4、When to Enter the Bath

4、什么时候进入浴缸

One issue that is repeated in the literature and voiced in the concern of mothers and their midwives is: When should the mother enter the bath?

文献中重复的和孕妇们和她们的助产士所关心的一个问题是：孕妇什么时候进入浴缸？

Many hospitals use the five-centimeter rule, only allowing mothers to enter the bath when they are in active labor and dilated to more than five centimeters.

许多医院使用5厘米的规则，只允许母亲进入活跃期并且宫口扩张超过5厘米是才进入浴缸。

Some physiological data supports this rule, but each and every situation must be evaluated and then judged.

一些生理数据支持这一规则，但必须因人而异。

Some mothers find a bath in early labor useful for its calming effect and to determine if labor has actually started.

有些妈妈发现待产早期时洗澡有xx效果，并确定分娩是否真的发动了。

The water sometimes slows or stops labor if used too early.

如果使用的过早有可能会使分娩减慢或者停止。

On the other hand, if contractions are strong and regular with either a small amount of dilation or none at all, a bath might be in order to help the mother relax enough to facilitate the dilation.

另一方面，如果收、宫缩很强并且规律，宫口扩张很少或根本没有，可以洗澡来以帮助母亲足够的放松，促进扩张。

It has been suggested that the bath be used in a “trial of water” for at least one hour, allowing the mother to judge its effectiveness.

有人建议，洗澡应该是“对水的尝试”至少一小时，让母亲判断其有效性。

Women report that often the contractions seem to space out or become less effective if they enter the bath too soon, thus requiring them to leave the bath.

妇女们反映如果她们进入浴缸太快，往往收缩似乎空间不足或变得不那么有效，因此需要他们离开浴室。

Then again, midwives report that some women can go from

one centimeter to complete dilation within the first hour or two of immersion.

再说，助产士说，一些妇女宫口在入水后的{dy}或两个小时内内从1cm到开全。

Deep immersion seems to be a key factor.

深深浸入似乎是一个关键因素

If the pool or bath is not deep enough, at least providing water up to breast level and completely covering the belly, then the benefits of the bath may be less noticeable.

如果池或浴缸不够深，至少要提供水到与乳房齐平并xx覆盖腹部，当时的好处可能不太明显。

The warm water will still provide comfort and the mother will benefit from being upright, in control and drug free, but full immersion promotes more physiological responses, the most notable being a redistribution of blood volume, which stimulates the release of oxytocin and vasopressin.

温暖的水仍然会提供舒适性，母亲将受益于处于垂直、控制中、和不用xx，但是xx浸入会引起更多的生理反应，最显著的是血容量重新分配，激发催产素和垂体后叶素的释放。

Vasopressin can also work to increase the levels of oxytocin.

加压素也可以提高催产素的水平。

The immediate pain reduction felt upon entering the bath is quite noticeable.

进入浴缸后很明显的感觉到疼痛立即减轻了。

It is what I refer to as “the ahh effect.”

这就是我称之为“ahh效应。”

The smile, the sound and the inner peace that mothers display are unmistakable.

微笑，声音和内心的平静，母亲所展现的毫无错误。

This response can happen at any point in the labor, but most notably when contractions are long and strong and close together.

这种反应可以发生在待产的任何时候，但宫缩强而且持续时间长、间隔短时最明显。

Some midwives who assume there is little or no progress in dilation because the mother is not displaying any outward signs of discomfort are often surprised to find rapid dilation in the first hour of immersion. 一些助产士会猜想在扩张上很少或者没有进展，因为孕妇没表现出不舒服的外在征象，他们会惊讶的发现入水后的{dy}个4小时内有很快的扩张。

Having experienced a waterbirth myself, I can verify the incredible difference in perception of pain from the room to the water.

在自己经历了水中分娩后，我可以验证从房间到水中的疼痛感有难以置信的差别。
When I am with a woman in labor I generally assess her pain on a scale of one to ten before she enters the bath.

当我和一个水中待产的孕妇在一起的时候，在她入水之前我通常用1-10的评分来评估她的疼痛程度

Most report at least a six or greater.

大多数报告至少6或更高。

Then after no less than half an hour, I will make another assessment. 然后，至少半小时后，我会再作评估。

The second subjective answer of course varies from person to person,

but the typical response is two to four.

第二个主观的答案当然因人而异，但典型的反应是2-4。

The mother is experiencing more than the sum of her physiological responses to warm   water immersion.

母亲的经历比暖水浸泡引起的生理反应的总和还要多。

Most women feel inherently safe in the water.

大多数妇女认为在水中本来就很安全。

The water creates a wonderful barrier to the outside world.

水创建一个很好的与外界的屏障。

It becomes the woman’s nest, her cave, her own “womb with a view.”

它成为女人的巢，她的洞穴，她自己的“有观点的子宫。”

If the pool is large enough to include her partner or husband, it then becomes an intimate place for the two of them to labor together and experience the love dance of birth.

如果池子足够大大能容纳她的男友或丈夫，那就成为了他们两个亲密的共同待产的地方，体验分娩的愉快。

If the midwife or physician wants to do a vaginal examination while the mother is in the water, it is much easier for the mother to refuse. 当妈妈在水中的时候，如果助产士或医生想做xx检查，妈妈可以更容易的拒绝。

Her mobility allows her to move quickly to the other side of the

pool.

她的移动性可以让她迅速移动到池子的对面

Vaginal exams can be easily done in the water, but to maintain universal precautions, long shoulder-length gloves need to

be worn.

xx检查可以很容易地在水中进行，但是要常规预防，需要佩戴长及肩部的手套

The control that women gain by being able to move freely in the water often helps them assess their own progress either by feeling the baby’s movements more intensively or actually being able to examine themselves internally.

孕妇能够在水中自由的移动所获得的控制经常帮助他们评价自己的产程，要么感觉宝宝的动作更强烈，要么真正能检查自己。

Women report that the water intensifies the connection with the baby at the same time that it reduces the pain.

孕妇们反映，水加强了与宝宝的联系，同时降低了疼痛。
They can feel the baby move, descend and push through the birth canal.

他们能感觉到胎动，胎头下降和通过产道。