Method for obstetric aid

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to obstetrics, and may be used in obstetric practice during an act of delivery for elimination of apprehension, pain management and control of parturient's behaviour. The obstetric aid accompanies the period of the act of delivery. A parturient is visually and verbally contacted by establishing the stable positive psychological interrelation during the contractions. Suggestion techniques are used for the psychotherapeutic effect on the parturient with creating cognitive attitudes to concentrate the parturient's attention on a baby and to form an active delivery position, to form a sense of confidence in the favourable delivery outcome. Then, the parturient is brought into the altered state of consciousness by intrusion of the intensive cohesive breathing; for this purpose each following contraction in the parturient is accompanied by operator's suggestions to breath together by a calm, mild yet directive voice, and the operators starts breathing together with the parturient by a maximum deep breathing and a calm breathing out without breath holding. Between the contractions, the operators intensifies the suggestive directive effect on the formation of the parturient's internal active position by creating the cognitive attitudes at the nonconscious level. A consequence of the psychotherapeutic effect is repeated until the parturient starts breathing adequately and behaving stably that are controlled by the operator and maintained by the respective actions until the act of delivery completed.

EFFECT: method enables eliminating the apprehension, reducing pain senses, as well as provides a complete conscious behaviour control by the parturient.

3 ex

The invention relates to medicine, namely to obstetrics, and relates to a method of psychotherapy using somatic techniques and can be used in obstetric practice in the process of the generic act to eliminate the fear, the pain of childbirth and control the behavior of mothers.

Childbirth, usually accompanied by pain of varying severity. Under the influence of generic pain seriously change the function of the cardiovascular system: there is tachycardia, increased cardiac output, increases arterial and Central venous pressure. May develop cardiac arrhythmias, decrease coronary blood flow, changing the pressure in the cavities of the heart, increased total peripheral resistance. In the absence of controlled breathing develops tachypnea, decreased tidal volume, at the same time significantly increasing the minute volume of respiration, which can lead to severe hypocapnia and impaired utero-placental circulation, lead to hypoxia. Pain can interfere with the function of the gastrointestinal tract, bladder, cause reflex spasm of the pelvic floor muscles, nausea and vomiting.

Pain in childbirth leads to emotional tension, fatigue mothers, contractile AK is Yunosti uterine and fetal suffering of the fetus, in particular, in the form of a hypoxia of the fetus and newborn, which ultimately contributes to the increase of injuries to the mother and newborn and an increased frequency of cesarean sections.

While the methods for labor pain relief following requirements: removal of negative emotions, fear; good analgesic effect; the absence of inhibitory action on generic activities; complete safety method of anesthesia to the mother and fetus; preserving the consciousness of the woman, her ability to actively participate in the birth certificate; no negative side effects for the mother and fetus, adverse effects on lactation and during the postpartum period; the simplicity and accessibility to obstetric facilities of any type.

In the result of a patent search revealed the following. Known methods psychoprophylactic preparation of pregnant women for childbirth for pain of childbirth (application No. 96111343/14, 18.06.1996; application No. 98121424/14, 02.12.1998; application No. 2006116952/14, 17.05.2006), under which preparation of pregnant women for childbirth by conducting psychotherapy and simultaneous massage; through training pregnant diaphragmatic breathing using biofeedback; by sessions psychophysical relaxation using view pregnant video, the content is asego verbal information, consisting of 25-th frame. The disadvantages of these methods is that they use a very time-consuming for the patient and a psychotherapist and time-consuming methods of psychological assessment and psychological impact of conducted courses and require special equipment. While the effectiveness of these methods is not stable, and, most importantly, they are intended only for the preparation of pregnant women for childbirth and the use of these methods directly in the process of a generic instrument is impossible.

The known method physiotherapeutical preparation of pregnant women for childbirth (Abramenko CENTURIES Fizioterapevticheskaya preparation of pregnant women for childbirth. - SPb., 1992), in which in a certain sequence used individual and group interviews and lectures, special gymnastic exercises in groups, as well as environmental factors (air, water, light)that promotes the development of internally meaningful relationship pregnant with processes and changes occurring in her body and the body of the fetus, through the creation and consolidation of required conditional reflexo.

There is also known a method of autogenic training pregnant for childbirth (Abramenko CENTURY Modern methods of preparation of pregnant women for childbirth. - SPb., 1991), in which a woman in the process of training is actively involved in p is iterations work with complete preservation initiatives self-control and learn to consciously manage their autonomic functions and affect your emotional state. The disadvantages of these methods is the low efficiency is largely dependent on psychological types and motivations of women, the need for long classes and the inability to use them directly in childbirth.

