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How to give birth at home? Home birth: an unjustified risk or the right fashion? My husband persuaded me to give birth in a maternity hospital.

Home births are those that take place outside the walls of a medical facility. Their management is usually carried out by so-called “spiritual midwives”. These people call themselves this beautiful name because, when offering their services, they do not announce the main aspect of the birth act physical condition, but the correct spiritual mood of the woman in labor, which determines the course of labor. Thus, if complications arise during childbirth, everything can be explained quite logically: it means that the woman herself is to blame - she was in the wrong mood for childbirth, did not really want the child, etc.

It may happen that expectant mothers who go to classes to prepare for childbirth find themselves in classes where it is very gradually, in a veiled form, instilled in them that home birth is the only the right method. At the same time, “spiritual midwives” gradually exert powerful pressure on the psyche of pregnant women, taking into account the characteristics of their neuropsychic state, which can change significantly under the influence of hormonal changes: expectant mothers can acquire such qualities as suspiciousness, suggestibility, emotional lability, etc. As a result of such “preparation”, sometimes quite sane people, without realizing the danger of the situation, as if under hypnosis, become ardent supporters of home birth.

What arguments do supporters of home birth give and what point of view do they adhere to in this regard? official medicine?

Psychological comfort

Proponents of home birth are, as a rule, ardent opponents of traditional obstetrics, and they are intransigent and aggressive, telling blood-chilling stories about the horrors of childbirth in a hospital. One of the most compelling arguments is the psychological comfort of the woman in labor and the child, who is born not in a government environment, but within their own walls, in the presence of loved ones.

The process of childbirth is always a stressful situation for both the pregnant woman and the fetus, since it little man transforms into a fundamentally different way of its existence, where literally everything - breathing, nutrition, conditions environment– is strikingly different from the conditions of intrauterine existence. Therefore, no matter whether the baby is born at home by candlelight in a warm bath or in the delivery room, he will still experience stressful situation. This stress is extremely necessary for him in order to successfully rebuild life support processes and move into qualitatively new living conditions outside the mother’s body.

As for a woman’s psychological comfort, modern maternity hospitals have individual single-occupancy maternity wards with transformable beds. No one is surprised by being present at a birth for a long time now loved one- husband, mother or girlfriend, and the environment in the maternity unit is close to home - you just need to take care of the choice in advance maternity hospital.

Baby-mother contact

According to people who promote home birth, at home the child immediately after birth falls into the tender hands of the mother, is applied to the breast, thereby establishing close contact between the mother and the baby.

Without a doubt, the presence of the mother is extremely important for the comfort of the child, but in modern times maternity hospital For a long time now, there have been no restrictions on the contact of a newborn with his mother immediately after birth, or on breastfeeding, unless there are medical contraindications for this.

Free behavior of a woman in labor

It is believed that when giving birth at home, a woman can take any comfortable position, breathe correctly, walk, lie in the bath, sing, massage and even eat food whenever she wants.

But even in maternity hospitals, no one needs to be convinced for a long time that the free active behavior of a woman in labor contributes to a smoother course of the period of cervical dilatation and a reduction in pain due to distracting actions. In many maternity rooms there are special large balls - fitballs, on which women can sit, lie, lean their backs, etc., showers and bathrooms for taking water procedures, which have an excellent analgesic and relaxing effect, and active behavior during childbirth - walking, taking comfortable positions to relieve the pain of contractions, using various massage techniques, etc. - welcome.

No drug aggression

One of the most important arguments in favor of home birth, its supporters include the so-called “soft” management of childbirth without outside interventions, without opening the membranes, pain relief and stimulation of labor.

But when women talk with undisguised pride about how they gave birth at home for 3 days, but not a single injection was given, then we are not talking about any “soft” childbirth. In these cases, the birth ended successfully for the mother and child not thanks to, but in spite of similar methods their management.

All interventions, from the use of medications to various manipulations during childbirth, have clearly defined indications, which are justified and recorded in writing in the birth history, so no prescription is made just like that when managing childbirth in the maternity hospital. For example, in some cases, such as flat membranes due to small quantity amniotic fluid or, conversely, an increase in the amount of amniotic fluid (polyhydramnios) means that the fetal bladder during childbirth will not only not be able to perform its functions inherent in nature, but will also interfere with the normal course of labor until it is opened. Pain relief for childbirth is not always carried out only at the request of the woman - there are also medical indications for this, such as high blood pressure, premature birth etc. And even more so, in the case of an absolutely normal course of labor, labor stimulation is never carried out without indications. According to modern legislation, all medical procedures can only be performed with the consent of the patient.

No surgical intervention

Women who passionately want to give birth on their own often decide to give birth at home, despite the fact that they are recommended to deliver by cesarean section according to relative indications. Such indications include situations in which a woman, in principle, can give birth on her own, but to one degree or another there is a danger of complications, most often for the condition of the fetus. In cases where surgical delivery is recommended for relative indications, and not for absolute ones, which arise in life-threatening conditions for the mother, written consent for the operation is always taken from the woman. Thus, if the expectant mother wants to give birth on her own, no one has the right to prohibit her from doing so, but you should not expose yourself and the unborn baby to unjustified risks - it is better to take care of choosing a doctor who will be sympathetic to the patient’s wishes and will take full responsibility for the management of childbirth.

