What Is an Abdominal Delivery?

Childbirth, especially the period and process during which the fetus is separated from the mother and becomes an independent individual. The whole process of childbirth is divided into 3 stages, also known as 3 labor stages. The first stage of labor, the period of Miyaguchi expansion. The second stage of labor, which is when the fetus is born. In the third stage, the placenta is delivered.

Basic Information

English name

delivery

Visiting department

Obstetrics and Gynecology

Common symptoms

pain

Contagious

no

Delivery process

Childbirth is usually divided into three consecutive processes.

First stage of labor

Also known as the Miyaguchi expansion period. It is from the beginning of the regular uterine contraction that appears intermittent for 5 to 6 minutes, until the cervical mouth is fully expanded up to 10 cm. This process takes 11 to 12 hours for a primiparous woman and 6 to 8 hours for a pregnant woman.

Cooperation in the first stage of labor:

(1) Eliminate fear and keep calm and optimistic;

(2) Eat on time and supplement enough nutrition;

(3) Urinate on time, every 2 to 4 hours, to make the bladder empty, so as not to prevent the fetal head from falling;

(4) If the fetal membrane is not broken, you can walk in the delivery room with the consent of the doctor;

(5) Some auxiliary pain-reducing actions can also be done during contractions.

2. The second stage of labor

Also known as fetal delivery. It is from the full expansion of the cervix to the delivery of the fetus. It takes 1 to 2 hours for a primipara, which can usually be completed in a few minutes, but it can also take up to 1 hour.

The peak of childbirth is coming and the baby is about to be born. The fetal head moves close to the vaginal opening, and the vulva and anus appear to bulge as the fetal head presses against the pelvic floor. You will soon see the fetal head, which moves forward with each contraction. When the contraction disappears, it may slide back slightly.

When the top of the fetal head is visible, the midwife often tells the pregnant woman not to use too much force, because if the fetal head is delivered too quickly, the skin of the perineum of the pregnant woman may tear, so the pregnant woman should relax and breathe for a few seconds. If there is a danger of severe laceration, or if the fetus is in danger, the pregnant woman will undergo a perineal incision. When the fetal head expands the vaginal opening, the pregnant woman will have a tingling sensation, followed by a numbness, which is caused by the blockage of nerve conduction when the vaginal tissue expands very thin.

When the head is delivered, the baby's face is facing down. The midwife may want to check the umbilical cord to make sure the baby's neck is not entangled with the umbilical cord (the umbilical cord often covers the head when the fetal head is delivered). The baby's head is then turned to one side so that the head and shoulders remain on a line. The midwife cleans the baby's nose and mouth, and if necessary, sucks fluid from the baby's airways.

During the next two contractions, the baby's body slides out of the mother's body. At this time, the baby is still connected to the umbilical cord, and the midwife will cut the umbilical cord. In addition, the midwife cleans the baby's airways again and gives oxygen if necessary.

3. The third stage of labor

Also known as placenta delivery. It takes 5 to 15 minutes from the delivery of the fetus to the delivery of the placenta, and it should not exceed 30 minutes.

After the fetus is born, there will still be contractions to promote the birth of the placenta, but at this time the contractions are relatively painless. Later, the doctor will clean up the pregnant woman, if there is a crack in the vulva, local suture will be performed.

Delivery method

1. Natural vaginal delivery

Natural vaginal delivery refers to a mode of delivery in which the fetus is delivered vaginally under normal premise that the fetus develops normally, the pelvic development of the pregnant woman is normal, and that the pregnant woman is in good physical condition and at the same time has safety protection. Pregnant women should understand the whole process of giving birth when deciding on natural delivery. Natural vaginal delivery is the most ideal method of delivery. It does not cause much damage to the mother and the fetus, and it recovers faster after delivery, with fewer complications. You can get out of bed on the day of delivery. And for the baby, the lung function is exercised when it comes out of the birth canal, and the nerve endings of the skin are massaged after stimulation. The nerve and sensory system develops better and it has stronger resistance. The baby is also squeezed when the head passes through the birth canal. Facilitates the establishment of normal breathing quickly after birth.

(1) advantages and disadvantages of natural delivery

1) Advantages The fetus is naturally squeezed through the birth canal, which can drain the amniotic fluid accumulated in the interstitial space of the lungs, and prevent the newborn from suffering from "wet lungs". can reduce the complications of maternal surgery, but also reduce trauma. The baby's ability to coordinate physical actions is better than that of other children. It can improve the communication and cooperation between mother and child, and enhance the happiness and responsibility of women as mothers. It is also conducive to the elimination of postpartum lochia, the recovery of the uterus, the rapid postpartum recovery, and it will not affect the future fertility at all, in addition, the milk is also faster.

