A woman who already has a baby believes that she knows almost everything about pregnancy and childbirth. But this is not entirely true: the first and second pregnancies can be very different.

The minimum interval between two pregnancies is considered to be one and a half to two years. The body must fully recover and be ready for a new pregnancy. Here, competent family planning comes to the fore; it must be remembered that pregnancy can occur in the absence of menstruation after childbirth, so it is important to use the necessary contraception.

When planning a second pregnancy, it is advisable to undergo a complete medical examination, this is especially important if pathologies were identified during the first pregnancy and childbirth.

It is imperative to do an ultrasound of the genital organs. To do everything necessary tests to exclude the presence of infection, which can occur when the cervix is ​​damaged. Be sure to make sure there is no erosion; these problems are much easier to deal with before pregnancy than during it. It is advisable to undergo a full medical examination, if you have chronic diseases, consult with specialized specialists and undergo the necessary course of treatment.

What are the main differences between the first and second pregnancies? During a second pregnancy, the risk of developing varicose veins increases sharply and it is necessary to take measures to prevent this insidious disease seriously. It is necessary to wear special compression garments designed for pregnant women. The risk of miscarriage increases, especially if there were problems with the cervix. If the birth was assisted caesarean section, then special attention should be paid to the scar on the uterus, especially if the incision was made longitudinally. It is possible low position placenta or the development of placental insufficiency, when the fetus receives insufficient nutrition due to decreased blood flow to the uterus and placenta. There is also a risk of miscarriage. Anemia appears much more often, especially if there was heavy bleeding during the first birth and the body did not have enough time to completely restore hemoglobin. Breastfeeding during a new pregnancy increases the adverse effects on the body of a pregnant woman. Milk production requires a lot of nutrients, which places a serious burden on all body systems, and pregnancy increases this load, which can negatively affect the fetus.

After the first birth, the uterus remains slightly enlarged, so signs of pregnancy become noticeable faster (by about a month). A month earlier, the expectant mother will feel the baby’s first movements. The first movements during the first pregnancy occur around the fifth month; a pregnant woman will feel her second child at four months.

Repeated births are also different from the first. They are usually much shorter in duration, since the muscles and uterus have become more elastic and require less time and effort to open. Usually the second birth lasts 4-5 hours, while the first 10-12. More often there are false contractions, to determine if they are false contractions or real ones, you need to change your body position or take a shower, the false contractions will subside. Women who give birth more often experience weakness in labor due to weakness of the anterior abdominal wall. Wearing a special bandage from the 20th week of pregnancy can help cope with this problem. Another problem that a new mother may face is a higher risk of bleeding after childbirth, especially if there is a scar on the uterus.

The likelihood of conception after childbirth is of interest mainly to those who are in no hurry to immediately have another after the birth of one child. However, there are (albeit much less frequently) other situations: parents want the difference between their children to be as small as possible; Unfortunately, tragic circumstances occur (for example, artificially induced premature birth due to severe deformity of the fetus or a high risk to the life of the mother). Regardless of the reasons for which you are interested in the likelihood of conception after childbirth, it is useful to first understand what happens to a woman’s ovarian-menstrual cycle during the postpartum period.

Even during pregnancy, a woman’s pituitary gland begins to actively produce the hormone prolactin, which prepares the mammary glands for lactation, stimulates lactation and at the same time suppresses ovulation. At the moment when the baby suckles, the secretion of prolactin intensifies, and as the time between feedings increases, it decreases. As a rule, while a woman is breastfeeding only, prolactin completely suppresses ovulation - lactational amenorrhea occurs (lack of menstruation during breastfeeding). However, there are, and often are, cases when, with sufficient lactation, the menstrual cycle is restored relatively quickly.

Regarding the likelihood of conception, the following can be stated.

When can you get pregnant after childbirth?

Firstly, it is almost impossible to establish any patterns in the timing of restoration of the ability to conceive. That is, of course, it is known that breastfeeding causes a delay in ovulation, but it is impossible to accurately predict the date of the first postpartum ovulation. The timing of the resumption of ovulation after childbirth is very individual. Moreover, they can be different for the same woman after different births, so you should not rely on your previous experience in this matter. The main indicator of ovulation restoration is the first postpartum menstruation. Non-breastfeeding women begin menstruation earlier than breastfeeding women. It is known that the earliest ovulation is recorded in the fourth week after birth in non-breastfeeding women and in the seventh week in lactating women. In order not to miss the first postpartum ovulation, it is recommended to use a temperature test1. Breastfeeding women should start measuring from the 6th week after birth, and non-breastfeeding women from the 4th week: so as not to miss the moment of its increase, indicating ovulation.

Secondly, after the restoration of menstruation, anovulatory cycles (i.e., menstruation without ovulation) may occur.

Thirdly, the absence of menstruation does not mean that a woman cannot conceive a child. The fact is that the moment of conception may occur exactly in the middle of a newly restored cycle.

It has been noticed that when the next pregnancy occurs, the child often refuses mother's milk. It is assumed that one of the mechanisms of a child’s refusal to breastfeed in this situation is the following. At the moment when the baby begins to suckle, the mother reflexively releases the hormone oxytocin, which stimulates the contraction of smooth muscles. This leads to a reduction in the terminal ducts of the mammary gland (milk is, as it were, “injected” into the baby’s mouth). At the same time, the muscles of the uterus contract. This is very useful after childbirth, but in the case of a new pregnancy, increased uterine tone can lead to miscarriage. Therefore, apparently, when the next pregnancy occurs, the secretion of oxytocin is suppressed, and the baby becomes unusually difficult to suck. In addition, under the influence of hormonal changes in the body that accompany pregnancy, the taste of milk may change. However, there is no natural connection between a child’s refusal to breastfeed and re-pregnancy.

How long does it take to recover after childbirth?

Modern medicine claims that for complete recovery female body after childbirth, the interval between childbirth and the next pregnancy should be at least two years, although, of course, this should be considered more of a recommendation than an immutable rule: many women have successfully given birth and are still giving birth to children of the same age.

