How to know when to give birth. High activity of a woman. How to distinguish false contractions from true ones

Pregnancy is one of the most exciting and at the same time crucial periods in the life of every woman, and therefore it is not at all surprising that each of us wants to know the date of birth as soon as possible. However, this issue often causes numerous disagreements and disputes. Expectant mothers “torture” doctors with their questions, because they want to prepare for an important event, but they only shrug, because they are not able to accurately determine the date of the birth of the long-awaited baby.
In order to Calculate the date of birth, click the "find the date of birth" button.

Today: 18.04.2019
Date of the first day of the last menstruation:
Conception most likely happened (+-2 days):

Estimated due date:
Left before birth:

The calculation of the expected date of delivery (ED) is carried out in several ways, each of which is indicative. That is, if, according to estimates, the baby should be born on January 1, then it is not a fact that this will happen with absolute accuracy on that day. Very often there are deviations from the expected date in one direction or another. And childbirth can begin either 2 weeks earlier or later. I bring to your attention a fairly simple, but very effective way to find out the probable due date of a child, which has been successfully used by many doctors in clinics for quite a long time.

Calculation on the last day of menstruation

So to be on your own calculate gestational age and on it to determine the expected day of birth, it is necessary to remember the date of the beginning of the last menstruation. It is on its basis that all calculations are made. From this date, you must subtract 3 months and add another 7 days to the result. The resulting number will be the estimated date of birth of your long-awaited baby.
For example, the date of the last menstruation is April 22. So, from this date you need to subtract 3 months. Subtract and receive - January 22. We add another 7 days to this figure and get January 29 - this day will be the expected date of birth.
It is worth noting that this method of calculation is best suited for women with a regular menstrual cycle that lasts 28 days.

4 Alternative Ways to Calculate Due Date

1. You can find out the due date, with a fairly high accuracy, by visiting the gynecologist's office. The doctor will not prescribe any tests for this, he will simply measure the size of the uterus, which will increase in size in accordance with the age of the fetus. However, this method of calculating the date of birth of the baby is effective only in the first trimester of pregnancy. In the later lines (in the 2nd and 3rd trimester), in each woman, an increase in the size of the uterus occurs with different intensity, depending on the individual characteristics of the organism.
2. You can calculate the date of birth by ovulation, which is the most favorable period in which conception is most likely to occur. On such days, a woman usually experiences an increased sexual desire. In addition, her secretions (cervical fluid) become more sticky and thick, basal body temperature rises by a few tenths of a degree, the cervix rises, and the mammary glands thicken and become painful.

So, in order to find out when your baby will be born, according to ovulation, you need to add 280 days to this day (pregnancy duration). The resulting term will be the date of birth. If the period in which ovulation occurred is unknown, then calculate the middle of the last menstrual cycle, and then add the rest to it.
In the same way, you can perform calculations on the date of conception. However, you should be aware that this period does not always coincide with the day on which sexual intercourse occurred. Fertilization of the egg, as a rule, occurs only on the third day.

3. Hardware calculation using ultrasonic waves can also be attributed to the most effective methods that allow you to determine the term of delivery with an accuracy of 1-3 days. The most correct calculations will be if ultrasound is done during the period of 11-14 weeks of pregnancy.
4. To declassify the secret of the date of birth of your child will help his first stirring, which usually occurs on the 20th week (in nulliparous) and on the 18th - in the second and subsequent pregnancies. In ancient times, when there was no ultrasound, this method of calculating the due date was almost the only one.

As soon as the expectant mother feels the first tangible tremors of her baby in her stomach, then 20 weeks should be counted from that moment. The resulting date will be the probable day of the birth of the child. If the birth is not the first, the movements are usually felt earlier - at the 18th week, so you will have to add not 20, but 22 weeks to this period.

The effectiveness of hardware methods in calculating the term of labor

A study of the fetus in the third trimester on an ultrasound machine allows you to determine the date of pregnancy with high accuracy, and hence the expected date of birth. The fact is that only with the help of ultrasound diagnostics, the doctor can observe the condition of the placenta, the position of the baby's head in relation to the entrance to the small pelvis, the level of opening of the cervix, signs of fetal maturity, as well as many other important factors. All these parameters are decisive in determining the readiness of the future baby and his mother for childbirth.

Deviation from the deadline - is it the norm?

