CHILDBIRTH' BEHAVIOR OF THE WOMAN IN LABOR'

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LECTURE ? 8

• CHILDBIRTH. BEHAVIOR OF THE WOMAN IN LABOR.
• Dr. Nagayeva S.

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FOREWORD

• 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.

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WHAT YOU MUST TO DO, WHEN CONTRCTIONS HAS BEGUN

• 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
  long-awaited 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.

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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.

• 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

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• 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" .

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PROCEDURES USED MOSTLY OFTEN IN THE MATERNITY
WARD.

• 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.
• 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.

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STAGE OF PUSHING

• 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 babys body. It is smaller than a
  head ,therefore it can't make a problem. So take
  a full breath and strain.

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MIRACLE!

• 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.

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LABOR HASN'T ENDED YET!

• 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.
• Your baby is examined by neonatolog (the expert
  on newborn babys) 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.

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THE FINAL STAGE

• 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.

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FIRST FEEDING

• 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.

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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!