Induction of labor, labor pains, premature labor
English: blow
Labor is the foundation of childbirth. The contraction of the muscular layer of the uterus (= des Myometrium) expelling forces are generated, which influence the cervix and the position of the child in the pelvic floor. During pregnancy, different types of labor occur, which increase in strength, frequency and duration up to the birth and with which the uterus (= uterus) prepares for the birth.
You might also be interested in the following article: The process of a birth.
The main focus is on the mother's information about back pain, menstrual pain or a feeling of pressure.
$config[ads_text1] not found
On the one hand there is the possibility of contractions through the cardiotocogram (CTG) to make them visible and at the same time to observe the heart rate of the unborn child.
Read more about the cardiotocogram at: Labor recorder
On the other hand, the contractions can be controlled by touching the abdomen with the hands.
Here you can read which CTG values are normal!
The effectiveness of labor can only be confirmed by palpation of the cervix or by measuring the length of the cervix using ultrasound.
The CTG is the abbreviation of the term cardiotocography, also known as heart pains. The child's heartbeat is recorded as a pulse curve (cardiogram) and labor activity (tokogram) at the same time. The heart's activity is always shown on the upper curve, the uterine contractions on the lower curve. In this way, among other things, the variability of the child's heartbeat and the child's immediate reaction to the labor activity can be shown, but the strength of labor and the duration of the contractions can also be understood.
$config[ads_text2] not foundIn addition, children's movements can be recorded in the CTG in the form of small horizontal bars. The child's heart activity is registered using a special form of ultrasound, known as Doppler sonography. The labor activity is recorded by pressure gauges placed on the pregnant woman's belly.
Cardiotocography is used both during prenatal examinations and immediately before and during childbirth.
During the birth, particular attention is paid to the reactions of the child's heartbeat to the labor activity in order to be able to determine at an early stage a possible risk to the child due to a stress reaction and possible oxygen deficiency and to be able to respond appropriately in an obstetrical manner.
So-called late decelerations are particularly feared, which means that the child's heart rate drops immediately after a contraction and indicates a lack of oxygen.
Read more about this: CTG
At the beginning, contractions can be perceived differently by every woman, especially since some subforms of uterine contractions can be distinguished, which differ significantly in their intensity. What all forms of labor have in common is that the uterus contracts and the pregnant woman's belly becomes harder and tense as a result.
$config[ads_text3] not found
During pregnancy and after the birth, however, these contractions are much less pronounced than during the actual labor pains. Some pregnant women experience uterine contractions similar to cramp-like pain during their period, only with greater intensity.
In addition, the loosening of the uterine muscles following the contraction and the almost complete disappearance of the pain are typical characteristics of contractions.
If the contraction continues over a long period of time without any signs of loosening and if it is accompanied by extreme pain and possibly vaginal blood loss, an immediate medical consultation must take place. These symptoms can indicate premature placenta detachment.
A possible, albeit rather unspecific and often unreliable way of identifying “real” contractions is bathing in warm water. In labor pains there is no improvement in the pain or tension in the abdomen, and the contractions may even become stronger.
In the various forms of labor, which do not actually serve the birth of the child but are supposed to fulfill other tasks, an improvement in the symptoms is often observed due to the warmth of the water.
Furthermore, to identify the onset of labor pains, attention should be paid to the timing and strength of the uterine contractions. If labor increases in frequency, takes longer and becomes more intense, it can be assumed that labor is approaching.
In that case, an early presentation in the delivery room should take place.
A distinction is made between different forms of labor, which are either associated with pregnancy, childbirth or the period immediately following the delivery.
$config[ads_text4] not found
The contractions that occur during pregnancy include the so-called Alvarez waves, localized uterine contractions, and the Braxton-Hicks contractions, also known as practice contractions.
In close proximity to the imminent birth, pre-labor and lowering labor occur, which serve to correctly position the child in the maternal pelvis.
The actual labor pains with the aim of child development include the opening and expulsion pains.
The afterbirth pains serve to expel the mother cake after the birth of the child.
Finally, there are after-pains, contractions that help the uterus to return to its original size in the days after the birth.
Learn more about this topic: The different types of labor
The term “labor pains” refers to the contractions of the uterus that already occur during pregnancy, but which are not yet strong enough to initiate the start of labor. Exercise contractions occur around the 20th week of pregnancy.
