Pushing during childbirth - their meaning, when they begin and how to push

Features of the first pregnancy and childbirth in women of different ages

Just a few years ago, women coming to register for pregnancy for the first time in their lives after 25 years old received a not very pleasant note on the exchange card - elderly or even old primigravida. Fortunately, in recent years the term “adult primigravida” has appeared, which sounds less offensive, and is applied to expectant mothers over 30 years of age. Modern women are increasingly postponing the birth of their first child until their fourth decade for various reasons. But doctors still believe that it is best to give birth between 20 and 25 years. Here are their arguments for not delaying the first birth:

the likelihood of genetic pathologies increases. Statistics show that more than 2/3 of the total number of babies with Down syndrome are born to mothers who are already 30 years old. After 40 years, every 30th child is born with the syndrome, but this pathology is not strictly associated with the first birth. Therefore, all pregnant women over 25 years of age are prescribed an expanded list of examinations;
By the age of 30, most people acquire some kind of chronic disease. In normal conditions, women practically do not notice them, and infrequent attacks are possible. And when carrying a baby, periods of exacerbations become more frequent. Sometimes previously unnoticed foci of chronic infections or sexually transmitted diseases are noted. Those planning a pregnancy should undergo all recommended examinations and continue to undergo regular tests before giving birth. Many diseases can be identified even before external manifestations and treatment can be started in time to prepare for pregnancy and childbirth with maximum responsibility;
Pregnant women over 30 years old are recommended to take 3-4 courses of multivitamins and folic acid during pregnancy, since their body especially needs additional microelements;
due to unstable hormonal levels, the most common complications during late pregnancy are premature birth or, conversely, post-term babies;
the elasticity of the tissues in the birth canal is reduced, which is why labor is weaker, because the uterine tone is lower than necessary. Ruptures of the cervix, vagina and perineum occur more often. Special gymnastics for expectant mothers helps to increase muscle tone throughout the body and improve blood supply to tissues.

Women who give birth at the age of 20–25 years have the highest chances of carrying the pregnancy to term and giving birth without complications.
The main advantage of giving birth before the age of 25 is considered to be the high percentage of natural birth. But giving birth just because time is running out, in my opinion, is wrong. The expectant mother must be psychologically and financially ready to take responsibility for someone’s life, and this comes most often after 30 years. Although, I have a friend who in her youth was, as they say, wild. Having given birth to her son at the age of 21, Inna changed a lot internally - she forgot her old company, completely devoting herself to her husband and child. When Deniska was one year old, his mother entered college and graduated from the educational institution, albeit without a honors diploma. Now she occupies a leadership position and it is difficult to recognize the Inca who lived in my yard when we meet her. And when she appears with her 17-year-old son, his friends do not immediately believe that it is his mother. And my class teacher gave birth to a daughter at the age of 39, next year Ksyusha will already graduate from school. Ten years ago they were left without a dad, but they did not lose heart. Elena Zinovievna works as an English teacher, and her daughter does not need anything, although they do without frills. The desire to give a child something more than just existence, it seems to me, is hidden under the expression “maternal instinct” without reference to age. Moreover, do everything possible on your own, and not relying on other people.

The postpartum period in women over 25 years of age is characterized by the following complications:

Uterine contractions become worse, which sometimes results in bleeding. Postpartum discharge (lochia) continues longer even without bleeding;
Difficult lactation due to insufficient production of necessary hormones. But mothers are quite capable of overcoming problems with breastfeeding. If you put your baby to the breast more often and do not use artificial feeding in the first weeks of birth, the flow of milk will increase and lactation will improve.

Contraindications for natural childbirth during the first pregnancy

It is believed that a cesarean section during childbirth is generally recommended for older primigravidas, but a woman’s age is only a relative indication for surgical intervention in the birth process. Necessary additional indications for cesarean section are:

weak labor activity;
post-term pregnancy;
chronic diseases in the mother.

The woman's desire also matters in controversial cases. The psychological attitude towards an unsuccessful natural delivery will lead to surgical intervention, even if a normal birth was initially planned. It is better to discuss the birth process with your obstetrician-gynecologist in advance. It helps to make a good choice by attending courses for expectant mothers or informal communication in order to learn from experience with women who have already given birth.

