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预产期将近需要知道些什么? (网上资料)
作者:home99
发表时间:2008-07-09
更新时间:2009-06-10
浏览:7539次
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::: 栏目 :::
写给准妈妈1
宝宝护理与成长3
写给准妈妈3
为人父母3
英语学习
为人处世
休闲娱乐
理财话题
为人父母2
写给准妈妈2
实用资料
宝宝护理与成长2
为人父母1
其它
医药健康话题
写给新妈妈
宝宝护理与成长1
异国他乡

预产期将近时JMs多少可能会有些紧张,如果知道WHAT TO EXPECT,做到心中有数,心
情放松,所谓知己知彼,才会百战百胜啊,呵呵。从网上看到的关于分娩前信号、征兆
及产程等的资料,以及birth plans,贴出来供准妈妈们参考啊。


一、分娩前有哪些先兆症状?

分娩开始前,常有一些先兆症状(称为“临产先兆”)。这是向你发出的一连串“信号”,
这些你都可以感觉到的。

1.子宫底下降 (dropping):

  初产妇到了临产前两周左右,子宫底会下降,这时会觉得上腹部轻松起来,呼吸会
变得比前一阵子舒畅,胃部受压的不适感觉减轻了许多,饭量也会随之增加一些。

2.下腹部有受压迫的一种感觉(pelvic pressure):

  由于下降,分娩时即将先露出的部分,已经降到骨盆入口处,因此出现下腹部坠胀,
并且出现压迫膀胱的现象。这时你会感到腰酸腿痛,走路不方便,出现尿频。

3.见红 (Bloody Show):

  妊娠最后几周,子宫颈分泌物增加,自觉白带增多。正常子宫颈的分泌物为黏稠的
液体,平时在宫颈形成黏液栓(mucus plug),能防止细菌侵入子宫腔内,妊娠期这种分
泌物更多,而且更黏稠。随着子宫规律地收缩,这种黏液栓随着分娩开始的宫缩而排出;
又由于子宫内口胎膜与宫壁的分离,有少量出血。这种出血与子宫黏液栓混合,自阴道
排出,称为见红。见红是分娩即将开始比较可靠的征兆。如果出血量大于平时的量,就
应当考虑是否有异常情况,可能是胎盘早剥,需要立即到医院检查。

4.腹部有规律的阵痛 (contraction):

  一般疼痛持续30秒,间隔10分钟。以后疼痛时间逐渐延长,间隔时间缩短,称为规
律阵痛。

5.破水(water breaking):

  阴道流出羊水,俗称“破水”。因为子宫强而有力的收缩,子宫腔内的压力逐渐增
加,子宫口开大,头部下降,引起胎膜破裂,从的阴道流出羊水,这时离降生已经不远
了。

  那么,破水到底是什么感觉?

据说有10%的准妈妈会发生破水而进入LABOR。破水的感觉可能会是下面的某一种或多种:

● feel a gush of water that is followed right away by uncontrollable and
steady leaking

● a certain type of a popping feeling

● a trickling of fluid or a general wetness of the perineum

孕后期,特别是38周之后,如果宝宝的头下来快要出来,那么发生破水能漏出来的羊水
量可能并不多,所以出现液体分泌物千万不要掉以轻心啊!如果不敢肯定是什么,最好打
电话给医院或联系OB。

这些水样的分泌物有四种可能,具有不同特点,JMs可根据下面初步判断:

● 尿 urinary incontinence (the leakage of urine):urine smells more like
ammonia

● 宫颈粘液塞脱落(mucous plug being passed): is usually bloodstained

● 白带 normal heavy vaginal discharge (leukorrhea): presents as a heavy
pale white sticky discharge

● 破水 羊水渗漏 amniotic fluid:has a sweet smell to it


去医院后会用试纸检查pH,变蓝就是破水,就要入院生产了。

另外如果是破水,通常12-24小时之内会发生宫缩,或者OB会让加催产素,进入ACTIVE LABOR,
通常24小时内宝宝出生。


二、分娩前容易被忽视的征兆

多数产妇能预测预产期是那一天,但却无法预测是什么时刻。一般说,即将分娩时子宫
会以固定的时间周期收缩。收缩时腹部变硬,停止收缩时子宫放松,腹部转软。另外还
有一些变化也许不为人们所重视,举例如下:

1.产妇感觉好象胎儿要掉下来一样,这是胎儿头部已经沉入产妇骨盆。这种情况多发
生在分娩前的一周或数小时。

2.阴道流出物增加。这是由于孕期粘稠的分泌物累积在子宫颈口,由于粘稠的原因,
平时就象塞子一样,将分泌物堵住。当临产时,子宫颈胀大,这个塞子就不起作用了,
所以分泌物就会流出来。这种现象多在分娩前数日或在即将分娩前发生。

3.水样液体的涓涓细流或呈喷射状自阴道流出。这叫做羊膜破裂或破水。这种现象多
发生在分娩前数小时或临近分娩时。

4.有规律的痉挛或后背痛。这是子宫交替收缩和松弛所致。随着分娩的临近,这种收
缩会加剧。由于子宫颈的胀大和胎儿自生殖道中产出,疼痛是必然的。这种现象只是发
生在分娩开始时。


三、分娩前的准备工作
分娩前作好充分的精神和身体方面的准备是保证安全分娩的必要条件。

1.精神准备

  产妇应该要有信心,在精神上和身体上做好准备,用愉快的心情来迎接宝宝的
诞生,丈夫应该给孕妇充分的关怀和爱护,周围的新戚朋友及医务人员也必须给产妇一
定的支持和帮助。实践证明,思想准备越充分的产妇,难产的发生率越低。

