Pregnant woman 4. Fourth pregnancy and fourth birth: possible risks and complications

Pregnancy is physiological process, in which a new one develops in a woman’s uterus human body resulting from fertilization.

Pregnancy lasts on average for women 280 days(40 weeks, which corresponds to 9 calendar months or 10 lunar months). Pregnancy is also usually divided into 3 trimesters of 3 calendar months each.

Signs of early pregnancy

In the early stages, the diagnosis of pregnancy is made on the basis of doubtful and probable signs.

Questionable signs of pregnancy- various kinds of subjective sensations, as well as objectively determined changes in the body, outside the internal genital organs: taste whims, changes in olfactory sensations, easy fatigue, drowsiness, pigmentation of the skin on the face, along the white line of the abdomen, nipples and areola.

Possible signs of pregnancy- objective signs from the genital organs, mammary glands and when staging biological reactions to pregnancy. These include: cessation of menstruation in women of childbearing age, enlargement of the mammary glands and the appearance of colostrum when squeezed out of the nipples, cyanosis of the mucous membrane of the vagina and cervix, changes in the shape and consistency of the uterus, and an increase in its size.

You can first verify the presence of pregnancy at home using a rapid test for the content of the hormone human chorionic gonadotropin in a woman’s urine (the test is carried out from the first day of the delay of the next menstruation).

It allows you to confirm the fact of pregnancy.

Changes in the body of a pregnant woman

Numerous and complex changes occur in a woman's body during pregnancy. These physiological changes create conditions for intrauterine development of the fetus, prepare the woman’s body for childbirth and breastfeeding newborn Menstruation stops, the mammary glands increase in volume, and the nipples darken.

Many pregnant women experience nausea and sometimes vomiting in the first trimester - these symptoms are commonly called. Weakness, drowsiness, heartburn, drooling, changes in taste, and frequent urination often occur. These disturbances in well-being are characteristic of a healthy and normal pregnancy.

Particularly large changes occur in the female genital organs. Each time the uterus grows, the blood supply to the internal and external genital organs increases. The tissues swell and become elastic, which facilitates their better stretching during childbirth. In the mammary glands, the number and volume of glandular lobules increase, their blood supply increases, they become tense, from the nipples. The number is increasing sharply gonadotropic hormones, as well as estrogens and progesterone, produced first by the corpus luteum (a temporary gland formed at the site of the follicle from which the mature egg emerged) and then. Hormones secreted by the corpus luteum (progesterone and, to a lesser extent, estrogens) help create conditions for the proper development of pregnancy. Corpus luteum undergoes reverse development after the fourth month due to the formation of the hormonal function of the placenta.

To manage pregnancy, it is necessary (3 - 4 weeks after the delay of menstruation), where the doctor examines and examines the external and internal genital organs, and, if necessary, prescribes additional examinations.

Genital organs during pregnancy

Uterus. During pregnancy, the size, shape, position, consistency and reactivity (excitability) of the uterus changes. The uterus gradually enlarges throughout pregnancy. Enlargement of the uterus occurs mainly due to hypertrophy muscle fibers uterus; At the same time, muscle fibers multiply and the newly formed muscle elements of the reticular-fibrous and argyrophilic “framework” of the uterus grow.

The uterus is not only a fruit repository that protects the fetus from adverse external influences, but also a metabolic organ that provides the fetus with enzymes and complex compounds necessary for the plastic processes of a rapidly developing fetus.

Vagina During pregnancy, it lengthens, widens, and the folds of the mucous membrane become more pronounced. The external genitalia loosen during pregnancy.

Lifestyle of a pregnant woman, regime, nutrition and hygiene

The developing fetus receives all the necessary nutrients from the mother. The well-being of the fetus depends entirely on the health of the mother, her working conditions, rest, and the state of the nervous and endocrine systems.