But there are also absolute contraindications for natural childbirth:

a narrow pelvis of a woman in labor, making it difficult for the child to pass through the birth canal. Tumors or deformities in the hip joints;
thinning or incompetent scar after surgery on the uterus, threatening it with rupture during childbirth;
the placenta is fixed above the uterine cervix, blocking the exit of the baby with its incorrect location;
vaginal or uterine pathologies - fibroids or tumors;
discrepancy of the pubic bones - symphysitis;
severe form of gestosis, especially the risk of developing a critical pathology - eclampsia, when the pressure rises to levels that pose a threat to the life of the mother and fetus;
chronic diseases of the nervous and cardiovascular systems, myopia and any degree of diabetes;
history of surgical interventions on the organs of the reproductive system, including plastic surgery;
vaginal varicose veins;
conjoined twins during multiple pregnancy;
child in transverse position;
chronic oxygen deficiency in the baby and, as a result, intrauterine growth retardation - malnutrition;
prolonged infertility before a successful attempt to conceive a child;
genital herpes in the acute stage;
oncological diseases in the expectant mother.

You cannot influence the frequency of contractions, but you can reduce the degree of pain - this is taught to expectant mothers at school, when they instill the skills of proper breathing during childbirth.
Sometimes the decision about a caesarean section has to be made during the process of natural childbirth. The help of surgeons may be needed in the following cases:

the amniotic fluid has receded too early and there is a risk of infection of the baby;
all kinds of anomalies of labor;
acute stage of oxygen starvation in a child;
placental abruption;
presentation or prolapse of umbilical cord loops;
abnormal position of the child's head, threatening cervical fractures.

What happens to your body during the transition phase of the first period?

Physiological changes:

The cervix dilates from 8 to 10 cm.
Contractions become very painful, and the intervals between them become shorter.
The intervals between contractions are 1–3 minutes, and the duration of contractions is 60–90 seconds.
Contractions quickly reach the peak of pain; there may be several of these peaks.
If the waters have not yet broken, it is during this phase that the amniotic sac may burst.
In the transitional phase, it may happen that the cervix has reached full dilatation, but has not yet completely effaced; part of the inner lining, called the labrum, protrudes, which often happens when dilated by 10 cm. Sometimes during a contraction, the midwife may use massage to smooth out this protrusion or ask you to begin pushing while simultaneously moving the protruding part away.
You may feel pressure on the rectum and the desire to push (the baby at this stage is in the birth canal, his head is pressing down, but it is very important not to push at this moment in order to prevent swelling of the vagina).
Uncontrollable trembling may occur in the legs as the baby puts pressure on the nerves.
You will feel hot during contractions and cold in between.
You may feel nauseous; you might vomit.

Emotional signs of the transition phase:

You will be ready to give up and give up.
The intensity of the pain will make you irritable and you will not want to be touched.
You may forget where you are and lose touch with reality.
You will find it difficult to move and maintain contact with people.
You may feel completely alone; you will feel like no one understands how bad your pain is.

Having overcome the transition phase, the woman is ready to move on to pushing.

The closer the day of birth gets, the more excited the expectant mother is in her soul and the more scared she is from the thought that contractions will soon begin. There are a lot of questions in my head and complete uncertainty: what, when and how?

When contractions begin, there is no need to panic. First of all, you need to calm down, take a deep breath and figure out whether these are contractions before childbirth or whether they are false. In order to understand exactly what is happening to you, you should remember the signs of contractions before childbirth, and then calculate the interval between them, since “false pains” differ from pain before childbirth.

What are the advantages and disadvantages of first childbirth?

Women who have been through childbirth at least twice can share comparisons between their first and subsequent births, talking about the pros and cons of each.

Table: features of first and repeat births

First birth	Second birth
Most women manage to get to 39–40 weeks before labor begins.	They most often begin at 37–38 weeks, since it is more difficult for a uterus that has already given birth to hold the fetus.
In most cases, they occur naturally, which is good for postpartum recovery and normal lactation.	The likelihood of a cesarean section increases, but with repeated surgical intervention in the process, labor and recovery are faster than with the first birth.
Lasts 6–12 hours. Most of the time is spent on dilation of the cervix.	They last up to 8 hours, but often even less, since with repeated births the cervix opens faster. The birth canal is now ready for the birth of the baby.
Primiparas are afraid of unfamiliar sensations during contractions and sometimes mistake training uterine contractions for the beginning of labor.	Women experience pain during contractions in the same way as during the first time, but they treat them more calmly. But excessive self-confidence can prevent you from following the obstetrician’s recommendations in force majeure situations.
The first child usually weighs less than younger siblings.	Second and subsequent children weigh more at birth, on average by 300–500 grams.
With the natural birth of a medium-sized baby, multiple vaginal ruptures can be avoided.	The tissue of the vaginal muscles is quite elastic, so there may not be repeated ruptures during the second birth.