The advantages of home birth include the absence of perineal incisions, which they allegedly “love” to do in the maternity hospital. This procedure is performed in two cases: when it is necessary to speed up the birth of a baby, for example, when signs of oxygen starvation appear - hypoxia during the expulsion of the fetus, or when there are signs of a threatening perineal rupture. In any of these situations, timely incision will improve the prognosis for either the fetus or the mother. In addition, a neat surgical incision is much easier to reconcile and close than to allow a rupture, which will have jagged edges and will not heal as well.

Native environment

Another argument put forward in favor of home birth is the contact of the newborn with the microflora of the mother and father, which is natural and familiar to this particular family.

But we should not forget about the high probability of the presence of pathogenic microflora in the house that causes various diseases. The required degree of disinfection can only be achieved in a maternity hospital, where cleaning is carried out regularly using special disinfectants, instruments are properly sterilized and the hands of medical staff and linen are treated, and the air in the premises is disinfected by quartzization. All this is done under careful control over the quality of the disinfection measures carried out - with the collection of crops, washes, air samples, etc. All these measures have important, since due to various reasons expectant mother and the child are especially defenseless against infections, and after childbirth the uterine cavity is a vast wound surface, which, if the necessary aseptic and antiseptic measures are not observed, can become infected.

Emergency situations

Why do obstetricians have such a negative attitude towards home births? The fact is that childbirth is a process, at any stage of which complications may develop that require very rapid medical care, and in some situations it is the time factor that is of paramount importance for the effectiveness of the measures taken. It is also important to remember this because predicting these emergency situations very difficult: even with an absolutely smooth pregnancy, no one is immune from complications during childbirth.

Let's list just a few of them:

  • Abnormalities of labor, which may manifest themselves in various options– from weakness of labor forces to excessively vigorous labor activity. The occurrence of this complication requires, firstly, treatment, and secondly, careful monitoring of the condition of the fetus. In the absence of adequate assistance, the child may experience intrauterine hypoxia - oxygen deficiency, and the mother, due to impaired contractility uterus - bleeding after the birth of the fetus.
  • Clinically narrow pelvis is a condition when the fetal head, due to various reasons, such as an anatomically narrow pelvis, large fetal size, incorrect insertion of the fetal head, post-term pregnancy, etc., is larger than the mother’s pelvis and cannot be born through the natural birth canal. Diagnosis clinically narrow pelvis can be placed at the end of the period of opening of the uterine pharynx, when contractions turn into attempts, or during the period of expulsion. This situation requires emergency surgical delivery. In the absence of qualified medical care, uterine rupture may occur with profuse intra-abdominal bleeding and intrauterine fetal death. A woman’s life in this situation will also be at risk.
  • Umbilical cord prolapse is a situation in which an emergency caesarean section will save the baby’s life. With this complication, more often with incomplete opening of the cervix, a section of the umbilical cord falls out at the moment of rupture of amniotic fluid. After this, the fetus’s head is pressed against the walls of the pelvis and oxygen stops flowing to the baby. It is clear that the number of minutes that will pass from the prolapse of the umbilical cord to the extraction of the fetus is a matter of the child’s life.
  • Bleeding is one of the most dangerous complications childbirth It can occur both during the period of opening and expulsion of the fetus, and after the birth of the child - in the afterbirth or early postpartum period. Bleeding represents real danger for the life of the mother and fetus, since they arise suddenly and are massive, i.e. a rapid increase in the amount of blood loss in a matter of minutes, and therefore require emergency care to eliminate the source of bleeding, avoid complications and replenish blood loss.

During labor, bleeding may occur due to premature detachment placenta, when its separation from the wall of the uterus occurs before the birth of the fetus. In unexamined women who did not have an ultrasound scan during pregnancy, profuse bleeding often begins due to placenta previa, a pathological condition when the placenta attaches to the lower segment of the uterus and blocks the cervical canal, preventing the birth of the fetus. In both of these cases, an emergency caesarean section is necessary. In these situations, the speed of providing qualified assistance can save the life of both mother and child.

After the baby is born, bleeding may begin in the third stage of labor, which is associated with processes of disruption of the separation of the placenta from the uterine wall. In this case, to stop the bleeding, you need to quickly remove the placenta from the uterine cavity, which requires surgery manual separation and discharge of the placenta, performed under anesthesia.

After childbirth, bleeding may occur due to decreased contractility of the uterus (hypotony) or rupture of the birth canal, such as the cervix. To quickly stop such bleeding, quick coordinated actions of the obstetric team using surgical interventions. At the same time, we must not forget about the need for sterile instruments and suture material, the possibility of good pain relief, the availability of means to replenish blood loss and resuscitate a newborn, which, of course, is only possible in a maternity hospital.

Home birth is a birth that takes place outside of a hospital or maternity hospital, usually in the mother's home. There are several varieties: most births are carried out by home midwives, much less often by obstetricians-gynecologists, sometimes home births take place without any outside medical assistance (such births are called freebirth or “free” births in the West).