Pregnant women are exempt from night shifts, heavy physical work, work associated with body vibration or adverse effects of chemicals on the body. substances. During pregnancy, sudden movements, heavy lifting and significant fatigue should be avoided. A pregnant woman needs to sleep at least 8 hours a day. A walk before bed is recommended.

Pregnant women must be carefully protected from infectious diseases, which pose a particular danger to the body of the pregnant woman and the fetus.

During pregnancy, you need to be especially careful about keeping your skin clean. Clean skin helps eliminate metabolic products harmful to the body through sweat.

A pregnant woman should wash her external genitalia twice a day with warm water and soap. Douching during pregnancy should be prescribed with great caution.

During pregnancy, you should carefully monitor the condition of your oral cavity and carry out the necessary treatment.

The mammary glands must be washed daily with warm water and soap and dried with a towel. These methods prevent cracked nipples and mastitis. If so, then you should massage them.

Maternity clothes should be comfortable and loose: you should not wear tight belts, tight bras, etc. In the second half of pregnancy, it is recommended to wear a bandage that should support the stomach, but not squeeze it.

A pregnant woman should wear low-heeled shoes.

People who have financial security can usually decide to have a fourth child. After all, this is another moment of crisis in the family.

More often, this pregnancy is planned, which means that the woman prepares for it in advance. Pregnancy follows already known, well-trodden paths.

However, repeated pregnancies, childbirth and the postpartum period differ in some ways.

The fourth pregnancy usually goes well, without obvious toxicosis, although each woman’s body is individual.

But there are still significant differences between first pregnancies and subsequent ones.

After 35 years, there is a likelihood of late toxicosis of pregnancy and the development of diseases such as pyelonephritis, hypertension, diabetes mellitus.
- with repeated pregnancies, there is a high probability of developing anemia and varicose veins.
- muscle overstretching abdominal cavity. Babies during repeated pregnancies usually weigh more than during previous ones. Therefore, the woman is stronger, feels heaviness and pain in the lower back and sacrum, in the lower abdomen.
- failure of the pelvic floor muscles, relaxed ligamentous apparatus due to stretching or rupture of the muscles and ligaments of the pelvic floor due to past childbirth can manifest itself in the form of urine leakage when laughing or coughing.
- low location of the placenta. The cause is usually “wear and tear” of the uterine lining from previous births or abortions.
- failure of the pelvic floor muscles. This can cause hemorrhoids and urinary incontinence both during pregnancy and the postpartum period.
- Rhesus conflict. With each new pregnancy, the risk of developing antibodies increases.
- post-term pregnancy. Due to the overextension of the uterus, the body becomes less sensitive to hormones, which, acting on the uterus, trigger its contraction, and the onset of labor is delayed.

Childbirth

The fourth birth is usually faster and easier. Birth trauma is reduced due to good stretching of the perineal tissue.

Quick birth. During the fourth birth, a softer opening of the uterine pharynx is characteristic, quite fast current the birth process as a whole. Childbirth can be fleeting (up to 4 hours), so it can catch a woman anywhere: at work, on the street, in transport.

Postpartum period

Bleeding. Due to a decrease in uterine contractility during the postpartum period, bleeding may occur.
The tendency to uterine laxity may continue to be present, which leads to retention of postpartum discharge in the uterine cavity. Against this background, inflammatory processes in the inner lining of the uterus develop.

Of course, a fourth pregnancy and childbirth is not an easy test. But knowing the features of repeated pregnancies and childbirth, as well as the experience of pregnancy and birth, allows a woman to go through the birth process more confidently and easily recover in the postpartum period.

Today it is rare to meet a couple who has decided to have more than two babies. Despite this, large families still exist. At the same time, a woman faces not only the difficulties of education. Many problems appear already during the period of gestation during the third and fourth pregnancies. In this article we will tell you what a woman may face in this situation.