Strictly speaking, the so-called Alvarez waves are not real contractions, as not the entire uterus but only a small part of the uterus contracts. Nonetheless, these localized contractions are also very important as they improve blood flow to the uterus.
The Alvarez waves get their name from the specific form of recording in the contractions recorder, the so-called tokogram. The contractions recorded there are presented with a low amplitude, i.e. low intensity, as well as at a fairly frequent frequency and thus often with an occurrence about every minute. This records the contractions in waves.
Towards the end of pregnancy, the Alvarez waves occur at a greater distance and with greater intensity.
The actual practice contractions include the Braxton-Hicks contractions. In the process, not just part of the uterus contracts, but the entire uterus. Compared to the Alvarez waves, these contractions are stronger, of slightly longer duration, and occur less frequently. The aim is to train and build up the myometrium, i.e. the muscular part of the uterus, in order to be able to provide the necessary strength for the expulsion of the child at birth.
The Braxton-Hicks contractions also increase in intensity towards the end of pregnancy and also become more frequent.
More information about this: Exercise contractions
$config[ads_text1] not foundSink labor is contractions of the uterus, which aim to position the unborn child in a position that is possible for birth. This involves the gradual sinking of the previous part of the child into the mother's small pelvis, usually beginning around three to four weeks before the birth. Often these contractions are clearly noticeable, but not infrequently painless.
Many pregnant women describe the pains with an uncomfortable feeling of pressure in the lower abdomen or pulling pain in the back, while other women hardly feel the pains. The changed positioning of the child can also often be seen visually.
If you look at the profile of the pregnant woman's belly, it reaches its highest point around the 36th week of pregnancy and becomes deeper as it progresses. This makes it easier for pregnant women to breathe and eat, because the lungs and stomach gain more space as the previous part of the child begins to sink into the mother's small pelvis. However, this also causes the child to put more pressure on the bladder, which usually results in the mother going to the toilet more frequently.
Also read this article: Labor pains
Premature labor is defined as the occurrence of labor-inducing labor before the 37th week of pregnancy. The most important difference to other forms of labor that occur naturally during pregnancy, for example exercise or lowering labor, is that, due to their intensity, premature labor can induce the onset of labor.
In addition, premature labor is one of the cervical forms of labor, which means that the uterine contractions cause the cervix to shorten and the cervix to widen, which is necessary for childbirth. If premature labor cannot be stopped, there is a risk of premature birth.
The risk of premature labor is increased, for example, in smokers, pregnant women under 18 and over 35 years of age, multiparous women, anomalies of the uterus and polyhydramnios, i.e. excessive amounts of amniotic fluid. Premature rupture of the bladder is also a risk factor. Another common reason for premature labor is bacterial infections of the female genital tract.
Between the 24th and 34th week of pregnancy, tocolytic, i.e. labor-inhibiting agents, can be used to try to stop premature labor. After the 34th week of pregnancy, contraception is only used in emergency situations, usually as a short time bridge.
Further information on this: Premature labor
The duration of labor depends on the one hand on the type of labor and on the other hand on the underlying main task of the labor sub-form. In addition, the duration of labor is very individual and different for every woman.
For example, pregnancy pains, which include the Alvarez waves and Braxton-Hicks contractions, are short-lived. They are used to stimulate blood flow in the uterus and as exercise contractions and usually last 30 to 60 seconds.
Lower labor pains, which are used for correct positioning in the mother's pelvis, also last between half a minute and a full minute.
Opening pains, which are part of the actual birth process and dilate the cervix, last about 30 seconds and occur about every 10 minutes at the beginning of the opening phase. However, as the cervix becomes wider, they can become longer, lasting around one minute, and occur more frequently, with a frequency of two to three minutes.
$config[ads_text2] not found
The opening phase is very individual and can last many hours. If the pregnant woman has already given birth, the full opening of the cervix is often achieved more quickly.
Expulsion contractions, also called pressure contractions, are used for the birth of the child. They usually last about 60 to 90 seconds and occur every five to ten minutes, and more frequently every three to five minutes towards the end of the expulsion phase.
This phase of labor usually lasts 60 to 90 minutes.