Along with traditional births in a maternity hospital, home births are becoming increasingly popular today. And this trend is not accidental - women want to have a pregnancy in which they will not interfere just because “the doctor needs to go home,” the maternity hospital has a plan, or simply because “that’s how it’s supposed to be.” Childbirth is such an intimate process that even a first-time woman feels at some instinctive level what she needs during this period. It is no coincidence that a woman seeks peace, solitude, understanding and support from those who are present with her at this moment. Unfortunately, modern maternity hospitals are not always ready to provide a “soft birth”. Not only in our country, but also in the West, childbirth is increasingly beginning to resemble pathological process, they are stimulated, anesthetized, slowed down or accelerated at the request of the doctor. Often there are no direct indications for such manipulations.

It is the lack of understanding basic needs women in labor and leads to the fact that many of them agree to home birth.

Let's figure out together how safe home birth is and are there any contraindications?

In the majority European countries The percentage of home births gradually declined throughout the 20th century, but home midwifery began to make a resurgence in the 1970s. Now in many Western countries and in America, home birth is seen by many women as an alternative to the overly “impersonal and overmedicated” hospital birth.

Proponents of home birth believe that childbirth in one’s own home has an extremely beneficial effect on a woman. The woman in labor does not experience stress because the birth takes place in a familiar environment with close and understanding people. It is believed that in home birth there is no average approach to the birth process as in a maternity hospital, and that is why a woman gives birth easily and naturally.

Indeed, some studies confirm that a planned home birth with a trained midwife for women with uncomplicated pregnancies is almost as safe as a hospital birth. At home, such types of obstetric care as forceps, episiotomy and epidural anesthesia are practically not used. It is known that each of these medical procedures may carry a certain risk for both mother and child.

When giving birth at home, at the time of contractions, a woman can take any position that is convenient for her, eat and drink what she wants, which is not always allowed in a hospital. The possibility of becoming infected with any pathogenic flora resistant to a number of antibiotics, for example, Staphylococcus aureus, at home is minimal.

A study conducted and published in the British medical journal" in 2005. " Outcome of planned home birth with a certified home midwife in North America" (Johnson and Davis, June 2005) showed that the rate of positive outcomes for home births is comparable to that of hospital births. Quantity medical manipulations(such as epidural anesthesia, episiotomy, use of forceps and vacuum extractor or) was significantly lower in women who began labor at home than in women with uncomplicated pregnancies who gave birth in hospital. The experiment involved 5,418 women who planned to give birth with certified midwives at home. 655 (12.1%) women who began labor at home were taken to the hospital during labor. Of these, 4.7% underwent episiotomy, 2.1%, forceps were used in 1.0% of cases, vacuum extraction in 0.6%, and cesarean section was performed in 3.7% of women in labor. In the group of women who gave birth in a hospital, the rates for the same items were much higher - episiotomy was performed in 33% of cases, vacuum extraction in 5.5% and caesarean section in 19% of women giving birth.

There were 1.7% fetal deaths per 1000 births reported during home births. These figures are comparable to other studies examining home birth rates among women with uncomplicated pregnancies. There were no maternal deaths recorded. The study found that home birth failure rates were also comparable to hospital birth failure rates.

According to WHO, the main causes of maternal mortality worldwide are: obstetric hemorrhage (25%), infections (13%), eclampsia (12%), complicated childbirth (8%), complications after abortion (13%) and other direct and indirect (diabetes, etc.) causes. Most of these problems happen during childbirth or pregnancy. Most high rate mortality is recorded in countries where there is no medical care during childbirth. An experienced midwife can see signs of beginning bleeding, eclampsia, or identify complicated births and quickly transport the mother to the hospital.

However, if complications occur during childbirth, such as prolapse of the umbilical cord, breathing problems in the child, or bleeding in the woman, the mother’s stay outside the hospital sharply reduces the likelihood of a successful outcome of the birth. You and your child may simply not have time to receive the necessary medical care.

Childbirth is a natural but unpredictable process. Sometimes healthy woman with an uncomplicated pregnancy during childbirth there are serious problems, and vice versa - women who are initially not very healthy give birth quickly and without problems. Unfortunately, your doctor cannot predict one hundred percent what your birth will be like. He can only guess based on your pregnancy history. However, even the most experienced doctor sometimes makes mistakes. But he has the ability to react quickly if problems arise. Childbirth is a burden on the entire body, and sometimes after childbirth bleeding may occur or an exacerbation may occur. concomitant diseases that will require medical intervention.

When deciding on a home birth, you need to be prepared for the fact that you may need medical care in a hospital.

In addition, there is a whole series contraindications for home birth. The latter include:

  • high blood pressure or diabetes in a woman in labor;
  • kidney or heart problems in a woman in labor;
  • history of caesarean section or other operations performed;
  • complications during childbirth (preeclampsia, twins or breech presentation);
  • genetic diseases in a woman, etc.

Unfortunately, in our country there are now many “home” midwives who, without specialized medical education, take on the responsibility of delivering someone else’s birth. Most home midwives in Russia do not even have special equipment to carry out resuscitation measures or stop the bleeding. We do not have certifying bodies to supervise and train home birth midwives. Therefore, very often mothers have to be content with the services of home-grown midwives. The danger is that a person who does not have a medical education can successfully deliver a baby until the moment when he suddenly needs to make a quick and medically sound decision in case of a complicated birth. The home “midwife” simply won’t know what to do. It would be good if she at least guessed to take the woman in labor to the maternity hospital, but there are times when the “midwife,” not understanding the seriousness of what is happening, dissuades the mother from going to the maternity hospital, says that everything will definitely return to normal, and precious minutes are wasted.

