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Vertical childbirth

vertical childbirth in MoscowAlong with water birth, vertical childbirth is causing a lot of controversy among doctors, midwives, and douls. Is this a fashion statement or a step towards physiology?

Everything is individual. It cannot be said that vertical childbirth is better or worse than traditional prone childbirth. Childbirth in an upright position is often chosen by women who are not giving birth for the first time. In this case, the perineal tissues are already more stretchable, and it may indeed be easier for the child to be born "under the influence of gravity." But, again, this does not apply to everyone.

Preparation for vertical childbirth

If you decide to give birth vertically, then the most important thing is to discuss this possibility with your doctor. If you have no contraindications for vertical childbirth, it will be useful to be like courses for pregnant women, "rehearse" various poses. But you also need to be prepared for the fact that the birth may not go as planned, and for your safety and the safety of the baby, it may be necessary to change the position, perform an epidural, or perform other manipulations.

How does vertical childbirth work?

Since a woman does not undergo epidural anesthesia during vertical labor, she can walk, lie in the tub, and use a fitball during labor – this is the so-called "free behavior in childbirth." When the period of labor begins, the woman in labor assumes a comfortable position on a transformer bed or on a special chair for vertical childbirth.

After the baby is born, the mother presses it to her stomach (like a kangaroo), waiting for the placenta to separate. If a woman is not comfortable, she lies down, and the third period of labor takes place already lying down.

Advantages and disadvantages of vertical childbirth

Vertical childbirth takes place without anesthesia. This is both an advantage and a disadvantage. The advantage of vertical childbirth is that a woman can walk and take any comfortable position to facilitate labor. The disadvantage is that free behavior during childbirth does not provide such anesthesia as epidural anesthesia. In addition, if a woman in labor moves around the delivery box, she is not connected to a CTG machine, and the fetus' condition is not continuously monitored.

There is another drawback: the position of a woman in vertical labor does not allow the midwife, no matter how experienced she may be, to help fully avoid possible perineal ruptures.

When is vertical delivery impossible?

Contraindications to vertical childbirth are complications in which it is necessary to continuously monitor the condition of the woman in labor and the fetus, for example:

  • pelvic presentation of the fetus,
  • multiple pregnancies,
  • scar on the uterus.

 

Vertical delivery at the EMC maternity hospital in Moscow

EMC doctors always listen to a woman's wishes regarding the course of labor. To do this, even during pregnancy, a woman meets with a doctor to discuss a birth plan, which is strictly followed in all cases when there is no threat to the life of the mother and baby. Perhaps a woman wants to give birth vertically because she has back pain and it is uncomfortable for her to lie down. Or she wants to "just try" natural vertical childbirth because she read about it on the Internet. In any case, the doctor explains in detail to the pregnant woman what the pros and cons of vertical childbirth are in her particular case, and they jointly make the final decision. If a woman prefers vertical childbirth, the price of the contract, of course, will not change from this.

If you want to give birth vertically, but in your case it is impossible, you should not worry. In maternity boxes has modern transformer beds that allow a woman to take the most comfortable position lying down, reclining, sitting or on her side.

 

 

 