Interesting fact: girls develop faster in the womb, so they are born a week earlier than boys. But this does not apply to multiple pregnancies; twins are born within a short period of time, one after the other, usually the difference between them does not exceed 25–30 minutes.

Where should we focus our efforts?

This is a very important question. It is not only the force applied that matters, but also where it is directed. It just seems that everything is simple: you need to “push” the child out of yourself, making every effort to do this. Some women push, as obstetricians put it, “in the face.” The woman in labor is very tense, but since her efforts have no direction, they do not lead to the advancement of the child; the process is delayed, and the woman’s blood vessels in her eyes and face may burst. In such a situation, if the expectant mother does not change tactics, doctors will have to “push for her”, squeezing the child with their hands through the anterior abdominal wall, and if the child begins to suffer, then apply forceps. You understand that neither one nor the other is desirable.

So “where should we push”? As already mentioned, in most cases, pushing is felt as a strong desire to empty the intestines (the fetal head irritates the nerve endings responsible for this act). Don't resist this urge. Don't be embarrassed, these are natural and correct sensations. Imagine yourself actually having a bowel movement and try as hard as you can to do it. The other leader will be pain. The fetal head stretches the tissues of the birth canal, and you feel severe pain and burning in the vagina. You need to push at the point of maximum pain, intensifying it. Increasing pain indicates that you are doing everything right, and the baby is moving along the birth canal.

Signs of the onset of first labor

The following physiological signs may indicate the imminent onset of labor:

so-called Braxton-Hicks training contractions, which help prepare the smooth muscles of the uterus for active contractions during childbirth. They got their name for their resemblance to athletes training before competitions to reduce stress levels for the body at hour X;
a decrease in the size of the abdomen, which occurs due to the fact that the baby’s head, with correct presentation, in preparation for childbirth, moves down into the small pelvis. The uterus also descends, releasing the lungs and diaphragm. From this moment on, it becomes easier for the woman to breathe, and heartburn bothers her much less often;
vaginal discharge before childbirth, which is often mistaken for leakage of amniotic fluid (amniotic fluid). To avoid unnecessary worries, you can buy medical tests at the pharmacy, such as those that determine pregnancy. Simple manipulations will help you find out for yourself whether amniotic fluid is present in the discharge;
When weighed, a weight loss of up to two kilograms is noted, associated with a decrease in swelling. The disappearance of swelling of the limbs is noticeable to the naked eye - until recently, the elastic of socks left a visible mark on the skin, but now you need to look closely to notice it;
a shift in the center of gravity causes a change in posture - the head tilts back a little. The gait also becomes different, it is also called a duck’s gait for its small springy steps;
The urge to visit the restroom is felt more and more often, and bowel movements become thinner than usual. This happens because the body clears the birth canal for the baby to pass freely;
a nagging pain appears in the lumbar region, affecting the abdomen. This stretches the ligaments in preparation for the birth of the baby. During repeated births, women miss this harbinger of an early birth because the ligaments were ready after the birth of their first child.

Some first-time mothers may, out of ignorance, not pay attention to these warning signs, but most often pregnant women are sensitive to the slightest changes in their condition. Overly impressionable people take everything that happens to their body as signs of a quick resolution of the burden.

Preparing for the first birth

A woman who has never given birth finds it difficult to accurately determine that labor has already begun, so it is important to learn in advance about the signs of its onset. You need to prepare for the meeting with your first child not only physically, but also mentally:

read the literature intended for expectant mothers;
you can watch informational videos telling about the upcoming birth;
do not forget to attend courses for pregnant women, which teach proper behavior during childbirth - for example, how to breathe and push;
Discuss with your gynecologist all your concerns regarding the upcoming birth;
No later than a month before the expected date of birth (DA), pack a bag with things for the maternity hospital - separately for yours and for the baby. The rules may vary in different maternity hospitals; it would be better to take a list of what is necessary and permitted in the institution where you will give birth, and check it with it when getting ready;
Approximately 2-3 days before the PDA, be prepared for antenatal hospitalization. You will be placed in a room and undergo the necessary examinations - ultrasound, weighing and others as indicated;
the first contractions do not cause severe discomfort, you can successfully sleep, eat and even walk along the corridor. Most often, the plug that seals the uterus comes off earlier, sometimes 2 weeks before birth. But if this happens already during contractions, do not worry - the process is painless, and the substance is a dense lump of mucus. The water may also break; the discharge is also painless;
if the onset of contractions finds you at home, do not fuss, but call an ambulance and wait, preferably lying on your left side. At the hospital, notify the attendant about the onset of uterine contractions. The doctor will examine you to see if your cervix is dilated and decide what to do next.

Video: advice from an obstetrician for those preparing to give birth for the first time

How does birth occur in first-time mothers?

According to doctors' observations, the first birth lasts longer than the second one. Due to the lack of elasticity of the birth canal, they can last up to 12 hours and are extremely rarely rapid. The process of giving birth to a child is conventionally divided into three periods. Let's look at each separately.

First period - contractions

The longest in the entire birth process. Contractions of the uterus, provoking its sufficient dilatation, can last from 4 to 10 hours:

At the very beginning, they cause practically no pain; rather, a slight tension in the abdomen is felt. But when the uterus opens, the pain will intensify. Try to think about good things, for example, that you will soon be able to hold the baby you have been carrying under your heart for many months. A positive attitude and proper breathing partially relieve the discomfort of contractions.
During contractions, you should not hold your breath, because both you and the baby about to be born need oxygen, and the sensations from uterine contractions will not become less painful due to such a delay. You shouldn't shout either, but quiet singing, they say, helps. It is best to take rhythmic, full inhalations and exhalations, which will somewhat ease the pain during contractions.
A massage of the sacrum, the penultimate section of the spine, located slightly above the coccyx, is a good way to reduce pain. Dads can come to the rescue with this, because not every woman can reach her back to alternate light strokes with strong pressure. The nagging pain recedes a little after such manipulations.
The cervix dilates faster when walking or at least standing. But it all depends on the well-being of the woman in labor; if there is no opportunity or desire to move, there is no need to force yourself.

In primiparas, the cervix opens first from the inside, then the time of external uterine os begins, and in multiparous women, the order of expansion of the os is reversed. A signal of complete dilatation of the uterine cervix is the desire to push, similar to the urge to go to the toilet, but much stronger. This is when the pushing begins and the expectant mother is moved to the obstetric bed, because the baby is about to be born.

Video: contractions in the prenatal department

Second period - pushing and expulsion of the fetus

The sensations during the expulsion of the fetus from the uterus vary among women. Compared to contractions, the pain may be felt stronger or, conversely, weaker. It is necessary to strictly follow the recommendations of the obstetrician present in the delivery room and take an active part in the birth of your child:

Attempts that arise reflexively do not mean at all that you can let everything take its course. Shallow breathing at frequent intervals—canine breathing—helps control pushing. And how to push correctly - into the stomach - is known to everyone and exactly repeats the actions when there is an urge to defecate.
The most difficult and most unpleasant moment of the pushing period is considered to be the eruption of the baby's head from the birth canal, but the baby needs your help. After the head is born, the rest of the body appears much faster.
The period of expulsion of the fetus can last an hour, but most often it is limited to 25–30 minutes, depending on the efforts made by the woman in labor.
The newborn takes a breath and the first cry comes from his chest. If the baby’s condition is not alarming, he is placed on the mother’s stomach, and after a few minutes the umbilical cord is cut and the baby is transferred to a neonatologist for examination.

A doctor's advice will help prevent injury to the child and ruptures in the mother. The active part of labor ends here, but the third period is also of great importance.

Partner births are popular among young couples; husbands help their wives facilitate the birth of a common child, at least at the stage of labor.

Third period - birth of the placenta

Contractions of the uterus continue, and the placenta (another name is the placenta) is born in up to half an hour, without being accompanied by pain. If the placenta fails to separate on its own, the doctor gently helps manually or introduces a drug that enhances uterine contractions.

The placenta undergoes a thorough examination to ensure that the membrane is intact. If even small parts of the placenta remain in the uterus, inflammatory processes or internal bleeding may begin.

Then they carefully examine the new mother, disinfect the birth canal and make sure there are no ruptures. If damage is detected, stitches are applied under local anesthesia. The woman does not feel pain.