Moms, don't rush. How long should you wait before planning your next pregnancy?

Agree, if there are certain WHO medical recommendations on the length of the interval between births, then it was not without reason that they were developed and written? In addition, unfortunately, not all women who want to have a bunch of children can be called practically healthy. For them, a certain period of break between children is not the last thing.

Why is the period measured: what should be the break between pregnancies?

From a physiological point of view, nothing prevents a healthy woman from becoming pregnant again literally immediately after giving birth (as you know, lactation does not prevent this at all). Often this is what happens, and identical brothers and sisters are born just a year or so apart. If the mother is healthy and the previous pregnancy went well, then everything will most likely go smoothly this time too.

Although, probably, there are very few parents who consciously plan for the same weather. Because, having barely given birth to one baby, immediately bearing the next one is not a lifting burden for all modern women (and their husbands). And the reasons do not always lie in the fatigue of the body after recent childbirth. The fact is that both physically and psychologically the female body at this time is not yet fully adapted to external life. A woman who has given birth, together with her child, has been in a rather closed “mother-child” system for a long time. All the strength and feelings of a woman are directed towards the baby, for whom, in turn, the whole world is concentrated for a long time in one single person - the mother. This relationship continues as long as the baby is breastfed, which means at least a year or two.

Officially, doctors believe that the optimal interval between births should be at least two years. Please note that this is the period between births, that is, before the next conception and pregnancy, the body needs to rest a little more than a year. The basis for such medical recommendations was a number of anatomical, biochemical, hormonal and other studies. According to doctors, the body needs to be given at least a year and a half (before conception) so that the functioning of all organs is finally restored, vascular system, blood flow, hormonal levels returned to normal.

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All the will of God?

It is quite natural that women who intend to endure a certain period of time and recover properly need to use protection. However, there are many in Russia who do not do this for fundamental, most often religious, reasons. Some of these women are already experiencing their sixth or seventh birth by the age of 25. Unfortunately, almost all of them are at risk. In practice, this means a risk of bleeding during childbirth and postpartum period, the development of diseases such as anemia, thrombophlebitis, thrombosis of the lower extremities and external genitalia (since the veins located at the same level as the inferior vena cava experience constant compression syndrome).

Due to the short break between pregnancies, the uterus does not have time to grow the necessary basal layer, to which the placenta should normally attach. As a result, fetoplacental insufficiency is formed, or a violation of blood flow between the placenta and the child. Children born to such mothers are often prone to malnutrition (stunted growth in the womb and low birth weight).

And all these problems are caused by one thing - insufficient time between births. After all, even if an absolutely healthy body is not given rest, at some point violations cannot be avoided. Some may argue that in the past, children were born one after another, without thinking about the timing. In general, it was believed that if a woman is able to get pregnant immediately after giving birth, this is normal. So be it. However, it is also known that not all children survived, and many were born weakened. It would seem that the progress of medicine instills certain hopes these days. But on the other hand, the environmental situation and living conditions leave much to be desired. All this does not make a person healthier.

What issues need to be resolved before getting pregnant again?

Of course, plans to expand the family are a purely personal matter. And yet, the recommendations of doctors should not be neglected. They are usually based on how your first pregnancy went. When making predictions for the future, doctors must take into account the difficulties that the woman encountered the previous time. Perhaps the patient suffers from general diseases. In this case, they need to be eliminated and only then think about a new pregnancy. If serious anomalies affect labor, it is necessary to carefully understand the reasons. Women who have undergone surgery during childbirth are automatically at risk. For them there is a certain procedure for mandatory examinations. It also applies to those who suffer from chronic somatic diseases, blood diseases (coagulation disorders, chronic anemia). Special attention required by patients with nephropathy. Against the background of this disease, in the last trimester of pregnancy, pressure increases significantly, swelling and unfavorable changes in the urine appear. If a woman is not cured or at least has not undergone the necessary examination, her new pregnancy will be more difficult than the previous time. Old problems inevitably overlap with new ones. And of course it’s better to get rid of them before the next pregnancy.

When should you wait before planning another pregnancy?

When preparing to become a mother again, a woman who is Rh-negative should take special care. It is not uncommon for the first child to be born with a positive Rh factor. But doctors do not conduct the necessary examinations; in the first 24 hours after birth, they do not administer the anti-Rhesus immunoglobulin necessary in this situation. The consequences of such mistakes are quite serious. Firstly, antibodies entering the child’s body through mother’s milk can cause serious changes in the child’s nervous system, including kernicterus. Secondly, if antibodies are detected already during another pregnancy, artificial labor has to be induced ahead of time so as not to aggravate the situation.

With a caesarean section, doctors recommend waiting at least 2-2.5 years in order to then conceive and carry the next child to term normally. Will mom be able to give birth this time? naturally, depends on the reason for which the cesarean section was performed. It's one thing if a woman had large fruit, foot presentation or fetal weight did not correspond to the size of the mother's pelvis. In this case, after passing the necessary examinations, she can give birth herself. If we are talking about diseases in which it is impossible to independently endure such a load as childbirth (indications of a neurologist, traumatologist or ophthalmologist), then it will not be possible to avoid a repeat operation. It is clear that chronic diseases of the spine, an obliquely displaced pelvis or a fracture of the spine will not improve for the next birth.

Extensive cervical ruptures that occur during childbirth also limit a woman’s desire to become pregnant again as soon as possible. In this situation, cervical plastic surgery and an appropriate adaptation period are necessary. Moreover, in this case natural childbirth impossible. The only option left is a caesarean section.

In case of multiple pregnancy, the uterus healthy woman returns to normal within the same time frame as during normal childbirth. However, according to doctors' observations, mothers of twins do not soon decide to have a second birth. Their workload is already considerable.

If a woman has suffered diseases such as syphilis and hepatitis, then several years must pass between present and future births.

