Delivery

　　Natural vaginal delivery refers to the mode of delivery in which the fetus is normally developed, the pelvic cavity of the pregnant woman is also normal, the physical condition of the pregnant woman is good, and there is a guarantee of safety. Under these conditions, artificial intervention is usually not used, and the fetus is delivered through the vagina. When a pregnant woman decides on natural delivery, she should first understand when the expected delivery date is and the whole process of delivery. Natural vaginal delivery is the most ideal mode of delivery, which causes little damage to both the mother and the fetus, and the postpartum recovery is also relatively fast, with fewer complications, and the mother can get out of bed and walk on the day of delivery. Moreover, for the baby, the lung function is exercised when coming out of the birth canal, the skin nerve endings are massaged through stimulation, and the nervous and sensory systems develop well, with stronger resistance. The compression of the baby's head when passing through the birth canal is also beneficial for the newborn to establish normal breathing quickly after birth.

　　Conditions required for natural delivery:

　　1. The position of the fetus should be extended breech.

　　2. The pelvic cavity of the pregnant woman must be large enough and not too small, so that the progress of labor is normal.

　　3. The fetus cannot be too large.

　　4. If there is anything abnormal during the process of labor for experienced mothers, they should change to an emergency cesarean section at any time, and should not insist on natural delivery. It is necessary to consider the safety of the fetus.

　　During the process of delivery, the pain caused by uterine contractions will persist throughout. The pain of uterine contractions is mainly in the lower abdomen, and sometimes it can also occur on the inner sides of the thighs or above the spine. Most women feel that the pain of uterine contractions is similar to that during the menstrual period, but it is stronger. When the fetus is about to be born, due to the expansion of the perineum and vulva, the mother will also feel burning and severe pain in these areas. Finding a comfortable position and performing deep breathing in a relaxed state can alleviate the pain of delivery. It is necessary to have a full mental preparation for the pain of delivery. Delivery is a natural physiological phenomenon, and the pain of delivery is physiological pain, which most people can bear. However, during delivery, a period of severe pain must be endured, and without sufficient mental preparation, pregnant women may be overwhelmed by unexpected pain. During the process of delivery, shouting and crying can prolong the labor.

　　Before delivery, pregnant women may experience the descent of the fundus of the uterus, uterine contractions, and the appearance of blood, with specific clinical manifestations as follows.

　　1. The fundus of the uterus descends

　　A few weeks before childbirth, due to the fetus entering the pelvis, pregnant women may feel that their upper abdomen is lighter, and their breathing and appetite improve significantly. However, the frequency of urination increases, and walking is not very comfortable. This is due to the descent of the fundus of the uterus.

　　2. Uterine contraction

　　A few days before childbirth, pregnant women may feel a series of hardening in the abdomen, accompanied by mild坠胀感, which is the contraction of the uterus. At this time, the uterine contraction often lasts for a short time, with varying intervals, often appearing at night and disappearing in the morning, and the cervix does not dilate. The vast majority of pregnant women give birth within two weeks before or after the expected delivery date. When there is regular abdominal pain and the intervals become shorter and the pain lasts longer, it indicates that labor is approaching.

　　3. Showing the red

　　About 24-48 hours before childbirth, a small amount of bloody mucus is discharged from the vagina, known as 'showing the red'. Rupture of the amniotic sac in the uterus, with the流出 of amniotic fluid, is also a reliable sign of impending labor. The 'showing the red' may last for several days, with a little discharge each day; it may also occur suddenly. If the amount of 'showing the red' is more than the normal menstrual amount, it is necessary to go to the hospital and contact the doctor or midwife in a timely manner.

　　Childbirth is a major event in a woman's life. Pregnant women should make adequate preparations before childbirth, and the specific preparation items are as follows.

　　First, daily life

　　1. Personal hygiene during childbirth:Take a bath frequently, trim your nails, and pay attention to safety; avoid long hot baths.

　　2. Sexual activity:Sexual activity is strictly prohibited before labor to prevent premature rupture of membranes and preterm delivery.

　　3. Exercise:Prohibit large movements such as chasing, crowding, and climbing.

　　4. Going out:Go out with someone, do not stay out for too long alone, and inform your family.

　　5. Nutrition:Ensure adequate nutrition, eat more milk, eggs, and chicken soup. Get enough sleep and accumulate physical strength.

　　6. Items:Check the items needed for hospitalization and properly arrange the items needed for childbirth and return home. Place the items needed for the mother and child at a visible location when discharged.