2.身体准备

* 睡眠休息:分娩时体力消耗较大,因此分娩前必须保持充分的睡眠时间,娩前午睡
对分娩也有利。

* 生活安排:接近预产期的孕妇应尽量不外出和旅行,但也不要整天卧床休息,轻微
的、力所能及的运动还是有好处的。

* 性生活:临产前绝对禁忌性生活,免得引起胎膜早破和产时感染。

* 洗澡:孕妇必须注意身体的清洁,由于产后不能马上洗澡,因此,住院之前应洗澡,
以保持身体的清洁,如果是到浴室去洗澡必须有人陪伴,以防止湿热的蒸汽引起孕妇
的昏厥。

* 家属照顾:双职工的小家庭在妻子临产期间,丈夫尽量不要外出。实在不行,夜间
需有其他人陪住,以免半夜发生不测。

3.物质准备

  分娩时所需要的物品,怀孕期间都要陆续准备好,怀孕第10月时要把这些东西归
纳在一起,放在家属都知道的地方。这些东西包括:产妇的证件:医疗证(包括孕妇联
系卡)、挂号证、劳保或公费医疗证。婴儿的用品:内衣,外套,包布,尿布,小毛巾,
围嘴,垫被,小被头,婴儿香皂,肛表,扑粉等均应准备齐全。尤其出院抱婴儿的用
品必须事先包好,做好记号,免得家属接婴儿时准备不全。产妇入院时的用品:面盆,
脚盆,牙膏,牙刷,大小毛巾,月经带,卫生纸,内衣,内裤等。分娩时需吃的点心也
应准备好。


四、分娩前必知道的7个问题

也许你会觉得自己没有必要对分娩的过程了解得那么清楚,有助产士和医生,她们会知
道如何帮助你。但是,从很多过来人妈妈那里了解到,如果你事先知道你会遇到哪些情
况,那么在分娩的过程中,你会多一份镇定和轻松,这也正是你在分娩关键时刻最需要
的。

下面的7个问题的答案是准妈妈最想知道的,它们将使你在分娩的过程中更有安全感。

1.我如何知道分娩开始了?

  有些女性在分娩的那天会感到烦躁,这是身体发出的一种明确的信号,还有的准妈
妈会出现心跳、燥热或者头痛等症状。此外,还会有人感到没有胃口或者特别饿,也可
能出现腹泻或者严重的便秘。这时,子宫口也开始慢慢打开,有更多的液体流出来,骨
盆和小腹开始感受到拉扯的疼痛。阴道和膀胱有被压迫感也是分娩要开始的信号。

  当流出的血或羊水增多的时候,就是该去医院的时候了,这时阵痛也开始变得有规
律了。有一个黄金定律可以帮助准妈妈判断分娩是否开始了:这个定律是4:1:1,具
体的说:每四分钟有一次疼痛,每次疼痛持续1分钟,这样的阵痛节奏已经持续一个小
时了。

  还有一种分娩即将开始的征兆,那就是准妈妈开始感觉到强烈的疼痛,疼痛的强度
让人难以忍受。

  还有一种最简单的信号是,准妈妈自己觉得马上要见到小宝宝了,这个时候应该相
信自己的直觉!分娩也许很快就会开始了。

2.我担心自己不能“胜任”分娩这项艰巨的任务,怎么办?

  对于分娩有恐惧感完全是正常的。准妈妈可以通过分娩准备阶段中的放松练习让自
己平静下来。这里了解一些和分娩有关的细节,对克服恐惧很有帮助:

* 分娩前的阵痛是慢慢增强的,而不是突然降临,因此准妈妈可以逐渐适应。

* 每次阵痛之间都有间歇,那时准妈妈感觉不到任何疼痛(除了分娩的最后阶段),可
以利用间歇好好休息一下。

* 此外,阵痛是有时间限制的,每一次阵痛都意味着宝宝离出生近了一步,当宝宝躺
在你的怀里的时候,阵痛就真正结束了。

很多研究显示,女性在怀孕20周到生产这段时间里,对疼痛的敏感程度会不断下降。其
中的原因是身体中分泌了一种类似鸦片一样有麻醉作用的激素。成功分娩并不意味着你
一定要忍受剧烈的疼痛,可以通过很多的方法和药物缓解疼痛,例如针灸、呼吸、缓解
疼痛的药物,以及局部麻醉等。

3.分娩需要多长时间?

统计数据表明女性在分娩第一胎的时候平均花费大约12个小时,第二胎平均需要8.5个
小时。但是这并不意味着女性在这10多个小时里要一直忍受没有间断的疼痛。每个人的
情况也不尽相同。总地来说,在熟悉的环境中、在信赖的人的陪伴下分娩会更快一些。

有些准妈妈阵痛的时间比较短,但是疼痛的强度高,而另外一些准妈妈痛感柔和一些,
却需要更多时间完成这个阵痛期。因此,准妈妈应该顺其自然,千万不要有压力。

分娩究竟需要多长时间因人而异,而且是可以遗传的。因此,你不妨询问你的母亲,看
看她的分娩经历如何。也可以了解一下你的姨妈和外祖母的生产过程,多少对你会有所
帮助。

你对阵痛的敏感程度与分娩持续的时间关联不大,但是你可以坚信,一切忍受到宝宝第
一声啼哭的时候就结束了。

4.谁应该在分娩时陪伴在你左右?