The golden mean: the optimal break between pregnancies

The interval between births should not be too long. After all, when a woman decides to have a child 15-20 years after her first birth, it is difficult for both doctors and her. Over time, as a rule, sores appear in the form of infection, inflammatory processes in the appendages, often. Abortion is often added to this. Age cannot be discounted either. The woman has become older, which means that in addition to medical problems, psychological ones also arise.

After so much time, they decide to have a second baby, as a rule, for the sake of a new husband. It is fair to assume that a woman is tormented throughout her pregnancy by questions: how will the stepfather treat the first child, and the older child - the newborn, etc. A woman is often forced to seek the help of a psychologist.

Of course, it is better to stick to the golden mean. However, it is clear that you need to prepare and plan for a new pregnancy in the same way as the previous one. Again, you will have to take the same tests and undergo all the necessary examinations.

By the way, in schools for expectant parents you can often meet experienced mothers who have decided to have another baby in our difficult times. They want everything to work out well this time too.

Elena Petrovna Ozimkovskaya, chief doctor of the maternity hospital

Friends, we have done it for you again - we have gathered representatives of 25 maternity hospitals in Moscow and the Moscow region on one site! That was incredible! Future parents could approach the staff of any maternity hospital, meet and communicate in person, and ask all their questions.

Often, just starting breastfeeding, a woman immediately faces a problem - cracked nipples. The most common causes of their occurrence are a lack of milk or improper latching of the nipple by the child. To soften the skin of the mammary glands, you can use ointments or creams based on Lanolin, since other oils (vaseline, etc.) can cause allergic reactions or indigestion in the baby. Purelan 100 nipple cream has proven itself very well.

Discharge after childbirth is usually very heavy. That is why the use of disposable panty liners is very convenient for the postpartum mother. These days, mom can use soft, super-absorbent sterile sanitary pads for heavy discharge.

If a woman produces a lot of milk, you can use so-called shells - pads to collect breast milk. Made from special plastic, they are placed in the bra and collect all the milk that flows out. Since the shells must be sterilized before use, the milk collected in them can then be poured into a bottle and, if necessary, fed to the baby. If you use shells in the maternity hospital, then what is collected in them breast milk, cannot be used.

Bra pads can be disposable or reusable. Reusable cotton inserts are sold in sets of 2 - 6 pieces. Inside they contain a material that can hold liquid for up to 3 hours. These liners can be washed with baby soap or baby soap. washing powder hands or washing machine. After washing, they must be rinsed well and, after drying, ironed on both sides. Disposable inserts are sold in boxes, 40 - 50 pieces each.

Postpartum bandages can be of several types: 1. Postpartum bandage in the form of an elastic band that can be used before childbirth. This practical model is very popular. The tape is put on the lower back and fixed on the stomach. However, the tightening ability of this type of bandage is not the strongest.2. The postpartum grace bandage has a high waist, a multi-level fastener at the bottom or side, and thick inserts on the stomach.

During breastfeeding, mothers will need a special nursing bra. It is better to purchase a nursing bra in advance - at about 36 weeks of pregnancy. True, in this case it is necessary to remember that the volume chest will decrease due to the fact that the tummy will go away. When buying a nursing bra, you need to remember the following: . When a woman begins to breastfeed, the mammary glands fill with milk, so they need additional support.

Unfortunately, the food in the maternity hospital may not always satisfy your taste preferences. Therefore, a woman’s diet after childbirth can be supplemented with the following products: apples 1-2 pcs per day; pear 1 piece per day; fermented milk products (yogurt, kefir) 100g per day; boiled meat or poultry 100-150g per day; It is not advisable to bring: grapes, bananas, melons, tangerines, oranges, chocolate. These products may cause allergies or intestinal dysfunction in a child.

Even a well-progressing pregnancy can end before term: for various reasons, including those that have not been fully studied, from 4 to 20% of expectant mothers begin giving birth prematurely. In Russia, premature birth is considered to be a birth between the 28th and 37th weeks of pregnancy, during which a baby is born weighing from 1 to 2.5 kg.

Pregnant women, women in labor or postpartum women who have at least a suspicion of an infectious disease are hospitalized in specialized infectious disease maternity hospitals (usually based in the corresponding hospitals) and observational departments of any ordinary maternity hospital.

During labor, women with hematologic problems may need urgent blood transfusions. Therefore, maternity hospitals that specialize in childbirth for women with blood diseases, as a rule, have their own blood bank. Perhaps the most common “blood” problem in pregnant women is anemia.

During pregnancy, existing kidney diseases may worsen, hidden diseases of the urinary system may manifest themselves, or kidney problems associated with pregnancy may occur. Pyelonephritis in pregnant women and nephropathy are fairly common complications of pregnancy. Nephropathy, which is one of the types of gestosis (late toxicosis) of pregnancy, usually develops in the third trimester and is characterized by edema, the appearance of protein in the urine, and increased blood pressure.

lead to complications in the mother and fetus. For example, in mothers suffering diabetes mellitus, premature births often begin, while babies are born with absolutely normal body weight, and full-term babies are born as heroes with a very large weight. This condition is called diabetic fetopathy, and it can negatively affect both the health of the child and the course of labor.

Nowadays, most cardiovascular diseases are not a contraindication to pregnancy. However, women with a weak heart need to take extra care in order to bear and give birth. healthy baby and not lose your health. Those who suffer from hypertension, heart disease, arrhythmias, mitral valve prolapse should consult their attending cardiologist even at the stage of preparation for pregnancy.

It happens that a mother who is breastfeeding cannot be with her baby all the time, because she needs to study, work, go to the hospital for examination, or simply wants to go on a visit, the theater, or somewhere else. Until recently, a mother, of course, could express a certain amount of milk so that in her absence it could be fed to the baby, but, unfortunately, it was impossible to store breast milk for more than one day, since there were no special devices for this.