As mentioned above, all calculations of the estimated date of birth are nothing more than an approximate guideline, which should not be heavily relied upon. According to statistics, only 17% of women give birth on the appointed day, while the remaining 83% - either earlier or later. Thus, we can conclude that no specialist, no matter how smart and qualified he may be, is able to predict with high accuracy the date of the onset of labor activity.
Normally, childbirth can occur between 38 and 42 weeks. pregnancy. The birth of a child will not be premature or belated, but normal and physiological. Sometimes, for certain reasons, labor can begin prematurely. This happens due to deviations in the development of the fetus, stressful situations, various pathological processes occurring in the mother's body, hereditary factors, etc.
Often there is a re-carrying of pregnancy due to the fact that in the first trimester there were any complications. In addition, maternal heredity should be taken into account. If your mother and grandmother gave birth much later than the due date, then most likely the same thing awaits you. Therefore, it is very important to realize that the calculation of the term of childbirth is a very complex, conditional and individual issue for each expectant mother.

How do the features of the menstrual cycle affect the date of birth?

The length of a woman's menstrual cycle also affects the duration of childbirth. For example, if it exceeds the standard twenty-eight days, then most likely the pregnancy will last more than forty weeks, and vice versa. However, in this case, the deviation in one direction or another usually does not exceed 5 days. It is worth noting that errors are often made in such calculations, since very often ordinary bleeding is taken for menstruation, which opened after the fertilization of the egg.

2 328

How to recognize the start of a process

Despite the fact that the preliminary date of delivery is calculated by doctors according to the date of the last menstruation, it does not always coincide with the real one. After all, it all depends on when ovulation took place. And it happens to every woman individually every month. Therefore, childbirth can begin both earlier and later. And there are also pathological situations when childbirth starts much earlier than expected.

Many women are worried and afraid not to understand that the process has already begun. In addition, it is worth considering the fact that childbirth can be rapid, and here it is important to understand in time that childbirth has already begun. Therefore, doctors advise expectant mothers to carefully monitor themselves in order to hear all the signals that their body gives them. The beginning of childbirth has quite characteristic features. There are also a number of harbingers that will indicate the approach of the process.

Already in the period of 38 weeks, the lady begins the prenatal period - it is in it that various training movements begin to appear, such as contractions. Also, the lady has increased pain in the area of the pubic joint - this diverges and softens the bones of the pelvis. A woman should learn to understand that contractions are training. These are usually not accompanied by soreness, there is no bleeding with them. They go according to the scheme of an approximate such option: 20-30 second fight, 20 minutes break. And this happens quite often. Real contractions get stronger and more frequent over time, and are also characterized by severe pain. When the first appears, you just need to wait, when the second appears, go to the hospital.

A huge number of changes occur in the body of a pregnant lady, incl. and rather complex ones, which together become the beginning of such a rather complex act as the beginning of childbirth.

What are the reasons for starting such an important process

The onset of labor primarily relies on the readiness of the uterus and the readiness of the child. If we consider what the uterus looks like, ready for childbirth, it must have a certain mass and size, and the placenta must also be fully ripe. In addition, childbirth begins only when nerve and muscle activity is at its height. As doctors say, a couple of weeks before the onset of labor, the uterus begins to lose a certain number of nerve fibers. Due to this, a decrease in pain is achieved and, in parallel, the contractility of the walls of the uterus increases.

The onset of labor occurs against the background of neuro-reflex factors, when the excitability of the brain in the head decreases, and the excitability of the spinal cord also increases. In addition, there is an increase in the sensitivity of the muscle fibers of the uterus to the hormone, which provokes the contractile activity of the uterus during childbirth.

Also among the reasons are hormonal changes in the body of the expectant mother. The end of pregnancy is characterized by a decrease in the production of progesterone, which supported the pregnancy for all 9 months. In addition, the production of estrogens responsible for the onset of labor increases.

Bioenergetic factors also have their influence. After all, by the time the baby is born in the body of a woman, quite a lot of different substances are collected, such as glycogen, phosphorus compounds, electrolytes and various trace elements. All this makes the uterus capable of fairly serious contractile movements.

Mechanical causes also make it possible to make the birth successful. The uterus, when fully matured, loses the ability to further stretch, after which, under the influence of the motor activity of the fetus and the effects of hormones responsible for the contraction of the muscular organ, it begins to actively and rhythmically contract.

Metabolic processes can also be the reasons for the onset of labor. So, by the end of the gestation period, the baby accumulates certain waste products, which provokes his more active movements.

Of no small importance for the beginning of the process is the psychological attitude of the mother. If her nervous system is not prepared, then all other mechanisms will not work smoothly and clearly.