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Questions and answers

Lump in my breast
I have noted the lump in my breast periodically appeared following breastfeeding my first child (as a result of plugged duct). I did an ultrasound, but it revealed nothing, as if everything was normal. I knead my breast periodically and feel pain at those moments. Now I am pregnant, due date is on 20th. What should I
do?? When to examine my breasts, is it possible to perform the examination during pregnancy and lactation?
...more
The "lump" in the breast cannot occur after feeding, even if it was the plugged duct. You should not "knead" the breasts. If there is a problem or even if you think it is – the breast should be examined. Pregnancy and breastfeeding are not contraindications for this. Under normal conditions for pregnant women we
recommend a breast examination during 1 and 3 trimester (before childbirth). There are no contraindications for breast examination in your case. You are welcome at any convenient time for examination and advice on breastfeeding.
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Benign disease
I have a benign lump in one breast size of 12.0*9.9 mm. Puncture or a biopsy will be done next week. I was told by mammologist that surgery is needed. As far as I know, concerning the surgery, axillary lymph nodes are to be removed together with the tumor. I also know that in Europe lymph nodes are testes for
specific markers and only affected ones should be removed; if lymph nodes are no affected, they are not to be dissected and the surgery is minimally invasive. So what is your approach? Does it make sense to do it or you have the same methods and the same equipment?
...more
If histological examination of the sample reveals fibroadenoma of basic type or tissue hyperplasia without atypia, or nodular type fibrocystic condition of the breast tissue, the question of surgical treatment should not arise. If biopsy reveals giant fibroadenoma sectoral resection is indicated, i.e. mass excision
within the healthy tissues and lymph nodes will be removed. In case of non- benign histological result, i.e. carcinoma is detected, subsequent immunohistochemical examination is required as well as a clinical oncologist and surgeon consultation; and the decision on complex treatment will be taken by case management team. With regard to the diagnosis and treatment methods in our center, each case is addressed individually. Sometimes we remove a benign area (for example, the area of hyperplasia with atypia) using the vacuum-needle technique through 3-4 mm incision. As for the surgical procedure protocols for benign breast tumors, benign simple fibroadenoma is not removed in America, Europe, Israel, etc. I would like to discuss your case with you in more details and perform some additional tests if needed, so I would be glad to see you at EMC’s Breast center.
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Melanoma
My mom had a mole (suspected for melanoma) removed in November 2015. Histology revealed lentigo melanoma in situ. We checked the slides back in the Netherlands, and the diagnosis was a superficial spreading melanoma of Clark 3 Т1а Beslow 0,8 stage; re-excision with capture of 1 cm of healthy skin is recommended. Is
it possible to make re-excision and subsequent histology in your hospital? If so, how soon?
...more
We absolutely agree with the opinion of the European colleagues: re-excision with a wider offset is required; according to the Russian Protocol it is necessary to move 2 cm from the peripheral edge. This is for counter insurance, as lentigo-melanoma is a favorable type, and previous surgery is likely to put an end to
this story and the forecast is favorable. All the necessary manipulations for the study are possible in our Clinic; we have our own well-equipped laboratory with the possibility to ask the advice concerning the sample in Germany and Israel. You should make an appointment with the surgeon-oncologist (Marina Bissessar) in the nearest time to conduct the diagnostic re-excision. Hope to help!
...more
A spot on the back and chest
I have a spot on the back and chest, what could it be?
A spot on the skin is one of the most common symptoms of various skin diseases. Infectious (viral, bacterial or fungal) as well as noninfectious skin including serious diseases and nevi (moles or birthmarks) can manifest as spots on the skin. You should go to the dermatologist for accurate diagnosis. The doctor will
examine you and, if necessary, a special instrument (Dermatoscope, wood lamp) will be used. A skin scraping can also be done in the lesion for microscopy, cytology or culture. A treatment will be prescribed after diagnosis.
...more
Batkaeva Nadezhda
07 September 2016
Uterine cancer
My mom was diagnosed with the uterine cancer. She is 68 years of age and has an obesity of 4th grade (the growth of 166 cm, weight 135 kg) and hypertension. Admission to the radiology department was recommended. What should we do? As far as I know the surgery is the only method for cancer of the uterus to be removed.
Is it really so that this surgery is only possible for young and relatively healthy persons?
...more
It is not quite so. We can operate on any patient, but the issue is which complications can lead to patient’s death and which of them can just delay the recovery. From the anesthesiologist’s point of view, it is a major challenge to intubate patients with 4th degree obesity; the abdominal section is also possible,
but there is a 100% risk of suture line disruption and inflammation, let alone the postoperative pneumonia, venous thrombosis, etc. There is another option such as vaginal hysterectomy which is more acceptable and relatively safe in obese patients. It is not a «treatment standard», however, as it allows not obtaining pelvic washings, but still there is a possibility of complete cure. Anesthesia remains a problem - both general and spinal. Radiation therapy without surgery is another acceptable treatment option besides vaginal hysterectomy. A chance of complete cure is still exists, but the survival rate is on average lower than in surgical treatment
...more
Vladimir Nosov
07 September 2016

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Dr. Marina Sharova = A+++++! Highlights => super knowledgeable! Confident! Professional! Mother-type! Truly terrific bedside manner! Spends endless time with moms! A wonderful choice for all, especially first time moms and foreigners who only speak English! Special thank you to
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