　　7. Daily training:Further master the auxiliary actions of childbirth and practice breathing techniques.

　　Second, mental preparation

　　Many pregnant women, after consulting the experiences of others, often remember more negative feelings and worry that they may encounter the same situation. In fact, everyone's childbirth experience is different, and modern medical technology and birthing environment can provide very safe care for childbirth. Therefore, pregnant women only need to have more confidence in themselves and do not need to add unnecessary pressure to themselves.

　　Childbirth is influenced by factors such as labor power, birth canal, fetus, and mental and psychological factors. Labor power is the driving force of childbirth, and normal delivery relies on labor power to expel the fetus from the body. At the same time, it also requires the corresponding expansion of the soft birth canal and a sufficiently large birth canal for the fetus to pass through. Labor power is affected by the position, size of the fetus, its relationship with the birth canal, and factors such as mental and psychological health. A smooth delivery depends on the mutual adaptation and coordination among these factors; otherwise, it can lead to dystocia, causing unnecessary injuries to the mother and fetus.

　　Childbirth is a normal physiological process, so maintaining a good mental and psychological state throughout the childbirth process is very important for a smooth delivery.

　　1. Labor power is the driving force for expelling the fetus and its appendages from the uterine cavity. Labor power includes uterine contraction, abdominal muscle and diaphragm contraction, and pelvic floor anal and levator muscle contraction. Among them, the uterine muscle contraction is the most important, playing a leading role throughout the whole process of childbirth. The abdominal muscles, diaphragm, and levator muscles play a supplementary role in the second stage of labor.

　　2. The birth canal is the passage through which the fetus is delivered, including the bony birth canal and the soft birth canal. The bony birth canal refers to the true pelvis, which is composed of the sacrum, the two hip bones, the pubic bone, the ischium, and the ligaments that connect them. The bony birth canal changes little during the process of childbirth, but it is not without any change. In the late stage of pregnancy, the water content in the joints of the bones increases, and during the process of childbirth, due to the effects of labor power and gravity, the bones also have slight displacement, which increases the volume of the pelvis. In addition, the position of the mother can also affect the diameter of different pelvic planes. The bony birth canal is a curved canal, and the fetus needs to make various movements when passing through it, which is the mechanism of childbirth. The soft birth canal is composed of the lower segment of the uterus, the cervix, the vagina, and the soft tissues of the pelvic floor.

　　3. The size of the fetus, its position, and whether there is any malformation are important factors affecting the process of childbirth. The size of the fetus is relatively to the size of the pelvis. The fetal head is the largest, the least malleable, and the most difficult part to pass through the pelvis. However, overly overweight macrosomic infants may also cause dystocia due to excessive subcutaneous fat.

　　Childbirth is a major event in a woman's life, so a reasonable diet is very important for both the mother and the baby. The following are some dietary注意事项 before and after childbirth.

　　1. Diet before delivery

　　1, Liver-Nourishing Soup

　　Take 7 red dates per day, wash them clean, and use a small knife to make 7 straight lines on each red date to help the nutrients溢出, then soak them in hot water of 280 milliliters for more than 8 hours, and then steam for an hour with the lid on, covering the water. The liver-nourishing soup can not only help the mother deliver the anesthetic toxicity but also alleviate the pain at the incision.

　　Whether it is a natural birth or a cesarean section, it is necessary to start drinking it 10 days before delivery, 280 milliliters per day, which can be either hot or cold, and should be finished in 2 to 3 sittings throughout the day. After delivery, it is still necessary to continue drinking for two weeks, but the boiled water should be replaced with rice wine water that has been boiled and completely evaporated of alcohol. Although the liver-nourishing soup is good, it should not be drunk too early to avoid internal heat. Similarly, the number of red dates should not be too many, as eating too many can also cause internal heat.

　　2, Lotus Root, Dried Scallop, and Rib Soup

　　Soak the dried scallops in 10 times the water the night before until the next day, and save the soaking water for later use; the lotus root should not be peeled or sliced, leaving the two ends of the joints, and putting the whole section into the pot; after blanching the ribs, put all the ingredients into the pot, add 6 times the water (including the water soaked in dried scallops) and a little salt, bring to a boil over high heat, then turn to low heat and simmer for two hours before it is ready to eat.