What are the signs and symptoms

A couple of weeks before giving birth, women may experience certain signs and symptoms of incipient labor. Among them:

Descent of the abdomen: the fetal head descends deeper into the pelvic area, the fundus of the uterus also decreases. Against this background, the mother's condition often improves, because. the fetus no longer puts pressure on the stomach and diaphragm. The woman notes that it became easier for her to breathe, and her manifestations of heartburn are also reduced. But at the same time, pressure in the bladder area often increases, as a result of which the expectant mother begins to visit the toilet more often.
The center of gravity shifts forward: as doctors say, her gait changes noticeably when her shoulders begin to move back
Protrusion of the navel: immediately before childbirth, the effect of estrogen hormones on the body begins to increase, due to which the tone of the muscles of the peritoneum decreases in front, and the navel becomes more pliable
The behavior of the woman in labor is changing: she may have both increased nervous excitability, and, conversely, they speak of weak apathy
Decrease in the body weight of the expectant mother - sometimes they even talk about several kilograms: this is due to the fact that the number of amniotic fluid decreases before childbirth, there is a change in metabolism, the fluid is less retained in the body
The child begins to move less: such a lull is due to a decrease in the amount of water, fixation of the head to the entrance to the pelvic area
Discomfort manifestations, as well as pains of a pulling nature in the lower abdomen and lower back: estrogen hormones affect the elasticity of the ligaments, there is an expansion of the pelvic bones
Excretion of the cork: the mucous plug that closes the entrance to the uterus begins to come out: it is a clot of mucus, often with bloody clots inside. Allocations for several days intensify, acquire a larger volume. True, it is worthwhile to understand that the cork does not always leave immediately before childbirth, it also happens that it comes out in a couple of days

Naturally, against this background, the question arises: when can you feel the harbingers of childbirth. Doctors answer: as a rule, they are noted from 37 weeks. At the same time, it should be understood that for all ladies they are individual - for some, the harbingers can last a couple of hours, for some for several weeks, and for some they do not appear at all until the very end.

How are the genera themselves characterized?

There are only two signs of the onset of childbirth:

Start of contractions
Outflow of amniotic fluid

And far from always everything starts with contractions, it also happens, and often, that childbirth starts with an outpouring of water. But in one they are the same - these both signs indicate the beginning of labor activity, therefore, every lady in position should know exactly what, how and for what should happen.

The contractions that mark the beginning of labor are called true contractions. They differ in regularity, and their frequency is not affected by the behavior of the woman in any way (for example, the expectant mother can reduce the manifestation of training contractions if she lies down on the bed). It should be understood that at the very beginning of the process, the contractions are still quite inconspicuous and weak. They are often said to be similar to menstrual pain. Doctors often advise to record the duration and duration of the contraction - this will allow them to quickly assess the development of the process when a woman in labor enters the maternity hospital. At first, the contractions go with an interval of half an hour. But as their intensity increases, the woman in labor more and more clearly feels these rhythmic contractions of the uterus. With each contraction, the baby puts more and more pressure on the perineum, causing the uterus to open more.

In the classical situation of the course of childbirth, the outflow of water occurs at about the time when the uterus opens up to 3-7 cm. This is due to the fact that the amniotic membrane ruptures under the influence of fetal pressure and the water flows out. After that, childbirth should end no later than 12 hours later. After all, it is bad for a child to be in an anhydrous environment for so long.

If the waters have poured out, but the contractions have not begun, doctors will stimulate the birth process.

How is the onset of labor in primiparous

Ladies who do not yet have children usually do not know what exactly awaits them. However, they have a number of features. So, for example, in primiparous women in labor, there is a rather large gap between the expected date of birth and the time of manifestation of precursors. In addition, expectant mothers, not knowing what to expect and being more emotional, take literally every ailment as a harbinger.

Also, ladies who give birth for the first time are often not prone to rapid childbirth. In them, unlike multiparous, childbirth proceeds from 8 to 11 hours. This is attributed to the fact that the birth canal has not yet passed through this process and is not stretched. Also, the uterus opens in a completely different way.

Features of delivery in multiparous

In women who are already experienced mothers, signs of impending childbirth appear at 38 weeks. Moreover, they develop more rapidly and more clearly indicate the imminent onset of childbirth. A distinctive feature of the harbingers in multiparous women is the fact that their stomach drops right before childbirth. Childbirth in multiparous women can take 6-7 hours. The uterus opens at the same time - i.e. both the inner and outer pharynx go together for the opening.

Childbirth at term never begins suddenly for a woman, which is especially feared by primiparous pregnant women. The beginning of regular labor activity is preceded by the harbingers of childbirth, which prepare the expectant mother for the birth of the baby and remind her of the imminent birth. And although the harbingers are necessarily manifested by certain signs, some women may not notice them.