The afterbirth, i.e. the expulsion of the mother cake, is also accompanied by short-term contractions and usually lasts about half an hour.
Homeopathic remedies, such as drinking special tea blends with labor-promoting properties, can be tried to stimulate labor. Natural laxative measures such as apricot or plum juice can also be used, as they simultaneously influence uterine contractility by stimulating bowel activity.
With all homeopathic approaches to promoting labor, it is important to seek medical advice beforehand to determine whether the use is sensible and harmless in your own case, as every pregnant woman has a different risk profile. Physical activity, especially towards the end of pregnancy, can also promote labor.
It is important not to overwork the body and rather to resort to moderate exercises. These include, for example, walks at a slightly faster pace, climbing stairs or light dance exercises.
Physical closeness and intimacy can also promote labor. In this way, hormonal influences influence the contractility of the uterus.
You can find more information on this here: Promote labor
A contractions tea is an infusion of herbs and spices that is supposed to trigger and support the labor activity. Ingredients commonly used in labor tea blends include verbena, cinnamon, camphor, and cloves. Anise, basil, ginger and mugwort are also said to have properties that promote labor.
You can buy contraindicated tea in some pharmacies, some of which are even made according to your own recipe. Some drugstores also have Wehentee in their range.Nevertheless, before consuming such herbal infusions, you should consult your doctor or midwife so as not to endanger the unborn child or your own health by taking the drink too early or by taking it incorrectly.
Whether and how strongly labor teas work at all is very individual and different for each pregnant woman. If the attending obstetrician has no objections, the labor teas can be used to gently try to stimulate and support the labor activity.
More on this: Use tea to stimulate labor
Cinnamon is a spice and is extracted from the dried bark of the cinnamon tree. The spice is said to have labor-promoting properties. This is why cinnamon is often used in homeopathy to stimulate labor, often with the addition of other herbal and natural ingredients.
As with many herbal active ingredients, due to the difficult-to-determine dose, which can lead to an effect, caution should be exercised if taken in excess during pregnancy. Cinnamon can be used to stimulate labor near an appointment. If this effect is explicitly desired, however, the treating gynecologist should always be consulted as to whether the application is really harmless in your own case.
Various behavioral measures can help to support the onset and activity of labor.
This includes physical activity, which, however, must not exceed a certain level of exertion. As a rough guideline with regard to the intensity of sporting activity to trigger contractions, it can be stated that you should always pay attention to the signals from your own body and that you should take a break if you feel tired or even stop the activity entirely. Only exercises that are good for you and that make you feel good are suitable. Therefore, labor stimulation activities can vary and vary from woman to woman. Going for a walk, climbing stairs or doing light housework can trigger labor.
Sexual intercourse can also trigger labor due to the hormones that are released during it. In addition, the man's sperm contains prostaglandins, which, when ejaculated in the vagina of the pregnant woman, can indirectly trigger labor by helping the cervix to mature.
If sexual intercourse is not desired, the hormone oxytocin, which can trigger contractions in the uterus, can still be released through physical closeness and caresses, especially the nipples.
Labor can be induced artificially for a variety of reasons. These can come from the mother or from the unborn child. If the mother has certain pre-existing conditions or if the child has problems developing, contractions can be used to help.
You can find detailed information on this topic here: Induce labor
A contraceptive drop is an infusion that is given to the expectant mother via the vein and contains the hormone oxytocin. Oxytocin acts on the muscles of the uterus and increases its ability to contract. This is how labor is induced. The contraction drip is one of the medicinal variants of induction and labor support and is used quite often when the cervix is mature, i.e. already soft and somewhat dilated.
Since the effects set in within a short period of time in most cases, the contraceptive drop is only used on medical advice and under careful supervision of the patient.
One advantage of the contraceptive drop is that the amount of oxytocin and thus the effect of the hormone can be well dosed.
Disadvantages include the increased pain that can sometimes occur during labor. Often, those who are in pain require pain relieving medication during childbirth or even an epidural anesthesia.
The hormone oxytocin is also used in the so-called active management of the afterbirth. This supports the detachment of the placenta and the ability of the uterus to contract and prevents postnatal bleeding.