　　This soup can help improve constitution and enhance productivity. Pregnant women need 10 grams of lotus root per kilogram of body weight, so a pregnant woman weighing 50 kilograms needs to consume 500 grams of lotus root, and so on. It is best to choose a larger lotus root, with the weight of the ribs being the same as the lotus root, and the dried scallops taking up one-tenth of the lotus root, with an average of 7 pieces. It is best to use an earthen pot or a clay pot to simmer, and make sure to eat the lotus root, dried scallops, ribs, and soup all together when eating.

　　3. Fish Head Soup

　　Cut pork belly and mushrooms into thin strips; fry the fish head with oil until half-cooked; heat a little oil in the pot, add pork belly, mushroom strips, and ginger slices to sauté; then add cabbage, tofu, fish head, and water, steam and cook for 2 hours, and add a little salt before serving.

　　Do not add monosodium glutamate, and you can also add vermicelli or noodles. It is best to use an earthen pot or a clay pot to stew. The fish head is rich in calcium. If it is consumed alternately with bone soup and chicken bone soup, it can better help pregnant women increase their strength.

　　4. Red Date and Lamb Soup

　　Boil 350 grams of high-quality lamb, 100 grams of red dates, 100 grams of brown sugar, 15 to 20 grams of Astragalus membranaceus, and 15 to 20 grams of Angelica sinensis in 1000 milliliters of water together. After boiling to 500 milliliters, pour out the soup, divide it into 2 bowls, and add brown sugar. Start taking it twice a day in the morning and evening three days before labor. This method can increase the strength of pregnant women and is conducive to smooth delivery. It also has the effects of calming the mind and quickly recovering fatigue. It also has a certain effect on preventing postpartum lochia from not stopping.

　　II. Postpartum diet

　　If there is no gas discharge within 24 hours after delivery, you can take radish soup or Simo soup to promote gas discharge. It is recommended to turn over on the bed to promote peristalsis. It is forbidden to drink water within 24 hours before gas discharge, and only a small amount of water can be used to moisten the lips. After gas discharge, you can consume milk-free and sugar-free liquid food. After defecation, you can resume normal diet, such as lean meat, milk, fresh vegetables and fruits, soup, etc., and avoid spicy and cold foods.

　　Labor is a continuous process, consisting of three stages. Labor is divided into natural childbirth and cesarean section. The specific process and methods of delivery are described as follows.

　　I. Labor is usually divided into three consecutive processes

　　1. The first stage of labor

　　Also known as the stage of cervical dilation. It refers to the period from the onset of regular uterine contractions at intervals of 5 to 6 minutes to the complete dilation of the cervix to 10 centimeters. This process takes 11 to 12 hours for primiparas and 6 to 8 hours for multiparas.

　　Cooperation during the first stage of labor:

　　(1) Eliminate fear and anxiety, and maintain composure and optimism.

　　(2) Eat on time to supplement sufficient nutrition.

　　(3) Urinate on time, every 2 to 4 hours, to keep the bladder empty and prevent it from obstructing the descent of the fetal head.

　　(4) If the amniotic membrane has not broken, with the doctor's consent, you can walk and move around in the delivery room.

　　(5) Some pain-relieving actions can also be performed during uterine contractions.

　　2. The second stage of labor

　　Also known as the stage of fetal delivery. It refers to the period from the complete dilation of the cervix to the delivery of the fetus. Primiparas usually need 1 to 2 hours, while multiparas can usually complete it in a few minutes, but some may take up to an hour.

　　The peak of labor arrives, and the baby is about to be born. The fetal head moves closer to the vaginal orifice, and the perineum and anal area appear protruding due to the pressure of the fetal head on the pelvic floor. The fetal head will soon be visible, and it moves forward with each uterine contraction. When the contraction subsides, it may slip back slightly.

　　When the top of the fetal head can be seen, the midwife often tells the pregnant woman not to push too hard, because if the fetal head is delivered too quickly, the skin of the perineum may tear, so the pregnant woman should relax and take a few seconds to breathe. If there is a risk of severe tearing or the fetus is in danger, the pregnant woman will have to undergo perineal incision. When the fetal head expands the vaginal orifice, the pregnant woman will have a sharp pain, followed by numbness, which is caused by the expansion of the vaginal tissue being very thin, blocking the conduction of nerves.

　　When the baby's head is delivered, the baby's face is down. The midwife may check the umbilical cord to ensure that the baby's neck is not twisted by the umbilical cord (when the fetal head is delivered, the umbilical cord often wraps around the head). Then, the baby's head turns to one side, so that the head and two shoulders are in a straight line. The midwife cleans the baby's nose and mouth, and if necessary, suck out the fluid in the baby's respiratory tract.