选择有很多种。有些人认为应该是宝宝的爸爸。因为宝宝的爸爸陪伴在你身边,这样你
们可以共同经历生产的过程。但是,也有一些准爸爸不能承受这样的场面,那么最好安
排他们在产房外面等待。

有些人则认为应该找一些有过生育经验的女性亲戚或朋友陪伴在身边。因为她们经历过
这个过程,会给你一些有用的帮助,而且不会过分紧张。

另外,你也可以选择医院提供的专业导乐服务,这些导乐都是很有经验的医护人员或者
助产士,她们给产妇带来安全感,使分娩过程缩短(据统计,在第一胎分娩中,平均缩
短了两个小时),而且她们还把“不胜任”陪产的父亲解放出来了。有了她们的指导,
你的分娩会更加顺利!当然,这项服务也是需要额外付费的。

在剖腹产的过程中,如果允许陪产,准爸爸们最好选择离准妈妈越近越好,哪怕不是直
接站在产床前,也应该选择一个让准妈妈看得见的地方,这对产妇的情绪很有帮助。

5.当分娩遇到停滞不前该什么办?

通过相应地调节呼吸、放松和活动可以使分娩重新“启动”。这样的“中场休息”很有
好处,因为我们知道阵痛是项艰辛的工作,因此产妇需要时间短暂地恢复一下。

在阵痛中,能够入睡吗?这几乎难以想象,但是有1/5的女性在阵痛的间隙时间里还是
做到了这一点。缓解疼痛的药物也能起到促进睡眠的作用。在阵痛中,准妈妈们不必忍
受所有的疼痛,因此可以接受一些缓解疼痛的药物或方法,从而让自己感觉好一些。

呼吸、放松和活动对顺利地度过阵痛有帮助。例如,在子宫张开的阶段,可以让准妈妈
坐在健身球上,身体向后弯曲,使呼吸变得容易,助产士或准爸爸坐在后面扶着。这个
练习非常简单易行,任何一位产妇不需要预先学习,就可以在分娩中运用它。而且这个
练习不仅对缓解疼痛有益处,而且也能帮助宝宝加速向下“降”如骨盆。

6.破水了,是否应该立即去医院?

很多女性在整个怀孕期间都在考虑,当分娩前,羊水大量流失该怎么办。其实,破水的
时候,羊水急泻是非常罕见的,因此不必对此过分担心。另外,还可以让你安心的是,
妇产科大夫会在预产期前为你检查胎儿的头是否已经进入骨盆中了。当宝宝的小脑袋已
经向下进入产道,羊膜囊破了,羊水流入产道,这个时候就应该去医院了。如果破水来
的太早,比预产期提前很多天,胎儿还没有进入准备降生的位置,就比较危险了。因为
这个时候脐带会先于宝宝滑向阴道,在后面的胎儿的脑袋压迫着脐带,阻碍的血液的流
动。因此,这个时候产妇应该平躺着被送往医院,以保证不压迫脐带,使给胎儿的供给
得以继续。

7.是否能够使用催产针控制分娩的进程?

如果分娩没有任何进展,可以考虑使用催产针加快阵痛。另外一种需要采用催产手段的
情况是,分娩一开始很正常,可是突然阵痛消失了,或者阵痛的节奏很慢,阵痛很微弱
的情况下也需要通过静脉注射催产针来推动分娩。

静脉注射的速度应该得到严格的控制,这样产妇才不会感到失去控制。如果阵痛频率太
高,就应该放慢甚至停止点滴,使阵痛间歇重新变得长一些。准妈妈应该根据自己的身
体情况,及时和产房中的护士沟通,提醒她们注意准妈妈对催产针的反应如何。

* 若出现下列情况,请马上去医院或请医生:

--即便在没有发生宫缩的情况下,羊膜破裂,羊水流出。

--阴道流出的是血,而非血样黏液。

--宫缩稳定而持续的加剧。

--产妇感觉胎儿活动减少。


五、分娩前要注意的六个方面

等待了9个月,历经了太多的艰辛,当腹中的宝宝即将来到眼前时,准妈妈们的心情自
然是无言的激动与兴奋。因此,如何做好生产前的准备就万分重要了。本期准妈妈的话
题就是探讨准妈妈临产前的必修问题。

由于现代产妇多数只生一胎,属于初产妇,没有经验。因此一到临产,往往是全家慌乱,
不知所措。对此,西城区展览路医院妇产科任主任表示,即将临盆的准妈妈们要做好
精神上和物质上的双重准备,才能够从容应对忙乱和意外事故的发生。

** 两大转变:准妈妈心情和生理发生变化

转变1:心情既紧张又兴奋

一般准妈妈们怀孕8个月的时候,就会觉得生产的日子近了,但一到了9个月,就要开始
着手准备迎接宝宝的来临了。而这个时候,准妈妈们都会很兴奋,心情也会随之转变,
是既忐忑不安又紧张兴奋。

忐忑不安是因为接近了预产期,有些准妈妈明明离预产期还早,却开始有阵痛现象,有
些妈妈则是预产期过好久了,宝宝还没有准备出来的意思。等待生产的心情加上生产时
间不如预期,都会让准妈妈们多多少少感到忐忑不安。

而生第一胎的妈妈因为没有经验,紧张是难免的,尤其不知道生产会有多痛,如果有经
验的亲友在身边的话,会成为新手妈妈很大的依赖。加上要和即将出世的宝宝见面,兴
奋的心情完全写在脸上。

转变2:生理变化很明显

除了心情的多种变化外,此时准妈妈们的生理也发生了变化。

因为这段期间宝宝的发育已完整,而准妈妈在怀孕9个月时子宫的位置会升到肚脐上方,
觉得胸部、腹部都充满压迫,感到不舒服,直到快生产时,宝宝会有一种快要出来的
感觉,大概降到骨盆的位置,也因此胸部和腹部的压力都会减少。因此在快生产的那几
天,要特别注意身体的变化,有阵痛、出血或羊水破的现象,就要赶快就医了。

