Massage to ease contractions. Pain relief during labor. General massage rules

So the period of pregnancy is coming to an end, the woman is waiting for when, finally, she will see her child. Contractions and the period of childbirth is the most important stage for which the expectant mother must definitely prepare and come up fully armed. Understanding the physiology of the processes occurring in the uterus and other organs of the reproductive system helps many to go through this stage with minimal discomfort.

Labor pain is painful, but it can be significantly reduced by following a few simple rules. The technique of massage, the ability to relax and rest during periods of calm, change of posture and other techniques will greatly facilitate your well-being. But first, about what signs of contractions before childbirth a pregnant woman can feel.

Signs of true contractions

Contractions can be divided into and true. Training contractions of the uterus occur almost from the very beginning of pregnancy, but are felt only from the 20th week. With skillful action, their intensity can be reduced (relaxation techniques, massage, warm bath, changing the type of activity or posture). They do not differ in a clearly traceable frequency, they can disturb several times a day or week. The interval between spasms is not reduced.

True contractions are more pronounced, accompanied by painful sensations. A woman cannot influence their intensity and duration (no technique leads to relaxation of the muscles of the uterus). An important feature of labor contractions is their frequency.

The first signs of contractions before childbirth may resemble a pulling sensation in the lumbar region, passing to the lower abdomen, over time the pain intensifies. The attacks of contractions become longer and more frequent. The interval between contractions at the first stage can be up to 15 minutes, later it is reduced to several minutes. In general, several signs can be distinguished that determine the onset of true uterine contractions, signaling the onset of labor:

1. Contractions appear at regular intervals.
2. Over time, the interval between attacks decreases.
3. The duration of the contraction increases.
4. Pain syndrome intensifies.

On examination, the obstetrician determines the gradual dilatation of the cervix, in parallel, drainage of water can be observed.

Behavior during labor

The onset of labor is, of course, a very exciting period for a pregnant woman, but it is necessary to concentrate as much as possible and record every contraction of the uterus, the duration of the contraction and the length of the relaxation period. Between contractions, you need to try to relax, breathe deeply in order to supply the muscles with oxygen as much as possible.

You should not immediately call an ambulance and go to the hospital - contractions can last up to 13-15 hours and it is better to spend part of this time at home with loved ones, and not in a hospital ward. Households can support and tune in to the positive, the husband can lend his shoulder and help in finding the most comfortable position.

Comfortable postures for waiting out the period of contractions

At home, you can look for a comfortable body position that will make it easy to wait out the period of contraction of the muscles of the uterus. Here are the most comfortable positions for this period:

1. Vertical position. You can rest your hands on a wall, headboard, chair and maintain an upright body position during the period of the contraction.
2. Sitting on a chair. You need to put a pillow under your buttocks and sit on a chair facing the back. During the period of the fight, cross your arms on the back of the chair, and lower your head on your hands. Can be used only in the initial period, when the child is still high enough.
3. Reliance on her husband. The pregnant woman can put her hands on the shoulders of her husband (both partners are standing), during the fight, the woman bends forward, bends her back in an arc. The husband massages the lower back and shoulders.
4. On your knees and elbows. Get on all fours and relax all muscles.
5. On a fitball or toilet. Pregnant women are not recommended to sit during labor, the baby gradually moves along the birth canal and a hard surface can make this process difficult. Therefore, a fitball (a sports ball on which you can sit) is an indispensable item during contractions). In its absence, you can sit on the toilet.
6. Lying on your side. It is often easier for a woman to endure contractions when she is in a prone position. In this case, it is better to lie on your side with pillows under your hips and head.

Other techniques to wait out the fight

The question of how to facilitate childbirth and contractions worries every woman. There are several techniques to achieve the desired effect.

Walking

No need to lie down during breaks. For labor, it is more useful if the expectant mother is on the move (no need to overdo it - walking at a moderate pace will be quite enough). While walking, the child with his weight will slightly press on the muscles of the cervix, and stimulate its opening. In order not to interfere with the baby, it is better to keep your back as straight as possible (not to hunch over). Heels can help with this, find the highest possible (contractions and childbirth are the only period of pregnancy when they can and even need to be worn). It is noted that women who are on the move during the period of labor give birth faster and easier.

Concentrating on a third-party subject

During the contractions, catch your gaze on an object at eye level (vase, painting, or any other). Distraction can provide relief from labor pains. You can sing (even if there is absolutely no hearing and voice).

The ratio of the contraction and the processes occurring in the body, methods of independent psychological training

Experience each contraction separately, try not to think that the next one is coming soon. Match the pain with a positive memory. You can imagine that this is a wave that rolls onto the shore and then disappears. Relate the contraction to the bud of the flower, which blooms more and more with each attack, and in the center of it is the long-awaited baby. Some women are helped by awareness of the processes that occur at this time in the body. Think that this pain is not an injury, but just the body's reaction to the opening of the cervix and the tension of the uterus itself. Think about the child, the more it hurts you, the easier it is for him to be born.

Massage

Try self-massage techniques:

1. Press during the period of muscle tension on the point that is located in the most protruding zone of the pelvic bones. The pressure should be strong enough to cause discomfort and slight pain.
2. Stroke the side of your abdomen with your palms. You can do this both from bottom to top and from top to bottom.
3. You can do circular stroking of the center of the abdomen with your hands, this will also reduce pain.
4. Rub your lower back with your fists (knuckles). Movements should be vertical, and the arms should be approximately at the level of the sacral dimples.