How does the body prepare for childbirth?

Aging of the placenta
The placenta, which produces hormones, plays a leading role in preparing the body for childbirth. From the 36th week, the ratio of secreted hormones changes: the production of progesterone, which is responsible for relaxing the smooth muscles of the uterus and prolonging pregnancy, decreases, and estrogens begin to be synthesized in greater quantities. Estrogens trigger the formation of uterine contractile proteins, due to which the susceptibility of myometrial cells to stimulation increases. In addition, high levels of estrogen increase the amount of prostaglandins in the uterus, which, in turn, trigger the release of oxytocin in the maternal and fetal pituitary glands and destroy progesterone.

Generic dominant
The normal course of childbirth depends on the formation of a “birth dominant” in a pregnant woman, which replaces the “pregnancy dominant” in the brain. In about 2 weeks, there is an increase in the electrical activity of those parts of the brain that are responsible for the birth process. In addition, the formed “birth dominant” or “full readiness of the body for childbirth” increases the synthesis of oxytocin, a contracting hormone in the pituitary gland.

fruit maturity
Due to the rapid growth of the fetus towards the end of pregnancy and the decrease in the amount of amniotic fluid, the uterus covers the unborn child more tightly. In response to this stress factor, the fetal adrenal glands in large quantities begin to synthesize cortisol, the stress hormone. Which in turn "spurs" the production of prostaglandins in the maternal body. Labor begins when a sufficient amount of both prostaglandins and oxytocin accumulate in the mother's body. And up to this point, estrogens “work”, which prepare the tissues of the birth canal (cervix, vagina and perineum), increasing their elasticity and suppleness.

Ripening of the cervix
The cervix is actively involved in the birth process, the course of childbirth and their completion depend on its condition. By the end of the gestational period, the cervix begins to "mature", that is, to undergo morphological changes due to the components (collagen, elastin, connective tissue). As a result of the changes taking place, the connective tissue softens, its hydrophilicity increases, and the muscle bundles “diverge”. The neck becomes pliable, easily stretchable and soft along its entire length, including the internal pharynx. The vaginal part of the cervix is shortened (less than 1.5 - 2 cm, normally up to 4 cm). The cervical canal straightens and smoothly passes into the internal pharynx. The sutures and fontanelles of the fetal head can be palpated through the vaginal fornix.

After maturation (“mature”), the cervix is located along the longitudinal axis of the pelvis, the external pharynx is in a straight line connecting the ischial bones. The "maturity" of the neck is determined in points according to the Bishop scale (in Russia). On this scale, each symptom (length, patency of the cervical canal, location and consistency) is evaluated in points (0 - 1 - 2).

Degrees of maturity of the cervix:

"immature" neck - dense or slightly softened, long, the external pharynx is closed or passes the tip of the finger, is rejected backwards;
“not mature enough” - the neck is shortened, softened, the cervical canal is passable for one finger, in primiparous to a closed internal pharynx, deviated anteriorly or posteriorly;
"mature" - the neck is soft throughout, shortened or smoothed as much as possible, located along the axis of the small pelvis - centered, the cervical canal is easily passable for the finger, you can feel the presenting part, landmarks (sutures, fontanelles), fetal bladder.

Harbingers of imminent childbirth is a set of external signs that reflect the ongoing changes in the body and are felt by the pregnant woman. That is, the harbingers of childbirth testify to the preparation for childbirth and their imminent onset. The time of appearance and duration of the precursors of childbirth are individual for each woman and even differ in the same pregnancy in different pregnancies.

How long before birth do their precursors appear? Harbingers of childbirth can appear 2 hours - 2 weeks before the development of regular labor

Descent of the uterine fundus
On the eve of childbirth, the bottom of the uterus sinks, or, as pregnant women say, “the belly sank”. If, up to about 37 weeks, the height of the uterine fundus increased by an average of 1 cm weekly and amounted to 37–41 cm, then before the onset of childbirth, the uterus drops by a couple of cm (in multiparous people, this happens in a couple of hours or with the onset of regular contractions). This symptom is due to pressing the head to the entrance to the small pelvis, which is explained by the adoption of the fetus in the most convenient position by the beginning of the contractions.

The shape of the abdomen also changes, it becomes sloping, as a result of which the pressure of the uterus on the diaphragm and internal organs decreases, and the woman notes the disappearance of shortness of breath, belching and heartburn disappear, as well as a feeling of heaviness in the stomach after eating (the stomach is located more freely).