因而在怀孕9个月的时候,如果是选择自然产的准妈妈,在预产期前几天都要和家人保
持联络,最好有人陪着,一旦发现阵痛、羊水破了或是出血的现象,就是待产的时候了。

** 六忌:准妈妈生产之前注意别犯忌
  
一忌:过度紧张

精神过度紧张,使肌体对外界刺激的敏感度增高,轻微外界刺激即会引起疼痛。所以孕
妇在临产前要消除顾虑,保持愉快轻松的精神状态。生孩子虽有一定的痛苦和危险,但
绝大多数都是顺产,难产是极少数。特别在现代条件下,分娩的安全性已大大提高,如
果孕妇能认真进行产前检查,重视孕期保健,一般都不会出问题。

二忌:焦虑性急

有些产妇是急性子,未到预产期就焦急地盼望早日分娩,到预产期后更是焦虑不安,甚
至乱用中西催生药物,这种心情也会给分娩带来不良影响。预产期是有一定活动期限的,
提前或错后十多天都是正常的。但如超过预产期l0天以上还不分娩,应请医生查明原因。

三忌:粗心大意

少数产妇和家庭粗心大意,到了妊娠末期各种准备仍不充分,临产时手脚忙乱,容易发
生各种意外。有少数孕妇已接近预产期,还乘坐车船到异地,由于车船的颠簸和劳累,
常在途中造成意外分娩,威胁母子的生命安全。所以孕妇临近预产期最好不要随便外出。

四忌:疲倦劳累

充沛的精力是保证孕妇顺利生产的重要条件。临产前如果精神或身体处于疲惫状态,必
将影响顺利生产。所以孕妇分娩前十多天,生活一定要有规律,吃好休息好,养精蓄锐,
静候分娩。

五忌:忧愁苦闷

有些孕妇临产前心情不好,处于悲伤忧愁状态,这种消极情绪也妨碍顺利生产,应努力
避免与消除。有些孕妇的精神压力是来自她的亲人——丈夫或公婆。他们盼子孙心切,
使孕妇形成无形的压力和沉重的精神负担。亲人应给予孕妇足够的关心和爱心,不要施
加各种压力,以免影响顺利生产。

六忌:忽视孕期保健

胎儿的娩出主要靠子宫收缩及腹压的作用,将胎儿从子宫“逼”出来,这要消耗大量的
精力。如果产前吃不好睡不好,对生产十分不利。临产前一定要注意营养,少食多餐,
注意补充足够的水分,吃好睡好,使体内能量充足,精力充沛,才能完成产时艰巨的任
务。临近产期,还要注意按时排净小便,临产前每隔2-3小时应排一次小便,大便也要
随时排净。因子宫、阴道与直肠相邻,如分娩时大便积留,不但会影响胎头下降,同时
随宫缩用力娩出胎儿时,还可能将大便与胎儿同时排出,造成胎儿感染。


六、分娩前信号、征兆及分娩过程 ***

1.四种分娩信号

胎头下降、阵痛开始、见红、破水,这是最重要的四种分娩信号,掌握这些,帮助你把
握最佳入院待产时间,做到心中不慌。从临产到分娩,初产妇要经历几个小时到十几个
小时,经产妇要短一些,因此初产妇夜间临产不必像经产妇那样急于去医院,但也不要
延误。

2.分娩预兆

* 阵痛

一天内可感觉子宫规律地收缩,膨胀六次以上,表示阵痛开始了。初次生产的孕妇每
10分钟阵痛一次时,或有生产经验的孕妇每15-20分钟阵痛一次时,即要入院待产。

阵痛可分为真痛及假痛,区别如下:

◆ 假痛
――生产前3-4星期开始发生

――无规则性

――因为走动会改善疼痛的感觉

――痛发生部位限下腹及腹股沟,很少伸展至背的周围

――子宫颈没有扩张

◆ 真痛
――生产开始时发生

――有规则性

――疼痛感觉强烈,无法因走动而改善

――痛部在腹部、背部、尾椎骨处

――子宫颈因子宫收宫而渐扩张

* 见红(Bloody Show)

因为子宫颈口的粘液栓脱落以及微血管破裂,有量少、粉红色或红色、粘稠状的分泌
物参杂少量血液的黏液状白带出现,一般在生产前1-2天开始出现。

* 破水 (water breaking)

包裹胎儿的卵膜破裂使羊水流出,称为破水,稍黏、无色与尿液相似。一般先阵痛才
破水,但也有无阵痛即破水。破水发生尽量采平卧姿势并尽速就医,此时请即刻入院待
产。

* 轻松感 (Lightening)

第一胎孕妇在36-37周时,胎头下降入骨盆腔内,使子宫位置变低、呼吸更顺畅、胃部
较不易发胀、感觉较轻松。第二胎以上孕妇需过预产期才发生轻便感,甚至产痛开始胎
头才下降。

3.分娩过程

什么时候疼得最厉害?分娩的漫长过程什么时候才能结束?……

统计数据表明,女性分娩第一胎的平均费时约12个小时。当然,每个人的情况不尽相同,
有些准妈妈阵痛的时间比较短,但是疼痛的强度高;而另外一些准妈妈痛感柔和一些,
却需要更多时间完成这个阵痛期。

分娩究竟需要多长时间因人而异,而且可能有些遗传因素。因此,你不妨询问你的母亲,
看看她的分娩经历如何。也可以了解一下你的姨妈和外祖母的分娩过程,多少对你会
有所帮助。

* 第一产程:漫长

时间跨度:约在进产房前8~12个小时(初产妇)