Labor suppressants are drugs that stop labor or increase the time between contractions. The uterus' ability to contract, i.e. the muscular contraction, is reduced as a result. Technically, labor suppressants are called tocolytics.
Beta-mimetics are among the most frequently used labor-inhibiting substances, but magnesium, oxytocin receptor and calcium antagonists are also used. Since tocolytics have a side effect profile that is not to be neglected, monitoring by medical and nursing staff is mandatory after administration.
Reasons for inhibition of labor can be, for example, premature rupture of the bladder or the prolongation of pregnancy to induce the child's lung maturity. Tocolysis can also be necessary if labor is too intense or too frequent. In addition, contractions are used for obstetric complications, for example to allow a temporary bridging to an (emergency) caesarean section or special positioning maneuvers.
A conscious breathing technique during labor can have several positive influences on the birth process. Many women report that this achieved better relaxation in the pauses in labor and that the birth was generally felt to be calmer. There are no strict guidelines regarding breathing during labor, as each woman has different needs. Therefore, it must be checked individually which breathing mode is good for the pregnant woman during the birth.
For example, so-called deep breathing can be tried in the early phase of childbirth. At the beginning of a contraction, inhale through the nose and exhale through the mouth slowly and with concentration, maintaining this type of breathing.
Alternatively, some women describe a shallower breathing mechanism as relaxing. A deep breath is taken at the beginning of the contraction in order to then breathe increasingly faster and thus more shallowly over the duration of the contraction.
When the time has come to actively press, a different breathing technique must be used, which, however, usually starts automatically. This takes a deep breath and stops it during the pressing process. After pressing, exhale and breathe normally a few times until the next contraction occurs.
In a broader sense, it also includes screams or other breathing sounds during childbirth. Here, too, an individual approach must be taken, which is good for the pregnant woman, since some women describe it as liberating to utter screams under the pain of childbirth. However, you should try to avoid excessive screaming, as this will also deplete the mother's energy reserves. However, these are urgently needed for the already exhausting labor process.
Read more on this topic: Breathe in contractions
On the one hand, labor intervals can be determined clinically, i.e. via the visible labor activity and the determined time pauses in between. On the other hand, cardiotocography is a more precise and, above all, objectifiable method of labor activity and its intervals. Labor intervals can give a rough guide to the phase of birth in which the pregnant woman is and what the further course of time up to child development may be.
It should be emphasized, however, that the meaningfulness of labor intervals must be assessed very individually, as numerous influencing factors, such as the number of previous births, are known and therefore a precise prediction of the further course of labor is never possible based on the labor intervals.
Physiologically, i.e. naturally, the intervals between labor during the birth become smaller and thus the number, i.e. the frequency of labor in a defined period of time, greater. In addition, the intensity of the uterine contractions increases sharply during childbirth and reaches its climax in the expulsion phase, which is used for child development.
At the onset of labor, the pregnant woman should present herself to the delivery room as soon as possible, since the intervals between labor cannot reliably estimate how soon the birth will come.
Even in the case of contractions that are rare at the beginning, a quick change to more frequent contractions and shorter intervals with subsequent birth is possible at any time.
More on this: Contractions
Where contractions radiate during delivery is different for every pregnant woman. Some report localized pain in the abdominal area with no back involvement. Other women, on the other hand, complain of severe back and lower back pain during labor, which exceed or even occur completely independently of the pain in the abdomen. In the case of single, new and severe back pain, it is important to clarify whether it is a common, harmless back pain in connection with pregnancy or a real labor.
As a further sub-form, contractions can be felt in the shape of a belt, in which pain occurs in both the stomach and back area.
Labor contractions can occur without accompanying pain.
In particular, the labor pains that occur during pregnancy are usually painless and are usually only registered on the basis of noticeable tension in the abdomen.
The pains that occur towards the end of pregnancy are usually painless and are more likely to be described with a feeling of pressure on the bladder.
The actual contractions that herald the approaching birth can be painless or only slightly painful at the beginning. Often, however, other abnormal sensations such as pressing, pulling or radiating discomfort in the back or vagina are expressed. Physiologically, pain is always to be expected during childbirth due to the enormous strain on the mother's body and the narrowness of the birth canal. This can be remedied by applying an epidural anesthesia, or PDA for short.