　　During the two contractions that follow, the baby's body will slide out of the mother's body, at this time the baby is still connected to the umbilical cord, and the midwife will cut the umbilical cord. In addition, the midwife will clean the baby's respiratory tract again and provide oxygen if necessary.

　　3. The third stage of labor

　　Also known as the placental expulsion stage. It takes 5 to 15 minutes from the delivery of the fetus to the expulsion of the placenta, and should not exceed 30 minutes.

　　After the fetus is delivered, there will still be uterine contractions to expel the placenta, but the contractions at this time are relatively painless. Subsequently, the doctor will tidy up the pregnant woman, and if there is a laceration of the perineum, it will be locally sutured.

　　Second, delivery methods

　　1. Natural vaginal delivery

　　Natural vaginal delivery refers to the delivery of the fetus through the birth canal under the premise that the fetus is developing normally, the pregnant woman's pelvic development is normal, the physical condition of the pregnant woman is good, and there is a guarantee of safety. Generally, artificial intervention methods are not used to allow the fetus to be delivered through the birth canal. When deciding on natural childbirth, the pregnant woman should first understand the entire process of childbirth. Natural vaginal delivery is the most ideal delivery method, which causes little damage to both the mother and the fetus, and the postpartum recovery is also relatively fast, with fewer complications, and the mother can get out of bed and walk on the day of delivery. Moreover, for the baby, the lung function is exercised when coming out of the birth canal, the skin nerve endings are massaged through stimulation, and the nervous and sensory systems develop well, with stronger resistance. The baby's head is also compressed when passing through the birth canal, which is beneficial for the baby to establish normal breathing quickly after birth.

　　(1) Advantages and disadvantages of natural childbirth

　　①Advantages

　　Ⅰ The fetus can naturally squeeze through the birth canal, which can expel amniotic fluid accumulated in the interstitial tissue of the lungs, thus avoiding neonatal 'wet lung' syndrome and other conditions.

　　Ⅱ It can reduce surgical complications in pregnant women and can also reduce trauma.

　　Ⅲ The coordination ability of the baby's body movement during natural childbirth is better than that of children born by other methods.

　　Ⅳ It can enhance communication and cooperation between mother and child, strengthen the happiness and sense of responsibility of women as mothers.

　　V It is also beneficial for the postpartum expulsion of lochia, uterine recovery, quick postpartum recovery, and it will not affect future fertility at all. In addition, milk comes out relatively quickly as well.

　　②Disadvantages

　　There is some damage to the vagina.

　　The pain of uterine contractions is quite severe.

　　If there is a difficult labor, it may be necessary to convert to cesarean section, which can cause double damage.

　　(2) Conditions for natural childbirth (normal delivery)

　　Firstly, the mother's age is between 25 to 29 years old, and the chance of natural childbirth is greater. The older the age, the higher the probability of complications such as hypertension, diabetes, and heart disease, so the chance of cesarean section also increases.

　　Secondly, whether the mother's nutrition is reasonable and her weight is qualified. The most ideal weight gain during pregnancy is: 2 kilograms in the early pregnancy (within 3 months), 5 kilograms in the middle pregnancy (3-6 months), and 5 kilograms in the late pregnancy (7-9 months). That is, a total increase of about 12 kilograms is appropriate. If the entire pregnancy increases by more than 20 kilograms, the baby may grow too large, and it is not advisable to choose natural childbirth at this time.

　　In addition, it is necessary to see if the mother has the strength for delivery. Generally, the labor process takes about 14 hours, and enough physical strength is needed to complete it. Systematic exercise can greatly help ensure the physical strength during delivery. Finally, it is necessary to see if the mother has psychological preparation for bearing the pain of delivery. Lack of sufficient psychological preparation is not conducive to natural childbirth.

　　2. Cesarean delivery

　　Commonly known as cesarean section, it is the method of opening the abdominal wall and uterus to deliver the fetus. It is a method often adopted when a pregnant woman with a narrow pelvis, abnormal placenta, abnormal birth canal, or early rupture of amniotic fluid, or a fetus with abnormalities needs to terminate the delivery as soon as possible. If the case is properly selected and the operation is timely, it can save the lives of both mother and child. Cesarean section can avoid the pain of labor for the mother, and if there are other diseases in the abdominal cavity, they can also be treated at the same time. However, cesarean section surgery causes greater injury to the mother, the postpartum recovery is slower, and there may also be postoperative sequelae.