Impact on biologically active points

Try distraction and other areas of the body to relieve pain. Some people may not see the connection between the points of action and the muscles that contract during contractions, but it has been practically proven that such a connection exists.

1. Work on the skin of the forehead - carry out smoothing movements from its center to the area of ​​\ u200b \ u200bthe temples. The pressure should not be strong.
2. Use your fingers to smooth light movements from the wings of the nose to the temples, this will also allow you to relax.
3. Use a patting motion in the lower part of your face in the chin area.
4. Work on the point between your index finger and thumb on either hand. The movements should be pulsating. If it is correctly identified, you will feel pain in response to pressure.

Breathing exercises

Breathing differs depending on the phase of the contractions. There are 3 stages in total:

1. Initial, it is also called latent or hidden.
2. Active.
3. Transient.

After passing through all the phases, the period of fetal expulsion immediately begins. Breathing during labor and childbirth has its own differences. Consider each stage of labor, labor, and breathing during these periods.

Breathing during the initial and active phase of contractions

The duration of the initial phase can last from 7 to 8 hours, during this period, uterine contractions occur regularly every 5 minutes, the contraction itself lasts from half a minute to 45 seconds. Neck opening is observed up to 3 cm.

Further, there is an increase in the frequency of attacks and the active phase begins. It lasts up to 5-7 hours. The intervals between attacks of pain are reduced to 2 minutes, and their duration reaches 60 seconds. The neck continues to open, and the size of the throat reaches 7 cm.

During these periods, a woman should alternate between periods of deep and shallow breathing.

When a contraction occurs, it is necessary to inhale and exhale through the mouth at an accelerated pace (like a dog); during a calm period, it is necessary to breathe deeply and evenly, making an entrance through the nose, and exhaling through the mouth.

Breathing in the transitional phase of contractions

Then comes a period of deceleration (transition phase). By its length, this period rarely lasts more than one and a half hours. Contractions last up to one and a half minutes, and the interval between attacks is from half a minute to a minute. During this time, the neck should open as much as possible (10 cm) in order to let the child pass. Often, a pregnant woman feels unwell, dizziness, chills, nausea. For a woman, this is the most difficult phase, attempts are already felt and they must be restrained until the obstetrician allows the pushing. Otherwise, swelling of the cervix and its numerous ruptures are possible.

Breathing during this period can help control the pushing. To do this, you need to breathe in the following sequence: first, two short breaths, and then a long exhalation.

Breathing during expulsion of the fetus

After the full disclosure of the uterus, the woman should help the baby and begin to push. Contractions during this period are replaced only by short periods of muscle relaxation, but in general they are less painful.

Breathing should oxygenate the muscles as much as possible. To do this, during the period of pushing, you need to take a deep breath, hold your breath and strongly strain all the abdominal muscles. If one breath is not enough, then the woman needs to exhale, take a deep breath 2 times, then hold her breath again and tighten all the muscles. When the fight is over, you need to breathe evenly and calmly.

After the birth of the child, the mother's work does not stop, there is another crucial stage ahead - the birth of the placenta. The process takes place in almost the same way as the birth of a child, only much faster and not as painful. The doctor can additionally inject oxytocin intravenously, which will allow the placenta to be delivered in just one attempt.

Do not be alarmed if, even after the birth of a child, a woman experiences uterine contractions - this is a normal process that stops bleeding and significantly reduces the size of the uterus.

With the correct psychological mood, the necessary knowledge about the birth process, some help from households and medical personnel, the sensations during contractions before childbirth and during the birth itself are transferred quite steadily. By combining breathing techniques and other relaxation techniques, pain can be reduced to discomfort. Many women describe their childbirth something like this: “I never got much pain”; "I thought it would be worse."

Modern medicine has a significant arsenal of medications that help reduce the pain of a woman in labor during labor. In our country, any woman has the right to pain relief during childbirth. Of course, there are situations when drug pain relief is simply necessary. However, it should be remembered that there are no drugs that are absolutely harmless to the mother and baby.

Any drug acts on the entire body as a whole, and, in addition to helping, causes the so-called side effects and sometimes complications. Therefore, any medical intervention during childbirth should be caused not by a whim, but by strict necessity. A similar need arises, for example, with various deviations from the physiological course of childbirth or with a pathologically low pain threshold of a woman in labor.

Labor pains are often identical to those sensations experienced by most women on "critical" days: the same nagging in the lower abdomen, the same aches in the lower back. As the contractions intensify, they intensify and painful sensations, however, the nature of the pain does not change.

At no point in labor is there any acute, unbearable pain. Feelings during a fight would be more correctly described as pulling, aching. In addition, each contraction develops in waves. With its onset, the woman in labor experiences minimal discomfort, as the contraction develops, the sensations gradually increase, and then also gradually decrease.

During the second stage of labor during labor instead of pain the woman in labor has a strong urge to push, caused by the pressure of the baby's head on the rectal wall. And at the moment when the baby is born, the tissues of the perineum are stretched so much that sensitivity in them completely disappears: that is, the mother does not experience pain at the time of the birth of the child.

