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Normal Birth in Ankara

As in all living things, reproduction, that is, having children and continuing the generation, is an instinctive and natural event for us humans. Birth in nature develops according to its own natural flow. In humans, there are also births that occur with human intervention. In this article, we will talk about normal and natural birth.

What is Normal Vaginal Birth and Natural Birth?

Normal birth is birth occurring without any surgical intervention. In modern medicine, medications are used to ensure painless birth or to accelerate birth , and this can be applied at the request of both the doctor and the patient. Simply,normal birth refers the delivery when the baby is born completely physiologic means - without any surgical intervention. But of course, the help of doctors and midwives should always be available in case of emergencies that may arise. In addition to these, normal birth with epidural and normal birth with episiotomy are also included in the group of normal births with intervention.

Natural birth is birth that occurs in full compliance with human nature after the normal process of pregnancy is completed. Compared to other methods, there is very little physician intervention pr medical support and birth takes place with the body managing itself. The moment and after birth are supervised by specialist physicians; but their interventions are quite limited.

Why is Normal Birth the Priority and What Are Its Advantages?

All methods in medicine are tried to be carried out in accordance with the natural flow of the body. Although there are exceptions, doctors generally start with the more natural choice. If the method that is suitable for the nature of the body poses risks for the patient, then the chosen method will be more artificial. The main reason for this is that the body adapts more easily to the natural one after surgery or procedures. There is a risk of many problems occurring in the body that cannot adapt.

Normal birth , as we have just mentioned, is the most suitable and natural form of birth for the body. The birth of the baby, which begins to occur without intervention between the 37th and 42nd weeks of pregnancy, is called normal birth or natural birth. As we mentioned, unless the mother is at risk, doctor intervention is quite minimal.

If it is thought that normal birth will not pose a risk to the mother, this will be the main choice of physicians. In women who give birth normally, the healing time of the wounds incurred during birth and the time for the woman to regain her previous shape are much shorter. However, less scarring is observed compared to cesarean birth. This significantly reduces the risk of infection and unwanted wounds.

Some hormones are secreted from the mother during and after birth. These hormones facilitate birth, increase the emotional bond between mother and baby, and ensure that breast milk is ready for the baby . The amount and effect of these hormones are quite high in normal birth. This is one of the main reasons why normal birth is preferred.

How to Prepare Psychologically and Physically for Natural Birth ?

It is very important for both the expectant mother and the father to prepare for birth. According to research, mothers and fathers who prepare themselves psychologically and physically are more peaceful before and after birth. In fact, the basis of psychological preparation is the maternal instinct for the expectant mother. Since this is a natural situation, it does not cause any difficulty. It is important for women who do not consider themselves ready for motherhood to receive psychological support. Otherwise , there is a risk of becoming depressed after birth. In summary, the things that need to be done in psychological preparation are as follows:

Information should be obtained about birth and postnatal baby care. The information learned on this subject is effective in making the couple feel more comfortable and ready.
One should be prepared before birth and the birth bag should be prepared early.
It would be very effective for couples who do not feel ready to receive psychological support.
Attending pregnancy courses can be effective in psychological preparation.
Doctor follow-ups should not be interrupted. Even thinking about the possibility that the baby is harmed can negatively affect the couple's psychology.
Necessary exercises should be done during pregnancy.
The expectant mother should pay attention to her diet. This is the most important physical preparation.

What are the Recommended Exercises when Preparing for Natural Birth?

During normal birth, the woman is asked to do what is commonly called pushing. The exercises done beforehand to increase the power of this movement are called preparatory exercises. The basis of the pushing movement is to push the baby down by contracting the abdominal muscles. This is exactly what your doctor needs during birth. Preparation exercises strengthen the abdominal muscles, allowing the pushing movement to be done more powerfully. Therefore, it is recommended to practice these movements during pregnancy. There are many pregnancy exercises. Some of these are those:

Sitting Cross-Legged Exercise
Stretching Exercise
Kegel Exercises
Pelvic Muscle Exercises
Squat
Walk
Butterfly Movement
Lunge Movement
Stair Climbing Exercise
Swimming

Vaginal Birth After Caesarean Section

It is very difficult to heal wounds caused by incisions in the vagina during cesarean birth . For this reason, normal birth is generally not preferred after cesarean section. Although the frequency of its preference is increasing today, physicians may not recommend it for many reasons.