Of non-pharmacological methods of pain management during labour used directly in childbirth, used psychological and physical relaxation, self-massage and relaxing massage, music therapy, singing, hydrotherapy, heat treatments, aromatherapy, acupuncture, skin stimulation and electroanalgesia. These methods are quite inefficient, often anesthetic effect is minimal or even otsutstvuet order to obtain the real analgesic of the woman should be fully prepared before delivery, it has to pass the pre-psychological training, which creates a positive mental attitude and skills among pregnant for use in delivery of any non-pharmacological methods of pain relief. If the woman was not prepared for the use of non-pharmacological methods of pain relief, their effectiveness in childbirth is significantly reduced (Korenovsk the e guide: Pregnancy and birth / DUE Hofmeyr, D.P. Neilson, H. Alfirevic etc. / Under the General editorship G.T. Dry. TRANS. from English. - M.: Logosphere, 2010. - 440 S.)

To medical pain relief used in childbirth, are sedatives, analgesics, antispasmodics, sedatives, derivatives of benzodiazepine, drugs. The route of administration injection, which carries the risk of infection of the body, it reduces the security of the method and may have a negative impact on organisms both mother and fetus. The effectiveness of drugs is often insufficient or even otsutstvuet drugs may cause disorders of contractile activity of the uterus, to have a negative impact on a pregnant woman (drowsiness, loss of control) and on the fetus, particularly narcotic analgesics, may cause acidosis, inhibition of the activity of the cardiovascular system and respiration of the fetus and newborn until the development of medical depression child. In particular, the use of epidural anesthesia does not allow women to take an active part in Photogem period generic act, because it practically eliminates the urge to push. In addition, often you may experience the suffering of the fetus and serious neurological complications. Medication pain medication can have contraindications (expressed GUI is ortensia, raised tone of bronchial tubes etc) and restrictions in the destination (pronounced inhibitory effect of morphine on the respiratory center of the fruit hinders its destination in less than 2-3 hours before birth)that can cause complications in the mother (disorders of the cardiovascular system, respiratory system, gastrointestinal tract, gistaminopodobnykh reactions, allergic reactions).

Closest to the present invention is a method of childbirth (RF patent No. 2075979, AV 21/00, 27.03.1997,), according to which at the beginning of the session at the same time with psychotherapeutic action massages, identify areas most severe muscle rigidity and reach their relaxation. Then search psychologically distressing scenes and initiate serial accommodation in their imagination, repeat accommodation each disturbing episode to relieve emotional tension in it. After that, using the techniques of Dianetics is called the imaginary return the patient during her own birth. Using verbal reinforcement create imaginative feeling fetal movement and carry out the correction voltage of individual muscle groups, change the pose and find the optimum position for convenient passage of the fetus. Mental accommodation repeat births to develop the necessary bodily as the presentations and create a sensual image of a successful delivery.

The disadvantage of this method, like the previous one, is that it is used only to prepare the pregnant woman for childbirth, so you cannot use it directly for delivery.

Thus, known methods of delivery when the implementation does not allow to achieve the technical result consists in the possibility of using them directly during the implementation of the generic act to relieve anxiety, reduce pain and, as a consequence, the ability to make full conscious control mothers over their behavior, which consists in the ability to fully control them during the birth process, to control the breath, concentrate on the child.

The proposed method obstetrics solves the problem of creating an appropriate way, which allows to achieve the technical result consists in the possibility to use the method directly in the implementation of the generic act to relieve anxiety, reduce pain without negative effects on the organisms of the mother and fetus, and, as a consequence, the ability to make full conscious control mothers over their behavior, which consists in the ability to fully control them during the birth process, to control the breath, concentrate on the price of the NECS.

The essence of the claimed invention is that the method of delivery, including the use of psycho-techniques aimed at removing the fear, pain reduction and the formation of the ability of conscious and active control of their behavior, what's new is that the personnel perform during descent act in the beginning of birth pangs establish persistent positive psychological relationship with the woman through visual and verbal contact, and then, by questioning the woman, estimating anamnestic and clinical data, while assessing the presence and nature of clinically manifested emotional disorders and the level of pain according to the method visual-analogue scale, then, using the techniques of suggestion carry out psychotherapeutic effects on woman with creating cognitive units concentration mothers on the child and the formation of its active positions in childbirth, on the formation of confidence in a favorable outcome of the delivery with the simultaneous creation of the installation to the woman managed hyperventilation of the lungs, as well as the implementation of the ability to fully control its behavior and to manage them until the end of the descent act, psychotherapeutic impacts is of a woman in labor to carry out building resilience occurrence of parturients in active and confident image of a successful woman, the appearance of stability rational breathing and behavior, which is strictly controlled by the operator before the end of labor.