And the main thing - there is no constant pain in childbirth! Both contractions and attempts alternate with intervals, during which the woman does not experience anything except, perhaps, the accumulated fatigue!

In order to feel good during normal, uncomplicated childbirth, the expectant mother should study self-pain relief techniques. These methods are easy to perform and do not require any special training. It's about massage.

Sacral zone massage

If we assume the possibility of rating the popularity of massage points used during contractions, then the first place would certainly belong to the sacrum area. This zone is located slightly below the lumbar region and is a projection of the eponymous - sacral - spine. It is in this section that the sacral nerve plexus is located - a powerful nerve node responsible for the innervation of the pelvic organs.

These organs include, among others, the uterus. By stimulating the sacrum area at the time of the contraction, we seem to block the transmission of the pain impulse. The impact on this area can be carried out in various ways, but in any case, the force of stimulation of the sacrum must be significant. These can be pressing movements performed with one or two hands, simultaneously or alternately.

The stimulation itself can be carried out with the fingertips, knuckles, the whole palm, the base of the fist. The area of ​​influence can be limited only to the region of the sacrum or spread much wider, depending on which option of exposure gives maximum relief to the woman in labor. To prevent irritation on the skin at the site of exposure, you can first apply a cream or massage oil to it.

Diversionary maneuver

This method is, in fact, the transfer of the source of pain. Remember how we three whiskey with a headache, creating an artificial source of discomfort and distracting from the real. In childbirth, we will assign the role of "imaginary patient" to two pretty bones, which are called the iliac bones. These are the very bones of the pelvis that, before pregnancy, protruded forward in the lower abdomen when you lay on your back.

They should be stimulated during the fight, simultaneously from both sides, using the same force and the same techniques as when rubbing the temporal region. You can also affect the entire area of ​​the lower abdomen. In this case, you should make simultaneous stroking movements with your palms on both sides, directing them from the bones to the pubis and back.

Iron

This is the name of the next version of anesthetic massage, which is most convenient to use while lying on your side. Place your palm on your inner thigh. During the contraction, press your palm against the skin of the thigh and drive it without interruption, like an iron, from groin to knee and back. Such an effect will both relieve and make you relax as much as possible.

The main thing is not to expect pain and do not be afraid of it. Remember that childbirth is a physiological process, and nature, which has prepared such a test for us, took care of help in it. Summarize:

• Sacral massage is the most effective method of pain relief.
• Stimulating the ilium is also an effective red herring.
• An inner thigh massage provides pain relief and relaxation.
• Relaxation and rest is essential between contractions.

The muscles of the abdominal wall and pelvic floor, being relaxed, do not resist, and each contraction of the uterus painlessly pushes the baby along the birth canal. If a woman is tense and afraid of childbirth, the circular muscles of the cervix contract sharply. The supply of oxygen to the uterus decreases, and the onset of spasm increases the painful sensations of the woman in labor. A new wave of painful sensations increases tension and lack of oxygen in the obstetric organs of the mother and the tissues of the fetus.

Breathing technique during childbirth

1. In the first stage of labor, the cervix dilates, which is accompanied by contractions. Contractions are not very painful at first, it is recommended to breathe using slow breathing. Such breathing promotes sufficient oxygen delivery to the tissues and organs of the small pelvis and adequate removal of carbon dioxide from them, relieves pain and tension characteristic of contractions.

Breathing technique: the breathing rate gradually slows down until the number of breaths reaches 9 per 1 min (at a normal breathing rate of 16-20 breaths per minute). Slow and deep inhalation and exhalation should be combined with active relaxation of the whole body. Inhale through the nose, exhale through the mouth. Both inhalation and exhalation are performed in three slow counts. In order to make it easier to maintain the rhythm of breathing, it is recommended to say the following phrases to yourself: "Breathe in for the child (take a breath), exhale for pain (exhale)" or "I am fine (inhale), I am all right (exhale ) ". Muscles should contract during exhalation. chest and the diaphragm (muscles located between the abdominal and chest cavities). Therefore, it is recommended to breathe throughout the contraction. Breathe deeply and calmly between contractions.

2. In the second stage of labor (during the expulsion of the fetus) it is necessary to use controlled breathing.

Exercise "breath holding". In two counts, a deep breath is taken, then, also in two counts, a strong exhalation is made. Repeat two times. After the third deep breath, you must hold your breath for 20 seconds, then completely exhale the air from your lungs. Gradually, you should try to increase the breath holding time to 30 s. After the preparation is completed, it is necessary to proceed with the actual exercise.

Aromatherapy also has a positive effect on the psyche of a woman in labor and has a pain-reducing effect. For this purpose, the essential oils of lemon, bergamot, rose, cinnamon, jasmine, geranium are suitable. Of course, you need to first check how well she tolerates them.

Before childbirth, this exercise is performed as follows.

Starting position. Stand on the floor with your feet shoulder-width apart, put your hands on your shoulders, inhale through your nose in two counts, raising your elbows to the side. Lower your elbows back to your body and exhale through your nose or mouth at the same time, also in two counts. Repeat 2 times. After the second repetition, immediately take a deep breath and hold your breath, while simultaneously describing circles in the air with your bent elbows. Then exhale the air completely, and then take a full calm breath through the nose. Repeat the exercise several times. With each repetition, try to hold your breath longer and longer. Then repeat the exercise several times with holding the breath after exhaling.