The lowered and pressed head of the child, in turn, puts pressure on the rectum and bladder, which is manifested by increased urination and the urge to defecate. In addition, the pressure of the presenting part on the muscles, ligaments and nerve receptors can cause pain in the lower extremities and lower abdomen.

Changes in urination and stool

As mentioned above, due to the pressure of the fetal head on the ureter, urination becomes frequent (the pregnant woman notes that she gets up several times at night to go to the toilet). In addition, the body tries to get rid of the "excess" fluid, which is necessary to thicken the blood on the eve of childbirth and reduce blood loss, and therefore the volume of urine excreted increases.

The nature of the stool also changes, it becomes more frequent and becomes more liquid, which is due to an increase in the content of estrogen and the loss of fluid by the mother's body. In some cases, there may be diarrhea and slight abdominal cramps, and the frequency of defecation reaches 2 to 3 times a day.

Fetal activity
By the end of pregnancy, the fetus has reached its maturity, that is, it has gained the required weight (about 3 kg), and its organs are ready for extrauterine existence. The uterus has already reached its maximum size and stops growing, the unborn child in its cavity becomes crowded. As a result, the expectant mother begins to notice that the baby has become less likely to move, and if the “serious” fetal movements disappeared as early as 34–36 weeks (turns, flips), then “small” movements (poking with arms or heels became less frequent and very noticeable, and even painful.

Frequent mood swings
On the eve of childbirth, people around the pregnant woman, and the expectant mother herself, note mood instability. A woman is easily excited and just as easily becomes inhibited, apathetic, thoughtful. Emotional lability is explained by ongoing changes in the nervous system.

Navel protrusion
Before childbirth, from about 37 to 38 weeks, many pregnant women begin to notice that their navel protrudes strangely. This is due to many reasons. Firstly, there is some softening of the connective tissue, which is necessary primarily for stretching the ligaments of the small pelvis and tendons of the muscles of the vagina and perineum during the passage of the fetus through the birth canal. Secondly, the muscles of the anterior abdominal wall and the skin of the abdomen are stretched. And, thirdly, intrauterine pressure increases significantly. Of course, the protrusion of the navel as a harbinger of childbirth should not be discussed in the case of significant polyhydramnios or multiple pregnancy, since all of these factors are explained by the excessive size of the uterus.

Weight loss
Before childbirth, almost all pregnant women note a decrease or stabilization of weight, by 0.5 - 2 kg. This symptom is associated with the excretion of excess fluid by the kidneys and a decrease in the severity of edema. Progesterone, due to the relaxation of vascular tone, retains fluid in the tissues, which causes the general swelling of the body of the pregnant woman. The mother-to-be may notice that gloves and rings are easier to put on, the shoes are not so tight and it becomes easier for her to put on shoes.

Removal of the mucous plug
By the end of pregnancy, the cervix undergoes a maturation process: it softens, shortens, and the cervical canal opens slightly and becomes passable for the fingertip in primiparas, and even wider in multiparous ones. In the cervical canal there is a mucous plug - thick mucus that blocked the penetration of pathological microorganisms into the uterus and protected the fetus from intrauterine infection. By the beginning of labor, in about 3 to 10 days, this mucus is liquefied, which is facilitated by estrogens, and is pushed out of the cervical canal. The mucous plug looks like a small colorless lump or yellowish color with streaks of blood. Its volume does not exceed 3 ml. It is possible for the mucous plug to come off in parts, over several days.

The discharge of the mucous plug is sometimes difficult to determine independently, even for multiparous women. Doubts arise - this is a cork or water coming out (it is possible for water to leak with a high opening of the fetal bladder). In case of leakage of water, there will be watery discharge, transparent and with a slightly opalescent hue (yellowish or greenish), increased leakage increases intra-abdominal pressure (cough, defecation, sneezing), in contrast to the discharge of the cork, which occurs in portions, over several days, water leak constantly. In case of any doubt - the water or the cork is leaving - you should immediately go to the hospital.

nesting syndrome
Many women notice extraordinary housekeeping before an early birth. This manifests itself in the form of thorough cleaning, even those places where I didn’t look before, re-washing dishes (cleaning the bottoms of pots) and washing, purchasing necessary and not very clothes for the baby, household chemicals, dishes and other things. The signs of the nesting syndrome are also explained by the influence of estrogen, in addition, endorphins and enkephalins, the so-called hormones of joy or "solar hormones", come into effect. For example, the production of "joyful" hormones increases after eating chocolate, juicy tomatoes and bananas, after playing sports, viewing pleasant pictures and photos. At the end of pregnancy, the production of these hormones is stimulated by the expectant mother's awareness of an early meeting with her child.