About stem cells in last years they talk and write a lot. Human blood is liquid gold, and is especially precious because it can save the life of another person. And the most valuable thing in blood is stem cells, which can help heal humanity from many serious diseases. True, they are not present in any blood, but only in the umbilical cord. And the moment when they can be obtained is short: this is the time between the baby’s first cry and the birth of the placenta.

Women tend to go shopping in moments of strong emotional unrest. Of course, while waiting for a baby, even the most calm ladies in an ordinary situation become much more emotional. This means that shopping becomes almost a mandatory item in the daily routine for many of them. In order to spend this time usefully and buy what you really need, we have compiled an approximate shopping calendar during pregnancy.

A pregnant woman who considers her “position” a reason for doing nothing is making a big mistake. A sedentary lifestyle is fraught not only overweight, which, by the way, to the expectant mother not needed at all. In a lazy body, metabolism is disrupted, the kidneys and liver try to cope with the increased load and give in. At the same time, protective functions are also reduced. Acute and chronic infections are just waiting for the moment when the immune system weakens.

Pregnancy and childbirth can be a difficult ordeal not only for a woman’s body, but also for her emotional sphere. A good way to avoid this is to attend special childbirth preparation courses. But a woman can and should help herself on her own. Don’t be shy about expressing your emotions. From the point of view of psychologists, pregnancy is a crisis comparable, say, to puberty or, conversely, menopause.

Childbirth is a natural process. Nature itself helps the woman in many ways during childbirth and tells her how to behave so that she and the unborn child will feel better. However, in order for the birth process to be easy and painless, it is advisable for a woman to prepare for it. After all, despite the fact that we live in a world of computers and many automated processes, childbirth is something that a woman needs to do on her own.

Commercial midwifery services are in very high demand among expectant parents. Especially in major cities. Moscow is no exception. Almost every maternity hospital in Moscow offers paid services. These can be either contracts for the management of pregnancy and childbirth, or one-time services: consultations with specialists, ultrasound, CTG, laboratory tests. To navigate the sea of ​​similar services and choose YOUR MATERNITY HOSPITAL, we invite you to familiarize yourself with information about maternity hospitals in Moscow.

Breastfeeding is the preferred choice for all normal children due to its many health benefits for both children and their mothers. In children of the first year of life, the need for food per unit of their own body weight is several times higher than in an adult; children are more sensitive to deviations in nutrition, they have a lower ability to adapt to various types, forms and properties of food.

Problems that arise during breastfeeding and ways to eliminate them (from the guidelines of the Health Committee of the Moscow Government and the Russian State medical university“On predicting lactation disorders, prevention and treatment of hypogalactia”) When a woman breastfeeds a child, we encounter some problems, such as cracked nipples, mastitis, etc.

Breastfeeding (from the Guidelines of the Health Committee of the Moscow Government and the Russian State Medical University “On predicting lactation disorders, prevention and treatment of hypogalactia”) Relevance of the problem of breastfeeding From time immemorial, breastfeeding a newborn child was common among all peoples at all times, this ensured their survival and health.

Discharge from the genital tractAfter childbirth, the obstetrician-gynecologist pays special attention to the nature of the discharge from the genital tract (lochia). When assessing lochia, the doctor determines their color, character and quantity. The first 2-3 days the discharge is quite heavy, like in the first days of menstruation. Then they become smaller, the color is brownish-brown, after 10-14 days they become yellowish. Usually, bleeding increases during breastfeeding.

Your long-awaited baby was born, and after him the placenta was born. From this moment the postpartum period begins, which lasts 8 weeks (40 days). During this time, in the body of the postpartum woman, the reverse development of organs and systems occurs, which changed accordingly in connection with pregnancy and childbirth, and the formation and flourishing of the function of the mammary glands occurs. In addition to physiological changes, other processes occur with a woman.

A pediatric neonatologist must be present at the birth and assess the condition of the newborn using the APGAR scale in the first minute after birth and 5 minutes later. For each of the parameters - heart rate, breathing, skin color, muscle tone, reflexes - a score ranges from 0 to 2. Usually newborns receive a first “score” of 7-8 points, after 5 minutes it increases to 8-10 points. After this, the child is cared for by a midwife.

Even if a woman gives birth without pain relief, she may need it during labor—for example, if there are some complications. Therefore, an anesthesiologist and a nurse in the anesthesiology-reanimatology department - an anesthetist - are always present as part of the team on duty during childbirth. If a woman gives birth by cesarean section, the anesthesiologist develops tactics for administering anesthesia, monitors its administration, and the mother's reactions to anesthesia during the operation.

An obstetrician-gynecologist can be compared to a commander in chief. It is the doctor who makes all decisions regarding the management of labor, writes out prescriptions, responds to changes in the patient’s condition and takes full responsibility for the course of her labor. The woman is under the supervision of a doctor from the moment of regular labor. At the same time, the doctor should not be constantly present with the expectant mother; in the first stage of labor, he looks at the woman in labor about once an hour.

Everyone is called a midwife nurses maternity ward. They carry out all the doctor’s orders: measure blood pressure and pulse, install a CTG machine to monitor contractions and fetal heartbeat, install a catheter for intravenous administration of drugs (not anesthesia!). They also regularly determine where the baby’s head is, how dilated the cervix is, and whether it is possible to move on to the second stage of labor.

Midwifery practice is carried out in accordance with the International Confederation of Midwives International Code of Ethics for Midwives, 1993 Preamble to the Code The purpose of the International Confederation of Midwives is to improve the standard of care for women, newborns and families throughout the world through the development of education and the appropriate use of the profession midwives.

Pregnancy pathology department - it houses women with any complications of pregnancy (threat of miscarriage, gestosis, etc.). It usually includes wards, treatment rooms, an examination room, and a dining room. There can be a shower and toilet in each room, or one for everyone.

Postpartum ward - mature mothers are admitted here directly from the maternity ward or from the intensive care ward after a cesarean section. Depending on the maternity hospital, the wards in which women are kept after childbirth can be single, double or multi-bed.