Dog Breathing Exercise. In this exercise, a person is like a dog resting after a run or during a heat wave. This type of breathing accelerates the movement of gases through the blood, tones up the entire body, makes it possible to escape from the thoughts of contractions, and increases the delivery of oxygen to the fetus. Technique: relax the muscles of the face, mouth, lower jaw. The mouth should be open during the exercise. Make a series of short, frequent breaths through the mouth. The use of this breathing method helps to restrain attempts during the second stage of labor, when the perineum is protected and the head is removed.

Exercise to synchronize heartbeat and breathing. Doing this breathing exercise recommended as one of best ways fight insomnia. Synchronized breathing provides calmness, balance and other positive emotions. In addition, it has all the beneficial effects of other breathing exercises.

You need to take a comfortable posture, relax, calm down, wait until the breathing takes on a normal calm rhythm. Concentrate on the heartbeat or vascular pulsation. If this fails, you can feel the heartbeat in the carotid artery (in the neck) or radial artery (in the wrist). Count the pulse and concentrate on it. Then start synchronizing breathing with the pulse, trying to inhale for two pulse beats, exhale for four. After breathing in this rhythm does not bring discomfort, begin to lengthen the inhalation and exhalation, adding one pulse beat for each of them, that is, inhalation should be carried out by 3 pulse beats, exhalation - by 5. Having mastered this rhythm, you can continue to lengthen the duration of inhalation and exhalation. Each person can choose the optimal, comfortable ratio of the duration of inhalation and exhalation.

Acupressure

During the fight, it is recommended to apply pressure (either increasing or decreasing) on ​​one of the listed points: at the elbow bend, between the index and thumb on both hands, on the outer edge of the little finger, between fingers III and IV on the palmar side of the hand, on the front and the posterior spines of the iliac crests (these are the bony protrusions in the pelvic part of the body). Also, pain reduction is achieved by rubbing the lumbosacral region, massage the neck area of ​​the body. Pressing on the points and rubbing them is carried out during the fight, in the intervals between the contractions, rest is necessary.

How to relieve pain

Strong, regular contractions - good sign the normal course of labor.

But if you feel that the pain has completely taken over you and you can no longer concentrate on the process of childbirth itself, then you need to ask the nursing staff to take appropriate measures that would reduce the pain.

There are many methods available to help a woman in labor cope more easily with pain during the opening phase. They are designed to take your thoughts away from painful sensations or help you overcome them. If this is not enough, then measures are taken to directly affect the perception of pain.

Pain relief naturally

There are women who know how to cope with labor pains and do not need special measures to relieve them. Concentration on their child, establishing contact with him (putting hands on his stomach, feeling the child under his fingers, consciously listening to his heart rate) and the joy of thinking that the baby will soon be born help these mothers to endure even the most intense contractions.

In order to experience childbirth as a great event and a very significant moment in their lives, most women resort to various methods of pain relief. Great importance at the same time he has an individual approach in choosing the appropriate means. Which method will be applied does not play a significant role. The main thing is that he helps the woman.

Relaxation

Since childbirth requires a lot of energy, you need to use your energy sparingly. Avoid unnecessary muscle work! The easiest way to achieve this is by relaxing after each contraction and deliberately removing all muscle tension.

During the contraction, it is important that the muscles do not cramp. Therefore, constantly change your position and at the same time try to determine which position is most convenient for you to relax.

You may find it easier to walk back and forth or sit on a gymnastic ball.

A warm bath helps many women to relax. But maybe you don't even want to hear about it and you will perfectly relax lying on your side in bed. There is no single correct position. Try for yourself what is right for you, listen to your inner voice.

If your pain is caused by tight muscles, applying a cherry pitted pad or heating pad to your lower back can provide relief. A hot bath is also beneficial. And sometimes just a warm foot bath helps. Also, bring a CD of music with you to the delivery room, which usually brings you to a calm, relaxed state.

Acupuncture

Although acupuncture does not provide complete pain relief, it can still break the cycle of fear, tension and pain. Because just those sensations that are perceived as unbearable, most often come from convulsive muscle contraction. That is, the more tense the muscles, the more painful the contractions become and the greater the fear of the woman in labor. In this situation, acupuncture acts in a regulating and harmonizing manner.

There are many points on the body that can be used for acupuncture during childbirth. One of them is the highest point on the head, located on an imaginary line from one ear to the other. The next important acupuncture point is located in the palm of your hand, right in the fossa between your thumb and forefinger.

If you have already had a positive experience with acupuncture, then most likely this method will provide you with good support during childbirth. If, on the contrary, you are skeptical about acupuncture, then now is hardly the right time to nevertheless change your attitude towards it and make sure of its effectiveness. Be sure to warn in advance about your fear of needles or your mistrust of this pain relief technique. Then your midwife will know that acupuncture will not do you any good.

Acupuncture has been sufficiently proven to be effective in the preparatory period.

Regular insertion of needles, starting from the 37th week of pregnancy, under certain conditions can lead to a decrease in the duration of the opening phase of the uterine pharynx (see page 300).

Percutaneous electroneurostimulation

This method consists in the fact that a device is fixed on the woman's back, which produces weak electrical impulses, they are felt as a slight tingling sensation. The impulses stimulate certain nerve pathways in the back. Through this stimulation, pain signals sent by the uterus and pelvic tissues to the brain are attenuated or even completely suppressed. When using this device, you can adjust the intensity of the pulses yourself.