Decreased appetite
Weakening of appetite, and sometimes its absence, is also one of the harbingers of childbirth, which is observed a day or three before the onset of labor. This sign is not fraught with danger, and you should not worry. If you don't want to eat, then you don't need to.

false contractions
Contractions that appear on the eve of childbirth are called false or training, since they do not lead to the development of regular labor activity. The appearance of false contractions is another of the harbingers of childbirth and their role is to prepare the myometrium for childbirth and the maturation of the cervix. Such contractions do not lead to the opening of the uterine os and are felt as a hardening of the abdomen in response to fetal movement or physical exertion. Training bouts are characterized by irregularity, low intensity, painlessness and periods of rest between them up to 30 minutes or more. False contractions occur about 4-6 times a day, usually in the mornings and evenings, and last no more than two hours in a row. After some time, the contractions either weaken, or their strength does not change, but may stop in a horizontal position, after taking a warm bath or massage.

Harbingers of childbirth in primiparous and multiparous

Most women, especially those who are preparing to become a mother for the first time, may not notice the listed signs of an imminent birth. The absence of harbingers of childbirth in primiparas does not mean at all that the body is not preparing for childbirth, because many changes can only be established using special tests (oxytocin, mammary) or during a vaginal examination.

More experienced women learn about the approaching birth not only by the appearance of precursors, but also because of their severity. The intensity of the precursors of childbirth in multiparous women is explained by the sensitive reaction of the body to the ongoing hormonal changes.

And it is not at all necessary that all the symptoms listed in the article will appear, indicating the imminent onset of labor. Especially at the same time. Perhaps the occurrence of one or two signs with a different interval in time (from 2 weeks, a day - an hour before delivery). And by the way, the discharge of the mucous plug does not always occur before childbirth, it happens that it is expelled with the onset of regular labor.

When do you need to urgently see a doctor?

At the end of pregnancy, all women should be ready for an immediate trip to the maternity hospital (collect an “alarming” suitcase, documents, shave off the hair on the perineum, remove nail polish), even if the harbingers still “do not smell”. Emergency situations for calling an ambulance:

outpouring of water, especially against the background of complete well-being, in the absence of contractions;
the appearance of bleeding;
rise in pressure (140/90 and more);
the occurrence of severe pain in the abdomen;
the appearance of a headache, flies before the eyes, blurred vision;
lack of fetal movements for 6 or more hours;
development of regular labor activity (2 - 3 contractions in 10 minutes).

Many pregnant women often wonder about the upcoming date. childbirth, and women who are about to give birth for the first time are especially worried. As a rule, they are very afraid of not recognizing the labor that has begun in time and confusing it with a temporary malaise. In many cases, a close observation of the woman for the changes that occur in her body will help to resolve these unrest.

Already at 38 weeks, the prenatal period begins, when the first harbingers of childbirth and the first, as yet irregular (training) contractions, appear. Such contractions appear irregularly, and they pass after a change in body position or a short rest. In nulliparous women, such training uterine contractions can continue for five, and in some cases even more, days before delivery. When they appear, you do not need to worry and urgently go to the hospital, but the expectant mother should inform her doctor, relatives and friends about such changes in her body.

When the first signs of leakage or outflow of amniotic fluid appear, which may indicate the onset of labor or premature labor, the woman should immediately notify the doctor or independently contact a medical institution to resolve the issue of further hospitalization.

If a woman has learned to recognize training contractions, then she will be able to distinguish them from the onset of labor, or true contractions. These sensations are difficult to confuse with any other symptom, since they are characterized by periodicity and rhythm. For example, a fight lasts 20-30 seconds, and then there is a 20-minute pause - this is repeated many times in a row, and the time intervals hardly change.

At the beginning of the onset of labor pains, a woman in labor or her relatives should inform the doctor about the onset of labor, call an ambulance or go to the maternity hospital on their own.

Reasons for the onset of labor

By the beginning of childbirth, a lot of complex processes take place in the body of a pregnant woman, which, being in close relationship, provide the beginning of such a reflex act as labor activity.

The main reason for the onset of labor is the readiness of the uterus for the birth of the unborn child and the maturity of the fetus.

Ready for childbirth uterus:

gaining sufficient weight and size;
her neuromuscular apparatus is ready for contractile activity;
fully mature placenta.