Peculiarities

The optimal reproductive period, according to most experts, ends after 30 years. Moreover, the fourth pregnancy for most representatives of the fairer sex, as a rule, occurs at an older age. This significantly increases the risk of complications for the mother and child. Of course, it cannot be said that all women over 30 will necessarily encounter troubles after conceiving. However, it is necessary to register as soon as signs of a fourth pregnancy appear. It’s good if you manage to go through full examination body. In this case, the risk of complications will be significantly reduced.

Pregnancy with a fourth child may be problematic if there is a predisposition to genetic complications. It’s worth thinking about if previous babies were born with certain defects. Already in the early stages of pregnancy, it would be useful to undergo an examination with a geneticist.

Each subsequent pregnancy is aggravated also if Rh-conflict is diagnosed. The most problematic blood group is considered to be fourth negative. Pregnancy, if it occurs, can be terminated early. To prevent this situation from happening, the woman is given a special immunoglobulin intravenously.

Even if the previous periods of gestation passed without complications, it is recommended that the expectant mother register as early as possible. The optimal period is 7 weeks. Early examination will eliminate the risk of complications. If an ectopic pregnancy is diagnosed, the patient will be referred for surgery.

How is the fourth pregnancy different?

Each subsequent pregnancy creates a serious burden on the female body. At the same time, unpleasant symptoms can develop in any vital system. To aggravation chronic illnesses may result in a fourth pregnancy. The peculiarities of this process consist in a more vivid manifestation of all unpleasant symptoms. A significant deterioration in well-being can be observed if a representative of the fairer sex decides to become a mother again closer to 40 years of age.

During the fourth pregnancy, the belly begins to increase much earlier. Already in the 10th week of pregnancy, others, as a rule, notice the interesting position of the expectant mother. Moreover, the belly size may be larger. At the same time, the baby’s weight does not always matter. This is due to the fact that the abdominal muscles are already stretched, which allows the uterus to freely increase in size.

An interesting fact is that a woman begins to guess about her situation much earlier. Many expectant mothers know even before the delay that changes have occurred in their body. Movements are also observed much earlier during the fourth pregnancy. The expectant mother will feel tremors closer to the 13th week of the gestation period.

Due to the fact that the risk of complications with each subsequent pregnancy increases significantly, the expectant mother is advised to follow a number of rules. It is strictly forbidden to lift heavy objects. In this regard, the fourth pregnancy should be planned when the older children are already a little older. Any physical activity may lead to premature labor activity.

Childbirth during the fourth pregnancy

Expulsion of the fetus in this situation also has its own characteristics. If the fairer sex follows all the doctor’s instructions, the fourth pregnancy will end with a successful birth. Signs that the baby has decided to be born may be vague. Abdominal prolapse during repeated pregnancies is not always observed, and the mucous plug begins to come off just a few hours before the onset of labor. A decrease in swelling may indicate the need to pack your bag for the maternity hospital. What other warning signs could there be of labor during the fourth pregnancy? Reviews show that a few hours before the baby is born, it becomes much easier to breathe. This is due to the advancement of the fetus to the cervix. Space is freed up around the lungs.

Pregnancy with a fourth child often ends in rapid labor. It may only take half an hour from the start of the first contractions until the baby is born. This poses a serious risk of complications for the life of mother and child. The expectant mother may experience a rupture of the soft tissues of the birth canal. The baby may be diagnosed with intracranial hemorrhage. To avoid unpleasant consequences, towards the end of the fourth pregnancy, it is recommended to go to the maternity hospital before the onset of contractions (closer to the 37th week).

With each repeat pregnancy, the risk of weak labor also increases. In this case, the woman will feel intense contractions against the background of a slight dilatation of the cervix. In this case, the doctor may decide to induce labor by drip administration of Oxytocin. If such actions do not show a good result, delivery will be carried out by cesarean section.

What week does one give birth for the fourth time?

