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Normal birth: as it is, advantages and care when performing

Normal birth: as it is, advantages and care when performing

Pregnancy is a time when there is no shortage of anxieties and worries. Especially who is expecting a baby for the first time has many doubts about the time of delivery. There are many myths and fallacies about normal birth, which is the traditional way of being born. The information is essential so that the pregnant woman and the doctor do not make the wrong choices that harm her or the baby.

What is normal childbirth?

Normal childbirth is the traditional vaginal birth usually done in maternity wards. Its opposite is cesarean birth, adopted when some clinical conditions require a surgical cut above the pregnant woman's pubis so that the baby can be born.

Is normal labor the same as humanized labor?

A normal birth does not is necessarily humanized. In normal childbirth, all procedures that are registered as "routine" but which in reality are mostly unnecessary or even harmful, as assessed by the World Health Organization.

These procedures are not always necessary , we can mention trichotomy, use of probe to empty the bladder, fasting for at least 6 hours, intestinal lavage before delivery, more liberal use of medicines (analgesics, anesthetics, sedatives, oxytocic to stimulate uterine contractions), frequent vaginal touches , early artificial rupture of the pouch, episiotomy (cut in the perineum). The parturient usually remains lying down, with no freedom to walk or adopt positions that seem more comfortable for her delivery.

The environment is more compatible with that set up for a surgical act (excessive lighting, absence of companions and lack of privacy ) and therefore inadequate with the harmonious "climate" for such a significant moment. Thus, so-called "normal childbirth" is no longer so "normal" as it is conducted under interference, many of which are unnecessary or even

Signs of labor

Although in essence, the dynamics of labor have similar characteristics, we observed significant individual variables among the parturients.

Labor is a progressive process, dependent on uterine contractions that will promote uterine cervix dilatation and fetal descent through the birth canal.

In the beginning The contractions are less frequent, irregular, less intense and of shorter duration, accompanied by minor pain or lumbar discomfort. The cervix is ​​still dilated slowly: it is the so-called

latent phase that lasts for 12 to 20 hours in the primigravidae. Each contraction pulls the muscle fibers of the cervix, progressively increasing its dilatation to 10 centimeters and pressing down the water pouch and baby. The dilatation of the cervix is ​​diagnosed and monitored by the "vaginal touch."

The active phase and the expulsive phase are characterized by the greater intensity, frequency and duration of contractions. During the expulsive period, the contractions recur every 1 to 2 minutes, with an average duration of one minute, promoting delivery of the baby through the vaginal canal.

Duration of normal delivery

In women who have previously given birth of multiparas), all the dynamics occur between 8 and 9 hours, instead of an average of 12 to 14 hours observed in those who never gave birth (called nulliparas). In the nulliparous the expulsive period lasts around 1 hour and in the multiparous about 30 minutes.

An expulsive period that lasts more than an hour is called prolonged, it poses risks to the baby and can lead to the maternal scam, hence the need of the strict monitoring of symptoms and clinical signs by the medical team.

Phases of labor

We can divide true labor in 3 phases: Dilation, Expulsion and Discharge:

Dilation:

according to the speed of the cervix dilatation, this first phase is subdivided into Latent Phase and Active Phase Latent Phase: The cervix is ​​dilated more slowly. This is the initial phase of labor. At this stage the contractions are irregular and of lower intensity. It is common for the pregnant woman to refer only "that the belly is hard, but, that is not feeling pain". At the beginning, the descent of the baby is still slow, the dilation of the cervix is ​​less than 1 centimeter per hour and this is getting more and more imbibed and softened.

  • -Active phase: from 4 centimeters of dilation occurs, on average , a contraction every 10 minutes lasting between 40 and 60 seconds. They promote progressive dilation of the cervix around 1 or 2 centimeters per hour. Usually, between contractions and shorter pauses, the active phase evolves between 6 and 12 hours, when the cervix reaches 10 centimeters of dilatation (complete dilatation) variable time if it is nulliparous or multiparous.
  • Expulsion

: The cervix has complete dilation and the contractions culminate with the expulsion of the baby from the uterine environment - it is the birth of the baby. This phase should not exceed 30 to 60 minutes.