2 or 3 weeks before the onset of labor, the uterus is released from the excess of part of the nerve fibers. This provides a reduction in pain during childbirth and increases the contractility of the walls of the uterus.

Several factors influence the onset of labor:

neuro-reflex - as a result of a decrease in the excitability of the brain, an increase in the excitability of the spinal cord and an increase in the sensitivity of the muscle fibers of the uterus to oxytocin, an increased contractile activity of the uterus is produced;
hormonal- at the end pregnancy the production of progesterone decreases and the production of a complex of estrogens increases, which stimulate the onset of labor;
neurohumoral - at the end of pregnancy in the body of a woman, the synthesis of oxytocin, prostaglandins, serotonin and other bioactive substances increases, which increase the sensitivity of the uterus to substances that cause active contraction of its muscles;
bioenergy - a sufficient amount of substances (glycogen, ATP, phosphorus compounds, electrolytes and trace elements) accumulate in the mother's body, which make the uterus capable of increased contractile activity;
mechanical - the ripened uterus loses its ability to stretch, and in response to the motor activity of the fetus and an increase in the level of oxytocin-like hormones, it begins to actively contract;
trophic and metabolic - the accumulation in the body of a mature fetus of some waste products leads to its active movement, and degenerative processes in the mature placenta and the full maturation of the muscle fibers of the uterus contribute to the onset of labor.

The state of the nervous system of the woman in labor is of primary importance in the formation of all mechanisms for the onset of labor, since it is she who ensures the readiness of the uterus for natural childbirth.

All of the above factors, being in close relationship, contribute to the appearance of contractions, which are replaced by attempts and end with the expulsion of the fetus from the uterine cavity and the birth of the placenta.

Harbingers of the onset of labor

Harbingers of childbirth are a set of signs that indicate the imminent onset of active labor activity. There are many harbingers of the onset of childbirth, but for each woman their totality is individual and depends on the characteristics of the body of the expectant mother.

Harbingers of childbirth:

Dropping of the abdomen.
Such a change, which is determined externally by a slight downward displacement of the abdomen, is individual for each pregnant woman, and may not always be noticed on its own. In nulliparous women, this harbinger may appear 2-4 weeks before the day of delivery, and in multiparous women, a few days or immediately before childbirth.

Gait changes.
The nature of the gait changes after the prolapse of the abdomen. The woman begins to walk "waddling" due to the pressure of the baby's head on the pelvic bones and the bottom of the uterus.

Changes in the nature of urination and defecation.
A prolapse of the abdomen can cause more frequent urination or urinary incontinence as the uterus puts more pressure on the bladder. The mechanical impact of the pregnant uterus on the intestinal wall can provoke constipation, and in some cases diarrhea, a few weeks or days before delivery.

Change in the nature of secretions from the genital tract.
Discharge from the vagina under the influence of hormonal changes becomes more abundant and liquid. In some cases, to exclude the discharge of amniotic fluid, a special test is performed by an obstetrician.

Removal of the mucous plug.
This harbinger of labor can occur 2 weeks before the onset of labor, and a few hours before it begins. In some cases, the mucous plug does not come off entirely, but in small portions. In practice, this sign looks like a discharge of vaginal discharge (sometimes mixed with a small amount of blood). A pregnant woman should inform her obstetrician-gynecologist about the discharge of the mucous plug.

Decrease in the body weight of the expectant mother.
A few days before giving birth, a pregnant woman may notice that she weighs 1-2 kg less. This weight loss can be explained by the removal of excess fluid from the body under the influence of changes in the hormonal background.

Reducing the number of fetal movements.
The fetus, a few weeks before birth, moves less frequently. This is due to its rapid growth. The future baby becomes crowded in the uterine cavity, and its movements are difficult.

Training bouts.
Closer to the date of birth, the uterus begins to increasingly come into increased tone, which is expressed in the feeling of training contractions. They differ from labor pains in a number of features: short duration, irregularity, weak pain sensations (reminiscent of pain during menstruation), spontaneous disappearance after a change in body position or rest.

The manifestation of the instinct of "nesting".
Many women in the last days and even hours before childbirth begin to prepare their homes for the upcoming birth of a child. These actions can be expressed in the fact that a woman begins to diligently clean, wash, and even start repairs.

Changes in the cervix.
Only an obstetrician-gynecologist can notice such a harbinger of an approaching birth when examining a woman on a gynecological chair. Under the influence of estrogen hormones, the cervix shortens and becomes more elastic by the 38th week. The external os of the cervix begins to open before the onset of labor pains.

Harbingers of childbirth in primiparous and multiparous women have their own characteristics.