The calculation of the timing of the onset of labor is influenced by many factors. At the same time, it does not always matter whether a woman is carrying her first baby or her fourth. Great value the baby is at full term. Some babies are fully mature by 37 weeks. It often happens that even at the 41st week the baby is in no hurry to be born. In this case, the absence of labor may indicate hormonal disorders in the mother’s body. If labor does not begin at 42 weeks, the doctor decides to perform stimulation. In this case, it is often enough to open the amniotic sac and full-fledged contractions begin.

Artificial labor is carried out with extreme caution. The doctor makes sure that after connecting the drip with Oxytocin, contractions come no more than once every 5-7 minutes. Stimulation often leads to rapid labor with subsequent complications.

If stimulation at 42 weeks of pregnancy does not show good results, labor never occurs, the baby is born through surgery.

The fourth pregnancy and childbirth is a serious test for a woman. The absence of contractions in the 40th week, pain in the lower abdomen, decreased fetal activity - all this may be a reason to go to the maternity hospital.

Features of the fourth multiple pregnancy

The risk of complications is significantly higher if two or more fetuses are developing in the womb at the same time. It is worth being under the close supervision of medical personnel if we are talking about a fourth pregnancy. Fetal movements, abdominal enlargement, deterioration in health - all these signs will appear much earlier. A double pregnancy puts a huge strain on the body. Starting from the middle of the second trimester, the woman will spend almost all of her time in confinement (in a hospital setting). This is the only way to avoid dangerous complications.

It is worth remembering that during multiple pregnancies, babies develop according to the principle of competition. Therefore, a woman must have enough strength to ensure that both babies receive the required amount. nutrients. With age, the likelihood of bearing healthy babies during multiple pregnancies decreases significantly. Already in the 6th week, the expectant mother is recommended to register.

Food deserves special attention. You will have to eat a little more than during a singleton pregnancy. It is worth remembering that the risk of obesity increases with age. It would be a good idea to contact a professional nutritionist who will develop a diet on an individual basis.

You should be prepared for the fact that labor during a multiple pregnancy can begin significantly ahead of schedule.

What are the dangers of giving birth at a late age?

It is worth understanding that a fourth pregnancy after the age of 35 carries a certain risk for the health of the mother and the unborn baby. Statistics show that children with Down syndrome are more often born to older mothers. Every year the risk of exacerbation will increase significantly chronic pathologies, which can also affect the development of the fetus inside the womb.

Those who decide to have a fourth pregnancy closer to the age of 40 need to be prepared for spontaneous abortion. The risk of miscarriage increases significantly due to chromosomal defects of the fetus. In this way, the woman’s body gets rid of a child who is developing defectively.

During late pregnancy, problems with the placenta often appear. Chronic placental insufficiency often leads to premature birth. In this case, the baby is born with pathologies.

Pregnancy immediately after childbirth

Signs of a fourth pregnancy may be blurred if a woman has recently given birth to a third baby and is breastfeeding. Often, the expectant mother learns about her situation when the gestation period reaches 12 or more weeks. At the same time, it is too late to terminate the pregnancy.

A serious threat arises primarily to the life of the unborn baby. The female body has not yet had time to fully recover. As a result, all the necessary substances will reach the baby in limited quantities. In addition, the mother’s body is configured to feed an already born baby. In the fourth pregnancy immediately after the third, children may be born prematurely. If the child was born after the 30th week of pregnancy, he has every chance of full life. He will be able to regain his strength thanks to artificial feeding.

A fourth pregnancy immediately after childbirth can cause a significant deterioration in the well-being of the expectant mother. The period of gestation in this case is quite difficult. A woman needs to make a decision whether to pay attention to the already born baby or completely entrust it to her relatives and continue her fourth pregnancy. It is possible that almost the entire nine months will have to be spent in a hospital setting.