The technical result is achieved in the following way. In the last decade especially important in the Genesis, the strength and sustainability of the pain attached to natural liquidators pain" - endorphins and enkephalins, which produce chromafenozide brain, adrenal glands, and intestines.

The experience of contemporary theoretical, experimental and clinical obstetrics confirms the major role of the Central nervous system in preparation of the woman's body for childbirth and during the birth process (Abramenko CENTURIES of Active management of labour: a Guide for physicians. - SP: spec lit, 2003). Proper functioning of the Central nervous system provides physiological for the generic act. The essential element of the mechanism to ensure the normal flow of the generic process is the establishment and sustainable operation of a generic dominant-congestive hearth excitation regulating a complete preparation for childbirth and the birth process itself. Formed the excitation focus on the law of induction inhibits other less necessary for the body in this period of reaction. At the forefront are the reflexes, providing for physiological birth the deed. Reactions to external stimuli (stimulus) becomes more efficient and selective. The most active and sustainable response occurs on incentives, meaningful and conducive to the optimal for the generic act. Occurs braking respond to other incentives, including reduced response to painful stimuli as a result of increasing pain threshold.

When various stressful situations (severe emotional distress, fear, pain and other Central nervous system mothers can along with a generic dominant to be other pockets of persistent excitation. In these cases it can cause weakening of the family structure, which will be accompanied by a pathological course of childbirth and increased perception of pain giving birth. Yourself the pain can be accompanied by formation of the center of persistent excitation, the inhibitory effect generic dominant and, consequently, worsen throughout the birth and the fetus.

To understand the mechanisms regulating mental processes in the Central nervous system, it is necessary to turn to the notion of the unconscious, which in a broad sense includes all mental phenomena outside the sphere of consciousness and beyond the field of conscious actively affects all systems of the physiological functions of the human body, including consciousness. The impact on the sphere of the unconscious offers an important opportunity management, motivation, direction and intensity of human activities, but the impact on the unconscious is an extremely difficult task.

Unconscious phenomena of the external environment play a very significant role in the mental life of a person when they are associated with emotional or motivational dominant entity, as well as due to the formation of attitudes, significantly determine the perception of the external environment, its evaluation and decision making.

English scientist N. Dixon in 1986, a condition necessary to influence the sphere of the unconscious: the parameters of the stimulus (exposure) should be significantly below the threshold of awareness. With weak external irritation, which in the quiescent condition is not recognized and does not act on the human, emotional arousal can change those or other functions of the body. Accumulated plenty of evidence that emotional unconscious words affect the look and presentation of the subject of subsequent consciously perceived images.

For the manifestation of the maximum effect of unconscious words you want:

1) they were emotionally significant at the p period of time for the subject;

2) the level of motivation or emotional stress personality was quite high.

Most subthreshold (unconscious) effect is observed in the coincidence of these two variables (Kostandov E.A. Psychophysiology of consciousness and the unconscious. SPb.: Peter, 2004, 167 S.)

Another form of unconscious cognitive installation. As a result of interaction of the subject with the environment in higher frontal parts of the cerebral cortex of the brain is formed a kind of "internal" state, the dominant way affect the function of perception of external objects and, as a result, the organization of the entire behavioral act. According to psychologist D.N. The Uznadze (1886-1950), under installation should understand the state of readiness of a person to a specific activity, which occurs at the subconscious level when there are 2 basic and necessary conditions: 1) the needs, relevant to the current in a given organism and 2) the objective situation of its satisfaction. In other words, in the interaction of the subject with the situation to the satisfaction of his needs and installation occurs. The latter is formed in humans as a result of repeated impacts of the same external stimuli in a certain situation. (D.N. Uznadze. Experimental foundations of psychology installation // Experimental studies in psychology at the system / Ed. A.S. prangishvili, THE Hodzhava. Tbilisi: Publishing house of the Georgian Academy of Sciences, 1958. C.5-126).

An important area of psychophysiology is the knowledge of the notion of altered States of consciousness. Altered States of consciousness (ASCS) is a qualitative change in subjective experience or psychological functioning from certain generalized for a given subject norms, reflexively by the person or celebrate observers (the classic definition A. Ludwig). The experience of ASCS is a characteristic property of consciousness and mind healthy people. Altered States can be stimulated by various triggers, and may or may not be related to pathology. ASCS can be used for learning, healing, medical treatment, all of this happens on the unconscious level and therefore has a huge impact on man, its condition and function. From ancient times it is known that the person who is in an altered state of consciousness, or else perceives sensations from his own body, including may not feel any pain.