2) Disadvantages There is some damage to the vagina. Contraction pain is more serious. If you have difficulty giving birth, you may need to switch to caesarean section, which will cause double injuries.

(2) Conditions for natural delivery

First of all, the maternal age is between 25 and 29 years old. The higher the age, the higher the chance of complications such as hypertension, diabetes, and heart disease, so the chance of cesarean section also increases.

The second is whether the maternal nutrition is reasonable and the weight is acceptable. The optimal pregnancy weight is: increase 2 kg in the first trimester (within 3 months), the second trimester (3 to 6 months) and the third trimester (pregnancy 7 ). 9 months) 5 kg each. That is, a total increase of about 12 kg is appropriate. If the entire pregnancy increases by more than 20 kg. It is possible to make the baby grow too large, and then it is not appropriate to choose to give birth.

In addition, it depends on whether the mother has the ability to give birth. Generally, the delivery process is about 14 hours and requires sufficient physical strength to complete. Systematic exercise will greatly help to ensure the physical strength during delivery. Finally, it depends on whether the mother is mentally prepared to withstand the pain of childbirth. Not having enough mental preparation is not conducive to maternity.

2. Cesarean delivery

Often referred to as a caesarean section, which involves dissecting the abdominal wall and uterus and removing the fetus. It is a pregnant woman with a narrow pelvis, abnormal placenta, abnormal birth canal or premature rupture of water, and abnormal fetus. It is necessary to end the delivery as often as possible. If the case is selected properly, timely operation can save the life of the mother and child. Caesarean section can save the mother from suffering from pain. If there are other diseases in the abdominal cavity, it can also be treated together, but the caesarean section will cause greater damage to the mother, and the postpartum recovery will be slower, and there may be sequelae.

Nursing after cesarean section:

(1) You should turn around more after surgery

Anesthetics can inhibit bowel movements and cause varying degrees of flatulence, which can lead to bloating. Therefore, it is advisable to do more post-partum movements after birth to promote the early recovery of paralyzed intestinal muscle peristalsis, so that the gas in the intestine is expelled as soon as possible. After 12 hours, you can drink some senna water to help reduce abdominal distension.

(2) Pay attention to doing fitness exercises

About 10 days after the cesarean section, if the body recovers well, you can start to exercise. The method is: lying on your back, with your legs raised alternately, first perpendicular to the body, then slowly lowering your legs 5 times each; supine, with your arms naturally placed on the sides of your body, lift your right leg with flexion, and make your thighs Try your best to get close to the abdomen, heels as close as possible to your hips, alternate left and right legs, 5 times each; supine, knees flexed, arms folded across the chest, then sit back into a semi-seat position, and then return to the supine position; supine, knees Flex, lift both arms straight, do sit-ups; in the prone position, with your legs bent towards your chest, your thighs perpendicular to the bed and your hips raised, your chest and your bed tight, do it once each morning and evening. 2-3 minutes gradually extended to 10 minutes.

(3) The semi-recumbent position should be adopted in bed

The maternal recovery is slower after caesarean section, and cannot be the same as those of natural vaginal delivery, and you can get up after 24 hours. Therefore, the caesarean section is prone to the difficulty of discharging the lochia, but if the patient is taken in a semi-recumbent position with multiple turns, the lochia will be promoted to prevent the lochia from accumulating in the uterine cavity, causing infection and affecting the uterine reset. Heal.

(4) Try to get out of bed early

As long as physical strength permits, you should get out of bed as soon as possible after delivery and gradually increase the amount of activity. In this way, not only the function of intestinal peristalsis can be increased, and uterine reduction can be promoted, but also intestinal adhesions and thrombophlebitis can be avoided.

(5) Pay attention to urination after delivery

For convenience, a urinary catheter is usually placed before the cesarean section. 24 to 48 hours after surgery, the effects of anesthetics disappeared, and the bladder muscles resumed urination. At this time, the catheter can be pulled out. As long as there is a urge to urinate, try to urinate by yourself and reduce the retention time of the catheter. And cause the danger of urinary tract bacterial infection.