In the West, home births are performed by certified midwives who have a license to work and papers confirming her experience. When giving birth at home, she must have with her not only a standard set of instruments and medications, but also oxygen, equipment for pediatric resuscitation, drugs to stop postpartum hemorrhage, and an IV. This midwife works with a nearby hospital and doctor who can be quickly contacted in case of unplanned complications.

Here, everything usually happens like this: first, parents attend specialized courses for pregnant women, where they are actively offered to experience the fullness of happiness from the birth of a child, that is, to give birth to a baby at home. Moreover, usually a woman is not asked whether she can give birth at home, what diseases she has, or whether the pregnancy is uncomplicated. Then, before giving birth, women increasingly try to offer their own services, that is, “ psychological attitude» for home birth with the participation of one of the course staff. Moreover, these employees do not always even have a medical education, but this does not bother anyone.

Home midwives are also found through friends or online forums. Their names are passed down from one mother to another. Of course, among these women there are educated and trained specialists who you can trust with yourself and your baby. In the case, I repeat once again, of an uncomplicated pregnancy and the absence of any serious illnesses in your history! But, unfortunately, the percentage of unqualified “midwives” is not so small, and there is no guarantee that you will not come across just such a professional in quotes.

In the West, not every woman has a home birth. If you have an uncomplicated pregnancy, you may well choose a home birth with a certified one! midwife, but if there is a suspicion possible complications you will be advised to give birth in a hospital and no one will think of refusing, because the consequences can be very dire. In our country, in my opinion, home birth is too risky a process, the responsibility for which, in case of an unsuccessful outcome, will most likely be borne only by the mother. And while statistics on childbirth in official medical institutions exist in our country, there is simply no such data on home birth in Russia.

Therefore, the question of childbirth at home remains open. Each woman must determine for herself, after weighing all the pros and cons, what kind of birth she would like to have. Is she ready to take a risk, take on at least part of the responsibility and give birth at home, or will she feel safer trusting the doctors? Of course, a maternity hospital is not a panacea for complications during childbirth. In the maternity hospital, there are also unqualified doctors and unsuccessful outcomes. Moreover, you need to understand that not everything depends on the doctor. Of course, professionals have a lower failure rate, but they are not gods either. But still, a hospital, in my opinion, provides a great guarantee that you will at least be cared for by trained doctors who deliver births almost every day, and not occasionally, and not alone. In the maternity hospital, in case of complications, you will be able to quickly receive a blood transfusion or undergo surgery. God grant that such a need does not arise, but it would be stupid to rely only on chance and live by the principle “nothing bad can happen to me.”

It seems to me that the best option for a woman giving birth would be to have the baby in a special hospital that is “friendly” for mother and child. That is, in an uncomplicated pregnancy, a woman in labor is provided with a separate room in which you lie during labor and give birth in it, your closest relatives can be present with you at the birth, and the birth is conducted by a trained midwife. You can behave as you wish during contractions, turn the lights on and off, eat, drink, laugh or sing. No one should rush you or stimulate your labor. Medicines unless absolutely necessary, reduced to a minimum. If complications arise, the woman can be quickly transferred to another department, and the team on duty will be able to promptly prepare the woman in labor for the necessary medical procedures.

To summarize, I would like to emphasize once again that the decision to give birth at home or in a hospital should be made by each woman individually, but always after consultation with a doctor. If you have contraindications for home birth, it is better to go to the maternity hospital. Remember that home birth is only suitable for women with an uncomplicated pregnancy. Unfortunately, a woman without a medical education, no matter how well she feels, cannot correctly and adequately assess the consequences of her decision. Therefore, a positive decision about home birth is possible only after a detailed consultation with a doctor and with the guarantee of the presence of an experienced obstetrician at the birth.

Pregnancy is the most emotional period in the life of every woman, and the closer the due date, the more worried and worried the expectant mother is. The 40th week of pregnancy is approaching, the mother is anticipating the long-awaited contractions, but they still do not begin. The last days of pregnancy drag on for a long time, and the baby still does not want to go out into the big world.

When the day passes on which the doctors suggested giving birth, mommy becomes truly anxious. Is everything okay with the baby? How long will it take for him to be born? Is it possible to induce contractions on your own? Every pregnant woman wants to quickly free herself from a heavy burden and press her beloved baby to her chest. There are several fairly effective ways to speed up labor at 40 weeks of pregnancy, the only question is whether it is necessary.

When should you give birth?

Pregnancy ideally lasts exactly forty weeks, or ten lunar months, but the child may be born earlier than the appointed time, or may linger in the womb. It is not considered a deviation from the norm if the baby decides to get out of the belly already at 38 or only at 42 weeks. In the first case, the baby is fully formed, continues to grow and gain weight, and in the second case, it does not yet show signs of postmaturity.

A woman’s body manifests itself very individually, but you can roughly calculate how long the pregnancy will last by looking at the length of her menstrual cycle. If menstruation recurs after 28 days, then the child will most likely be born exactly on the date determined by the doctors, but if menstrual cycle takes more than 30 days, then gestation will be long.

If for some reason the baby is born before 38 weeks, he is considered premature and must be nursed in the postpartum department. And if a baby is born after 42 weeks, all the signs of postmaturity are noticeable, which also does not have a very good effect on his health.