If you can no longer give birth

During a difficult fourth birth, a specialist may recommend that the woman have her fallopian tubes tied. Surgical intervention is performed if the fairer sex is no longer recommended to give birth. The intervention can be carried out in a gynecological clinic. At the same time, the likelihood of complications and side effects is reduced to a minimum. The operation provides 98% protection against pregnancy. Despite this, menstrual cycle the woman’s libido is not disturbed and does not suffer.

A full pregnancy cannot occur after surgery. However, there is always a risk of ectopic development ovum. If menstruation does not come on time and the test shows two lines, you should seek help immediately.

In addition to the difficult fourth pregnancy, there are other indications for dressing fallopian tubes. These include: leukemia, severe diabetes mellitus, active form hepatitis, kidney failure, launched form hypertension.

Preeclampsia

With each subsequent pregnancy, the risk of late toxicosis increases significantly. Preeclampsia is a pathological condition in which dangerous symptoms occur, such as swelling, a significant increase in blood pressure, rapid deterioration in health. Such complications are observed in 20% of cases during the fourth pregnancy. In the most difficult cases, eclampsia develops. This condition is characterized by seizures. A pregnant woman may fall into a coma. There is already a serious threat to the life of the expectant mother and child.

Dropsy is one of the first manifestations of late toxicosis. Initially, the woman begins to suffer from swelling of the arms and legs, then excess fluid appears in the lower abdomen. At a late stage of the pathological process, swelling appears on the face. Unpleasant symptoms develop against the background of decreased diuresis. In addition, a woman may have protein in her urine. Such a symptom will indicate inadequate kidney function.

A rapid increase in blood pressure is also considered dangerous. An increase in diastolic value may indicate a decrease in placental circulation. The pathological process leads to oxygen starvation of the fetus. As a result, the baby may die or be born prematurely.

Women with gestosis in their fourth pregnancy must be hospitalized. Thanks to round-the-clock monitoring, it is possible to eliminate disturbances in the vital systems of the body. If the risk of eclampsia increases in the later stages, the doctor decides to induce labor.

Let's sum it up

A fourth pregnancy poses a serious threat to the life of the woman and the unborn baby. However, it is not worth interrupting the life of the fetus. If the expectant mother registers in a timely manner and follows all the specialist’s instructions, there is a good chance of carrying healthy child without complications.

We live in a world of stereotypes - they are familiar, understandable and easy to use. Like ready-made semi-finished products: you choose the right package, heat it up, swallow it - and your head doesn’t hurt. For example, if when meeting you you say: “I’m 35 years old, I’m a manager in a foreign company; I can’t stand my job, but I get eighty thousand rubles a month,” - you will immediately receive approval: “Wow, great, eighty thousand, and probably also have health insurance!”

And if, under the same circumstances, you say: “I’m 35 years old, I’m a mother of three children, I don’t work; I love my kids,” - they will certainly express sympathy for you: “Well... uh... you're great; You’re very tired, aren’t you?” A dislike for work can easily be forgiven, but three kids will not. Because being tired, lacking sleep and being nervous at work is possible, necessary and even prestigious. But spending the same resources on home, family and children is not very good. Because children, children... What are “children”?

This is nine months of burden, childbirth, sleepless nights, frequent crying of a small, demanding person. This is affection, constant control: where did you reach, what did you grab, did you knock over the ironing board, did you knock over the flower pot. This is a waste of time, money and - most difficult - yourself. Without salary and social approval. That is, from the point of view of stereotypes, a mother with many children is an unhappy woman.

Well, really, unfortunate. The arithmetic is very simple. Let’s take a mother with many children and subtract - minus quiet time “to yourself”, minus a weekly beauty salon and gym, minus salary and annual bonuses, minus communication with colleagues, minus professional development, minus nice trips to restaurants and cafes, minus freedom of movement, minus more a lot of things remain... love.

But this is the most important thing! Without love, no matter how much you add, you will still get zero. The familiar world of stereotypes is sad. There are two main colors - black and white. Whenever you mix them, you won’t get anything other than gray. Love gives us so many colors and colors, so many nuances and halftones. But to fill your life with love, you need to forget about stereotypes. At least about the most common ones. Let's start with mothers of many children. So what do we know about them?