虽然当子宫开始有规律的收缩一直到胎盘娩出都算是自然分娩的全过程,但对准妈妈来
说,第一产程的待产是真正分娩前的一个漫长前奏。

第一产程是指子宫口开始扩张,直到宫口开全(约为10厘米)。这是整个分娩过程中历
间最长的一个产程。此时子宫的收缩间隔会越来越短,从开始时的每隔5~6分钟收缩30
秒以上到每隔2~3分钟收缩50秒。在第一产程中,准妈妈宫缩时感觉下腹痛,宫缩越紧,
间隔时间越短,子宫颈口则开得越快。在这一阶段准妈妈一定要保持安静,不要大喊
大叫白白消耗体力,以免到后来精疲力尽,无法配合。

◆ 第1阶段:临盆早期(长时间持续,最多可达20多小时)

在临盆早期,准妈妈的宫缩间隔时间长而且温和,其间隔时间为20~30分钟,每次宫缩
的持续时间一般不超过1分钟。到第一阶段结束的时候,宫缩的间隔一般为5分钟,子宫
颈扩张到3厘米。

准妈妈放松TIPS:

――建议你在家中度过这个阶段。你可以散一散步或洗个热水澡(如果羊水没有破)来
放松自己。你还可以在家里睡一觉,贮存足够的体力。

――当规律的宫缩间隔变为5分钟时,你就拿上待产包可以去医院了。

◆ 第2阶段:活跃期(持续大约4~6小时)

在临产活跃期里,宫缩变得有规律而且频率更加密集,一般时间间隔为2~5分钟;宫缩
持续的时间也相对较长,会持续将近1分钟之久。在这期间,你的子宫颈从4厘米扩张至
8厘米。这段时间,准妈妈会感觉很痛,可能会出汗并感到疲惫。如果这个时候你的羊
膜仍然未破,你的医生或助产士就会穿破它,以便分娩按步骤顺利进行。

准妈妈放松TIPS:

――你可以决定是否需要无痛分娩。

――如果你请一位导乐陪伴在你身边,她会对你有所帮助,让你的分娩更加顺利。

――在宫缩疼痛难忍时,可采取一些减痛方法,如呼吸减痛或者请家人帮助按摩减痛。


◆ 第3阶段:过渡期(不超过1小时)

过渡时期是整个分娩过程中最具挑战性的。在此期间,你的子宫颈将从8厘米扩张到10
厘米,宫缩的间隔时间为2~3分钟,每一次宫缩都将持续1分半钟。这个时候的宫缩是
最痛的,你还可能会感到恶心反胃、双腿打颤、打嗝或对于别人的触摸十分敏感。你可
能会感觉到筋疲力尽,烦躁不安,但是你同时要认识到这些都是好现象,因为你的子宫
颈即将完全扩开了。

准妈妈放松TIPS:

――这个时候你还不应该用力。在子宫颈完全扩开之前用力会导致子宫颈撕裂或肿胀。

――尽量配合医生的指示。


* 第二产程:需要用力

时间跨度:约1~2个小时

一旦你的子宫颈完全打开了,就进入了胎儿娩出阶段,也就是终于到了你的宝宝要离开
你身体的时候了。第二产程就是指从子宫口开全到胎宝宝娩出这个阶段。此时随着子宫
收缩加强,宫口全开,胎头先露部分开始下降至骨盆,随着产程进展,宫缩加强,迫使
胎宝宝从母体中娩出。

第二产程的宫缩更强,准妈妈开始出现想排大便的感觉。由于宫缩的频繁和腹压的增加,
产力也大为增强,你的用力将会帮助胎儿离开子宫,顺利通过产道及骨盆底肌肉。到
了这个时候,宫缩开始没有那么剧烈,频率也开始放慢。

当胎儿的头开始出现并准备通过骨盆底肌肉的时候,你的医生或助产士需要决定是否实
施外阴切开术。这是一个很小的切口,但是可以扩大阴道开口以便胎儿顺利地娩出。当
实施外阴切开术的时候你不会感觉到任何的疼痛,因为胎儿头部的压力提供了一种自然
的麻醉;如果你在此之前没有接受硬膜外麻醉的话,这个时候也可以要求实施局部麻醉。

准妈妈放松TIPS:

――准妈妈不要因为有排便感而感到不安,或因为姿势不好看而觉得不好意思,只要尽
可能地配合医生。

――尽量采用上半身直立的姿势用力,这样你就可以借助重力将胎儿顺利娩出。

――如果你使用硬膜外麻醉,你就无法感觉到这个过程,你需要配合医生给你的指令来
做。


* 第三产程:娩出胎盘

时间跨度:约5~15分钟

第三产程是指胎宝宝出生到胎盘排出阴道这个阶段。此时胎宝宝已经娩出,宫缩会暂停
一会儿又重新开始,胎盘因子宫收缩会从子宫壁剥落移向子宫口,准妈咪再次用力,胎
盘就会顺利脱出。医生或助产士会检查胎盘及隔膜以确认它们全部被排出来了,任何留
在子宫内的碎块都应该被清理出来。医生或助产士还将检查你的子宫,以确认它在继续
收缩,这样才能够止住胎盘剥落地方的流血。如果你接受了外阴切开术,这个时候伤口
也需要进行缝合。

准妈妈放松TIPS:

――胎盘娩出之后,你的工作就是放松自己。

――配合医生完成胎盘娩出并缝合因分娩造成的阴部撕裂。

4.分娩后的1小时

在分娩后的1个小时里,产妇和宝宝会经历些什么呢?