The doctor informs you of the preliminary date of birth to the expectant mother even at the first appointment antenatal clinic, and a more precise period is determined during an examination with an ultrasound machine, when the physician observes the degree of development of the embryo. At the 40th week of pregnancy, if there are no pathologies or complications, childbirth takes place naturally. But under certain conditions, the doctor may prescribe a caesarean section.

Is it really necessary to induce labor?

Whether it is worth inducing labor at 40 weeks of pregnancy, only a doctor can tell after an examination. If the baby grows and develops normally in the womb, there is enough space for him, the mother does not have to worry, waiting for natural birth process. In this case, it is better not to interfere during pregnancy.

But if the baby is large, he may not have enough oxygen from the aging placenta. A post-term baby who does not want to get out of his belly experiences oxygen starvation. In addition, after the 40th week of pregnancy, the fetus’s skull bones begin to harden, which means that it will be very difficult for him to move along the birth canal, and the mother will experience severe pain during childbirth. In this situation, in order not to wait for a referral for a caesarean section, the pregnant woman is advised to induce labor.

How to induce labor at home?

Already at 39 weeks, doctors begin to scare a pregnant woman artificial stimulation childbirth using medications. No mother wants to poison herself or her unborn baby. medicines, so many people wonder how to induce contractions at home. There are many ways to independently induce contractions and childbirth; a doctor at the antenatal clinic can tell you about them in detail. Women who are determined to give birth should take a good rest and sleep, because childbirth is a long and tiring process.

  1. Hiking. Brisk walking on fresh air useful at any stage of gestation: it increases the tone of the body and gives it a good shake-up, bringing birth closer.
  2. Physical activity. Many women admit that their contractions began as soon as they finished cleaning the house. The main thing is not to overwork, so as not to provoke placental abruption instead of childbirth. You can wash the floors, dust the furniture, take out the trash, give your older child a bath, wash the clothes, but you cannot carry heavy buckets or lift loaded boxes and bags of groceries.
  3. Sex. Natural and very effective way speed up childbirth at home, especially if the intimate process ends with orgasm. Spermatozoa contain a high concentration of the hormone prostaglandin, which helps soften the tissue of the uterus, and orgasm causes its active contraction, which can smoothly develop into labor pains.
  4. Breast massage. Intense stimulation of the breast in the area around the nipples provokes the production of the hormone oxytocin, which is responsible for the onset of labor.
  5. Laxatives. Increased peristalsis intestinal tract not only helps speed up labor, but also cleanses the body, which allows high probability avoid loose stool during contractions. A good laxative for pregnant women is ordinary castor oil; one tablespoon is enough to induce contractions. Also in last days During pregnancy, it is advisable to eat more fresh fruits and vegetables, and cereal porridges.
  6. Folk remedies. Activates labor, softens cervical tissue, strong tea from raspberry leaves, but should not be taken before 40 weeks of pregnancy. This is very strong remedy, which can cause miscarriage early stages. A thoroughly whipped mixture of sparkling water, apricots, almonds and castor oil also helps to quickly stimulate labor.
  7. Linseed oil. The components it contains make the tissues of the uterus and birth canal soft and elastic, preparing them for the upcoming birth. If there is allergic reaction flax oil, you can replace it with primrose oil.
  8. Fragrances. It is believed that the scents of certain flowers, especially roses or jasmine, can induce contractions. A woman who wants to give birth sooner later, can perform aroma therapy at home using flower oils. The main thing is not to cause allergies.
  9. Acupuncture. This method of inducing labor is best left to a specialist. The master uses the finest needles to influence the points of the body responsible for the functioning of the uterus. This technique quite often contributes to the occurrence of contractions.

Every pregnant woman knows approximately when to expect labor. But sometimes the process begins quickly and you have to give birth at home. Therefore, you need to be mentally prepared for such a turn of events and know what to do in this case.

How to give birth at home at home, what to do if labor starts at home? Let's talk about this on this page “Popular about health” today:

Signs of the onset of labor

It is very important to determine that the birth process has actually begun. Its onset is indicated by characteristic signs:

There is a desire to push, to go to the toilet.

Scarce discharge from the vagina spotting. They can appear on their own, or are released following uterine contractions.

Contractions begin. They can follow after the appearance of discharge or before it. If during contractions the discharge becomes profuse and turns into bleeding, this is very dangerous. Urgently .

If there are signs of the onset of labor, you need to try to calm down, do not panic or be nervous. There must be a husband or someone close to you or neighbors at home. This is necessary to help the woman in labor and her safety (if something goes wrong). Be sure to call an ambulance. The doctor, like no one else, knows what needs to be done in certain cases.

It is necessary to prepare:

Clean boiled water, sterile bandages;
- clean diapers, ironed on both sides, a blanket;
- medical or any other clean oilcloth;
- a small syringe, brilliant green, iodine, a knife, alcohol, or at least vodka for disinfection (the knife and syringe should be boiled for at least 5 minutes);
- a new plastic bag for packing the placenta - it must be handed over to doctors for examination.

What to do if labor begins?

First of all, the woman in labor and the person who will deliver the baby should thoroughly wash their hands and wipe them with alcohol.
The birth process is divided into three periods:

First: Regular contractions. It can last from 2 hours to a day. It is during this period that it is important to call an ambulance and take the woman in labor to the maternity hospital.

