分娩过程全览

Are you dreading labor? Do yourself a favor–learn as much as you possibly can about labor beforehand. Most women fear labor because of what they think will happen. And while, grant you, labor is no picnic, you can allay many of your fears by understanding what will be happening to your body.

Labor is different for each woman and for each pregnancy, there are 3 main stages:

Stage 1–the longest stage

During this stage–which begins with the first uterine contractions and ends with complete dilation of the cervix–you’ll probably spend most of your time at home. At first, the contractions are like strong menstrual cramps, lasting from 30 to 40 seconds and occurring every 5 to 15 minutes. They increase in rhythm, strength, and duration until, eventually, they last as long as 60 seconds and come every 2 to 3 minutes.
What’s happening during stage 1:
Your uterus and cervix, which together look like an upside-down pear, are rearranging themselves into the shape of a keg. The cervix, or neck of the pear, is getting shorter and dilating or opening so baby’s head can get through. This change is called effacement. At the end of this stage, the cervix will be dilated to about 10 centimeters (nearly 4 inches).
备注:产妇分娩顺利与否,除了胎儿大小, 胎位如何,骨盆大小及形态的因素以外,还有一个很重要并起决走性的因素,这就是产力。所谓产力即指子宫肌肉和腹肌的收缩力而言,子宫收缩需要一定的能量。据实验表明,每一次子宫收缩所需要的能量相当正常人上一层楼梯。而一个初产妇平均产程需要8~16小时,按临产后正常的子宫收缩为3 ~5分钟一次计算,一个初产妇在整个产程宫缩约200次左右,也就是说相当正常人走200多层楼梯,可见其消耗能量之 大。因此,增加一定量的热能以补充体力消耗是很有必要的。 在这一产程中,孕妇应照常吃些高热量的液体或半流质食物。比如红糖水加鸡蛋、鸡枣汤、桂园汤等营养丰富,热量高的食物。对不能进食者,应给予10%的葡萄糖液500~1000毫升静脉滴注,内加维生素C 500毫克。另外产妇经过一段时间熟睡, 改善全身状态后,也能使体力恢复,子宫收缩力转强。如若做不到产妇临产后和产程中及时补充营养和热量,势必影响产力的正常发挥,使产妇过于疲劳,导致产程延长,给产妇和未出世的孩子带来不利。巧克力是由奶油或牛奶、白糖、可可粉等精制而成的营养丰富、热量较高的食品。因此,产妇在临产后和产程中吃些巧克力,无疑是一种简便、易行、增强产力的方法。

Stage 2–pushing and delivery

Now it’s time to go to work. Although this stage is no more comfortable, at least you’re an active participant, pushing with the contractions. Using the techniques learned in childbirth classes will help you breathe and bear down, making each contraction more effective. Plus, you’ll get lots of coaching from your partner and the medical personnel.
What’s happening during stage 2:
Near the end, the baby’s head can be seen during and after a contraction. That’s called crowning. At this point, the doctor may do an episiotomy–a shallow cut into the lower vagina to keep your tissue from tearing. Next (the part you’ve been anticipating forever!) the baby is born, usually head first and face down. At this point, the doctor may place your baby face down on your abdomen for skin-to-skin contact. Your newborn may take a first breath at that moment, or perhaps the doctor will have you gently massage the baby’s back. Sometimes the doctor will perform a little suctioning to make sure the baby breathes freely. Finally, the umbilical cord is cut. Your partner may be allowed to assist here. There also may be other activity, for example treating baby’s eyes to prevent gonorrheal infection, evaluating baby’s condition, or perhaps injecting baby with some vitamin K to aid in blood clotting. And of course, someone will take footprints and issue the ID bracelets–one for you and one for baby.
备注:此产程胎儿胎头由子宫进入阴道。因胎头压迫直肠,产妇有要排大便的感觉;这时产妇应先吸二口气,然后随着宫缩向下用力,靠迸气增加腹压来逼出胎儿,是加速分娩的重要做法。宫缩停止后就休息、产妇应尽可能的不要乱喊或乱动,以免消耗体力。产妇在产床上的有利姿势是:平卧,两腿屈曲,足蹬在产床上,两手拉住产床的把手,然后随着阵缩的加强向下迸气。

Stage 3–the afterbirth
One more job to do–deliver the afterbirth. Your contractions may have stopped but will restart, and will last between 5 and 20 minutes until the placenta is expelled.

Fetal monitoring
During the first 2 stages of labor, your baby’s progress may be monitored electronically.

What about pain control?
While labor pains sometimes can be significant, there are several ways you can help alleviate the pain.
• The epidural.
This is the most common anesthetic used in labor and delivery. Here, the doctor threads a catheter through the vertebrae and into your lower back. Then, moderate doses of anesthetic are injected about once an hour. The anesthetic blocks both your motor and sensory fibers. The sensory nerves are easier to numb than the motor nerves, so you may, for example, be able to move your legs a little bit but you won’t feel them very well. So, when it’s time to deliver, you can’t feel your contractions and don’t have a sense of when to push, which is a drawback.

• The continuous epidural.
This newer version solves that problem. As with the epidural, a catheter is inserted, but now only small amounts of anesthetic are administered by a pump so your nerve fibers are continuously bathed in anesthetic, rather than overwhelmed with one large dose. As a result, your sensory nerve fibers are blocked, but not your motor nerve fibers, so you’re able to push.

• The walking epidural.
This newest option allows you to remain mobile. Ask your doctor about this new one.

• Analgesics like Demerol and Stadol.
If you’re given either of these medications through an IV or as an injection, they can take the edge off the pain of contractions. While they are narcotics, addiction is not a problem because the medications aren’t used for days at a time.

Drug-free pain control
In addition to the pain-relief options that include medication, you also may consider the following:

• Hydrotherapy. If your hospital has a whirlpool spa, you can spend the most intense part of your labor letting the warm water jets massage your aching back. Perhaps even more importantly, the water will let you relax and ride through the pain and work with your contractions. Today many hospitals include spas in their maternity unit for this very purpose. If your water has broken, you may not be able to take advantage of this therapy. Check with your doctor about any limitations that may be necessary.

• Self-hypnosis. This allows you to focus on a pleasant image while relaxing your body.

Categories: 十月怀胎, 孕期保健

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