Situations Where Normal Birth Cannot Be Performed After Caesarean Section

Normal birth is not recommended for 2 to 2.5 years after cesarean section.
If cesarean section is still necessary or if normal birth has risks to the mother and baby, normal birth is not recommended.
Having undergone uterine surgery poses a risk in normal birth.
If the expectant mother has diabetes or hypertension, normal birth cannot be performed.
One of the main conditions for normal birth is that the birth canal is suitable and wide enough. If these conditions cannot be met, cesarean delivery is preferred.

How Do We Know When Birth Is Approaching?

There are many symptoms of normal birth. Since each birth has its own unique and special characteristics, only some of these symptoms are seen during the woman's pregnancy. These are also specific to that woman. However, although some symptoms may appear, they may not be noticed. Some of these symptoms include:

Engagement (Bloody Discharge)

The human body takes its own precautions to protect the baby. One of these precautions is a layer of mucus that acts as a plug in the cervix. This layer is there to prevent infection in the uterus. A few days before or just before birth, this plug is removed along with some blood. This indicates to the woman that normal birth is near. This spot-shaped discharge is called engagement among the public.

Regular Uterine Contractions

Irregular contractions that start long before birth become both more severe and regular as birth approaches.

Water Breakdown

This phrase, which is frequently used in TV series and movies, is also a very important symptom. When the amniotic sac containing the baby ruptures, the water in the sac is thrown out. This event, which occurs due to contractions, may be a sign of birth.

Back pain

Many expectant mothers experience increased back pain as birth approaches.

Frequent Urination

As the size of the baby increases, the pressure it puts on the bladder also increases. Due to this pressure, the usable portion of the bladder decreases and even when a small amount of urine accumulates, the woman feels the need to go to the toilet.

How Do Labor Cramps Begin?

İn the last trimester expectant mother starts to experience some contractions which may be mistaken by labor contractions This is named as Braxton- Hicks contractions . These contractions tend to be short-lived, irregular and painless . These pains, which usually last between 30 and 45 seconds, start to be felt in the upper part of the uterus and slow down shortly and disappear.

Birth contractions are more regular and intensive then the Braxton Hicks contactions. This pain is regular and painful and does not go away due to position change. During labor pain, the cervix also opens. It is felt between the 38th and 42nd weeks of pregnancy and is usually seen earlier in mothers having their first birth.

Labor pain indicates that birth is approaching. Birth pain is considered quite worrying, especially for women who experience it for the first time. These pains, which are actually completely natural, are caused primarily by Braxton. It starts as Hicks pains and begins to become regular and severe in the later stages. It is at its most severe in the period close to birth.

How Does Normal Birth Begin?

Birth begins when the cervix is fully dilated. This stage, when the pains are at their highest, lasts until the baby is born and is medically called the 2nd stage. The stages of normal birth are explained in the rest of the article.

What are the Stages of Normal Vaginal Birth?

Normal birth basically consists of 3 stages. Each universe has its own special features and items that need to be applied. Now let's talk about these 3 phases.

Birth and the thinning and opening of the cervix
Pushing and the birth of the baby
Removal of the placenta

1) Labor and Opening of the Cervix

This is the first beginning of the birth process and labor. In order for the baby to be born, the cervix must be soft, thin and flexible. This first stage may last up to 13 hours in the first-born patient. In the second or third birth, it decreases to 7-8 hours. It is the uterine contractions that allow the cervix to open during labor . This is a period when contractions come at light and long intervals. This first phase has 3 sub-phases;

a) Early Phase: In this phase, the cervix dilates up to 4 cm . Patients mostly spend this process at home because the mother is quite comfortable at this stage. He can continue his normal activities at home, eat and drink water, but it is recommended to eat light foods. At this stage, it is requested to monitor the contractions. As contractions become stronger over time, the time between 2 contractions becomes shorter. If the mother can no longer feel comfortable between contractions and even does not want to talk, it can be said that she is in active labor.

