How to prepare the cervix for childbirth, the degree of maturity
Pregnancy is a complex process, where all changes at any stage are regulated by the hormones. The whole pregnancy the uterus provides reliable retention of the fetus, the cervix is tightly closed. The closer to the due date, the more changes the hormonal balance, the womb is prepared for the opposite mission — to help the fetus to leave her. How to prepare the cervix for childbirth, what will it take, and whether to intervene into the natural mechanisms?
The physiology of the process
The cervix is almost 40 weeks is stressed, her muscles firmly hold the throat shut. But the closer the time of childbirth, the more important becomes its maturation, that is, the ability to relax in order to miss out a ripe fruit. From tightly closed muscular SAC, the uterus must be transformed into open, flexible generic path, wide enough for unimpeded passage of the baby’s head.
In the third trimester of a complex ensemble of hormones works on the softening of the throat, increasing tissue elasticity. The main role in the process is increasing the amount of estrogen that triggers the production of other catalysts of labor. The concentration of progesterone in this case gradually decreases. All the changes happen by themselves and usually do not require intervention.
After 37 weeks, the doctor at every vaginal examination assesses the maturity of the cervix. This does not mean that the uterus is already have to be ready to leave. Often the process of maturation takes place rapidly, taking only a few days. The rapid maturation of the cervix is characteristic of re-birth.
The degree of maturity of the cervix expressed in points and is determined by several criteria: neck length, degree of softness, the permeability (opening), the location relative to the center of the pelvis. For each indicator, count the points.
Assessment of the degree of maturity of the cervix according to the Bishop:
|Sign||0 points||1 point||2 points|
|Consistency||Dense||Softened at the periphery||Soft|
|Length||More than 2 cm||1 – 2 cm||Less than 1 cm|
|The opening of the cervical canal||The outer jaws closed or skips the tip of your finger||The outer jaws have conceded one finger||The outer jaws have conceded two fingers|
|Position||Posteriorly||Posteriorly or slightly anteriorly||Axis of the pelvis|
In sum, they constitute a number that determines the readiness (maturity) of the uterus:
- from 0 to 2 immature;
- 3 to 4 is not Mature enough;
- from 5 to 8 Mature.
Figure 6 points means that the cervix has shortened to 2 cm, cervical canal is expanded the at least one finger, the throat is located precisely in the center of the vagina (without deviation to the pubis or the spine), the tissues relaxed and loose. This evaluation shows that labor may begin soon.
If the period of 38 — 40 weeks, the cervix is not relieved, begins to open, there is a risk of early labor when not ready “rigid” the cervix. This condition threatens tissue for the mother, hypoxia to the fetus and is a frequent indication for cesarean section. For the timely preparation of the cervix for childbirth there are medical methods and procedures.
Most often, the body itself incorporates the right processes at the right time. The question about the need for drug stimulation of maturation of the uterus is in such cases:
- Overcarrying pregnancy (>41 weeks).
- Of fetal developmental disorders of the fetus.
- Signs of hypoxia of the fetus (CTG).
- Rhesus conflict or preeclampsia, if you see natural childbirth.
- Indications for urgent delivery of the diagnosis to the mother.
The immature cervix is preparing for childbirth in advance, begin procedure for 1 — 2 weeks (indication — for the month) before the expected birth. Can be given medication in the form of capsules, tablets, suppositories, intravenous injection.
Most often used:
- Mifepristone blocks the action of progesterone, is considered the most safe is the way to prepare the cervix for childbirth in a short period of time.
- Gels with prostaglandins (by introduction into the cervical canal) is effective in ripening the cervix.
- Kelp in the form of a thin sticks inserted in the cervical canal for it the extension applies if you have a large stock of time and immature cervix.
- Mechanical opening finger method or using a Foley catheter (a painful, albeit effective techniques in case of impossibility of drug exposure).
Spasmolytics, and beta-blockers have proven ineffective compared to the above methods, is rarely used in modern obstetric practice.
It is interesting to know! The amount of produced estrogen depends on the fruit. When it is sufficiently Mature placenta begins to produce active estrogens, preparing the body for childbirth. Introduction of estrogen from the outside does not affect the maturation of the uterus and is blocked by the body of the mother, because in recent years not applicable.
- Regular walking: regular walking and climbing stairs. The gradual pressure of the baby’s head at the immature cervix causes the release of the hormone oxytocin is responsible for labor, which helps maturation.
- Physical activity should not be restricted. Housework, special exercise, swimming strengthens the body, preparing muscles for generic loads (without fanaticism!).
- The stimulation of the nipples triggers the production of oxytocin. Held for 5 minutes three times a day.
- Sex without protection mechanically stimulates the vagina and delivers to the cervix with the sperm prostaglandins, softening the muscles. Regular sexual life is useful in the absence of contraindications.
Even just changing the diet can significantly help the body. In weeks of the completion of pregnancy, should abstain from meat, daily eat fatty fish, use vegetable oil, vitamin cocktails, juices from fresh fruits. As a source of fatty acids that promote the production of prostaglandins, the physician, pharmacy taking capsules with evening primrose oil.
Attention! Any vaginal irrigation and enemas is permitted only in consultation with a gynecologist. Enema can cause contractions and trigger labor.
Help ripening the cervix decoctions and infusions of certain plants. A decoction of raspberry leaf drink half a Cup before meals daily. Infused over night in boiling water rosehips filter and take on an empty stomach in the morning as a tea for 200 ml of Cooking compote of strawberries with leaves. Such methods typically do not cause side effects, are soft, have a beneficial effect on the entire body.
Pharmacy alcohol tinctures (e.g., hawthorn) is allowed to take only on the advice of the attending physician. In the normal course of pregnancy, when the uterus is prepared independently and within a period of excessive stimulation.
Exercises and breathing techniques
Special courses for expectant mothers is therapeutic gymnastics, all the necessary exercises are studied under medical supervision. At home you can safely apply the following exercises to strengthen and increase elasticity of the muscles involved in childbirth:
- squats, squat (make sure to keep your heels do not lift off the floor);
- lifting the legs to the sides, to strengthen and stretch muscles, is standing with an emphasis on the back of a chair;
- pulling bent legs (alternately) to the stomach from a standing position, using his hands;
- Kegel exercises (which support in muscle tone of the perineum and pelvic floor) are recommended to perform during the period of pregnancy, they are also useful after childbirth;
- the preferred posture for sitting with crossed legs (Lotus position or “Turkish”, position “butterfly”).
Squats are allowed to perform only at the normal height of the uterus or a high position of the fetus, it helps the head in the correct position in the pelvis. If there are no contraindications, it is good to train the muscles following exercise: wide legs apart, arms extended in front of him, possibly deeply to sit down and transfer the weight from right foot to left and back. Perform at a slow pace, as many times as comfortable.
For preparation natural childbirth one of the most important factors is the mental attitude. To avoid fear, panic, and then muscle spasms in the prenatal period and in childbirth, helps breathing exercise.
For complete relaxation of the muscles, the smooth opening of the uterus showed a slow abdominal breathing: inhaling through the nose with protrusion of the stomach through the mouth (through the mouth, folded tube), muscles of the pelvis and press to tighten. The ratio of inhalation and exhalation duration of 1:2. Relaxing breath it is advisable to train beforehand, in gymnastics, to make it easier to hold then in childbirth.
Peace of mind and confidence that all processes are normally very important for women in the final stages of pregnancy. Simple methods of psychological and physical training help to increase the readiness of the cervix to natural childbirth to avoid tearing and injury, and medical supervision at all stages ensures the timely assistance when needed.