Video: Documentary about the stages of labor

Now I regret that I didn’t decide to have a partner birth 10 years ago. The second time I would definitely take my husband with me, but apparently we are not allowed to have another child for health reasons, which is a pity. The attention and support of a loved one is especially important at such moments. I also used to consider the presence of a spouse in the family unacceptable. Newspapers and magazines for women like to write that after this, husbands lose sexual interest in their wives. But for my neighbor Tonya, having a joint birth did not prevent her from conceiving and giving birth to three children in 8 years, and her father delivered all of them. By the way, it is not necessary for a man to be directly involved in the birth process; his presence in the room, even out of sight, is very calming, Tonya told me. And during contractions, a back massage with the caring hands of your husband works wonders. So, don’t be afraid to take your spouse to the birth if they show even the slightest desire, otherwise you will regret it, like me.

How long does the first birth last?

The duration of labor in primiparous women is 15-20 hours; For those who have already given birth, the birth of a baby takes 1.5-2 times less time. What is this connected with? While experiencing the first birth , the body adjusts the functioning of the organs involved in the process of childbirth. During all subsequent births, only the reproduction of the program compiled and stored in memory occurs.

The first birth is divided into three stages:

Contractions. In first-time women, they last about 18 hours, in all others - 11. Contractions are a contraction of the muscles of the uterus, as a result of which the birth canal opens.
Pushing and fetal release. If you are giving birth for the first time, this period will take you 1 to 2 hours. Women who go through the birth process again will need half as much time.
Disposal of the placenta and membranes. This stage takes the same amount of time for both those who are in the delivery room for the first time and those for whom this is not the first time, and lasts about half an hour.

All the figures we give are averaged. There are cases when the first birth proceeds much faster, but there are also women for whom this process lasted a whole day. The main thing is to be in time under the supervision of doctors who will make sure that your first birth proceeds normally.

Now let's take a closer look at how childbirth takes place .

Possible complications during childbirth and how to avoid them

Complications during childbirth occur in the following cases:

long period of contractions. Sometimes it happens that preparatory contractions of the uterus do not develop into labor for a long time. Normally, this takes up to 8 hours, but with pathology, the process can be extended to two days. But doctors are trying not to let the process drag on. Contractions are stopped by medication until the uterus has fully matured, and in case of failure, surgical intervention is used;
weak labor activity (SL). It happens that a woman in labor does not have enough strength to give birth to a baby on her own. The condition is fraught with the development of hypoxia in the fetus. The solution to the problem depends on the period in which it arose - oxytocin is administered for stimulation, or in severe cases, a caesarean section is resorted to. There are two types of SRD: during primary contractions, contractions are weak from the very beginning and do not intensify to expel the fetus;
with secondary, there is a weakening of initially sufficient uterine contractions;

the opposite of the previous complication is violent labor. Rapid childbirth is dangerous due to injuries to the baby and ruptures in the mother’s birth canal, and premature placental abruption is possible. The pathology is characterized by excessive pain, but it is not so difficult to cope with it with the help of drugs that reduce uterine tone;

premature release of amniotic fluid. Amniotic fluid normally drains only after the cervix is fully dilated, and from this moment until the birth of the child, a maximum of 18 hours should pass. Otherwise, the baby may become infected and the umbilical cord may fall out. To avoid this, labor is stimulated or surgery is used;

premature placental abruption. Usually the placenta comes out after the birth of the child and this is considered the final stage of childbirth, but if blood clotting is poor or contractions are very strong, the placenta may detach prematurely. This threatens the mother with bleeding and oxygen deficiency for the fetus. Most often, a caesarean section comes to the rescue;

narrow pelvis Even women with normal pelvic sizes can hear a similar diagnosis on a prenatal ultrasound or already on the obstetric table. If the fetus is too large or its head is not positioned correctly at the entrance to the pelvis, the delivery process is delayed and the baby suffers from a lack of oxygen. In such a situation, an emergency caesarean section cannot be avoided;

mother's ruptures. If there are small tears, they are treated, but are not classified as complications. And deep dissections of soft tissues are considered a pathology that occurs due to the large size of the child or rapid labor. Anticipating such a development of events, the doctor himself makes an artificial incision with a scalpel, which is subsequently sutured. Smooth edges make the healing process shorter than after natural tears;

oxygen deficiency (hypoxia) of the fetus. With each contraction, the child feels a lack of oxygen due to interruptions in the flow through the bloodstream. This is why it is so important to breathe correctly during contractions and pushing. In especially severe cases, even death is possible. Umbilical cord entanglement, rapid labor and premature placental abruption contribute to the appearance of hypoxia. To avoid consequences, you need to establish the cause as early as possible, eliminate it and help the baby be born faster;

birth injury. Sometimes children suffer serious injuries at birth due to rapid or premature birth. The risk of injury is increased by the actions of inexperienced obstetricians and incorrect placement of the child's head into the pelvis.