: This is the process of detachment and expulsion of the placenta. This phase should occur between 5 and 30 minutes after birth. Normal labor pain

The pain sensitivity in the process of parturition is a reality, however, it varies greatly in intensity from woman to woman. Nature is wise, as it progressively enhances the production and release of endorphins (substances with a high analgesic and sedative power), greatly reducing the severity of painful complaints.

It is incumbent upon the medical team to guide and guide the pregnant woman during the pre-

It is possible to bet on more "natural" resources such as: to keep the parturient in a more comfortable position (crouching, alternating with walks) , lumbar-sacral massage, heated immersion or shower baths, use of Pilates ball, in addition to the reassuring and active presence of members of the obstetric team. According to each phase of labor, if necessary, we can make appropriate use of analgesic drugs and / or anesthetics, reserving racemic or epidural anesthesia for the end of the period of dilation and the expulsive, so that the woman can give birth with greater tolerance and comfort

Local anesthesia is much used for normal delivery at the time of episiotomy, whenever this is necessary.

Benefits of normal delivery for the mother

Normal delivery allows an experience with more intensity of the experience of having a child, once the mother participates actively of all the steps in the process of the parturition, which gives rise to him of the self-esteem in the experience of his new role of mother. Among other good things are:

Lose less blood when compared to what happens in the cesarean section

  • Avoid the discomforts and risks of a surgical procedure, such as cesarean section, such as hemorrhage, puerperal infection, organ damage
  • Preventing thrombosis, due to the possibility of the mother moving during labor, activating the circulation of the lower limbs.
  • Use fewer drugs in the course of the procedure of labor and postpartum.
  • Facilitate and anticipate the production, lowering of milk and breastfeeding. The suctioning of the breasts leads to the prevention of postpartum bleeding and the resumption of the uterus to its normal size, thanks to the increase in oxytocin that ejects the milk and contracts the uterus.
  • Avoid scarring (occurring only in cases of episiotomy )
  • Reduce the risk of death (which is statistically much lower)
  • Reduce the incidence of complications in future pregnancies and childbirth
  • Recover the mother's body faster (physiological)
  • )
  • Benefits of normal birth for the baby

Substantially reduce the possibility of prematurity that the indiscriminate use of cesarean sections can cause

  • Give greater opportunity for breastfeeding and breastfeeding soon after birth
  • Create immediate conditions for establishing the affective bond between mother and child with undeniable benefits for the baby's psyche
  • Eliminate the liquid contained in the baby's respiratory tract, especially when in the position of squatting. Compression and decompression of the baby's thorax during vaginal expulsion induces the infant's first inspiration
  • Stimulate the fetal adrenal gland, thanks to the natural stress of labor itself, which promotes the increase of cortisol and accelerates the production and release of chemicals (surfactants), benefiting the rapid maturation of the baby's lungs.
  • When we do not opt ​​for normal birth and risk

Although we know that normal delivery is what gives the mother and baby , certain conditions do not recommend this route for delivery and indicate that a surgical delivery (caesarean section) is used.

Normal delivery should be contraindicated when the risks and / or disadvantages of a vaginal route are greater than that of a caesarean section. Maternal factors include hypertension, decompensated diabetes, heart disease, active or non-active HPV and genital herpes, cervix cancer, certain infectious states, and maternal, fetal, and obstetric factors.

Among the fetal factors we found: fetal heart diseases, very large fetuses (maternal-fetal disproportion), and the appearance of signs compatible with fetal distress.

Care in performing normal delivery

A careful follow-up of all the stages, with preservation of the autonomy that should always be offered to the woman during childbirth, is important.

Hospital care should provide security for the mother and baby through consecrated practices that aim at a healthy birth and prevent, prevent or minimize maternal complications and risks.

It is to ensure these benefits, the process of preparation for a normal birth is initiated from the prenatal period.

It is important that the medical staff see both gestation and normal delivery as a physiological event inherent in mammals and only adopt measures

Normal childbirth video

Actual normal birth video

Source consulted:

Content prepared by the obstetrician obstetrician Cláudio Basbaum


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