(6) Keep the genital and abdominal incisions clean

Within 2 weeks after surgery, avoid getting wet in the abdominal incision. Clean the whole body with a rubbing bath. You can take a shower afterwards, but you must not take a bath until the lochia is drained. Rinse the vulva 1 or 2 times a day, taking care not to allow dirty water. Enter the vagina; if the wound is red, swollen, hot, or painful, do not squeeze and apply it yourself. Seek medical treatment in time to prevent the wound infection from continuing.

(7) Do not eat flatulent food

Gastrointestinal function can be restored about 24 hours after caesarean section. After the gastrointestinal function is restored, liquid foods such as egg soup and rice soup are given for one day, and flatulence foods such as milk, soy milk, and a large amount of sucrose are avoided. After the intestinal gas is ventilated, use semi-liquid foods such as gruel, soup noodles, and ravioli for 1 to 2 days, and then switch to a normal diet.

(8) Use less pain medication

After cesarean section, the effect of anesthesia gradually disappeared, and the pain of abdominal wounds began to recover. Generally, within a few hours after surgery, the wounds began to have severe pain. In order to get a good rest and make the body recover as quickly as possible, you can ask the doctor to give some painkillers on the day or night of the operation. After this, it is best not to use too much medicine to relieve pain, so as not to affect the recovery of intestinal motility. Generally speaking, the pain of the wound disappears after 3 days.

(9) Sexual intercourse is absolutely forbidden during puerperium

6 weeks after the cesarean section, if the vagina no longer bleeds, the doctor will check that the wound is healing well and can resume sexual life. However, you must take strict contraceptive measures to avoid pregnancy. Otherwise, scarred uterus may be perforated or even ruptured during curettage.

Medical care during childbirth

Enema

Paramedics inject certain fluids into pregnant women's intestines to empty stools and stimulate contractions.

Procedure: The enema is performed by the medical staff. It will be a little uncomfortable and can be adjusted with easy breathing. After the injection is completed, wait 10 to 20 minutes in the bathroom to dissolve. This action sometimes requires the help of family members.

2. Prepare the skin

Shaving the body hair of the genitals is convenient for medical personnel to deliver, and can prevent bacterial infections, making the perineal incision wound easy to care for and recover. It should be noted that small wounds are easily caused during skin preparation, and care needs to be taken to prevent bacterial infection.

3. Artificial water breaking

If there is no natural water break before the pelvis, the medical staff will do artificial water break before or during childbirth. This process does not make the mother feel pain.

4. Fetal Heart Sound Monitoring

A fetal heart rate detector is usually used during labor until the end of labor. This device provides continuous recording of uterine contraction pressure, frequency, and fetal baby's heartbeat, and graphs the contractions and heartbeat.

Medical staff need to use this continuous record to learn about the heartbeat of the baby during the entire delivery process, especially during contractions.

5. Intravenous injection

Intravenous injections are usually performed before entering the delivery room. Instill some glucose or saline to replenish energy and moisture. This can keep the mother and baby in good condition. In addition, injections can prevent maternal dehydration and provide body heat, as well as facilitate the intravenous administration of drugs related to pain relief and contractions.

Childbirth

Pain caused by uterine contractions will continue throughout the delivery process. Contraction pain is mainly in the lower abdomen, and sometimes also occurs on the two medial or above the spine. Most women experience uterine contractions that are similar to menstrual cramps, but more intense. When the fetus is about to die, the mother will also feel burning and intense pain in these areas due to the expansion of the perineum and vulva. Finding a comfortable position and taking a deep breath in a relaxed state can relieve childbirth pain.

Be fully prepared for the pain of childbirth. Childbirth is a natural physiological phenomenon, and childbirth pain is physiological pain that most people can tolerate. However, it is necessary to experience a period of severe pain during delivery. Without adequate mental preparation, pregnant women will be beaten by unexpected pain.

During childbirth, yelling will prolong the labor process. Being physically and mentally prepared can help with pain.

You should have a positive attitude towards pain during childbirth. You do not need to be afraid or anxious. You can use self-suggestion and self-consolation. In addition, before becoming pregnant, familiarize yourself with the environment of the delivery hospital, and talk with your doctor to determine the best delivery method for you, and let the doctor guide the preparations for delivery, such as breathing exercises.

You can also ask your doctor about painless labor, drug-induced analgesia, and other labor-saving methods of delivery. You can also choose a guided delivery, or choose a family ward, husband's birth or sitting delivery.