1ST CITY CLINICAL HOSPITAL

Authors of the article:

• Obstetrician-gynecologist (head of department) of the maternity department Kupchina A.N. (highest category);
• Obstetrician-gynecologist Pokatovich O.K. (first category).

For many expectant mothers, the fear and anticipation of pain that is associated with the birth process is a real sore subject. Horror stories from grandmothers and friends spread from mouth to mouth. The fact is that when a pregnant woman languishes in uncertainty in anticipation of the “pains of death,” stress hormones are released into the blood - adrenaline, cortisol. Under their influence, ischemia develops - spasm of blood vessels and muscles, the nerves of the uterus are compressed, and a deficiency of nutrients and oxygen in the blood occurs. These processes lead to pain.

Meanwhile, childbirth is a pleasant event, it is a holiday, it is a sacrament. And contractions and attempts are the path to celebration. You just have to work hard to make the holiday a success. Thinking about contractions and the pain that arises during them as a difficult path to the joy of meeting your baby is the first step to avoiding pain. And the joyful acceptance of contractions is almost a hundred percent pain reliever. But this is already a feat of maternal love.

Usually the most painful stage is the first stage of labor, when the cervix dilates. At first, the intensity of contractions may be comparable to the unpleasant sensations during menstruation. Gradually they become more frequent, longer lasting and stronger. You won’t be able to regulate them, but you can control your own pain.

There are many simple and natural pain relief methods. In our age, many means have been invented to make any job, any path easier. And in such a primordial human activity as obstetrics, there are dozens of such methods, both ancient and modern. Let us only make a reservation that only natural childbirth can be effectively relieved by natural methods, that is, those that are not “induced” artificially and occur without drug interventions. Then, believe me, looking back immediately after giving birth, you will say: it was wonderful!

The right pose will help you relax. The recommendations of the World Health Organization (WHO) state that a woman, in the absence of contraindications, has the right to freely decide what position she should take during childbirth. A well-chosen position relieves most of the pain. Find your pose and move! As a rule, expectant mothers prefer to walk during contractions, sit on a special rubber ball, or stand leaning on the headboard, table or windowsill. You can make swaying movements with your hips, and dancing is not prohibited. This helps relax the perineum, relieves discomfort, and helps open the cervix. Perhaps the ideal options for you will be “on all fours” or “sitting on a chair with your legs spread wide apart.” If you are tired and decide to lie down, the best position is on your side with pillows under your chest and between your legs. In the “on your back” position, your blood pressure may drop, you may feel dizzy and even lose consciousness. In addition, this position reduces the intensity of uterine contractions, which means it lengthens the entire process.

Water has a wonderful analgesic and relaxing effect. If there are no contraindications and appropriate conditions are available in the maternity hospital, you can take a warm shower. Once you are comfortable and relaxed, direct the shower stream to where you find it most comfortable. The shower provides local warmth and a gentle massage. Water procedures (not to be confused with childbirth in water) reduce pain, help you relax and rest between contractions.

It has been proven that music affects our mood. Childbirth, especially the first one, is a rather lengthy process. The main forces will be needed at the very end, during pushing. Therefore, between contractions you need to use every opportunity to relax yourself and let your baby rest. Music can have a good effect. During childbirth, you can turn on the songs of your favorite artists and sing along to them.

Massage can significantly relieve pain. Most women enjoy touch during contractions. It can be done by the woman herself, or by one of the medical staff or relatives. Firstly, this procedure helps to relax, and secondly, it distracts. As a result, pain decreases. The sacrum is the area where the nerves to the uterus originate. If you look closely at the lower back, you will see a diamond shape that is formed by the muscles of the back and buttocks. Often stroking from top to bottom, or vigorously rubbing at points on the sides of the diamond, significantly changes the sensations. Some people find that simply applying firm pressure to the area helps. A woman can do a massage with her own hands only in the initial stage of childbirth; in the future, this sometimes has to be done by her husband or someone who helps in childbirth. You can gently massage the lower abdomen with your palm, moving from the center to the periphery. You yourself must choose which massage technique will bring relief.

During contractions, simultaneously clench one hand into a fist or strain one foot, and try to relax the remaining muscles.

Instinctively holding your breath and straining is a natural human reaction to a disturbing stimulus. Proper breathing has an analgesic effect. If you breathe correctly, the irritant will miraculously bother us less!

-Long exhale. Take a deep, calm breath in through your nose and a long, calm (not forced!) exhale through your mouth. To make your exhalation last longer, you can make a “tube” of your lips, as if you were blowing on a flame.

- Intermittent exhalation. Take a deep, calm breath and a long, intermittent exhalation that sounds like “pu-pu-pu-pu-pu...”.

- "Locomotive". You inhale and exhale briefly, making sounds similar to a steam locomotive puffing.

- "Dog's breath." Frequent short breathing: this is how a dog breathes in the heat. This breathing helps prevent or contain pushing too early (preventing tearing).

At the end of the first stage of labor, when the baby's head drops down, you want to push, but you can't do this yet. Breathing on a count helps to overcome the desire: first, as usual, exhale completely and take a deep breath, and then several short inhalations and exhalations (from 1 to 5 and in reverse order), ending with a long exhalation through pursed lips.

In the second stage of labor, when the cervix is ​​fully dilated, the fetus is expelled with the help of pushing. Unlike contractions, a woman can easily control them (for example, delay them). At this moment, to relieve pain, you should synchronize pushing and breathing and, more than ever, carefully follow the commands of the midwife, who protects the perineum from ruptures and the baby from injury. You need to push after taking a deep breath, as if pushing the baby out with the help of the diaphragm. To do this, direct your efforts downwards, towards the perineum, and not towards the head. But what you shouldn’t do is scream and strain your facial muscles: a lot of energy is wasted, but the child and you get no help. For many, it is much easier to “sound” during a fight than to remain silent. This should in no way be a scream, but prolonged sounds of varying pitches as you exhale. From the outside it looks like a primitive song. You need to choose the pitch of the sound individually for yourself. After pushing, restore your breathing and try to relax before the next episode.

Verbena, lavender, orange and bergamot oils work great as a relaxing and pain reliever if you rub a drop in your palms and inhale the vapors, as well as if you use an aroma lamp. Those who suffer from allergies should test with a very small amount of oil and observe their reaction.

Take it on faith: you know how to give birth (this has been encoded in the genes of every cell of your body since ancient times) and you know what exactly you and your baby need to make childbirth easier and better. You just need to understand your own body language.