labor pushing ends you can
to relax, to close an eyes, to feel as
heat spreads throughout your body.
Pauses between labor pushing are
about 1 - 1,5 minutes. Mentally tell to
your baby an endearing words. The
new labor pushing will take you out
from relaxation.
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As soon as the head of your
baby begins to come through ,
you will feel the pressure
sense in the perineum. Listen
to the midwife attentively ,she
will release a head of your
baby accurately.
You should strain in a half of a
force to prevent the rupture of
the perineum. Thus you gave a
birth to the head, and then you
might to do the same with the
baby’s body. It is smaller than
a head ,therefore it can't make
a problem. So take a full
breath and strain.
MIRACLE!
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My congratulations to
you. You are a mom
now, your baby lays on
your abdomen, feels
your heat, your love!
Rewarding your
diligence . Here is it
your miracle, you just
have made it.
LABOR HASN'T ENDED YET!
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It is necessary to give birth to a children's place,
that is placenta. While you observe your child on a
special warming little table, the children's place is
separated from a place of the attachment. When it
will be separated completely, the doctor or the
midwife will ask to strain again. Then cargo will be
placed on the bottom of an abdomen. This action
is necessary to prevent postnatal bleeding.
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Your baby is examined by neonatolog (the expert
on newborn baby’s) at this moment, an umbilical
cord is processed by the disinfectant, will put on
a bracket and a bandage. Eyes, and a vulva at
newborn girls are processed with a special
antimicrobic drops.
THE FINAL STAGE
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It is an examination of maternal
passages by the mirrors.
Certainly it is not such pleasure
as the childbirth, but you can
tolerate it. Genitals will be
washed with the warm water,
then will be drained. Now you
can relax and enjoy the dialogue
with the child.
FIRST FEEDING
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Baby can't see well yet, can't concentrate a
sight, but has a well developed sucking reflex.
And you'll engage with it now. The midwife or
doctor will bring the newborn to you, will show
how to hold the baby at feeding. At the first
feeding, you will transfer nutrients , immune
complexes, which will protect your baby from
infections, your love, by the first drops of
colostrum.
And in the answer you'll get a love of the baby,
his boundless trust, and also reliable
prophylactic of the postnatal bleeding (as
during the moment of breast feeding ,there in
woman's organism hormon oxytocin develops
and causes the uterine contractions).
During feeding hidden strings are stretched
and communicate from soul to soul.
THE CONCLUSION
You'll spend 2 hours at the
maternity ward. You and
your newborn will be under
medical personnel's
supervision and then will
move to" Mother and the
child " ward .
 Enjoy your motherhood!
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