This fear is especially strong in primiparas - because of the unknown. They know only what is expected of them, and theory and practice often do not coincide. Of course, in each of the women the births take place individually, in their own way. But in fact it is informed - means, it is armed. Therefore, to know as much as possible "before" can be (and, as a rule, it does) is not just useful, but decisive.
Here, for example, the ruptures in childbirth, which are so afraid and feared by all women in labor, in many cases can be avoided. Much depends on your behavior at the time of delivery and preparation for them during the gestation period.
Causes of ruptures during childbirth
There are a number of factors that contribute to this. But first things first.
You can read about the anatomical structure of the muscles of the pelvis and perineum - this is actually very interesting, because this complex of muscles is extremely important for any person, what to say about a woman, and these muscles have a unique structure, genius thought out by nature.
During pregnancy, the elasticity, shape and even the location of many abdominal and vaginal muscles vary slightly. The organism prepares to pass the child by generic ways, providing easier its promotion, as soon as it can. Among other things, the muscles involved in this process are slightly weakened and seem to part ways, freeing the way to the fetus.
However, in order to control the passage of the child by generic ways and help to correct the course of this process, first, a woman should be able to control her muscles, and, secondly, the muscles themselves should be ready for such work, that is, be as flexible as possible. The latter property is in many cases genetically laid: a good ability to stretch and return to the former state of the muscle is acquired hereditarily. True, it can also be trained - by diligent training and performing specifically designed for this exercise. Then your chances of "seamless" birth will increase significantly. But in any case, under certain circumstances, ruptures still occur, because any muscles have a tension limit.
- So, in addition to good or vice versa elasticity, the likelihood of gaps in delivery depends on many other factors:
- Inflammations and infections of the urinary and genital tract, as well as chronic female sores: colpitis, vulvovaginitis, thrush, and other diseases increase the risk of rupture in labor because they reduce the healthy elasticity of tissues.
- Misrepresentations of the woman in childbirth: you must know how and when to breathe and act in general. Listen carefully to the instructions of the midwife and calmly follow them. Premature attempts are often the cause of gaps: in labor there comes a time, which must be "breathed in", not allowing straining.
- Rapid birth: ideally the child should go out smoothly and slowly: it is better not only for him, but for the mother, including to prevent breaks. But it happens that the birth takes place very quickly. In this case, they are artificially slowed down, and also give strict instructions to the mother in relation to the behavior, especially breathing and relaxing at this time. If the stage of labor is not controlled, then strong gaps are possible.
- Swelling of the perineum during labor: if the labor activity is lethargic or the contractions are too long in time, the perineum can swell, which leads to ruptures.
- Wrong actions of the medical staff: if the midwife makes an error in removing the head and shoulders of the child from the vagina, then among other things, it can also cause a rupture.
- Scars from the seams: if there are stitches from previous births or any other operations, it is almost certain that a break will occur in the same place.
- "Sports crotch": many professional athletes muscles are heavily pumped, including muscles of the pelvis and the perineum. This makes it difficult for them to stretch, which leads to ruptures.
- Late childbirth: if a woman first gives birth after 35 years of age, the risk of ruptures in childbirth increases. Anatomical features of the parturient: in particular, the so-called "high perineum", when the distance between the anus and the entrance to the vagina is 7-9 cm.
A rupture or incision : what's better?
Usually, doctors try not to allow ruptures, because the ragged edges of the tissues are difficult to perfectly match for the connection. This can be the cause of suppuration in the sutures, weak attachment, in the future, various complications may develop, including prolapse of the uterus and so on. Therefore, when a critical moment comes and the doctor sees, that without breaks obviously will not manage (and on it to it many signs specify), he does an incision. In this case, many undesirable consequences can be avoided, and such wounds heal faster and better: it is possible to combine the equal edges of the cut tissues much more accurately and qualitatively. In any case, after completion of labor, the doctor carefully examines the birth canal for any breaks and incisions (if any), assesses the degree of their severity and layer-by-layer stitching: silk threads, which in 4-7 days will be necessary remove, or ketgutovye or vikrilovye samorassasyvayuschiesya seams, not requiring further doctoral involvement. Depending on the degree of damage, anesthesia (local and internal) may be used or not (for example, in case of rupture of the cervix, since there are no nerve endings here).
It should be noted that the ruptures are internal (inside the vagina) and external (at the exit from it), and that in addition to ruptures of the perineum, cervical ruptures occur during labor and ruptures of the uterus. The latter are much more serious complications, which are accompanied by severe bleeding and may have a fatal outcome. But when performing obstetric instructions, usually the risks can be avoided.
How to prevent gaps in childbirth?
This should be taken care of long before delivery. It can not be said that gaps can be completely avoided, but the risks of their occurrence can be greatly reduced - absolutely! The most important, probably, factor is your awareness of normal childbirth and the readiness to calmly and obediently follow the instructions of a midwife. Learn to breathe properly and relax in advance. Only in this way will you help yourself and the baby survive this natural but difficult process with minimal damage and prevent artificial interference in it.
It is very useful to exercise the gymnastics of the vaginal muscles, the meaning of which is in their alternating tension and relaxation. Known Kegel exercises in general are useful for every woman and are able not only to perfectly prepare the muscles and pelvis for childbirth, but also significantly improve the sex life.
It is very convenient that you can strengthen the crotch this way anytime, anywhere. However, in some cases during pregnancy such exercises can be contraindicated: for example, with the existing threat of miscarriage. So, first of all, you should consult with your gynecologist about a possible method of preparation for childbirth and prevention of ruptures.
As among the risks - infectious and inflammatory diseases of the urinary and genital tract, at the 36th week the relevant tests for reinsurance are submitted. If something is found, you will have to treat and take the tests again. But do not worry about it: the doctor will prescribe drugs that are safe for this period.
A special massage of the vagina aimed at strengthening its walls, increasing elasticity and acquiring skills to relax the muscles of the pelvic floor in conditions of pressure produced on them, is also used for preventive purposes, which is what happens during childbirth. However, it should be noted that performing such a massage, you must strictly adhere to the technique and create the conditions of absolute sterility, which is almost impossible. Therefore, many doctors oppose such practice.
If you can not get away from the breaks, you will have to take care of the seams and adhere to some rules of behavior until they heal. The rehabilitation period includes the disinfection of the joints (hydrogen peroxide and zelenok or manganese), which is carried out once a day, as well as their frequent ablution - after each visit to the toilet. It is very important to wash properly in this period - only in the direction from the pubis to the anus. And carefully dry the seams. It is better to lie down for a while without washing, so that everything will dry up on its own. And do not forget, that the gaskets should be changed as often as possible (at least every two hours), so that the wound remains dry.
The first 2-3 days is very undesirable to go to the toilet on a large (there is a risk of divergence of sutures), in connection with which you need to adhere to a diet, in particular, to exclude from the diet fiber. If you feel the urge to defecate - ask the on-duty midwife to give you a glycerine rectal candle to soften the stool.
In addition, about a month (for everyone in different ways, maybe ten days), the "sewn" puerpera can not sit down (unless it's just a little sit on one buttock), so the child will have to feed only while lying down or standing.
The risk of contracting or developing complications after delivery with tears and incisions remains high for a long time. In addition to the fact that you must strictly adhere to hygiene and follow the rules mentioned above, watch for well-being and the state of the seams. At the slightest signs of edema, suppuration or similar phenomena, as well as with increasing pain, increasing twitching and discomfort in the area of ??the seams, the gynecologist should immediately appear.
And in general, you should understand that childbirth is a natural process. All pregnant women go through it, and you will succeed. You just need to prepare a little and do not panic at all.