Nonetheless, the patient will continue to feel pressure, which can be uncomfortable. However, this oppressive sensation is very important in order to be able to continue to register and feel contractions during the expulsion phase in the case of a natural, vaginal delivery. This allows the mother-to-be to support the birth by actively pressing during labor.
Further information is available here: Birth pains
A labor simulator should be able to simulate how the expectant mother feels the contractions of the uterus during childbirth. These artificial contractions are simulated using electrical impulses that act on the abdomen. A labor simulation can be used by both women and men. The intensity of the current surges can be set variably and increased gradually. This tries to simulate the increase in contractions and pain, as they also occur in a real birth.
The medical benefit of such a labor simulator is very questionable. Birth is a natural process that has been going on for thousands of years and does not need to be “practiced” using such a simulator. In addition, purely physical stimuli are set via the simulator, the emotional aspect of a birth and the moment of actually having a child cannot be simulated.
In most cases, such a labor simulator is tried out by future fathers who want to experience the pain of childbirth.
Pathologies during childbirth are disorders of labor with a resulting abnormal course of labor (labor dystocia).
Normo- / hypotonic labor weakness is defined as too short (less than 20 seconds), too rare (less than 3 contractions per 10 minutes) and / or too weak (less than 30mmHg) contractions.
Basal tone can be normal or decreased. If the weakness of labor persists from the beginning of the opening period, one speaks of primary weakness in labor. The causes for this are drugs, especially tranquilizers (= sedatives) or general anesthetics (= narcotics) or a so-called dystopic arousal. This means that the muscle contractions of the uterus do not start from one center and are therefore coordinated and strong, but rather uncoordinated from several centers and therefore not as strong.
However, these contractions can develop into coordinated contractions during the course of delivery. If the weakness in contractions only develops during the opening or expulsion period, this is called secondary or fatigue weakness. The main causes for this are the overstretching of the uterus, e.g. with twins, older children or too much amniotic fluid (=Polyhydramnios) or an extended (= more protracted) Course of birth. Risk factors for prolonged labor are too small a pelvis or malformations of the mother's pelvis or position, attitude (= turning of the body into the birth canal) and posture anomalies of the child. A full urinary bladder or cold feet are also simple causes of inhibition of labor.
Hypertonic labor weakness: Contractions are regular or slightly more frequent, with normal strength and duration. However, the pressure in the uterus (= basal tone) is increased to over 15mmHg, so that the effectiveness of labor is reduced. The cause of this are usually uncoordinated uterine contractions. Due to the increase in pressure, the blood flow to the uterus is reduced and there is a risk of oxygen deficiency (=Hypoxia) of the fetus.
Contraction storm: This refers to too strong (more than 50 mmHg) or too frequent (more than 5 contractions per 10 minutes) contractions. The basal pressure of the uterus is normal. The development of the contraction storm is mostly caused by mechanical birth problems, such as a disproportion between child size and pelvic width or posture / position anomalies. A too high concentration of oxytocin (effect see above) can also be the cause. This can be caused by an overdose or by the body's own increased secretion, e.g. by artificial amniotic sac rupture (=Amniotomy) or caused by overstretching the uterus. During the labor storm there is an increased pressure in the uterus, which can lead to a lack of oxygen in the child. There is also the risk of tearing the uterus (=Uterine rupture).
Other pathologies:
Premature labor: Premature labor refers to efforts to give birth before the 37th week of pregnancy, i.e. up to and including 36 + 6 due to labor. This is the limit for premature birth. There are many reasons for premature labor to occur. Infections are most commonly involved. These can include generalized infections (such as urinary tract infections) or fever, but also local infections such as inflammation in the vagina (= colpitis), in the cervix (= cervicitis) or in the uterus directly (=intrauterine) be.
This topic might interest you: Breathe in contractions
Mental or physical overload is also given as a reason. A multiple pregnancy or problems with the placenta (placenta) continue to pose a high risk, which can be placental insufficiency or detachment. Too much amniotic fluid (=Polyhydramnios) can be considered as the cause.
Postoperative labor: If surgery is necessary during pregnancy, e.g. in appendicitis (=appendicitis), then the stress can trigger contractions.
Depending on the week of pregnancy, a preventive (=prophylactic) Contraception should be necessary or useful.
