The dream of every future mother – to give birth without tearing the perineum and cervix. Let us tell you how to get into the number of such lucky women. And also what exactly can be torn, and on what the condition of the birth canal depends.
Why skin can stretch
Human skin is completely penetrated by a dense network of connective tissue elastic fibers. They are so named because of their ability to strongly stretch without breaks, and then again gradually reduced to the original state. A typical example of the enormous benefits of such a skin feature is a pregnant tummy, sometimes growing in circumference up to 120 cm and flattening again several weeks after giving birth. Now you know that the state of the anterior abdominal wall depends not only on the strength of the muscle press, but also on the content of elastic fibers in the skin.
What rushes during childbirth
The crotch on the outside is skin, of which we have already told about the miraculous elasticity. It is her, if there is a threat of rupture, the doctor who takes delivery, cuts with scissors. Dissection (episiotomy) may be performed in the direction of the rectum (pink arrow in the diagram) or at an angle (light green arrow). This is done to prevent severe trauma to the skin of the perineum, in which tissue relaxation can even reach the rectum, which is fraught with serious complications and long-term treatment.
After removing the baby, the doctor places a neat suture that heals much faster than natural breaks, leaving a thin scar. The problem is that in the area of the scar elastic fibers are replaced by coarser collagen fibers that are not capable of stretching. During the following genera, especially if the fetus is large or postponed, the probability of rupture of the perineum is very high along the rumen. Therefore, the doctor usually makes a skin incision again for women who have to give birth.
The vagina is a mucous membrane. It has a folded surface, extending under tension and thus providing protection during childbirth during the passage of the fetal head and coat hanger. Isolated tears in this area, including the labia minora, are often superficial and small, and deeper – in combination with a trauma to the skin of the perineum.
This is the deepest area of the birth canal, subject to strong stretching. This is a channel formed by circular muscles. When a head of a fetus arises suddenly or with excessive pressure on them, their rupture of varying degrees of severity is possible depending on its length. In the most difficult cases, tissue damage can “spread out” even on the body of the uterus.
In what situations may break the tissues that make up the birth canal:
- during rapid delivery;
- in case of discoordination of labor;
- with large fruit;
- with traumatic obstetric benefits: imposition of forceps on the head of the child, with pressure on the mother’s abdomen during labor, with vacuum extraction;
- with the restless behavior of women in the period of the disclosure of the cervix and in attempts.
How to avoid tears during labor
It is certainly impossible to predict whether the woman will have ruptures of the genital tract, as it depends on many circumstances. But you can significantly reduce the risk of such trouble. There are several ways.
1. Massage of the skin of the perineum and mucous of the vestibule of the vagina
After a hygienic shower, lubricate the skin of the intimate area with any vegetable, baby or cosmetic oil. Lie on your back, bending your legs, and relax as much as possible. Insert two fingers shallowly into the vagina and gently stretch their skin, pressing down to the anus, and holding at the peak of tension for at least a minute. After pressure, stop and gently massage the skin. Repeat this several times in a row.
Such a massage at the beginning of pregnancy can be done most, and in the later periods will have to resort to the help of a spouse. It is contraindicated in cases of threatened interruption, accompanied by severe weakness or the beginning of the opening of the cervix, during inflammatory processes in the genitals.
A similar procedure will be effective in women who give birth first, and those mothers who already have old postpartum scars on the perineum. But it is important to remember about the need to perform it regularly, and on the eve of childbirth – daily. By the way, in the poduzhny period the midwife who is giving birth, carries out the same reception during cutting of a head of a fruit. So she in advance gradually stretches the threshold of the vagina, preparing it. This is part of a set of mandatory measures to protect the perineum from gaps.
2. Follow the instructions of the midwife during the attempts
From the moment in the birth canal of the woman, the cut-through head of the baby is shown, the midwife standing in her twin skin presses on the head of the fetus with her palm from top to bottom. So she warns of premature extension of his head. This is done to ensure that the baby passes through the birth canal in the smallest – parietal-occipital – size. At the same time, with the fingers of the second hand, she gradually shifts the skin of the mother’s perineum from the baby’s head advancing to the exit. At the same time, the condition of the birth canal is assessed so as not to miss the moment when the skin is about to burst. She abruptly turns pale, becomes much thinner and “grows numb”, completely losing sensitivity. Then the doctor quickly makes an incision with scissors. This is a full range of measures to protect the perineum during childbirth from gaps.
The mother in the drinking period must carefully listen to the instructions of the midwife, quickly and clearly follow them. And no questions or disputes – because the bill goes on for a second! What it may require:
- Weaker or harder to push.
- Do not push at all and instead often breathe shallowly to wait out the bout (at this time, it is common to stretch and shift the skin of the perineum from the top of the fetus).
- It takes a long time to force out half-lengths (either it is necessary to make a dissection of the perineum, or to wait for the rotation of the fetus’s calf).
- Do not shout, but breathe with your mouth open (this is how the woman in labor switches attention, which allows the muscles of the birth canal to relax).
- Do not raise the pelvis and do not make sudden movements, so as not to interfere with the midwife to protect the crotch from ruptures.
3. Proper breathing during contractions and strokes
Breathing techniques not only help reduce pain. It is important that in this case the fetus does not move in jerks, but smoothly and gradually, pushing, not tearing, the tissues of the mother’s birth canal.
4. Wiggle in sitting position on fitball in the period of cervical dilatation
About the benefits of childbirth in an upright position – see here.
5. Calm behavior and maximum relaxation of the perineum in labor
Soft tissue is easier to stretch than dense. The musculature of the uterus does not obey the wishes of the woman. It is impossible to stop the fight that has begun by will. But you can add the already powerful tension of the circular muscles of the cervix, if you are restlessly rushing, screaming and breathing incorrectly. The child, pushed out by the shrinking body of the uterus, will still advance along the birth canal, overcoming more pronounced resistance. As a result, he will suffer, and the mother will have deep gaps. And if you do not strain and try to relax as much as possible between contractions, the tissues of the perineum will become much more pliable and will be able to stretch.
Chance to give birth without breaks increase regular physical education during pregnancy. Especially useful swimming and water aerobics. Equally beneficial is riding a bike or wiggling in a sitting position on a fitball. In addition, the skin is less elastic, if it has accumulated a lot of fluid, or there is a thick fatty layer. Therefore, it is important to eat properly and prevent the appearance of edema.