b) Active Labor Phase : At this stage, the mother's cervix has reached 4-7 cm dilation. It would now be beneficial for the mother to be hospitalized. Contractions start coming every 3-4 minutes and last about 60 seconds each. These contractions allow the cervix to dilate faster (about 1 cm in 1 hour). As the labor progresses, the patient's water may break and the mother may suddenly realize that the water is draining from between her legs. After the water breaks, contractions become faster. During this process, the mother begins to need to be comforted. With the help of family members or midwives, position adjustments are made, gentle massages are applied, efforts are made to support the mother with warm and birthing applications, slow walks or sitting upright. It is very important for the mother to relax between each contraction and this relaxation will make it easier to dilate. Soaking in warm water will relax the mother's muscles and provide very relaxing support.

c) Late Active Labor Stage: It is the stage when the cervix reaches 7-10 cm dilatation. It is the most painful and stressful period. Contractions come every 2-3 minutes and last 60-90 seconds. As the baby's head descends into the vagina, the mother begins to push with a feeling of pressure on the anus and tension in the vagina. However, this stage is a period that should not be pushed. You should not start pushing until the midwife or doctor following you tells you that you can push. When the cervix is fully dilated, the straining process will begin. In these final stages, the mother feels tired and tense, may have nausea, sometimes hot flashes and sometimes a feeling of cold. During this period, it will be extremely helpful for the mother to breathe slowly and loosely.

2) Pushing and Birth of the Baby

the cervix is fully dilated and thinned, the second stage of labor begins. Contractions are very intense at this stage, but the time between two contractions is longer. This gives the mother the opportunity to gather strength to push between contractions. The mother is asked to push the baby towards the canal every time a contraction begins. Meanwhile, the mother feels a strong desire to defecate, which is an expression that the baby's head is very close to the exit. The mother is very sensitive during this period; He may want to be in contact with his relatives, or he may prefer to be alone. The mother's wishes should be supported as much as possible, and behaviors or excessive noise that may disturb her should be avoided. As the baby's head comes out of the vagina, the mother feels severe pain around the vagina . This is the moment when the doctor supports the birth, and if the baby's head needs to make the necessary maneuvers to prevent tearing as it comes out, it may be necessary to perform an episieuromy . When the baby's head comes out completely, the mother is asked to relax and gently push the baby. The baby's entire body is gently removed from the vagina and the baby's first adaptation to the world begins at that moment.

The cervix is fully dilated. Birth begins exactly at the beginning of this phase. There are regular and severe pains. These pains last between 30 minutes and 1 hour and eventually the baby is born. It is important not to extend this period, and straining shortens this period.

3) Removal of the Placenta

After the baby is born, contractions continue to release the placenta. The delivery of the placenta may occur within a few minutes after birth or within half an hour. Immediately after birth, placing the baby on the mother's lap and ensuring skin-to-skin contact will increase contractions and make it easier for the placenta to come out. It is also very beneficial for the mother to breastfeed the baby at this stage if she wants to. This approach will also ensure that the mother's postpartum bleeding is less.

At this stage, the mother and her baby come together. The placenta in the womb also comes out with the massage within the first half hour. Thus, the birth is completed. Suturing procedures for any damage at the entrance of the vagina are also performed at this stage.

Medical Interventions in Normal Birth

Normal birth does not mean that there will never be any intervention. Interventions in normal birth are applied in a way that positively affects the health of the mother and baby . If there is any risk at the time of birth, physicians must of course intervene. But usually the perfect harmony between the bodies of mother and baby shows us that this is not necessary.

What are the benefits of normal birth?

Hospital stay is short
The risk of infection is low
The mother recovers faster and returns to her daily life
The baby has fewer postnatal respiratory problems
There is no risk of bleeding due to the operation.
Mother-baby relationship begins faster

What are the risks of normal birth?

There may be a risk of the mother's uterus rupturing.
If the baby's oxygen needs cannot be met, fetal There may be vital problems due to lack of oxygen, which we call distress . .
The baby's cord may get in front of the baby and threaten the baby's life due to cord prolapse.
The infection present in the mother can be transmitted to the baby. ( HPV, Herpes , Gonorrhea, Group B streptococcus)
breech presentation are risky births.
It may get stuck while the baby's shoulder is being removed and cause nerve damage.
Normal birth in multiple pregnancies may put babies at risk.
Birth may not occur due to anatomical incompatibility between the baby's head and the mother's pelvis ( cephalopelvic disproportion).
In cases where the placenta covers the cervix, excessive bleeding can threaten the life of the mother and the baby.

What are the risks that the mother may face after normal birth?