The operating room is where births take place via cesarean section. A woman can be referred to the operating room from the emergency department if she requires an urgent caesarean section, or from the pathology department when she is undergoing a planned operation. The operating unit consists of several operating rooms and a preoperative room, where doctors and midwives prepare for surgery.

A maternity ward is a series of rooms in a maternity hospital where births occur. Sometimes they occupy an entire floor, sometimes a wing maternity hospital. Women from the emergency department who arrived in labor and patients from the pathology department who were hospitalized in advance and who began planned labor are admitted here. The maternity ward of older maternity hospitals usually has several prenatal wards and one or two general delivery rooms.

A maternity hospital is an obstetric medical institution whose main task is obstetrics. Obviously, to solve this problem, the maternity hospital must have a certain device, different from, say, a children's hospital or clinic. But it’s not just the device that makes a maternity hospital a maternity hospital. The main component of a maternity hospital is its staff and patients, as well as the rules that regulate the relationship between them.

Childbirth is a physiological process that ends pregnancy, in which the fetus, as well as the placenta (placenta, membranes, umbilical cord), are expelled from the uterine cavity through the birth canal. The basis of childbirth is the so-called mechanism of childbirth. Mechanism normal birth- a set of translational and rotational movements of the fetus as it passes through the pelvis and soft parts of the birth canal. Movement of the fetal head begins simultaneously with the onset of regular labor.

In recent years, women have been actively using another product from the disposable category - disposable panties for the maternity hospital. Used panties are simply thrown away, eliminating the need for laundry or the hassle of storing dirty laundry until you get home. Disposable panties can be made from soft mesh fabric or elastic mesh.

Ultrasound is not only an informative research method that is actively used in medicine, but also very interesting. After all, future parents are so curious to see what the baby looks like! Find out his gender! Watch in dynamics how it grows! There is no alternative to ultrasound in this regard. Over the years of use, the method has proven its safety. Currently, it is included in the list of mandatory examinations that a woman must undergo during pregnancy.

Determining the duration of pregnancy and childbirth is based on the fact that a woman has a 28-day menstrual cycle with ovulation on the 14-15th day of the cycle. The average duration of pregnancy is 280 days or 40 weeks or 10 obstetric months. There are 4 weeks in one obstetric month. However, 280 is the average length of pregnancy.

Every expectant mother, starting from the 36th week of pregnancy, is recommended to prepare things for the maternity hospital and pack a bag for the maternity hospital. It is better to do this in advance and slowly, since when labor begins, it will be very difficult to concentrate and put everything you need.

Future parents now have the opportunity to choose a maternity hospital. But how to do that? We want to offer you an algorithm that will help you choose YOUR maternity hospital. 1. Specialized or general profile?At the first stage, it is important to understand whether, for health reasons, you can give birth in a general maternity hospital or whether you may require specialized assistance during childbirth.

Please note that this information is intended for specialists, but can be recommended for future parents who are distrustful of the work of maternity hospital medical staff. 1. Boxes for newborns and premature babies are filled with 1-2 children with one pathology, taking into account the age and epidemiological state of obstetric hospitals.2. Boxes, corridors and a treatment room, a room for dismantling dirty linen, etc.

Paid childbirth is the conclusion of an appropriate contract directly with a maternity hospital, a commercial company providing medical services, or the conclusion of a voluntary health insurance agreement with an insurance company. Voluntary health insurance contracts are currently the most widespread in our country.

Even the most sober-minded people, having become pregnant, no, no, and will begin: “But they say that...” Then usually follows a description of a common sign, prejudice or superstition - about the behavior of a pregnant woman, about the gender of the child, about what needs to be done during childbirth to make it easier or what not to do after the birth of the baby. To believe or not in “folk wisdom” - let each expectant mother decide for herself.

During last weeks Before the hour of labor appointed by nature, a woman may feel more or less noticeable contractions. But until they become regular, and the time between them begins to steadily shorten, it is too early to say “mom, I’m giving birth” - this is not childbirth, but only preparation for it. The uterus is training, testing its strength before the decisive “performance”.

Full dilatation of the cervix indicates that the second phase of labor has begun - the period of expulsion. It is significantly shorter than the first period: in primiparous women it lasts 1-2 hours, in multiparous women it lasts from 15 minutes to 1 hour. During this period, the child is born. By the beginning of the expulsion period, the amniotic fluid had already poured out ( amniotic sac either ruptured itself, or the doctor performed an amniotomy to coordinate labor).

No matter how difficult the first pregnancy was, no matter how many complaints came from young mothers: about toxicosis, heartburn, pain, fatigue, it seemed what a terrible state pregnancy was, but very little time passes - six months, a year, the firstborn grows up a little and the mother thinks about second. Yes Yes! Again about this terrible feeling that they are ready to experience again and again! These women are amazing creatures.

When is the best time to have your second baby?

The first question that may arise when planning a second pregnancy is? Experts recommend not to rush into getting pregnant again; ideally, at least two to three years should pass after the birth of your first child. During this period of time, the mother’s weakened body after the first pregnancy and childbirth is able to fully recover. In addition, postponing your next pregnancy for several years will benefit not only your body, but also your first-born, because then you can extend the period of breastfeeding your baby, which will undoubtedly have a beneficial effect on his health. While when a new pregnancy occurs, continue breast-feeding It’s more complicated: the body has to “work on two fronts” - spend energy on developing a new life and maintain the proper composition of milk. As a result, it may turn out that the mother will be left with nothing: the older child will independently refuse the breast due to the fact that the milk has become tasteless, while the unborn child may suffer from a lack of necessary substances, the consequence of which may be malnutrition. The mother herself can acquire a whole range of diseases, one of which is anemia.

In addition, when observing pregnant women who give birth the same age, doctors were able to find out that during repeated pregnancy, women experience toxicosis not only in the first half of pregnancy, but also in the second, and iron deficiency is also likely. On later pregnancy, there may be a threat of miscarriage or premature birth. And since the pregnancy period does not always proceed well, babies are born weak and underweight. That is why it is better not to rush into giving birth again.