Homeopathy

The successful use of homeopathic medicines requires good professional knowledge and a lot of experience from the doctor and midwife, since the choice of means and doses must exactly correspond to the individual condition of the woman in labor. Without special education in this area, it is very difficult to find the right medicine.

As an anticonvulsant, midwives often use a complex homeopathic medicine"Spaskuprel".

Since homeopathic medicines do not provide side effects, you should not be afraid of them, because no problems will arise even if the wrong tool is used.

Truth, positive influence of these medicinal substances for the course of childbirth is still not fully proven. However, homeopathy does help in individual cases, and this is already a sufficient argument in favor of trying it.

Try to breathe freely

You may not need to learn a special breathing technique for childbirth. It is only important that during painful contractions you try to maintain your natural breathing. Be careful not to hold the air while inhaling or to breathe too quickly. In this way, you will provide both your own body and your child's body with sufficient oxygen. It is best if you concentrate on breathing in and out calmly and deeply.

The CHENS device is fixed on the back and allows a woman to independently regulate pain sensations.

In order to be born a baby, you have to work hard. And the sensations that a woman experiences in childbirth can hardly be classified as pleasant.

Meanwhile, unnecessary tension and pain can be easily relieved with a fairly simple massage.

To understand at what stage of childbirth you can resort to one or another massage technique, you need to understand that the whole process consists of two stages: hidden and active. The first one is characterized by weak contractions, so it is better for a woman to just rest and tune in to the further process. The second is characterized by strong and regular contractions, so that various breathing techniques, postures and massage will come in handy.

FACT!

Experienced midwives do not advise using creams during massage: they are quite oily and, being absorbed into the skin, leave behind unpleasant and interfering pellets. Instead of cream, it is better to take oil with you.

5 main massage points

• Underbelly

It is this place in a woman in labor that may be the most vulnerable - there is an actively contracting uterus.

TYPE OF MASSAGE: stroking, rubbing.

HOW TO DO

Place both palms on your lower abdomen, where the pain is concentrated, and use your fingertips to stroke the skin from the center to the sides. Choose the pace yourself: some need only light touches, others - active rubbing. If such a massage will be done by your partner in childbirth, it is better for him to sit behind the expectant mother and, hugging her arms, perform stimulation.

• Sacrum, loin

This is perhaps the most popular massage area used during contractions. Just below the lower back, in the sacral spine, is the sacral nerve plexus - a very powerful nerve node responsible for the connection of the pelvic organs with the central nervous system. Stimulating the sacrum with massage movements at the time of the contraction, you can block the transmission of pain impulses to it.

TYPE OF MASSAGE: active rubbing, pressing.

HOW TO DO

The impact on this area can be carried out in various ways, but in any case, the force of stimulation of the sacrum should be significant, much stronger than the abdomen or neck. It can be rubbing or, in case of severe pain, active pressing movements produced by the fingertips, the entire palm, its rib or knuckles. The area of ​​influence can be limited only to the sacrum region or spread much wider, depending on which option provides maximum relief to the woman in labor. To prevent irritation on the skin in the massage area, you can first apply massage oil to it.

• Iliac

Massaging the apex of the pelvic bones is a good red herring. It essentially transfers pain from a real source to an imaginary one, creating local discomfort. This is comparable to a massage of the temples for a headache - the discomfort quickly disappears.

TYPE OF MASSAGE: rubbing.

HOW TO DO.

If it is self-massage, then the woman can intensively, slightly pressing, stroke the lower abdomen with both hands, moving from the ilium down along the bikini line to the pubis.

• Collar area

Your shoulders should be relaxed during childbirth. This will help the woman breathe rhythmically. Such breathing saturates the body with oxygen, which is necessary for the expectant mother and baby.

TYPE OF MASSAGE: kneading.

HOW TO DO

This massage is done by the woman's assistant in childbirth: he puts his hands on her shoulders and presses lightly. You can stimulate this area by smoothly descending from the shoulders to the elbows, or massage the area of ​​the shoulder blades in a circular motion. The pace and strength of the massage should be set by the woman in labor herself, having understood what movements soothe her breathing. Excessive pressure can, on the contrary, knock him down.

• Buttocks

Under the gluteal muscles, where the sciatic nerve passes, there are effective reflex points. They are easy to find - they are located in the very center of each buttocks.

TYPE OF MASSAGE: pressure, rubbing.

HOW TO DO

The partner stimulates the buttocks in a circular motion with the help of fists: with the right - one buttock clockwise, with the left - the other buttock counterclockwise, or vice versa.

FACT!

Bathing and showering is also very helpful in helping a woman in labor to relax and relieve pain. Experts advise doing massage with a stream of water in circular movements in the lower abdomen, on the collar and lower back. Many expectant mothers prefer to be watered with a bucket during labor.

Massage rules

The ways to stimulate a particular zone of a woman in labor can be completely different - it all depends on her desires, well-being, on what exactly brings relief. However, there are still general massage rules.