The piece of placenta remaining after birth may pose a risk of bleeding and infection .
Pelvic muscles may be damaged and chronic pelvic pain may occur.
Uterine prolapse may occur due to weakening of the muscles.
Urinary incontinence problems may begin as the pelvic muscles relax.
The uterus, which should contract after birth, cannot contract and may cause excessive bleeding, which may lead to complete removal of the uterus.
Epidural anesthesia imay cause the leakage of the cerebrospinal fluid leading especially headache.

Normal Birth Variations

Painless Birth ( Epidural Birth)

This birth generally has a progression similar to normal birth. When the expectant mother's cervix reaches 4 centimeters, the spinal cord is reached with the help of a special needle in her waist and an epidural analgesic is administered. This analgesic causes the expectant mother to lose feeling from the waist down. The most important part of this birth method is that the mother cannot adjust the pushing times on her own. During natural birth, the expectant mother's body reduces her pain at certain intervals. At these moments, the woman strains. In epidural birth, the woman does not feel any pain or discomfort. For this reason, experts tell the expectant mother when she should strain.

Women Controlling Their Own Birth: Lamaze Technique

The Lamaze technique is to explain to the woman the necessary medical information and techniques that will speed up the birth at the time of birth. Women who have been trained in this technique are knowledgeable about every stage of birth and know what to do and when. Women who apply the Lamaze technique not only participate in and positively influence their birth, but also become more self-confident and peaceful.

Things to Consider After Natural Birth

Do not neglect stitch care after birth.
Be sure to use the prescribed medications.
Start exercising, even if only lightly, by consulting your doctor.
Pay close attention to your nutrition.
Due to minor bleeding that occurs after birth, pay attention to hygiene and use pads or tampons.
Do not neglect the baby's check-ups and vaccinations.
Be careful not to open the stitches at birth and do not try to have them removed early.
If your psychology is bad during this period and you feel like you are depressed, get psychological support.

Is Routine Episiotomy Necessary ?

Episiotomy is an incision made between the vagina and anus at birth to prevent vaginal tears when the baby comes out and to widen the canal. This incision is made when the specialist physician has a risk of damaging the surrounding tissues during the birth of the baby due to canal stenosis.

Episiotomy used to be applied to all first births, but studies have revealed that it is unnecessary to perform episiotomy routinely. Studies show that even if it is the first birth, there is a high probability that birth will not harm the surrounding tissues, except in some cases. In fact, some studies show that the wound caused by episiotomy carries greater risks. For this reason, episiotomy is no longer performed in cases where the physician does not need it.

How Long Does Normal Postpartum Bleeding Last?

Bleeding that occurs after birth while the uterus is shrinking is quite normal. Although these bleedings last for up to 6 weeks in natural birth, they may last longer in cesarean birth.

What to do if birth does not occur in 40 weeks?

Under normal circumstances, starting from the 36th week of pregnancy, the pregnant woman is called for a check-up every 7 days. If the woman has not yet given birth at the 40th week, this control period is reduced to 3 days. During these checks, the baby's health status is checked with tests such as ultrasound and NST. If any negativity is observed, the mother is taken into labor immediately.

When Do Normal Birth Stitches Heal?

Although it varies depending on the mother's skin structure and health condition, the stitches usually heal completely within 7 days. During this process, the mother must act carefully to avoid any tension in the seams.

Is Natural Birth Very Painful?

Although it may vary depending on the techniques, the answer is generally yes. Although it is very painful, many women forget about it right after birth. For this reason, I recommend that you focus on the process after birth, not on the pain. In addition, as the pain threshold varies from person to person, the experience of each woman giving birth is unique. While some mothers talk about lower pains, some mothers may say that they experience quite high pains. However, in this case , you should get the most accurate information on this subject from your doctor, rather than allowing unrealistic and exaggerated stories to have a negative impact on you.

Every woman and every birth is different. So what others experience will not apply to you. Everyone will have their own unique birth story , and mothers who abandon themselves to the natural flow of birth and take an active role in the birth with the knowledge they have previously acquired will achieve success at the end of their own story..

Normal Birth Ankara

Gynecology and obstetrics specialist Op. Dr. Aslı Yücetürk follows normal birth and pregnancy processes in her own practice in Ankara. For information about normal birth and to make an appointment, you can call 0552 328 9989 .