　　(1) Cesarean section postoperative care

　　① After surgery, one should turn over more often

　　Anesthesia drugs can suppress intestinal peristalsis, causing varying degrees of intestinal distension, thus causing bloating. Therefore, it is advisable to do more turning movements after delivery to promote the early recovery of the paralyzed intestinal muscle peristalsis function, so that the intestinal gases can be expelled as soon as possible. After 12 hours of surgery, drinking a decoction of senna leaves can help alleviate bloating.

　　② Pay attention to doing fitness exercises

　　About 10 days after cesarean section surgery, if the body recovers well, fitness exercises can begin. The method is: lying on the back, alternately lifting the legs, first perpendicular to the body, then slowly lowering them, doing 5 times for each leg; lying on the back, placing the arms naturally on the sides of the body, bending and lifting the right leg, trying to bring the thigh as close to the abdomen as possible, and the heel as close to the buttocks as possible, alternating between the left and right legs, doing 5 times each; lying on the back, bending the knees, crossing the arms and holding them in front of the chest, then slowly sitting up to a semi-recumbent position, and then returning to the supine position; lying on the back, bending the knees, raising the arms straight up, doing sit-ups; lying on the stomach, bending the legs towards the chest, the thighs perpendicular to the bed and lifting the buttocks, the chest pressed against the bed, do this in the morning and evening, each time gradually extending from 2 to 3 minutes to 10 minutes.

　　③ The bed should be taken in a semi-recumbent position

　　The postpartum recovery of cesarean section mothers is slower than that of those with natural childbirth, and they cannot get up and move around as soon as 24 hours after delivery like those with natural childbirth. Therefore, cesarean section mothers are more prone to the condition of difficult lochia discharge. However, if they adopt a semi-recumbent position and turn over frequently, it will promote lochia discharge, prevent lochia from accumulating in the uterine cavity, causing infection and affecting uterine复位, and also facilitate the healing of the uterine incision.

　　④Strive to get out of bed early

　　As long as the physical condition allows, it is advisable to get out of bed as early as possible after childbirth and gradually increase the amount of exercise. This not only increases the function of intestinal peristalsis, promotes the复位 of the uterus, but also prevents the occurrence of intestinal adhesions and thrombophlebitis.

　　⑤Pay attention to urination after childbirth

　　For the convenience of surgery, it is usually necessary to place a catheter before cesarean section. After 24-48 hours, the influence of the anesthetic drug disappears, and the bladder muscle recovers its urination function. At this time, the catheter can be removed, and you should try to urinate on your own as soon as you feel the need to urinate, to reduce the risk of urinary tract bacterial infection caused by retaining the catheter for too long.

　　⑥Keep the vulva and abdominal incision clean

　　Avoid getting the abdominal incision wet within 2 weeks after the operation. The whole body should be cleaned by sponge bath. After that, you can take a shower, but you must avoid taking a bath in a basin before the lochia is completely cleaned. Wash the vulva 1-2 times a day, and pay attention not to let dirty water enter the vagina. If the wound becomes red, swollen, hot, or painful, do not squeeze or apply bandages arbitrarily. Seek medical attention in time to avoid delayed healing of the wound infection.

　　⑦Avoid eating bloating foods

　　About 24 hours after cesarean section, gastrointestinal function can be restored. After the gastrointestinal function is restored, give liquid food for 1 day, such as egg soup, congee, and avoid milk, soy milk, and large amounts of sucrose and other bloating foods. After the intestinal gas is discharged, change to semi-liquid food for 1-2 days, such as congee, noodles, wontons, and then switch to normal diet.

　　⑧Reduce the use of painkillers

　　The effect of the anesthetic drug after cesarean section gradually disappears, and the pain sensation of the abdominal wound begins to recover. Generally speaking, the wound starts to hurt severely a few hours after the operation. To rest well and recover the body as soon as possible, you can ask the doctor to prescribe some painkillers on the day or night of the operation. After that, it is best not to use too many painkillers to avoid affecting the recovery of intestinal peristalsis. Generally speaking, the pain of the wound will disappear spontaneously after 3 days.

　　⑨Absolutely forbidden sexual intercourse during the puerperium

　　Six weeks after cesarean section, if there is no longer vaginal bleeding, and the doctor checks that the incision has healed well, sexual life can be resumed. However, strict contraception measures must be taken to avoid pregnancy. Otherwise, the uterus with scars is prone to perforation or even rupture during dilatation and curettage.