• Where it hurts, we massage there. It is not necessary to study all the main points "according to the book". Stimulate the area where the pain is concentrated, only then will relief come.
• It is not always possible to find the place "X" at once. The pain sometimes radiates to several places at once, the feeling can be created that absolutely all parts of the body are aching. A woman in labor should not hesitate to ask her partner to try different massage, and the partner himself, in turn, should be proactive, but not persistent.
• Don't forget the oil. It is necessary so that there is no irritation on the skin after active rubbing, as well as to facilitate the massage movements themselves. In such a cosmetic product, you can add a few drops of essential oil with an analgesic effect: jasmine, bergamot, lavender, chamomile. But before using it, be sure to consult with an aromatherapist for advice on the right remedy. Essential oils- potent drugs, and can affect the natural process of childbirth, so amateur performance is useless here.
• You can use the Lyapko applicator. This is a special massage roller that fits in the palm of your hand and is applied to the focus of pain (usually on the lower back and sacrum). It creates a distracting effect: during the operation of the applicator, a constant weak electricity, which has a physiotherapeutic effect.

Unfortunately, none of the currently known methods of drug pain relief in childbirth is perfect. All of them, one way or another, affect the fetus and the duration of labor and their use is not always possible. However, there are methods of pain relief that do not have any contraindications for mom and baby.

Methods of non-drug pain relief are absolutely harmless, very simple and effective, they can be used at any stage of childbirth. Self-anesthetic methods include birth massage, special breathing techniques, relaxing postures and movement techniques, the use of a fitball (gymnastic ball) and aquatherapy during childbirth. In order to master these techniques, only one thing is required - desire!

Active position

The first and most important factor in reducing pain from labor is active labor behavior. This term denotes the free behavior of the woman in labor, the constant change of postures and movement around the ward, the search for the most comfortable body position. The movement alone significantly reduces the overall sensation of pain. And not only because any action is distracting.

First, the level of pain depends on the blood circulation. During contractions, the muscle fibers of the uterus contract, wasting energy. The main "energy fuel" for the work of all cells in our body is oxygen; myometrial cells (uterine muscles) are no exception. As you know, oxygen is contained in arterial blood; hence, cell respiration depends on the level and velocity of arterial blood flow. When the body is stationary, the total blood flow decreases, the supply of oxygen to the uterine muscle slows down and the pain sensations increase. If the woman in labor is walking around the ward or moving in a comfortable position, the movement increases the level of blood flow and the cells of the uterus are better supplied with oxygen. Therefore, with active behavior in childbirth, pain from contractions is much weaker than with a stationary position. Even in the case when medical indications a woman in labor cannot get up, she can actively behave during a contraction - sway, spring on the bed, spread and bring her knees. These small movements will noticeably reduce the pain of the contraction.

Secondly, the feeling of pain depends on the general tension. More precisely, there is a direct proportional relationship between these concepts - pain and tension. That is, the more we strain, the more it hurts, and vice versa. During a contraction, when the uterus becomes tense and painful sensations appear, some women instinctively "freeze", completely stopping to move. This behavior of a woman in labor is caused by a fear of pain. The woman in labor, as it were, hides from the pain and from herself for the duration of the bout. In childbirth, this behavior does not bring relief: "freezing", the expectant mother unconsciously strains, which leads to a sharp increase in pain. The main assistant in the fight against excessive stress during contractions is physical activity. After all, when we are in motion, our muscles alternately tense and relax; therefore, hypertonicity (excessive muscle tension) is excluded. And if movement helps to relax, then it reduces the overall level of pain.

Movement during childbirth can be very diverse. If childbirth proceeds without complications, the choice of the type of movement during the contraction remains with the woman in labor. In this case, there is one, but very important limitation. At no stage of labor should you make sudden, impulsive movements. Here are examples of the most common active behaviors during a contraction:

• walking in the ward or corridor;
• tilts to the sides and forward;
• stretching and turning with the whole body;
• swinging and rotating movements of the pelvis;
• shifting from foot to foot;
• transfer of body weight from toes to heels and back;
• half squats;
• arching and arching of the spine;
• in the prone position: swinging the pelvis, turning from side to side, springy movements of the hips, bringing and extending the legs.

During contractions, you should behave freely, choosing the most comfortable body position. There are many known postures that can help reduce discomfort during labor and help you relax. The basic principle by which a woman in labor chooses a posture for the duration of a contraction is the level of comfort, stability and relaxation. Most "generic" postures use four points of support and a predominantly vertical position of the body; there are also "recumbent" postures. However, in order for the poses to help, you should change the position of the body as often as possible and do not forget to move a little within the framework of any pose. To reduce pain during labor, try the following positions during labor:

• Stand by the bed (sink, windowsill, bedside table) with your legs slightly apart. Lean your hands on the bed, relax your back and stomach, as if transferring the weight of your body to your arms and legs. Sway from side to side, back and forth, shift from foot to foot, wiggle your pelvis.
• Stand in the pose of a sumo wrestler: legs are wide apart and bent at the knees, the body is slightly tilted forward, hands rest on the middle of the thighs. Shift from foot to foot or sway from side to side.
• Squat down with your legs wide apart and resting on your full foot. There should be a fixed support behind the back (headboard, bedside table, wall). Place your feet shoulder-width apart and put your hands on your hips. Swing left and right, back and forth. Get on all fours on the bed with your legs slightly apart. Alternately arch and arch your back at the spine.
• Stand on the bed in a knee-elbow position, legs slightly apart, and sway from side to side. You can put a pillow under your elbows. Kneel on the bed, rest your hands on the headboard, Shift from one knee to another. Squat down facing the bed. Hands and head can be placed on the bed.
• Sit on the boat, placing it on a chair or a special bench (you cannot sit on the chair itself - this creates unnecessary pressure on the perineum and can harm the baby). Bend your legs at the knees and spread them wide to the sides (both the boat and the bench are always in the room).
• Stand by the headboard or bedside table. Put your arms bent at the elbows on it. Squat down, as if sagging in your arms,
• If you are tired and want to lie down, lie on your side with your knees and hips bent.