Second: pushing and childbirth. Here you can no longer go anywhere - the baby begins to move along the birth canal. During this period, a woman cannot even sit, so as not to harm him.

Third: birth of placenta.

With the start of pushing, the woman should be laid down and given birth at home. Usually women instinctively choose a bath for this. There is water and soft wide towels.

Place the woman behind a previously laid clean oilcloth, which you have previously wiped with alcohol. The external genitalia and perineum should be washed with soap and rinsed. Nails need to be trimmed and nail plates oiled disinfectant– iodine or brilliant green.

Next, monitor the pushing process. To reduce pain, massage the woman’s lower back and wipe her face with a damp, cool towel. Don’t fuss, if the baby is ready to be born, he will soon be born on his own and there will be no complications.

When the head is born, hold it suspended until the next push occurs and the shoulders appear, support them too. If the umbilical cord is wrapped around the neck, very carefully but quickly remove it through the head.

Next, the baby quickly comes into the world, so be prepared to quickly pick it up. If your nose and mouth are clogged with mucus, remove it immediately using a small, sterilized syringe. If the baby was born in amniotic sac, quickly tear it apart.

Place him on his tummy, on a sterile warm diaper. In this case, it is desirable that the head is slightly tilted down. Gently, very carefully rub the chest and back with your palm, lightly pat the heels so that the baby can breathe. When breathing appears, he will cry loudly and his skin will turn pink. This means everything went well. Cover him with a warm diaper.

The woman in labor needs to push again to release the placenta. When pushing, gently pull the umbilical cord and it will come out easily.

As for the umbilical cord, it must first be tied with alcohol-treated thread twice, at a distance of approximately 2-3 cm. It should be cut between the tightened places, 20 minutes after the birth of the baby. By this time, the pulsation in it should stop.

Lubricate the tip of the baby's umbilical cord with iodine and apply a sterile gauze pad or a piece of bandage folded several times. Wrap the newborn in clean, ironed diapers on both sides and cover with a blanket.

After labor is over, wash the woman’s genitals with clean warm water and dry with a soft towel. If there are external tears in the perineum, treat with iodine. Place the woman in a clean bed and cover her with a blanket. Place a heating pad with ice on your lower abdomen. Place the baby next to you. Let mom rest and sleep.

If a woman is bleeding, place her in such a way that her legs are elevated above her head and immediately call an ambulance.

In conclusion of our conversation, we note that doctors do not recommend giving birth at home. Even with the woman’s exceptional health and excellent pregnancy. Home birth can be dangerous for mother and baby, as the possibility of possible complications can never be ruled out.

In many families, often Orthodox families, recent years Home births have become popular. Expectant parents turn to numerous commercial centers that offer the services of “spiritual midwives” who are ready to deliver births at home. Main reason- in the desire to give birth “naturally” and the widespread opinion that this is supposedly impossible in maternity hospitals. However, the consequences of such a choice are often tragic. Given the wide interest in these problems, we turned for comment to Roman Getmanov, an obstetrician-gynecologist at the Moscow maternity hospital of the Spas-Perovsky Peace and Mercy Hospital, based on the 70th city hospital.

- Roman Nikolaevich, how do you feel about home births, which are very popular today?

I am against home birth. I'll try to explain my position.

First. I have been working as a doctor for 20 years, but I can say honestly and absolutely definitely: I can never guarantee anything during any childbirth. Childbirth is, on the one hand, a natural process, and on the other hand, we never know God’s providence about the person who is in front of us. In my practice, there have been cases when, in the complete well-being of all circumstances, under normal physiological childbirth children were stillborn. And at the same time, we very often encounter difficult, complicated births, with sick women whose children are initially suspected of some kind of problem - but everything ends well. But any birth is always a risk, and even more so if this birth takes place at home.

The second is the danger of obstetric hemorrhage. Direct transfusion Blood surgery today is considered an operation for which there must be very strict indications. The World Health Organization has left only two such indications - when a person, relatively speaking, is run over by a tram, and with each contraction of the heart he is thrown out. large number blood. And the second indication is obstetric hemorrhage. Obstetric hemorrhage can be described by a very simple anlogy: if your kitchen faucet is broken, then the water flows and you cannot stop it. As you know, an adult has 5 to 6 liters of blood in the body. So, very often seeing when normal birth heavy bleeding and understanding how and how quickly this could end, I, of course, will never undertake a home birth. Even if you save the woman, you will leave her disabled.

Just recently such an incident occurred. One of our parishioners gave birth at home, and the “spiritual midwife,” as they call themselves, delivered babies to two or three women at the same time, moving around Moscow from one apartment to another. It ended with our parishioner ending up in the nearest maternity hospital with blood loss of two liters of blood. And it’s good that it all ended like this, although according to the description there was an episode of pressure loss, that is, it was actually hemorrhagic shock, and people come out of it with big consequences. Chronic syndrome disseminated intravascular coagulation is at least what she acquired. There is no need to talk further about this woman’s health. This is the price of frivolity.

