Only in the twentieth century labor was begun in maternity hospitals. In the article on the topic "Birth of a child outside the maternity hospital" you will learn valuable information and understand where it is most comfortable to give birth to a child.
Benefits
Many women feel more secure in a maternity hospital, but some of them are frightened by equipment and bright lights that are an integral part of the medical setting. Therefore, they decide to conduct childbirth at home. Some women choose this way of delivery, because the home environment seems to them more natural for the birth of a child. In addition, home births allow the partner and, if desired, other family members to take a greater part in this process. Childbirth at home is becoming more popular. Also, an increasing number of women prefer to control the course of their pregnancy on their own and seek to ensure that the birth is more of an intimate event than a medical procedure. The results of these studies suggest that home births allow the mother to feel more relaxed and less likely to need anesthesia.
Preparation
When a woman first consults a doctor to confirm a pregnancy, she can discuss the preferred method of delivery.
Risk
In most cases, giving birth at home is as safe as in a maternity hospital. Nevertheless, if a woman has an anamnesis (for example, any pathology in previous births) or during a real birth, complications (for example, with breech presentation of the fetus) that may require special medical care are suggested, doctors advise to apply to a medical institution . Usually a midwife with an experience of taking birth at home helps. In addition, she supports a woman throughout her pregnancy. In rare cases, the presence of two midwives is required. On the eve of the proposed date of birth, the midwife visits the house to make sure that everything is ready for them. A convenient access to the house is necessary in case of urgent transportation of the woman in childbirth to the hospital, good ventilation, optimal air temperature, lighting and water supply. The midwife usually makes up a list of necessary things, which includes:
- buckets - may be needed to ensure that the woman in labor is squatting during the exit of the asphyxia, and also for cleaning;
- clean towels and diapers;
- lamp;
- thermometer;
- disinfectant and kitchen towels;
- polyethylene bags for garbage;
- other things on personal preferences, for example a tape recorder with quiet music and candles, so that a woman feels more relaxed during childbirth.
The midwife brings most of the necessary tools with her, on the day of birth, including the instruments for clamping and separating the umbilical cord, sterile cotton wool, dressings and others. It can also have a device for recording the heart rate of the fetus and a tonometer for measuring blood pressure in the mother. For analgesia in labor, a midwife may have a gas-air mixture bottle and, if necessary, other painkillers. For emergency cases, the midwife kit provides everything needed for resuscitation of the newborn: oxygen, intubation tools (to maintain airway patency), urinary catheter and suction to clean the respiratory tract from mucus. With the onset of labor, the mother gives birth to a midwife. During this period of childbirth a woman can freely move around the house and relax. The midwife estimates the frequency and duration of uterine contractions. At the earliest stage of labor, she can communicate with the woman in labor by phone and thus monitor her condition.
Active phase of childbirth
With the onset of the active phase of childbirth (when the cervix is 4 cm or more open), the midwife is always next to the woman in childbirth. Home births are conducted in the same way as in the maternity hospital, except that the mother has the opportunity to control the process of delivery more. A lying-in woman should not lie in bed all the time or be in the same room. She can walk, take a bath or go out into the garden. The vertical position of the body can accelerate the contractions, as with this gravitational forces contribute to lowering the head of the fetus, softening the cervix and its rapid opening. If any complication occurs during the home birth, the midwife immediately contacts the staff of the maternity hospital. Based on the evolving symptoms, the doctor on duty can recommend hospitalization for the purpose of providing necessary medical assistance. Midwives usually have enough experience in detecting the pathology of labor.
Observation
Heart rate, body temperature, heart rate and blood pressure, as well as the heart rate of the fetus are carefully monitored. In addition, the force, duration and frequency of uterine contractions are recorded. A regular assessment of the degree of cervical dilatation and fetal progression through the birth canals is performed. Constant monitoring allows us to suspect in time an abnormality of labor and hospitalize a woman in childbirth until the development of dangerous complications.