There are so-called "partner positions" for which a woman in labor will need an assistant. Here are some of the simplest and most convenient positions for pain relief:

• Stand facing your partner and wrap your arms around the neck, Top part press your body against your partner, turn your head to the side. Bend your legs at the knees, spread them as wide as possible and sway from side to side without lifting your legs off the floor.
• Stand in front of your partner as a "little train". Ask him to put his arms bent at the elbows forward (boxer pose). Spread your legs wide bent at the knees, lean back on your partner and hang on his hands, like on gymnastic rings, without lifting your legs off the floor and swaying (in this position, the woman in labor is fixed with her armpits on the partner's forearms).
• Ask your partner to sit on the edge of a chair or bed with their legs wide apart. Squat down with your back to your partner, legs wide apart and leaning on your full foot, Lean back on your partner and sway from side to side.
• Lie on your side and ask your partner to sit next to the bed. Bend your upper leg at the knee and rest it on your partner's shoulder. Try bending and extending that leg (ask your partner to offer slight resistance to this action).

V recent times in many maternity hospitals, women in labor are allowed to use a fitball for pain relief. A fitball is a rubber gymnastic ball commonly used for aerobics and pilates. With the help of a fitball, you can take a wide variety of poses, easily changing one to another, guaranteed to relax and move continuously, while saving strength. For use during contractions, the fitball is not fully inflated so that it remains soft and springy. On the ball, you can take all the positions listed above; in addition, there are special positions with fitball:

• swing, rotate the pelvis, spring, roll from side to side, sitting on the ball;
• get on all fours, with your chest, arms and chin leaning on the ball and swinging on it;
• lie on your side, placing the ball under your side and arm and springing on it;
• lean on the ball with your back in a reclining-half-sitting position with legs wide apart;
• swing, pushing off the back from the ball; sit or kneel, leaning on the ball with outstretched arms and springing;
• lie on your side, placing the ball between your calves and springing them.

As you can see, active behavior during childbirth does not require special physical training. In order to use the "active" one, you only need the knowledge and desire of the woman in labor to be a participant in childbirth, and not a passive patient.

Pain-relieving breathing

The most effective way to relieve labor is through breathing techniques. The analgesic effect of breathing is based on hyperoxygenation - the oversaturation of the blood with oxygen. The respiratory center of the brain, registering the excess of oxygen in the mother's blood, sends an impulse to the pituitary gland - the main hormonal gland of the body responsible for the release of endorphins. These substances, called "pleasure hormones", regulate a person's pain threshold. The more endorphins are released, the higher the pain threshold; that is why correct breathing in contractions and strains is as pain-relieving as analgesics.

Breathing techniques can be used at any stage of labor without restriction. They are applicable in any position of the body, equally effectively help both in the normal course of childbirth, and in the development of various deviations of labor.

At the beginning of labor, when contractions are practically painless, it is recommended to use "belly breathing". At the beginning of the contraction, the woman in labor takes a relaxed, slow breath in through her nose, and then exhales air for a long time through her mouth (as if blowing on water). Such breathing helps to relax, relieves nervous excitement and ensures high oxygen saturation of the blood, stimulating and pain relieving contractions.

By the middle of the first stage of labor, when the contractions grow and become painful, "candle breathing" helps. This is a frequent, shallow breathing, in which a short inhalation is made through the nose and exhalation through the mouth (as if we are blowing out a candle). As the contractions intensify, breathing becomes more intense, but still very fast. Breathe in this way only during the fight; at the end of the painful sensations, the woman in labor takes a deep breath in and out, evening out breathing, and rests until the next contraction.

At the moment of full dilation of the cervix, when the contractions become especially long and frequent, it is most effective to breathe in a "train". This breathing is an alternation of the previous techniques. At the beginning of the contraction, the expectant mother uses abdominal breathing, saving strength. As the pain intensifies, breathing quickens and becomes as intense as possible at the peak of the contraction. Then, as the contraction "subsides", the woman in labor calms and evens out breathing.

In the second stage of labor, when the fetus begins to move along the birth canal, each contraction is accompanied by a false urge to defecate (the desire to empty the intestines). This sensation is caused by the pressure of the fetal head on the rectum, located next to the vagina. At this stage, the woman in labor needs to avoid premature and relax as much as possible, helping the baby to descend through the birth canal. To achieve this goal during the fight you need to breathe "doggy". This is a rapid, shallow mouth breathing that really resembles dog breathing. When breathing with a "dog", the diaphragm - the main muscle of the abdominal press - is in continuous motion, which makes pushing impossible. Breathing has the maximum analgesic and relaxing effect.

Magic touches

Another effective way non-drug pain relief of childbirth is massage. By stimulating certain points and zones on the body during contractions, the expectant mother can independently regulate the pain impulse, reducing the level of pain and relaxing.