And third. During each birth, situations may arise when you need to make a decision instantly. I am a fan of classical obstetrics, and on my table lies my favorite book - a 19th-century obstetrics textbook, authored by Stekel. This is a German author; my grandfather studied using his textbook in the thirties of the twentieth century. This is a classic textbook on obstetrics. Of course, today the attitude towards obstetric care has changed a lot. Then everything was more natural, and mortality was different then - both maternal and child. But a classic is a classic. Here they are described difficult situations, for example, childbirth in a leg presentation, and every time, when describing such a responsible situation, the question is asked: what should the doctor do? In 90 percent of cases, the answer is the same: keep your hands in your pockets. But as soon as the doctor takes these hands out of his pockets, he must do everything quickly, clearly, with complete dedication and understanding what he is doing and why. But with a home birth, everything we start doing will be amateur. We will not be able to provide qualified assistance to the woman.

- How can one explain such popularity of home births?

The clinic opened by Oden was equipped with special single rooms for women in labor. These chambers have no windows, but there may be a bathtub, or a hanging rope, or the floor may be covered with soft mats at human height. A woman can do whatever she wants there: hang on a rope, lie in a bath, etc. But all this time she is alone in the ward. And when she starts to push, her husband and midwife come and deliver the baby. Women, of course, were specially prepared for such childbirth. If you take a woman in labor from the street, put her in solitary confinement without light and without anything else, the woman will immediately fall into hysterics, thinking that she was locked in solitary confinement, and in general that she was very offended. She will demand that someone be with her and help her with something.

I am a big fan of the Auden method, but, having worked for 20 years in my profession, I, of course, understand that selectively taking some of his provisions and trying to implement them is completely wrong. If you want to give birth according to Auden, then you need to do everything from start to finish, and not just some individual details that you like. In our country today it is not possible to give birth using his method. Maybe we should strive for this, but now it is impossible.

Very often, advocates of home birth refer to the experience of Holland, where quite large percentage childbirth takes place at home. But, firstly, at the stage of gestation, all women there are monitored very carefully. First, with midwives, and if there are any changes in the tests or the woman’s condition, then specialists get involved. A certain percentage of women with a physiologically normal pregnancy express a desire to give birth at home, and they can do this. But a large percentage of women are definitely eliminated, and they give birth in hospitals in the presence of doctors. Today we can often hear: “Why is it possible in Holland, but not here?” Yes, because, firstly, in Holland, at every house in which a woman gives birth, there is an ambulance, which is so well equipped that, if necessary, even quite a lot can be done right in it. major operations! And this ambulance is equipped with a supply of plasma and blood substitute. Moreover, the plasma corresponds to the blood group and Rh factor of the woman who at the moment gives birth. And the estimated time of arrival of this ambulance at medical center, where in the event of any complication a woman can be treated at any time specialized assistance, is calculated in minutes. And secondly, imagine how long it will take you, even in Moscow, to get to the nearest maternity hospital, how long you will stand in traffic jams, and what will you do if a child or woman dies at that moment?

Therefore, I want to say again that Holland and we are two huge differences. And referring to Holland in our conditions is simply irresponsible.

I had offers to take part in home births. And every time I told myself: well, okay, childbirth is a natural process, all the indications are wonderful and the woman is healthy, and most likely everything will go fine. One hundred people will give birth normally at home, two hundred... And the two hundred and first child will die. And you will understand that if this woman had been at that moment not at home, but in a maternity hospital, where she could have urgently received specialized care, then the child could have survived there just fine. And with this understanding, I swore off giving birth at home. If I am a doctor, I must do everything possible so that no one dies. And if someone dies, then I need to know that I did everything possible to prevent this from happening. Therefore, I believe that the risk here is completely unjustified, this is not the same risk if there was nowhere to go, there was a war or something else. I understand well that sometimes a woman is better off giving birth in a field or at a trolleybus stop than in a maternity hospital. This really happens. But we don’t select women in labor, they come to us themselves. And they are very different, but we have no right to take risks with these women, no matter how smart, or stupid, or absurd they may be. Our sacred duty is to help them give birth to their children.

Home birth is very fashionable now. But I have a suspicion that this fashion will soon pass. Because a lot of all sorts of complications have already appeared, many different questions have arisen. I have already been approached as a reviewer to help justify in court the tragedies that happened during home births. And I think that this fashion will not last long. Women should not be exposed to such danger.

- Are there any statistics on home births?

Regarding statistical data, I can tell you the following story. Recently, Christmas readings were held in Moscow, and within their framework there was a subsection dedicated to obstetrics. I was not officially invited there, but my friends who were invited there called me, and I got to the meeting of this subsection. You know, I was simply in quiet horror. And I was forced to leave this meeting, from the very first part. Since no one gave me my blessing to intervene or speak there, I decided to leave quietly. I must say that there were wonderful people there, real devotees from Yekaterinburg, Volgograd, Nizhnevartovsk, who are fighting against abortion in local maternity hospitals. But who represented Moscow? Moscow was represented by “spiritual midwives.”

I don’t know who blessed all this, who organized it, but the fact is that the capital was represented by a real sect. There is no other way to call it. A fairly limited circle of people who are absolutely confident that they are right and are very aggressive towards others. Officials from the Ministry of Health were invited to this meeting. And these ladies in headscarves - “spiritual midwives” - attacked them in the literal sense of the word. Like, you, official medicine, are real bandits! In our home, women give birth for a day, or two, or three, but everything is fine. And in your maternity hospitals you have labor stimulation, pain relief, and something else, but still everyone dies. In general, you are all killer doctors!