Most physiological, and most importantly, purposeful and conscious way to achieve altered States of consciousness is the breath. (Abramenko V.V., Kovalenko I.E. Perinatal psychology: Theory, methodology, experience. - Petrozavodsk: Intelteck, 2004.- 350). With the help of the so-called intense coherent breathing, which is based on controlled hyperventilation of the lungs, there is an expanded state of consciousness (RCC) - a special condition related to altered States of consciousness. RCC is characterized by a maximum mobilization of reserve possibilities of the human psyche, when people conscious connected breathing and maximum relaxation receives advanced management of the Central and peripheral nervous systems, the organism as a whole.

The process of coherent breathing as a way to achieve the RCC has qualities such as awareness, accountability, manageability, the presence of will and the possibility of implementing their intentions, can at any time return to a normal state of consciousness. The RCC has a specific phenomenology and is autosale touch areas, distortion of time perception, hypermnesia, increasing the threshold of perception of some sensation, particularly pain, and some other qualitative changes in mental processes (Kozlov V.V. Origins of consciousness: Theory and practice integrative psychological technologies. Minsk, 1995).

The basis of the effects of intensive breathing is the hyperventilation of the lungs, which leads to an increase in blood oxygen, and in General to a significant increase oxygen capacity of the blood of the mother and fetus, which in turn leads to the optimization of metabolic and trophic processes, enhance the functions of the nervous, cardiovascular and endocrine systems. As a result, the use of the inventive method for achieving an altered state of consciousness mothers intense coherent breathing allows you to perform two functions: the possibility of psychosomatic effects on the mother and oxygen enrichment of the blood of the mother and fetus, which reduces the possibility of the development of hypoxia and promotes successful childbirth.

In the proposed method the basis for the assessment of pain lying-in women are: subjective feelings of a woman in travail, which are fixed as a result of its survey during labor, and supervision of a physician for its behavior in the process of childbirth. Estimate tolerable pain in childbirth perform using visual analogue scales (VAS) (H. Brevik, Borchgrevink P.C., S.M. Allen et al. Assessment of pain. British Journal of Anaesthesia 2008; 101 (1): 17-24). YOUR is a sheet of paper with a drawing of a straight line length of 10 cm with marks through every inch, on which the woman says at the request of the doctor intensity of pain in childbirth. The beginning of the line corresponds to no pain and the end of the line - the feeling of being in excruciating pain. In the end, the doctor has the objective assessment of pain.

From the above it follows that in savlon the m method directly during descent act carried out on a pregnant woman at the same time psychological and somatic effects, minimizing pain. This psychosomatic effects include the formation of: persistent positive psychological relationship between obstetrician-gynecologist and a pregnant woman by visual and verbal contact; forming an active role in childbirth (birth dominant) using the techniques of suggestion and cognitive installation; concentration mothers on the child; control of breathing and behavior of mothers. Simultaneously with the creation of psychological contact between the operator and the mother is teaching mothers the rational techniques of breathing and behavior. The use of technology psychosomatic pain of childbirth continue to create (occurrence) of the stability of the occurrence of the parturients in active and confident image of a successful woman, the appearance of stability rational breathing and behavior, which is strictly controlled by the operator until the end of labor.

Thus, the proposed method of delivery allows you to optimize the mental state of the woman, to eliminate the feeling of fear, to minimize pain, reduce them to insignificant level, regardless of the psycho and motivate women. As a result, due to a complex psychosomatic impact on the psyche of the woman and her basic systems of life is obespecheniya, this is an opportunity to control the behavior of mothers as well as optimization of the status of the mother and child, raising the level of life and functional capacity of the system "mother-fetus". The proposed method is effective, relatively simple method for correcting the psychological state of the person, eliminates the need for the introduction of the patient into a hypnotic trance and state, the need for encoding and eliminate the associated risk of adverse effects for the patient; reduces the time required for the implementation of effective psychological impact.

From the above it follows that the proposed method of delivery in the implementation ensures the achievement of the technical result consists in the possibility to use the method directly in the implementation of the generic act to relieve anxiety, reduce pain without negative effects on the organisms of the mother and fetus, and, as a consequence, the ability to make full conscious control mothers over their behavior, which consists in the ability to fully control them during the birth process, to control the breath, concentrate on the child.