If, on the contrary, the interval between the first birth and the second is long and amounts to more than ten years, then in fact the second pregnancy can be called the first. Over such a long period of time, the body has already forgotten all the skills of childbirth. Yes and in most cases general condition The older mother’s health is no longer as good as before. And therefore there is a high risk of pregnancy with unpredictable consequences. Often women over the age of 35 have gynecological problems, such as uterine fibroids, endometriosis and others, which can also affect the course of a second pregnancy.

Experienced mom

Many doctors note the fact that mothers who give birth repeatedly are much more responsible and disciplined than first-time mothers. They do not need to be regularly reminded of the obligatory observance of the correct daily regimen, nutrition, rest; they follow diets on their own, spend a lot of time on fresh air, regularly visit the doctor, take all necessary tests on time and undergo examinations on time. Repeated women are psychologically prepared for changes during pregnancy. It is during repeated pregnancy that mothers become more relaxed, are not embarrassed by their interesting position and happily show off their belly to others.

Experienced mothers are much less nervous and afraid during pregnancy. In addition, the experience gained during the first pregnancy helps the mother to better navigate during the second pregnancy, to better feel and understand the unborn baby.

Features of repeat pregnancy

Repeated pregnancy is quite problematic to hide from others for a long time. Since the abdominal muscles, as well as the ligaments that hold the uterus in place during the first pregnancy, are stretched, during the second pregnancy your belly will increase before your eyes. That is why the expectant mother, during a second pregnancy, is recommended to wear a prenatal bandage from the 20th week, which will relieve the load on the spine and legs. For many women with a second pregnancy, a prenatal bandage is a mandatory attribute not only at work, but also at home, during rest and rest.

Another feature of repeat pregnancy is that mothers who gave birth feel the first movements of the fetus already at the 18th week of pregnancy, since mothers who have given birth again already know what exactly to listen for, while first-time mothers may confuse fetal movements with peristalsis intestines.

If a woman had toxicosis during her first pregnancy, it is possible that during the second pregnancy the symptoms of toxicosis will intensify. In addition, if during your first pregnancy you were diagnosed with “high blood pressure”, “protein in the urine”, or you were tormented by edema, then during your second pregnancy you need to regularly take blood and urine tests, measure blood pressure, follow a diet and monitor possible excessive weight gain, observe the salt and water regime. And of course, it is necessary to warn the doctor observing you about past problems, he will help you avoid them, tell you what needs to be done, and that the pregnancy went smoothly.

During the first pregnancy, the fundus of the uterus, or as they say, the abdomen, descends approximately two weeks before birth, i.e. If the child prepares for the final stage in advance, then during a second pregnancy, the lowering of the abdomen is more difficult to notice: the baby’s head is pressed against the mother’s pubic symphysis immediately during childbirth.

During a second pregnancy, the cervix may be shorter. But only a doctor can determine this, and the doctor must also check how tightly it is closed. Closure of the cervix should be complete in any pregnancy, no matter what the number.

If during your first pregnancy there was a Rh conflict, then subsequent pregnancies will make you worry. After the first pregnancy, antibodies remain in the mother’s blood that tend to destroy the red blood cells of the fetus and can develop hemolytic disease of the child. To avoid this, you need to go to a specialized hospital for examination and further observation before conception. Mothers will have to take a monthly blood test for antibodies and monitor the amount using ultrasound. amniotic fluid(there should be no polyhydramnios) and the size of the placenta, which should not be thickened. All these problems can be solved if you know about them in advance.

The most important thing is that a woman knows in advance about possible complications during pregnancy, she is less nervous, and this in any case has a beneficial effect on the course of another pregnancy. But the expectant mother needs to be nervous and worry as little as possible.

Often, women's second pregnancy is much easier than the first. This fact can be explained by the fact that children are of different sexes: it has been established that in women expecting boys, toxicosis, for example, occurs less frequently. Sometimes children from different fathers behave differently.

Some mothers are convinced that the first pregnancy is always “overstayed”, while the second, on the contrary, is a couple of weeks shorter. But this is just a delusion. Childbirth occurs at the same time as before.

Repeated pregnancy after caesarean section

If your first baby was born as a result of a caesarean section, the mother should think about getting pregnant again no earlier than a year later: it is necessary to give the scars on the uterus a chance to heal. However, if you want a second baby, then you should not delay the second pregnancy: it is believed that over time the scar loses its strength and elasticity. The optimal difference between the first and second pregnancy should be 2-3 years, but preferably no more than 5 years.

It is the strength of the scar on the uterus after a cesarean section that will become the main problem of a second pregnancy. Even before conception, the expectant mother needs to undergo an ultrasound examination, which can objectively assess the condition of the scar.

C-section scar tissue is different from the inner layer of the uterus, the myometrium. As a result, if the site of attachment of the fertilized egg becomes on the anterior wall of the uterus, close to the scar, then theoretically this can lead to various unpleasant consequences, for example, subsequent fetoplacental insufficiency. But only theoretically: the placenta is an organ with great compensatory capabilities. For example, she can “grow” another additional lobe, which will provide the fetus with everything it needs. Therefore, if the problem is only in the scar, then the placenta will cope with it. In addition, a pregnant mother can always count on the help of doctors, who during each visit antenatal clinic will do the appropriate examinations: ultrasound biometry of the fetus and placentometry, in this case any deviation will be immediately noticed. The mother herself also needs to monitor her well-being; it is especially worth paying attention to painful movements of the fetus, which are often associated with scar dehiscence. However, even a very difficult pregnancy in a hospital setting, doctors will be able to “hold out” until the functional maturity of the fetus.

The time when after a caesarean section a woman was categorically forbidden to give birth in the future is behind us. Nowadays, it is not uncommon for not only a second baby to be born through Caesarean section, but even a fifth one. As they say, the main thing would be desire, but you can cope with difficulties.