Of course, they get tired, sleep little and therefore look bad. And in this state they will live until the end of time - this is their sad fate. They probably don’t have money, because it’s impossible to feed such a crowd with a regular salary. After all, the mob daily destroys a food supply comparable to the needs of a small African country. They also don’t have decent clothes, because we know how quickly children grow, and clothes get dirty and torn. They also lack a good education, interesting recreation, hobbies and interests, because, again, we know...

These were my thoughts on the topic of “mother of many children” a year and a half ago - until I settled in the online community dedicated to motherhood. Then I was carrying a son and longed for “communication on the topic.” The community of mothers with many children turned out to be one of the nicest groups on the multimillion-dollar site. I was interested in every diary, every message. Within a few days I was surprised to discover that mothers with many children manage more with three, four or five children than I do with one pregnant belly!

Many mothers bought excellent clothes for themselves and their children, skillfully planned the day, took their children to clubs and classes, and could prepare a delicious dinner in twenty minutes. Let me note, with absolutely average incomes. But the general standard of living was an order of magnitude higher than mine, due to the experience of managing a large family.

It was also amazing how much they adore their babies! Yes, yes, “problem” babies who have colic, bad dream and frequent tears. With great tenderness, mothers of many wrote notes specifically about newborns - the very ones whom one-mother calls “I-Never-Decide-On-Such-Again.”

Not deciding, of course, is the easiest thing to do. I have friends who did just that - they ran away to work as soon as the child turned one. Not from need, not from boredom at home, not from brilliant talents. But because if you stay at home, you will get fat and turn into a lump, a large family is not affordable, it is better to give birth to one and give him everything. And then: if you give birth to many, you will work for them all your life.

On the same mother’s website it turned out that people with many children are pitied. Compassionate aunties and grannies shamelessly ask: how are you, my dear, pulling everyone along? And not so much to offend, but out of interest and pity - to endure so many, to give birth to so many. And it’s not enough to give birth - then you need to dress, feed and educate them!..

And many mothers are also scolded, but not by old women, but by women and men - just like you and me. They scold you in lines because “they brought such a crowd to the store,” they scold you in the children’s clinic: “Where are you, woman, going with your people ahead?” (although those with many children have benefits for admission out of turn), they scold them in the kitchen and on the Internet: “No, Vasya, can you imagine, these families with many children live at our expense: they have so many benefits, free plots, all sorts of kindergarten clubs, but for ours Petenka..."

Don't think anything bad. The story is not at all about how you feel about having many children and how many children to have - one or six. This issue is closed from public discussion. Probably, as much as there is, so much is good. And the point is not in quantity, but in attitude to it. How is it that it is easier for us to judge than to rejoice? Hit rather than hug. To be sarcastic than to encourage. Why is there dislike for large families? Saving time in queues and hospitals? Concern about the targeted use of tax funds? Somehow I can’t believe it...

In my opinion, this is a complex of false superiority. We give birth to one or two at most, we work hard at work - often unloved, but what can we do - we drag out a mortgage, loans, a car, everyday life, English classes for the child. A load lifted by hard work. But this is still better, more correct, because a decent life requires decent money. We are bending over under the weight of worries, we are almost bent over, and here on the playground - no, look - she gave birth to three, is pregnant with the fourth and is smiling!

Everyone has their own concept of a worthy life. Some have money, some have children. And you can endlessly argue about what is “right” and what is not so good. Everyone has their own story, their own experience.

And a mother with many children does not need reasoning. She needs warmth and support, because a large family is really difficult. It is very important that we can tell her from the bottom of our hearts: skip the line. Or smile. Or just ask: how can I help? Without a touch of melancholy and pity. Well, if a large family suddenly hurts you in some way, please do not judge those who have allowed love into their lives.