The claimed method of delivery is as follows. Obstetrics perform direct what about during labor. At the beginning of the birth pangs establish persistent positive psychological relationship with the woman by visual and verbal contact. Then, by questioning the woman, estimating anamnestic and clinical data, while assessing the presence and nature of clinically manifested emotional disorders and the level of pain according to the method visual-analogue scale. Then, using the techniques of suggestion carry out psychotherapeutic effects on woman with creating cognitive units concentration mothers on the child and the formation of its active positions in childbirth, on the formation of confidence in a favorable outcome of the delivery with the simultaneous creation of the installation to the woman managed hyperventilation of the lungs, as well as on the implementation of the ability to fully control its behavior and to manage them until the end of labor.

Psychotherapeutic effects on a pregnant woman exercise to build resilience occurrence of parturients in active and confident image of a successful woman, the appearance of stability rational breathing and behavior, which is strictly controlled by the operator until the end of labor.

At the first stage of execution of the claimed method study of medical documentation (exchange map bere the military and birth history), get additional information from medical personnel. To determine the physical status of mothers and midwifery situation in childbirth.

At the second stage in the delivery room is set persistent positive relationship with the woman through visual and verbal contact, for which the patient is formed, the maximum concentration of attention on the doctor, his face and his speech with the suggestion it possible to provide quick and effective assistance, which will provide a significant reduction of pain, increase oxygen supply to the fetus, the acceleration of cervical dilatation and acceleration of the generic act with subsequent successful birth of a healthy child.

Active fixation woman on the words of the doctor by using multiple repetition of certain key words and phrases, namely, "You feel very bad, unbearably bad and You think that the situation is hopeless. If You want me to help You, listen to me carefully and do everything I tell You. If will be accurately and actively to do everything, You'll feel better, the pain will diminish and go completely. You and Your child will feel better bout will be active, but if You will exactly follow my advice, the pain will be almost feel quickly and parents". You need to get an answer: "D is, want"

Then calm, gently prescriptive tone doctor says, "come on, let's breathe together. Breathe me" and begin to breathe, making the process a deep breath and calm without delay of exhalation. The ratio of the duration of inhalation and exhalation is like 3: 1, when the frequency of respiratory movements 10-11-12 1 minute (frequency selected individually, the breath, the deepest takes 4.5 seconds, exhale - 1.5 seconds).

Then he repeats: "You want that I actually helped You? Do what I tell You, and You are quick and good parents. The pain gradually fading. You feel much better. Gradually the pain You will not feel". Then the doctor again working together with the woman breathing during labour and repeatedly utters the language of suggestion to enhance the suggestion of policy impacts and the formation of the inner active position woman by verbal suggestion.

In between contractions, the doctor conducts a thorough survey of women and thorough assessment of anamnestic and clinical data. Then produces external obstetric examination women, evaluates the clinical course of delivery, determined by the presence and nature of clinically manifested emotional disorders and by self-assessment methodology to use visas to the visual analogue scale (VAS) is determined by the level of pain.

Having full contact with the woman and control its behavior, after the mother began to follow all instructions of the operator is to stand up and standing to pursue the recommended breathing in the right rhythm.

The mother must be in the delivery room standing, slightly bent to reduce the voltage of the anterior abdominal wall during contractions, slightly bent legs and always with an emphasis on hands (elbows) with compression of the brush, which must be securely hold hands on some kind of support: the edge of a generic table, a horizontal headboard. This situation is in contrast to the prone position is the most physiologic, provides the most deep breath, free arrangement of the parts of a woman's body and optimal circulation of the fetus. In this position the load is removed from the muscles of the pelvis and anterior abdominal wall and these muscles relax.

The vertical position of the woman is saved until futile.

In the third stage using continue using the technique of psycho-somatic pain of childbirth is achieved by removing the woman from affective state and managed her attention, breath, and behavior with subsequent transition women in a state of complete self-control over the maintenance of these functions.

In the fourth stage (during the entire period of labour) actions occur, and to monitor the condition and behavior of mothers and implemented supporting actions aimed at preserving its full control and execution of all physical and mental functions.

On the fifth stage of the information-psychological preparation for photognome period, and then his psychological and somatic maintenance.

At the final stage after the delivery is carried out to assess the mental and physical condition postpartum women and adolescent girls through a survey, the visual observation and the standard of objective examination.

Negative effects or complications during or after the application of psycho-somatic pain of childbirth was not observed. Clinical example # 1. The patient GDM, 23 years. This first pregnancy, coming first delivery.

From the anamnesis: in the childhood has transferred varicella, had an allergic reaction to iodine and margantsevokislogo potassium. Menstruation of 14 years, 25 days to 5 days, was installed immediately, regular, moderate, painless. Sex life of 18 years. Married. Husband is 23 years old, healthy.

Occupational hazards among women and her husband is missing, both spouses do not smoke, alcohol is absent. This pregnancy first came 3 months after marriage.