Preparing our eldest child for a new family member

In addition to preparing for the upcoming happy event for the mother herself, spouses need to prepare in advance for the arrival of a new family member and an older child. This is a rather important moment that needs to be approached competently. You need to prepare your child for the arrival of a brother or sister gradually throughout pregnancy; the most important thing in the preparation process is to let the child know that he is still loved. This moment is very important for the older child; he should not feel that with the appearance of a little one in the family, he will be loved less. If the child feels this, then the birth of the baby will be as long-awaited an event for him as for the parents themselves.

The course of pregnancy is laid down in the genetic program of the female body. But, fortunately, modern doctors have learned to intervene in certain aspects of this program. If your doctor has information about your first pregnancy, and ideally managed it himself, he will help prevent possible problems during a second pregnancy, which means only one thing: very soon you will have a healthy baby.

Magazine My little one

Someone might think that if a woman is pregnant for the second time, she is already experienced, knows everything and is not afraid of anything. But in reality, it is scary and difficult no less than the first time, and there are quite a lot of myths about this, some of them are true, some are not.

There is a widespread belief that the second experience is easier than the first, but it must be said right away that this is just a myth. It may be easier psychologically, because you already have some experience, but there are more prerequisites for complications and troubles.

The peculiarity of the second pregnancy is that it occurs at a more mature age, when there may already be chronic diseases. If there were problems the first time, for example, Rhesus conflict, now it is possible that it will worsen.

A second pregnancy immediately after the first does not mean the most good conditions, the mother’s body is weakened after childbirth, vitamin deficiencies and anemia are very common.

If you are pregnant again, your second labor will likely be much faster than your first, but that doesn't mean it will be less painful; in fact, it will be more painful. If you have a conception that occurs after a long period of time, its peculiarity is that it will proceed almost like the first one, the body seems to forget everything, and the birth will also be approximately the same.

Repeated pregnancy after the first in a year or less means that the birth will be quick, or even rapid. How to explain this? During pregnancy, and then childbirth, nerve connections are formed in a woman’s brain, which provide a unique pattern for how pregnancy, and then childbirth, should proceed. If little time has passed, these connections remain quite strong, everything flows according to the established rules; if the period between children is long, the connections will have to be formed virtually anew.

It's good if you have a planned pregnancy. Preparation for it should be no less serious than for the first. It is worth paying special attention to planning for those women who have a burdened obstetric history (there were problems in the female part), or have common chronic diseases. Having learned everything about a second pregnancy with a particular pathology, it will be possible to take the necessary measures in a timely manner and undergo the necessary examinations.

Timely planning for many is a reason to try to conceive a boy or girl. If at the birth of the first baby in the family this issue is not very concerning, you really want to plan the pregnancy with the second child so that his gender is desired. Of course, there are no reliable ways to choose the sex of a child, but you can at least try.

Second pregnancy, does timing matter?

Quite often, after giving birth to a child, women either become pregnant too early (second unplanned pregnancy), or, on the contrary, they put it off for too long. Of course, a second conception in a row is not very good for the mother’s body, which has not yet recovered from the first birth, but it’s also not worth putting it on the back burner.

Late repetition has its drawbacks, and, as a rule, it is more difficult. Giving birth 10 years after the first is like the first time.

How long does the second pregnancy last?

There is a myth that the second pregnancy lasts less, and childbirth occurs within normal terms, but may be a little earlier than with the first. In reality, everything is individual and depends on many factors. Postmaturity actually happens less often, and this is due to the already formed dominant of labor.

Signs of a second pregnancy, how does it begin?

The symptoms of the second pregnancy are no different from the first, although this does not mean that it will proceed in exactly the same way, most likely, everything will be different. Having become pregnant for the third, fourth, fifth time, each time you will bear a child differently than in the past, this is due to the fact that everything will take place under new conditions, and your baby will be genetically different from the one you carried before.

You may notice signs of re-conception a little later than the previous time or a little earlier, this cannot be predicted, it promises fewer complications and an easier course if you are healthy, young, and at least 2 years have passed between conceptions.

Thus, a second pregnancy, the beginning of which occurred in the first months after birth, may not show itself in any way until... the baby’s first movement. If you are breastfeeding, your missed period can smoothly flow into a new pregnancy, and if you are lucky that the first weeks pass without toxicosis, you will not notice its onset. It is quite possible that others will notice the change before you, this happens even with doctors.

How to determine a second pregnancy in such cases?
The most important thing is to try not to create preconditions for its onset, that is, to protect yourself. You cannot rely on breastfeeding or interrupted coitus as methods of contraception; this is not very reliable and does not always work. A repeat pregnancy that occurs against the background of postpartum amenorrhea, the early stages of which occurred at a time when you feel tired, lacking sleep, immersed in caring for your baby and household chores, can be difficult for self-diagnosis. The slightest suspicion is a reason to take a pregnancy test.

If conception does occur, you should not have an abortion for fear that the child will be born defective. But similar children are just as difficult as twins.

If you have fully recovered and have regular menstruation, the first signs may be the same as with the first one. Toxicosis, delay, gaining weight, changing breasts will give a clear signal that conception has occurred.

But still, in the second case, the symptoms will not necessarily be the same as the first. For example, in one case, heartburn can be very severe, and in the second, it can occur without it at all. The differences can be simply dramatic. It is worth remembering this for those women who suffered and had complications last time, do not be afraid to get pregnant again, everything can be very good with this attempt, especially if the child is desired.

The second experience differs from the first due to changes in the body. The previous child “stretched” your anterior abdominal wall, its elasticity and firmness are lower - which means that the tummy will be noticeable earlier.

In the later stages, the lowering of the head also occurs differently, if in primiparous women it may be pressed against the pelvic bones 2-3 weeks before birth, in multiparous women it can only descend during childbirth.