Today the state has gradually begun to turn its face towards the Church. Remember famous phrase President that Russia has two defenders - the Church and nuclear weapons. Apparently, this idea was conveyed to the officials, and they are now trying not to conflict with the Church. And so, a high-ranking official who is responsible for motherhood and childhood in Moscow came to the Christmas readings, and immediately fell for these “spiritual midwives” who usurped their right to speak on behalf of the Church. This is what caused my internal protest. Because they are not the face of the Church at all. Perhaps this is their own point of view or the point of view of their confessors, but this is in no way the official position of the Church.

So, this head of motherhood and childhood was clearly not ready for such a conversation. It turned out that we have almost no statistical data on home births; no one simply counts them. This surprised me very much. The official said that according to statistics in Moscow for last year There were 700 complicated home births. But here only those women who were brought to the hospital after home birth were taken into account. To understand the whole picture, you need to question not maternity hospitals, where these women actually end up only with complications, but registry offices: how many babies are registered not with maternity hospital certificates and certificates, but with ambulance coupons, according to witness testimony. But there is no such data. 700 complicated births in Moscow - is this a lot or a little? It is difficult to say, since we do not know the total number of home births. But when women are brought to our maternity hospitals with blood loss, with placenta that cannot be born for almost a day, and other complications, we all understand that this is a complete disgrace.

“And yet the prospect of giving birth in a maternity hospital now frightens many women rather than attracts them.

Firstly, in Moscow today there are many new, modern maternity hospitals.

When I first started working, maternity hospitals still had a single “prenatal room.” This large room with many beds on which unhappy women in labor lie. All of them are on different stages fights, and everyone looks at each other and compares. As soon as one woman starts voicing, everyone immediately starts voicing at the same time. When one of them experienced full opening, in which the fetal head descends into the pelvic cavity, they, these women, were lifted from their beds and taken to maternity rooms, where the so-called “Rakhmanov” chairs stood. The women somehow climbed onto them and began to push. This is a picture very far from natural birth. But our wives gave birth that way.

So, there are few such outdated maternity hospitals left in Moscow, and after reconstruction they are transferred to a new one, modern principle arrangements. Now this is a single rod block, consisting of single boxes, each box has a bed, which can easily be transformed into a chair at the right time. Here a woman gives birth and spends two hours after giving birth with the baby. This best option, no one bothers the woman, she is alone, and when necessary, staff appears.

If a woman is reasonable and prepared, if she understands why she is going to a maternity hospital and that a maternity hospital is not a hotel or a sanatorium, this is a place from which she should always go home quickly - so, if everything is organized correctly, then childbirth in a modern maternity hospital should be no different from giving birth at home. In many maternity hospitals, where women in labor are kept in separate isolated boxes, the presence of a husband or one of the relatives is now allowed at the birth. Therefore, by and large, this is not much different from home birth.

- But they say that a woman relaxes during childbirth at home and does not experience such fears as in the maternity hospital.

In modern maternity hospitals, separate boxes are installed so that a woman can feel as free and relaxed as possible. The main pain relief during childbirth is relaxation, and I specifically teach this to my patients. You need to be able to relax between contractions, and then painful sensations will be completely different. And of course, a woman should be calm. She should not be afraid of what the doctor will do for her now. Often a woman during childbirth asks the doctor questions: “What did you do to me? What are you going to do to me now?” All these fears and thoughts indicate that a woman is completely unprepared for childbirth. She must turn her head completely off! This is what women need to be taught: so that they understand well what is required of them during childbirth, and prepare correctly for it.

- Many women are afraid of being exposed unnecessarily abdominal surgery- caesarean section.

This is a completely wrong way to pose the question. A caesarean section is an operation that is performed medical indications. Absolute readings for a caesarean section is very small. Basically, we perform these operations according to relative indications, which are determined by the doctor. Most often, we operate in the interests of the child - when it is obvious to the doctor that this fetus will not pass through this pelvis. But today such cases are very rare. Usually everything is aimed at giving birth healthy child. That is, any woman can, in principle, give birth. Increase in number caesarean sections, in my opinion, is associated with an increase in well-being. The logic is this: why should a woman give birth herself if she can pay? This has already become a kind of evidence of belonging to a certain social class. By the way, in Orthodox Greece the percentage of such operations is very high for Europe. We haven't gotten to that point yet. I repeat, we operate in the interests of the child. And the main guarantee of a successful birth is mutual trust between the doctor and the patient. If there is no such trust, then you are in very dangerous situation. If you start making a scandal and blaming the doctor for something, you are driving yourself into various pathologies of labor, such as weakness, incoordination, and so on. If you trust the doctor, you must obey him unconditionally. Then you have at least some semblance of a guarantee that everything will end well.

Returning to home births, we must not forget that now this is quite a serious business. Average price home birth - $500. But if you are ready to pay such midwives who will drive around Moscow in a car from one woman to another and give birth at home, then is it really impossible to find good doctor? Doctors are also very different, but find normal people, good specialists in your business you can. They will always help you.

- What advice would you give to those who are planning to give birth at home?

Do not anger or tempt God. Nobody can tell you how this will all end. And then it may be too late.

Interviewed by Anna Yanochkina

The material was prepared jointly with the newspaper “Church Bulletin”