The most "popular" massage zone among women in labor is the lower back, or rather the sacral region. The sacrum is the motionless connection of the vertebrae at the bottom of the spine. In this area of ​​the spinal cord is the sacral plexus: the nerve node that innervates the uterus and other organs of the small pelvis. By stimulating the sacral zone (lower back in the middle) during the contraction, the woman in labor blocks the transmission of the nerve impulse, thus reducing pain. The massage can be performed with one or two hands, massaging the area with the pads and knuckles, the base of the fist, the base of the palm, the inner side of the palm, or a hand massager. Movement during massage can be stroking, pressing, you can pat, pinch, and even lightly tap the affected area. To prevent irritation on the skin of the sacral region, you can periodically lubricate it with cream or oil. If you have not stocked up with massage oil, do not be discouraged: ask the midwife for liquid petroleum jelly, which is always available in the hospital.

During the contraction, the protrusions of the pelvic bones on the sides of the abdomen can be stimulated. These bones should be affected in the same way as the sacral area. You can try different methods: squeeze, press and release, stroke, pinch. Choose the type of massage stimulation that is most effective in relieving pain for you. This method is a kind of red herring, transferring the source of pain.

Periodically during the contraction, gently stroke the lower abdomen in a semicircle, the area of ​​\ u200b \ u200bthe bottom of the uterus (the uppermost part). The same stroking movements can be performed by moving your hands from the lateral protrusions of the pelvic bones along the groin fold towards the perineum and back. These movements soothe the woman in labor, help to relax and improve blood circulation in the uterus,

The next massage option is most conveniently applied while lying on your side or sitting on a ball. Press the inner sides of your palms against your inner thigh. During the contraction, move your hands with pressure, without lifting your palms, from the groin to the knees and vice versa. In this area is the recurrent nerve that innervates the pelvic organs. Massaging the inner thighs helps to reduce pain and relax as much as possible.

In a partner birth, the assistant can constantly perform a light relaxing massage of the whole body, avoiding only the breasts, perineum and abdomen of the woman in labor. The touch of the hands of a loved one calms the expectant mother and helps to relax better.

Water as a helper

The main advantage of aquatherapy is the relaxing and analgesic properties of water. In warm water, contractions feel softer, blood circulation improves, the woman in labor has the opportunity to relax and take a comfortable body position, and gets tired less. Water eliminates the occurrence of such side factors of discomfort during childbirth as dry skin, increased sweating, chills or a feeling of heat,

Recently, many maternity hospitals have begun to use non-drug pain relief using water. For childbirth with aquatherapy, special showers and a hydromassage tank located in the maternity ward are used. The rooms for water procedures in the rodblock are disinfected in a special way. Of course, staying in water during childbirth without risk to the health of the woman in labor and the fetus is possible only under the supervision of a qualified medical specialist. When using a special bathroom, the expectant mother should fit in it entirely, being able to turn and change the position of the body. The water temperature should not exceed normal body temperature (36.0 ° C-37.0 ° C) and should not fall below 30.0 ° C. A childbirth partner or a specialist in the maternity hospital should always be near the woman in labor (in the shower or near the massage bath).

Unfortunately, this wonderful method of pain relief cannot always be used. Staying in a reservoir of water during childbirth can be considered absolutely safe only as long as the baby and the uterine cavity are protected by a wall. After the rupture of the membranes, the last barrier between the sterile uterus and the non-sterile vagina disappears. After all, water through the vagina can penetrate into the uterine cavity and cause its infection. There are fewer restrictions on the use of a shower during childbirth: this method will have to be abandoned only if the doctor recommends bed rest for the woman in labor.

If childbirth proceeds without complications, you can visit the shower quite often during the entire first stage of labor. For this, two conditions are necessary: ​​the presence of a shower room in the rodblock, equipped for women in labor, and the possibility of observing the expectant mother during water procedures. Shower cabins for women in labor are made open (without doors - for the possibility of medical supervision), pallets with a "non-slip" coating are used, and comfortable handrails are installed along the walls. During the entire stay in the shower, a midwife or doctor should always be with the expectant mother. Of course, this is possible only in the case of individual management of childbirth; however, in a partner birth, the “observer” and helper can be the mother’s husband.

The optimal analgesic and relaxing effect can be achieved by using a jet of water like an aqua massager. To do this, you need to take the shower head in your hand and, changing the water pressure from low to medium and even strong, water the stomach in circular motions throughout the entire contraction. If you have an assistant, you can ask him to massage the lower back and sacral area with a jet of water. Between contractions, it is worth making the pressure of the water weaker and directing the stream to the face, shoulders, chest and legs, achieving complete relaxation. The ideal water temperature for pain relief during labor is 36-40 ° C; lower temperature affects nervous system exciting, and too hot water can cause bleeding.

The birth of a child is the most wonderful event in a woman's life. Of course, the process preceding this event requires a lot of strength and patience from the expectant mother. But you should not expect torment and unbearable pain from childbirth; childbirth is a rewarding work. And if a woman was preparing for childbirth, knows how to help herself and goes to give birth with a smile, this exciting event becomes a real holiday. And there is no place for pain at the holiday!

Elizaveta Novoselova, obstetrician-gynecologist, Moscow