The second pregnancy with twins is different. As a rule, the risk of not carrying twins to birth is due date less during the second pregnancy. The uterus is ready to stretch more than if you were lucky enough to become a mother of twins for the first time, and the body is set up for a normal pregnancy (this applies to those cases where the conception of twins was preceded by one child and birth at term).

Repeated pregnancy, is the second child necessarily larger?

One of the common ideas among people is the belief that the child will definitely be larger the second time.

This is not a myth, but the truth.

Indeed, the fetus often gains 300-500 grams more weight. This difference is especially noticeable if the children are same-sex or the second born is a boy.

Why does this happen?

The main reason is that the mother’s body is already fully configured to bear a child and the best conditions for development are created for the fetus.

Will there be earlier movements during the second pregnancy?

Women feel the first movements about 2 weeks earlier than with the first one. This is also not a myth, but the truth, and is taken into account by doctors when calculating the gestational age based on the first movement.

The reason that the baby's movement is felt earlier is that the mother remembers what it was like the last time. If the first tremors of the baby are felt on average at 20-22 weeks, expectant mothers can feel the movement of the fetus during the second experience as early as 17-18 weeks.

The familiar feeling can no longer be confused with the work of the intestines, as it happened the first time.

Does your belly grow faster during your second pregnancy?

Most women's bellies actually grow faster, this is not a myth. However, this is not due to the fact that the uterus is enlarged. It’s just that her ligaments were stretched last time, and the anterior abdominal wall has weakened and is not as elastic as in women who have not given birth. Thanks to this, the uterus has more freedom to bend forward under the weight of the fetus and amniotic fluid, and it is understandable that it appears that the growth of the abdomen is happening faster.

It is interesting that the shape of the abdomen for various obstetric pathologies under the same conditions is also different. For example, if a woman has a narrow pelvis, her stomach will be saggy, whereas at the first experience, it is usually sharp and high.

Another difference in the abdomen can be noticed in the later stages, if a woman’s belly has dropped during her second pregnancy - childbirth will occur any day now.

Was it a caesarean section, is the second pregnancy also a caesarean section?

If you had a caesarean section, the second experience must be planned, and here it is important to observe the optimal timing for conception. The fact is that the operation leaves a scar on the wall of the uterus, which must have time to mature and strengthen. But scars, having reached a certain strength limit, eventually atrophy and become thinner, that is, the uterine wall in the area of ​​the scar weakens.

The ideal period for conception, in which the second pregnancy after a cesarean section will proceed in optimal conditions, is two years after the operation.

The method of delivery largely depends on compliance with deadlines. In Russian maternity hospitals, the frequency of surgical births currently exceeds 10%, and of course, many women would like to try to give birth on their own, rather than go under the knife because of a diagnosis of “uterine scar”...

If the second precedent after surgery occurred less than a year after the first or, on the contrary, many years later, doctors are more likely to choose a second operation.

If pregnancy occurs after 2 years, the chances of spontaneous childbirth are high.

Such an experience almost always ends surgically; a woman is rarely allowed to give birth on her own.

Second pregnancy and breastfeeding, compatible?

Quite often, the persistent myth about effective contraception through breastfeeding leads to a kinder surprise almost one and a half to three months after birth. It’s good if conception does not occur at least in the first six months, but often this happens unexpectedly for the mother and very early. In this case, quite often the first child himself refuses to breastfeed. Perhaps the taste of milk changes, perhaps the mother feels reluctance to feed.

Still, you can continue breastfeeding; it does not pose a threat. You just need to be provided with truly nutritious nutrition and constantly take vitamins for pregnant and lactating women. In such cases, the risk of calcium and iron deficiency is quite high, so it is worth taking the supply of vitamins and minerals so seriously.

Second frozen pregnancy, pregnancy after a frozen one

Preparing for a second pregnancy in cases where you have experienced a frozen pregnancy requires particularly careful attention. If the cause is not identified and it turns out that this did not happen for the first time by chance, a second frozen pregnancy is quite likely.

Each experience can be repeated for the same reason, for example, due to the presence of an infection, and the more often this happens to you, the greater the chance that the death of the embryo will become habitual, and you will completely lose hope of bearing a child.

The second attempt after a frozen one does not necessarily end in tragedy, but there is a risk.

How to prepare for a second pregnancy to avoid problems?

You must first undergo an examination by a gynecologist for the presence of sexually transmitted infections, antiphospholipid syndrome, genetic obstacles and other reasons that could have been the factors that killed the first embryo.

Rh conflict, second pregnancy with negative Rh

If the mother has a negative Rh factor and the father is positive, each subsequent pregnancy increases the level of anti-Rh antibodies in the maternal blood and increases the risk for subsequent children. Immunoglobulins must be monitored in order to prevent Rh conflict, and if it is present, to soften its course, then the baby will definitely be born healthy.

Rh negative dangerous only for those women who have already given birth to an Rh-positive child or had an abortion. If there were no blood transfusions, no abortions, no miscarriages, if the first child had Rh negative blood, there is no risk of conflict between you and your baby during your second pregnancy.

Second pregnancy and childbirth

Repeated births are very different from the first. Even the harbingers of childbirth will be different. Shorter in time and brighter, you won’t suffer from training contractions for a long time, everything will start very quickly.

Many people think that during the second birth there will be less pain, and in general, it will be easier, but the first period is usually, although shorter, much more painful. During the second pregnancy, the cervix opens differently than the first time. If during the first birth it opens as if in 2 stages, which makes the process less painful, but somewhat longer, then in the second case, the cervix opens simultaneously, and therefore quickly and painfully.

Let's summarize the results of the second pregnancy:

1. After delivery by cesarean section, it should be postponed for a period of two years.
2. Early conception after a normal birth is not dangerous, although it is not advisable, because it will be difficult for you physically and mentally.
3. After an abortion, miscarriage, ectopic pregnancy, dying, with Rhesus conflict - requires especially careful attention to planning.
4. The differences between experiences can be striking. A difficult first pregnancy is not a reason to refuse a second one.