Last menstruation 25-30.01.2011, without features. Registered in urban antenatal clinic with 8 weeks of pregnancy. Height 165 see, the weight of 62.8 kg at the first t is e in 11 weeks of pregnancy. HELL within 120/70 - 110/70. Blood is Rh (-) without antibody titer. The dimensions of the pelvis was normal. In the period 37-38 weeks of gestation revealed swelling pregnant. Total weight gain during pregnancy - 10 kg In total blood hemoglobin - 125 g/l (norm) from 06.09.2011,

Entered operationally generic block maternity hospital No. 10 City perinatal Centre, Ekaterinburg 29.10.2011 GV 2 hours 10 minutes with an indication of the bout with 23 hours 28.10.2011,

Upon admission to the hospital in 2 hours 10 minutes 29.10.2011 g: General condition is satisfactory. No complaints. Skin and visible mucous net, and the regular color. Pulse 76 beats per 1 minute rhythmic, satisfactory filling and voltage. AD - 120/80 on both hands. The abdomen is soft, painless on palpation. Physiological functions are normal. The uterus is normal tonus. Bout 5-6 minutes 30-35 seconds of moderate strength. The position of the fetus longitudinal, slated to be actually head pressed to the entrance to the pelvis. The fetal heart beat is clear, rhythmic 140 beats in 1 minute.

2 hours and 30 minutes produced vaginal examination: cervix smoothed, the opening of the external uterine OS 3 cm, edges thin throat, tensile. SAC a whole. The fetus's head is pressed to the entrance to the pelvis. Diagnosis: I period term labor. Swelling pregnant. Rh (-) blood without antibody titer. Neuro-circulatory dystonia of mixed type. Var is cosna disease of the lower extremities. Childbirth is 3 hours and 30 minutes.

In 5 hours and 30 minutes General condition is satisfactory. No complaints. HELL 120/80 mm Hg Bout 3 min at 30-35 sec. the average force. The fetus's head is pressed to the entrance to the pelvis. The fetal heart rate 144 kick in 1 min. clear, rhythmic. The water didn't move.

6 CAS minutes General condition is satisfactory. No complaints. BP-120/80 mm Hg, Pulse of 80 beats per 1 minute of the Uterus in normal tonus. Bout 3 min at 30-35 sec. the average force. The fetus's head is pressed to the entrance to the pelvis. The fetal heart rate of 144 beats per 1 min. clear, rhythmic. Started light leak amniotic fluid. Produced vaginal examination: cervix smoothed, the opening of the external OS - 5 see the fetus's Head is pressed to the entrance to the pelvis. Membranes no. Childbirth is 7 CAS minutes

9 CAS minutes General condition is satisfactory. BP - 120/80 mm Hg Bout 4-5 minutes 25-30 seconds. strong. The woman in the last hour manifests expressed concern complains of painful contractions, restless, and asks for medication or surgery caesarean section. The fetus's head is pressed to the entrance to the pelvis. The fetal heart rate of 136 beats per 1 min. clear, rhythmic. Water leak light.

In 10 hours. The patient is on the verge of collapse, behaves hysterically, screaming, that is, there is pronounced with stress is standing. Work has begun on the method of psychosomatic pain of childbirth, in accordance with the stated method of delivery. The mother asked to note the effect of pain on visual analogue scale. Mark on the scale corresponded to 10 points. Within 15 minutes pregnant gradually calmed down, began to breathe correctly, between contractions adequately answers questions on her face appeared a smile. The woman said that was unaccountable fear and have confidence that really started to think about the child that really feels like a defender of the interests of the child and is confident in the successful birth outcome for him. In 10 hours and 30 minutes the mother repeatedly asked to make an assessment of the experience of pain on a visual analogue scale. Mark on the scale corresponded to 3 points.

In the 11th hour. the contractions continued active through 2.5-3 minutes for 45-50 seconds. The mother behaves calmly, confidently, during contractions deep breathes. The fetal heart beat is clear, rhythmic 136 beats per 1 minute.

In 12 hours. 20 minutes of the bout gained potoglou character in 1.5-2 minutes at 50-55 sec. The fetus's head on the pelvic floor. The fetal heart beat is clear, rhythmic 130 beats per 1 minute, a woman full straining, behaves quite adequately.

In 12 hours. 40 minutes is born live, full-term boy with estimation on APGAR scale - 7/8 points (norm), weight 335,0 g, length 53 see a Woman happily hugging a child, talking with her, her state of calm, satisfied. After 15 minutes independently separated and singled out the placenta, whole, shell all. Blood loss of 200.0 ml vaginally whole.