* 产妇的子宫迅速从健身球那么大收缩成一个甜瓜的大小。

* 在分娩后的一段时间里,产妇的身体会感觉到有些无力,很虚弱。

* 产妇心脏、肝脏、胃和肺在分娩后重新得到了更多的空间,开始逐渐地回到原位。
刚开始的时候,这些器官向下滑动也会令新妈妈感觉不太适应。

* 宝宝出生后先要被评分(阿氏评分),医生对新生儿心率、呼吸、肌肉张力、反射
反应和对颜色的反应等情况打出分数。这个评分可以提示医务人员孩子对新世界的适应
能力,了解他们是否需要帮助。

* 助产士会给婴儿洗澡、称体重、测量身高、穿上衣服。

* 如果是预产期或稍早时候出生的小宝宝,出生的时候,皮肤表层会有一层胎脂,洗
干净后,他的皮肤可能会有一些脱皮。

* 新生儿在出生后的20~30分钟之间,吸吮反射最为强烈,他们迫切地想吃到妈妈的
乳头。新生儿在第一次接触妈妈的乳房的时候,几乎不需要任何帮助,他就能很快地学
会如何从妈妈的乳房中吸取他所要的乳汁。

分娩,是超级强度的生命体验,它不仅仅体现在妈妈疼痛上,对宝宝的触动也独一无二,
从这个意义上讲,每个宝宝都和妈妈一样了不起。



看看下面说的临产征兆与我们的有什么不同啊:
-----------------------------------------
Signs of Labor:

Probably every woman who tells you about her labor experience, tells you a different story. Your delivery will be just as unique. However, the following information will prepare you for when “Labor Day” is just around the corner.

*** Six Signs that Labor is Within a Few Weeks or Days ***

1. Dropping(Lightening): occurs when the baby descends into the pelvis. You can breathe again! This is an indication that the baby has dropped, settling deeper into your pelvis and relieving some of the pressure on your diaphragm, so you are not so short of breath. You may feel increased pressure on your bladder, which means more trips to the bathroom. Others may comment on your changed appearance, although you might not be aware of it at all.

2. Bloody show: Loss of mucus plug. During pregnancy, a thick plug of mucus protects your cervical opening from bacteria entering the uterus. When your cervix begins to thin and relax, this plug is expelled. Some women think the plug will look solid like a cork, but it is actually stringy mucus or discharge. It can be clear, pink or blood tinged and can appear minutes, hours or even days before labor begins. Not all women notice this sign.

3. Rupture of membranes: Your water breaks! Only 1 in 10 woman experience a dramatic gush of the amniotic fluid and even then it usually happens at home, often in bed. Sometimes the amniotic sac breaks or leaks before labor begins. Your uterus is sitting directly on top of your bladder, which can cause you to leak urine. Sometimes it can be quite difficult to distinguish urine from amniotic fluid.

If your membranes have ruptured and you are leaking amniotic fluid, it will be an odorless fluid. This can occur with a sudden gush or a constant trickle. If you notice fluid leaking, you need to try to determine if it smells like urine or if it is odorless. If it does not seem to be urine, you would want to contact your health care provider.

Until you see your physician or midwife do not use tampons, have sexual intercourse or do anything that would introduce bacteria to your vagina. Let your health care provider know if the fluid is anything other than clear and odorless, particularly if it's green or foul smelling, because this could be a sign of infection.

4. Nesting: Spurt of energy. For most of your pregnancy you have probably been fighting the urge to take a nap, so you'll know when you experience this. One day you will wake up feeling full of energy! You'll start making a long list of things to do, things to clean, things to buy and everything you've put off doing will become a high priority. In all your preparations, don't forget that “Labor Day” may be just around the corner so save some energy.

5. Cramps

Menstrual like cramps are another symptom of labor. Backache and leg cramps may also occur. As the baby drops into pelvic inlet he or she will put pressure on your nerves which can cause cramping in your legs.

6. Pelvic pressure

You may notice an increase in pelvic pressure or a feeling like baby is going to "fall out". This pressure increases as your pregnancy nears to an end.

7. Effacement: Thinning of the cervix. Usually in the last month the cervix begins to stretch and thin. This process means the lower segment of the uterus is getting ready for delivery. A thin cervix will also allow the cervix to dilate more easily.

Your health care provider may check for effacement in the final 2 months of pregnancy. Effacement is measured in percentages. You may hear your helath care provider say,“You are 25% effaced, 50% effaced, 75%...” The Braxton Hicks contractions or “practice contractions” you have been experiencing may play a part in the effacement process. You will not be able to determine your effacement process, this can only be done by a health care provider's exam.

8. Dilation: Opening of the cervix. Dilation is the process of the cervix opening in preparation for childbirth. Dilation is measured in centimeters or, less accurately, in “fingers” during an internal (manual) pelvic exam. “Fully dilated” means you're at 10 centimeters and are ready to give birth. In the same way that your health care provider may be checking for effacement in the last 2 months, your health care provider may also tell you how many centimeters your cervix has dilated.

9. Other signs of labor

Some women will notice nausea, diarrhea, restlessness, or irritability.


*** One SURE Sign Labor is Really Happening ***

Consistent Contractions: When you begin to experience regular uterine contractions, this is the strongest indication that you are in labor. This is a good time to get out your notebook to record the exact time each one begins and how long they last. These contractions may feel like menstrual cramps or a lower backache that comes and goes, and during early labor they may be as far apart as 20 to 30 minutes. Over the course of several hours your contractions will typically begin occurring at shorter intervals; and you may notice they start happening every 10-15 minutes or less. When your contractions are consistently 5 minutes apart, it is time to call your health care provider.

*** Labor Contractions Have the Following Characteristics ***

● They are regular

● They follow a predictable pattern (such as every eight minutes)

● They become progressively closer

● They last progressively longer

● They become progressively stronger

● Each contraction is felt first in the lower back and then radiates around to the front or visa versa

● A change in activity or position will not slow down or stop contractions

● There may be bloody show

● Membranes may rupture

● Your health care provider will notice cervical changes, such as effacement (thinning), or dilation

------------------------------------------
***   Birth Plans   *** 

In the happy haze of early pregnancy, you're probably already thinking of baby names and planning to shop for baby clothes. The reality of labor and birth may seem extremely far off — which makes this the perfect time to start planning for the arrival of your baby by creating a birth plan that details your wishes.