Complications
Hospitalization in the process of childbirth or immediately after them is necessary for the development of the following complications:
- staining of amniotic fluid with meconium (green or black) - may indicate a poor state of the fetus. The entry of meconium into the respiratory tract of a newborn can cause severe breathing disorders;
- distress of the fetus - with prolonged labor there may be a pathology accompanied by a disturbance of the heart rhythm in the fetus;
- bleeding - slight bleeding during labor is normal, but it may indicate premature placental abruption;
- exhaustion of the mother - develops with severe or prolonged childbirth. In this case, the midwife can provide some degree of anesthesia (gas-air mixture), but hospitalization may be required for epidural anesthesia (blockage of the spinal nerves);
- intensive postpartum hemorrhage - may be observed with insufficient uterine contraction after the release of the afterbirth;
- delayed departure of the afterbirth - there may be a need for manual separation of the placenta under anesthesia;
- violation of breathing in the fetus - despite the availability of a midwife resuscitation kit for a newborn, in such cases, you must immediately call an ambulance.
Noticing the first signs of labor, a woman contacts a midwife. During childbirth, it will allow family members to share this intimate event with each other. In the process of any birth, three periods are distinguished:
- cervical dilatation;
- expulsion of the fetus;
- expulsion of the placenta.
With the onset of labor (when uterine contractions become regular or amniotic fluid flows away), the midwife comes to the woman in labor, examines her, measures blood pressure and determines the stage of the birth process.
Cervical opening
In most cases, the first period of labor takes from 6 to 12 hours - in the initial stage, the presence of a midwife is not necessary. One of the advantages of home births is that at this stage a woman can move freely around the house, and not be in the setting of a medical institution. This allows her to feel more relaxed and distracted from pain.
Acceptance of childbirth
When the cervix has almost fully opened, the midwife is constantly next to the woman in childbirth, monitoring her condition and providing psychological support. Her participation is minimized to allow the mother and her partner, as well as other family members, to share the tremendous sensations from the joint birth. The midwife notices the frequency and strength of the uterine contractions, as well as the degree of opening of the cervix. She also measures blood pressure. Convinced of the normal course of labor, the midwife usually leaves and regularly contacts the woman in childbirth, supervising the process by phone. The father of the unborn child is next to the woman in childbirth, supporting her at an early stage of childbirth. As the labor progresses, contractions become more frequent and intense. A woman feels a great relief when the amniotic membrane surrounding the fetus breaks free of the amniotic fluid. The floor in the room where the pregnant woman is lying is covered with plastic wrap. Transparent amniotic fluid is a sign of a happy state of the fetus.
Cervical dilatation
The midwife is satisfied with the success of the woman in childbirth. Several hours after the start of the fights, and the cervix almost completely opened. At this stage, uterine contractions become the most frequent and intense. A partner helps a woman in childbirth to push, while a midwife explains to the children what exactly happens to the mother. Fortunately, parents prepared them for the upcoming events. As the woman in labor is pushing, her ancestral ways widen and from them the head of the fetus is shown. The rest of the family watches the child's shoulders appear after the second attempt. Father supports the head, and after another attempt, the baby is born. After the initial examination, the mother is given the baby. The midwife shows her father how to cut the umbilical cord. A few minutes later the placenta is born. The midwife carefully examines her.
Mother and child feel good. The midwife examines the child, controlling the frequency of his breathing and pulse. She carefully examines the umbilical cord, since any anomaly, such as lack of an artery, can be a sign of the pathology of the cardiovascular system. Then the placenta is inspected: it is important to make sure that it is completely out of the uterine cavity. Having made sure of the integrity of the placenta, the midwife cautiously gets rid of it. If the mother and the child feel well, the midwife leaves the room to allow the family to communicate with the child, and begins cleaning. While the mother is resting, the midwife helps her father to bathe the newborn. Then she leaves the house and returns in a few hours to once again examine the mother and child, as well as answer the questions of the parents. The midwife visits the family on the first days after birth and continues to monitor her mother's condition for a month. In the postpartum period, it is recommended to minimize the visits of friends and relatives to give the mother and child time to rest and regain strength. Now we know that the birth of a child outside the maternity hospital can be carried out in safety.