Clinical example # 2. The patient NSA 35 years. This pregnancy 4th, coming 2nd delivery.

History: in the past had German measles, acute respiratory infections. Menstruation, age 16, was installed immediately, regular, moderate, painless after 28 days to 5 days. Sex life of 20 years, in a registered marriage. Pregnancy rate was only 3, this pregnancy 4th. 1st pregnancy ended in 1997 glamorously miscarriage in 8-9 weeks; 2nd pregnancy ended in 1998 gcroce childbirth without complications; 3rd pregnancy in 2003 gzagenius medical abortion. This pregnancy - 4th.

First attendance at antenatal clinic in the period of 7-8 weeks, were observed regularly. The pregnancy was uneventful, the total weight gain of 11 kg

Contractions began at 4 a.m. 30.09.2011 hostopia in maternity hospital 30.09.2011, 6 hours and 10 minutes with regular active labor.

An objective examination of organs and systems revealed no pathology. Height - 173 cm, weight - 68,8 kg HELL - 110/80 mm Hg Moderate swelling of legs. Obstetric status normal.

8 hours for 40 minutes, the grip is strong and after 3-4 minutes 40-45 seconds. The woman is extremely restless, crying, asking to numb childbirth. Introduction baralgina 2.0 ml and antispasmodic drug shpy 2.0 V/m effect does not.

8 hours 30 minutes. The puerperal is in generic beside generic table and at each scrum loud screaming, crying out for help, her face distorted by a grimace of pain and suffering, the sight is missing, pointless wandering. When she fights frantically grabs the edge of a generic table, squeezing his hands, literally writhing in pain and choking from screaming.

Initiated psychosomatic pain of childbirth. The mother asked to note the effect of pain on visual analogue scale. Mark on the scale corresponded to 10 points.

After the first bout, during which travaileth complied with all instructions given perinatal psychologist, a woman stated that she felt much lighter. The woman asked again to note the effect of pain on visual analogue scale. Mark on the scale corresponded to 5 points. The expression on her face became more relaxed and in the future it more clearly and correctly complied with all instructions. After 10 minutes it was not published not only cries, but even moans. Feeling a definite improvement, it already without special teams performed all the necessary actions. The travaileth in the future behaved quite confidently, correctly breathing on her persons who even appeared calm smile.

9 CAS minutes labor activity is increased: the contractions became stronger through 2.5-3.0 minutes at 55-60 seconds. The fetal heart beat is clear, rhythmic 148 beats per 1 minute. The fetus's head is a small segment at the entrance to the pelvis. Discharge from the genital tract no. The puerperal behaves calmly, during contractions concentrates his thoughts on the child, the desire to help him. After the bout relaxes, breathes in the usual, natural, friendly way it tells about his health, about the child, smiling.

In 10 hours. labor activity is active: strong contractions in 1.5-2.0 minutes at 55-60 seconds. The fetal heart beat is clear, rhythmic 154 kick in 1 minute. The fetus's head is in the pelvic cavity. Discharge from the genital tract no. The puerperal behaves calmly, during contractions concentrates his thoughts on the child, the desire to help him. After the bout relaxes, breathes in the usual, natural, friendly way it tells about his health, about the child, smiling.

In 10 hours, 10 minutes began attempts. The woman is on the family table, behaves calmly, adequately perceives all instructions and accurately executes them. During labour actively straining, in between contractions rests calmly.

10 CAS min. born alive Dono the military boy weighing 3210,0 grams, growth - 51 see(34/34). Occurred cord entanglement around the neck 2 loosely. Scream loud, immediately. The child on Apgar scale: 7/8 points. The child was placed on the mother's breast, and then attached to the breast. Woman hugging a child, tells him tender words, expresses appreciation perinatal psychologist, providing methodology for psychosomatic pain of childbirth.

Clinical case N 3.

The patient PIG, 28 years. This third pregnancy, have the second child. In the past underwent medical abortion and emergency childbirth. When pregnancy was observed in commercial medical center.

25.08.2010, 11 hours 00 minutes. The generic unit. Perinatal psychologist walked into the family, next to the medical post, raised heart-rending cries of the woman. The woman was on the family table, literally could not find a place in pain, screaming, trying to attract attention. Beside her was a confused man who hugged her and something vaguely said, trying to reassure her and to relieve suffering. Effect from trying to help from the husband's side no. In this situation, the medical staff the new mother to help could do nothing. The screams continued, the woman too loud screaming.