The term birth plan can actually be misleading — it's less an exact plan than a list of preferences. In fact, the goal of a birth plan isn't for you and your partner to determine exactly how the birth of your child will occur — because labor involves so many variables, you can't predict exactly what will happen. A birth plan does, however, help you to realize what's most important to you in the birth of your baby.

While completing a birth plan, you'll be learning about, exploring, and understanding your labor and birthing options well before the birth of your child. Not only will this improve your communication with the people who'll be helping during your delivery, it also means you won't have to explain your preferences right at the moment when you're least in the mood for conversation — during labor itself.

A birth plan isn't a binding agreement — it's just a guideline. Your doctor or health care provider may know, from having seen you throughout the pregnancy, what you do and don't want. Also, if you go into labor when there's an on-call doctor who you don't know well, a well thought-out birth plan can help you communicate your goals and wishes to the people helping you with the labor and delivery.

★ What Questions Does a Birth Plan Answer?

A birth plan typically covers three major areas:

1. What are your wishes during a normal labor and delivery?

These range from how you want to handle pain relief to enemas and fetal monitoring. Think about the environment in which you want to have your baby, who you want to have there, and what birthing positions you plan to use.

2. How are you hoping for your baby to be treated immediately after and for the first few days after birth?

Do you want the baby's cord to be cut by your partner? If possible, do you want your baby placed on your stomach immediately after birth? Do you want to feed the baby immediately? Will you breastfeed or bottle-feed? Where will the baby sleep — next to you or in the nursery? Hospitals have widely varying policies for the care of newborns — if you choose to have your baby in a hospital, you'll want to know what these are and how they match what you're looking for.

3. What do you want to happen in the case of unexpected events?

No one wants to think about something going wrong, but if it does, it's better to have thought about your options in advance. Since some women need cesarean sections (C-sections), your birth plan should probably cover your wishes in the event that your labor takes an unexpected turn. You might also want to think about other possible complications, such as premature birth.

Questions:
●  Who do you want to be there?
●  Do you want a doula?
●  Will there be children/siblings present?
●  Do you want mobility or do you wish to be confined to a bed?
●  What activities or positions do you plan to use? (walking, standing, squatting, hands and knees)
●  Would you prefer a certain position to give birth?
●  What will you do for pain relief? (massage, hot and cold packs, positions, labor imagery, relaxation, breathing exercises, tub or Jacuzzi, medication)
●  How do you feel about fetal monitoring?
●  How do you plan to keep hydrated? (sips of drinks, ice chips, IV)
●  Do you want pain medications, or do you want to avoid them? Do you have preferences for which pain medications you want?
●  Would you like an episiotomy? Or, are there certain measures you want to use to avoid one?
●  What are your preferences for your baby's care? (when to feed, where to sleep)
●  Do you want a routine IV, a heparin/saline block, or nothing at all?
●  Do you want to wear your own clothing?
●  Do you want to listen to music and have focal points?
●  Do you want to use the tub or shower?
●  For home and birth center births, what are your plans in case of hospital transport?
●  If you need a cesarean, do you have any special requests?

★ Factors to Consider

Before you make decisions about each of your birthing options, you'll want to talk with your health care provider and tour the hospital or birthing center where you plan to have your baby.

You may find that your obstetrician, nurse-midwife, or the facility where they admit patients already has birth-plan forms that you can fill out. If this is the case, you can use the form as a guideline for asking questions about how women in their care are routinely treated. If their responses are not what you're hoping for, you might want to look for a health provider or facility that better matches your goals.

And it's important to be flexible — if you know one aspect of your birthing plan won't be met, be sure to weigh that aspect against your other wishes. If your options are limited because of insurance, cost, or geography, focus on one or two areas that are really important to you. In the areas where your thinking doesn't agree with that of your doctor or nurse-midwife, ask why he or she usually does things a certain way and listen to the answers before you make up your mind. There may be important reasons why a doctor believes some birth options are better than others.

Finally, you should find out if there are things about your pregnancy that might prevent certain choices. For example, if your pregnancy is considered high risk because of your age, health, or problems during previous pregnancies, your health care provider may advise against some of your birthing wishes. You'll want to discuss, and consider, this information when thinking about your options.

★ What Are Your Birthing Options?

In creating your plan, you're likely to have choices in the following areas:

※ Where to have the baby. Most women still give birth in the hospital. However, most are no longer confined to a cold, sterile maternity ward. Find out if your hospital practices family-centered care. This usually means the patient rooms will have a door, furnishings, a private bathroom, and enough space to accommodate a family, including the baby's crib and supplies.

Additionally, many hospitals now offer birthing rooms that allow a woman to stay in the same bed for labor, delivery, and sometimes, postpartum care (care after the birth). These rooms are fully equipped for uncomplicated deliveries. They're often attractive and have gentle lighting.

But some women believe that the most comfortable environment is their own home. Advocates of home birth believe that labor and delivery can and should occur at home, but they also stress that a certified nurse-midwife or doctor should attend the birth. An important thing to remember about home birth is that if something goes wrong, you don't have the amenities and technology of a hospital. It can take a while to get to the hospital, and during a complicated birth those minutes can be invaluable.

For women with low-risk pregnancies who want something in between the hospital and home, birthing centers are a good option. These provide a more homey, relaxed environment with some of the medical amenities of a hospital. Some birthing centers are associated with hospitals and can transfer patients if necessary.

※ Who will assist at the birth. Most women choose an obstetrician (OB/GYN), a specialist who's trained to handle pregnancies (including those with complications), labor, and delivery. If your pregnancy is considered high risk, you may be referred to an obstetrician who subspecializes in maternal-fetal medicine. These doctors have specialized training to care for pregnant women with medical conditions or complications, as well as their fetuses.

