Attention to the details: childbirth without stress and aggression
Authors: Zhuk S.I. 
Published: July 2021

Background. Perinatal obstetrics involves the interests of both the mother and the fetus. The main sections of perinatal obstetrics are prenatal diagnosis, intensive care during pregnancy and childbirth, choice of optimal delivery way, resuscitation and care of the newborn. WHO experts believe that the comfort of the mother, psychological support of relatives, adequate analgesia, lack of aggressive delivery (unreasonable opening of the amniotic sac or unreasonable labor stimulation), monitoring of the childbirth dynamics and even the pose of the woman during labor are extremely important.
Objective. To describe the modern views on childbirth.
Materials and methods. Analysis of literature data on this issue.
Results and discussion. Current trends in childbirth include the increase of the average weight of the fetus, of the number of high-risk mothers, of childbirth duration, of the incidence of traumatic injuries of the birth canal, of the frequency of surgical interventions. Obstructive labor is often accompanied by the aggressive management: hyperactive actions of obstetricians and gynecologists, uncontrolled use of oxytocin, any action in immature cervix. In obstructive labor, the obstetric situation should be assessed by vaginal examination and/or transabdominal ultrasound (US). If the latter does not show the middle structures of the head, one can combine transabdominal and transperitoneal US. With regard to birth injuries, their prevention should begin several weeks before the expected date of birth to reduce the risk of episiotomy and spontaneous perineal rupture. To do this, there are special vaginal hydrogels that reduce friction during childbirth. The composition of the hydrogel Ginodek (“Yuria-Pharm”) includes an antiseptic component (decamethoxine 0.02 %), a regenerating component (hyaluronic acid 0.5 %) and a component that regulates the vaginal pH (lactate buffer). Decamethoxine has bactericidal, viricidal, fungicidal, anti-inflammatory, desensitizing and antispasmodic action. Lactate buffer eliminates the symptoms of acid-base imbalance, helps to moisturize the vaginal mucosa and to maintain normal microflora. Hyaluronic acid restores the water balance of cells, promotes the entry of nutrients into the cells and the excretion of metabolic products, stimulates regeneration. Indications for the use of Ginodek include the prevention of infectious complications in obstetrics and gynecology before surgery, minor diagnostic operations, abortion, childbirth, intrauterine device insertion, as well as treatment of genital infections and conditions accompanied by dryness and atrophy of the vaginal mucous membrane.
Conclusions. 1. When conducting childbirth in a natural way, the comfortable condition of the woman in labor, psychological support of relatives, adequate anesthesia, and the absence of aggressive assistment are of great importance. 2. There are vaginal hydrogels that prevent birth injuries via reducing the friction during childbirth. 3. Ginodek hydrogel, which contains decamethoxine, hyaluronic acid and lactate buffer, helps to reduce the number of birth injuries.