Video: how to give birth without gaps - the experience of a young mother

Is continuous effort necessary?

During the birth of the fetus, there are times when it is necessary to reduce the force of pushing. Moving along the birth canal, the child puts pressure on the birth canal, stretching it to the width necessary for its passage. The vaginal mucosa and pelvic floor muscles can stretch quite strongly. If this process occurs smoothly, then the soft tissues of the birth canal gradually adapt to the stretching. If the second stage of labor proceeds too quickly, the unprepared soft tissues of the birth canal cannot withstand such a load, and ruptures occur. In cases where doctors see that a perineal rupture is about to occur and it is impossible to prevent it, they resort to an episiotomy during childbirth (perineal incision). They do this in order to avoid complications in the postpartum period, because an incised wound heals better than a lacerated one.

With a rapid birth, the fetus also suffers. It is squeezed out of the birth canal with great speed, its members do not have time to adapt to traveling through such a narrow canal, powerful pressure is exerted on the spine and head, as a result of which the baby can be injured. Therefore, when the midwife tells you that you cannot push, you should stop pushing. Quickly relax and exhale the air smoothly through pursed lips. Sometimes, to help your baby progress or so you can rest and regain strength, your doctor may tell you not to push during one or more contractions. You will not be able to stop the effort, but you can significantly weaken it. It is necessary to relax as much as possible and breathe often, often, with your mouth slightly open, and superficially, “like a dog.”

Rehabilitation after the first birth and its features

Discharged home 3–5 days after natural birth without complications. The order of birth does not affect the time spent in the maternity hospital; only the condition of the mother and child matters. Caesarean section and problems encountered during delivery prolong the stay in a medical facility for an individually recommended period. Postpartum rehabilitation involves the gradual return of the organs and systems of the mother’s body to their natural state:

The respiratory system is restored immediately after the birth of the baby, because the fetus in the uterus no longer displaces the diaphragm, making full breathing difficult. Shortness of breath subsides and the load on the heart muscle weakens;
the cardiovascular system undergoes maximum changes during the gestation period and takes a long time to return to function. In the absence of circulatory pathologies, blood clotting in the first days after delivery increases due to natural bleeding. At this time, the risk of blood clots increases, it is recommended to wear stockings with compression properties, especially the first day after childbirth, when bed rest is required;
The uterus returns to its pre-pregnancy size after a natural birth in about one and a half to two months; a cesarean section delays the recovery process for another month. Postpartum bleeding is called lochia; for the first 3 days it is very similar to menstrual bleeding, but by the end of the week it becomes lighter and its strength weakens. At first, the uterus weighs about a kilogram and is shaped like a ball, and at the end of the recovery period it weighs up to 80 grams, which is slightly more than the weight of the uterus of a nulliparous woman, and again looks like a pear. Oxytocin speeds up the recovery process, and since this hormone is produced with each feeding of the baby, a woman may feel pain from uterine contractions when putting the baby to the breast;
the next pregnancy is possible already in the first weeks after birth, when the next ovulation occurs. The menstrual cycle is restored: when breastfeeding without additional complementary foods - 6–18 months after birth;
with mixed feeding - up to 6 months;
if it is impossible to feed breast milk for any reason - after 1.5–2 months;

The vagina after childbirth will almost restore its previous size, but will still be slightly larger than before. To return to prenatal shape and as a solution to vaginal incontinence, Kegel exercises are helpful. Vaginal dryness due to the production of a hormone that stimulates lactation can last up to 12 months;

The cervix changes the most after childbirth; a gynecologist can easily identify the woman who gave birth by it. This organ takes on a cylindrical shape, and the opening becomes like a slit. Before childbirth, the cervix resembles a cone with the base down, and its opening is round. The process of her recovery lasts for 4 months.