Another medical choice is a family practitioner who has had training and has maintained expertise in managing non-high-risk pregnancies and deliveries. In some areas of the United States, especially rural areas where obstetricians are less available, family practitioners handle most of the deliveries. As your family doctor, a family practitioner can continue to treat both you and your baby after birth.

And doctors aren't the only health care providers a pregnant woman can choose to deliver her baby. You might decide that you want your delivery to be performed by a certified nurse-midwife, a health professional who's medically trained and licensed to handle low-risk births and whose philosophy emphasizes educating expectant parents about the natural aspects of childbirth.

Increasing numbers of women are choosing to have a doula, or birth assistant, present in addition to the medical personnel. This is someone who's trained in childbirth and is there to provide support to the mother. The doula can meet with the mother before the birth and can help communicate her wishes to the medical staff, should it be necessary.

Your birth plan can also indicate who else you'd like to have with you before, during, and immediately after the birth. In a routine birth, this may be your partner, your other children, a friend, or other family member. You can also make it clear at what points you want no one to be there but your partner.

※ Atmosphere during labor and delivery. Many hospitals and birthing centers now allow women to make some choices about the atmosphere in which they give birth. Do you want music and low lighting? How about the freedom to walk around during labor? Is a hot tub something you'd like access to? If possible, would you like to eat or drink during labor? You might be able to request things that may make you the most comfortable — from what clothes you'll wear to whether you'll have a VCR or DVD player in your room.

※ Procedures during labor. Hospitals used to perform the same procedures on all women in labor, but many now show increased flexibility in how they handle their patients. Some examples include:

●  enemas. Used to clean out the bowels, enemas used to be routinely administered when women were admitted. Now, you may choose to give yourself an enema or to skip it entirely.
●  induction of labor. At times, labor may need to be induced or sped up for medical reasons. But sometimes, practitioners will give women the option of getting some help to move things along, or giving labor a little more time to progress on its own.
●  shaving the pubic area. Once routine, shaving is no longer done unless a woman requests it.

Other procedures that you can include in your birth plan are requests about fetal monitoring, extra birthing equipment you'd like in the room, and how often you have internal exams during labor.

※ Pain management. This is important for most women and is certainly something you have a lot of control over. It's also something you'll want to discuss carefully with your health care provider. Some women change their minds about pain relief during labor only to discover that they're too far along in their labor to use certain methods, such as an epidural. You'll also want to be aware of the alternative forms of pain relief, including massage, relaxation, breathing, and hot tubs. Know your options and make your wishes known to your health provider.

※ Position during delivery. You can try a variety of positions during labor, including the classic semi-recline with the feet in stirrups that you've seen in the movies. Other choices include lying on your side, squatting, standing, or simply using whatever stance feels right at the time.

※ Episiotomies. When necessary, doctors perform episiotomies (when the perineum — the area of skin between the vagina and the anus — is partially cut to ease the delivery). You may have one if you risk tearing or in the case of a medical emergency, but if there is an option, you can discuss your preference with your provider.

※ Assisted birth. If the baby becomes stuck in the birth canal, an assisted birth (i.e., using forceps or vacuum extraction) may be necessary.

※ Cesarean section (C-section). You might not want to think about this, but if you have to have a cesarean, you'll need to consider a few things. Do you want your partner to be present, if possible? If you have a choice, would you like to be conscious or unconscious? What about viewing the birth — do you want to see the baby coming out?

※ Post-birth. Decisions to be made about the time immediately after birth include:

●  Would your partner like to cut the umbilical cord?
●  Does your partner want to hold the baby when the baby emerges?
●  Do you want immediate contact with the baby, or would you like the baby to be cleaned off first?
●  How would you like to handle the delivery of the placenta? Would you like to keep the placenta?
●  Do you want to feed the baby right away?

★ Communicating Your Wishes

Birth plans are relatively new inventions, and your doctor or nurse-midwife may not be completely comfortable with them. For this reason, make sure you communicate clearly that you intend to create a birth plan.

Give your health care provider your reasons for doing so — not because you don't trust him or her, but to help ensure cooperation and to cover the possibilities if something should go wrong. If your caregiver seems offended or is resistant to the idea of a birth plan, you might want to reconsider whether this is the right caregiver for you.

Also, think about the language of your plan. You can use many online resources to create one or you can make one yourself. Here are some tips:

●  Make your birth plan read like a list of requests or best-case scenarios, not like a set of demands. Phrases such as "I would prefer" and "if medically necessary" will help your health care provider and caregivers know that you understand that they might have to alter the plan.
●  Think about the other personnel who'll be using it — hospital staffers might feel more comfortable if you call it your "birth preferences" rather than your "birth plan," which could seem as though you're trying to tell them how to do their jobs.
●  Try to be positive ("we hope to") as opposed to negative ("under no circumstances").

Once you've made your birth plan, schedule a time to go over it with your doctor or nurse-midwife. Find out and discuss where you agree or disagree. During your pregnancy, review the birth plan with your partner periodically to make sure that it's still in line with both of your wishes.

Strive to keep the plan as simple as possible — preferably less than two pages — and list them in order of importance. Focusing on your priorities will help ensure that the most important of your wishes are met.

You may also want to make several copies of the plan: one for you, one for your chart, one for your doctor or nurse-midwife, and one for your birthing coach or partner. And bringing a few extra copies in your labor bag is a good idea, especially if your doctor ends up not being on call when your baby is born.

Although you might not be able to control everything that happens to you during your baby's birth, you can play a role in the decisions that are made about your body and your baby. A well thought-out birth plan can help you to do that.

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