Perinatal psychologist - obstetrician-gynecologist, owning the means of delivery stated in ispitaniy, turn the Xia to the woman and the work was commenced by the method of psychosomatic pain of childbirth. Specialist focused on the attention of the woman, asked if she wanted to get rid of these pain and having positive emotional response, began to teach her the maximum concentration on the child and proper breathing. After 8-9 minutes, the woman began to implement the recommendations and to breathe correctly. After another bout she was asked the question: "How do You feel now? You endure the contractions in this breath?" She replied: "Yes, it is easier". Pregnant gradually calmed down, deeply and actively breathing, behaved much calmer and more obediently stopped overreact to fight. Mothers were asked to note the effect of pain on visual analogue scale. Mark on the scale corresponded to 6 points. Between contractions adequately answered questions, her face acquired a peaceful expression, as feeling the pain of contractions decreased significantly. Husband also cheered and cheered. Listening to the heart of the fetus showed that the fetal heart beat is clear, rhythmic 134 hit in 1 minute.

In the future, the woman continued to implement all the recommendations on concentration, breathing and behavior. Her condition was calm, complaints she didn't show.

30 minutes after the start of the events by the method of psychosomatic pain of childbirth, the head of plagiobothrys on the pelvic floor muscles, the contractions have become increasingly acquired potoglou character. In 11 hours and 45 minutes is born live, full-term boy weighing 3150,0 g, length 50 cm with an estimate of the scale Apgar 8/9 points, scream loud, immediately. The woman joyful mood, she hugs the child, which she was put on his chest, and expresses its gratitude for the assistance rendered. After 10 minutes independently separated and singled out the placenta, whole, shell all. Blood loss 280,0, the Uterus decreased dense. Vaginal delivery inspected, whole.

After delivery it was found out that the woman was regularly observed in the private medical center, where he took the full course (10 lessons) psychoprophylactic preparation for childbirth with the participation of a psychologist who was in the group listening to the information, training techniques, self-anaesthesia delivery and learning the practical skills of breathing during fights. Classes were held in full accordance with present principles of conducting studies on the preparation of pregnant women for childbirth. In the process of delivery, the woman tried to use course knowledge of anesthesia, but no effect is obtained.

In this case, the mother was given urgent psychological help with a positive result in the absence of time and opportunities to receive additional anamnestic and clinical information.

Pre the proposed method psychosomatic pain and control the behavior of a woman in travail has in comparison with the known, including the prototype, the following advantages:

has comprehensive functionality, removing fear, exerting a positive influence on the emotional state of the woman, through the reduction of pain and the ability to control the behavior of a woman in travail;

- high efficacy and lack of adverse side effects and complications;

- possibility of use in the presence of contraindications to the use of medical methods of pain or inefficiency;

- availability implementation and use without prior training of mothers, in almost any conditions (outpatient and inpatient);

- reduced incidence of obstetric complications for women and newborn (reducing the frequency of violations of the contractile function of the uterus, injury to women and children, hypoxia and asphyxia of the newborn);

- the ability to drastically reduce or completely avoid the introduction of drugs during childbirth;

- can be used in emergency situations in childbirth when inadequate and unresponsive behavior of mothers;

- can be used as an effective means of emergency psychiatric care in emergency situations in childbirth when inadequate and not palaemon behavior of mothers, associated with pain intensity;

- practically no contraindications (contraindications are different types of disturbance of consciousness, state of alcohol intoxication or drug sleep).

The method of delivery, including the use of psycho-techniques aimed at removing the fear, pain reduction and the formation of the ability of conscious and active control of their behavior, characterized in that the personnel perform during labor, when it first during labor establish persistent positive psychological relationship with the woman through visual and verbal contact, the operator generates the patient maximum attention on yourself, on your face, and speech, and then using the techniques of suggestion carry out psychotherapeutic effects on woman with creating cognitive installations aimed at concentration mothers on the child and the formation of its active position in childbirth, on the formation of confidence in a favorable outcome of delivery, after which the mother result in an altered state of consciousness by imposing her intense coherent breathing, which during the next battle mothers operator calm, gently prescriptive tone offers the woman on the address together and begins to breathe with her, making a deep breath and calm without delay of exhalation, and the duration of inhalation and exhalation are as 3:1, when the frequency of respiratory movements from 10 to 12 in 1 min, while in the interval between contractions operator increases suggestive policy impact on the formation of internal active position woman creating cognitive installations at the subconscious level by re-voice the suggestion, saying the wording suggestion, during the next battle mothers operator again performs joint with the woman breath and in the next interval between contractions again says the wording of the suggestion, then the execution sequence of psychotherapeutic influence repeat until stability mothers rational breathing and behavior, which the operator monitors and maintains appropriate action until the end of labor.