Harbingers of the onset of labor - video

Signs of the onset of labor

Reliable signs of the onset of labor are:
1. contractions;
2. Outflow of amniotic fluid.

These two signs always indicate the onset of labor and every pregnant woman should know how they proceed.

Contractions

True, or labor pains are called contractions of the muscle fibers of the uterus, which occur at regular intervals, and which a woman cannot control. It is this sign that indicates the moment of the onset of childbirth.

The first true contractions are accompanied by minor pain, which most women compare with pain during menstruation. The pain is tolerable and can be given to the lower back or localized in the lower abdomen. Most women in labor begin to feel contractions at night. Some women note that during labor pain the uterus “hardens”, i.e. if during the contraction the woman in labor puts her hand on her stomach, then she can feel a hard, tense uterus.

You can determine the truth of contractions using a stopwatch. Their periodicity and constant occurrence, which is not eliminated by a change in body position, taking a warm bath or rest, indicates the onset of labor.

At first, contractions occur at intervals of half an hour (in some cases more often). With each contraction, the woman in labor begins to feel not only soreness, but also rhythmic contractions of the muscles of the uterus. Gradually, contractions become more noticeable, and their frequency, duration and intensity increase. With each contraction, the amniotic sac and the head of the fetus press against the fundus of the uterus, causing a gradual opening of the cervix.

Outflow of amniotic fluid

In the classical course of childbirth, the outflow of amniotic fluid occurs after the opening of the cervix to 3-7 cm. Under the pressure of the fetus, the amniotic membrane is torn, and part of the amniotic fluid is poured out.

A woman in labor, with a classic outpouring of water, may seem to have involuntarily urinated. In some cases, water is poured out gradually, in small portions. In this case, a woman may notice the appearance of wet spots on her underwear or bedding and experience such sensations as when separating vaginal or menstrual flow.

Sometimes the rupture of amniotic fluid can occur before the onset of regular contractions and dilatation of the cervix, or much later than the full opening of the os of the uterus. These conditions do not always mean that there will be a pathology of childbirth or the fetus, but usually gynecologists use various special tactics for the further conduct of such labor to prevent possible complications.

Signs of the onset of labor - video

Contractions at the beginning of labor

Obstetrician-gynecologists distinguish three phases of labor pains:

Initial (hidden) phase:

the duration of the fight is 20 seconds;
the frequency of contractions is 15-30 minutes;
opening of the cervix - 0 or up to 3 cm.

The duration of the initial phase is from 7 to 8 hours.

Active phase:

the duration of the fight is 20-60 seconds;
the frequency of contractions is 2-4 minutes;
opening of the pharynx of the uterus - 3-7 cm.

The duration of the active phase is from 3 to 5 hours. Usually it is in this phase that the amniotic fluid is poured out.

Transitional (transient) phase:

the duration of the fight is 60 seconds;
the frequency of contractions is 2-3 minutes;
opening of the pharynx of the uterus - 7-10 cm.

The duration of the transition phase is from half an hour to an hour and a half.

Labor pains occur in the first stage of labor (the period of disclosure).

Beginning of labor in primiparas

Probable harbingers of childbirth in primiparas have their own characteristics. As a rule, they have a more pronounced time difference between the day of birth and the date of the appearance of precursors. Some expectant mothers are overly emotional and take any slight ailment for the harbingers of childbirth. If they do not know about this or that sign, they may not notice them.

At what time (what week) does labor begin? Full-term pregnancy is considered to be . From this moment until at any time, childbirth can begin.

How to determine the onset of labor? There is no way to predict when this will happen. But there are a number of first signs by which one can judge the imminent onset of labor.

There are many theories explaining the beginning of the birth process. In ancient times, it was believed that the starting point of childbirth is the constraint of the fetus by a small space and its hunger.

Current theories suggest that childbirth begins due to the formation of a generic dominant in the brain, an increase in the concentration in the blood of a pregnant woman of substances that stimulate the excitability of the muscles of the uterus, an increase in the level of estrogen sex hormones, and the accumulation of additional energy in the cells.

Main signs and symptoms

Two to three weeks before giving birth, pregnant women may experience a range of signs and symptoms incipient labor:

. This is due to the fact that the fetal head descends deeper into the small pelvis, the bottom of the uterus decreases and begins to put less pressure on the diaphragm and stomach. It becomes much easier for a woman to breathe, manifestations decrease. However, the pressure in the bladder increases, the pregnant woman begins to go to the toilet more often.
Shifting the center of gravity forward. Because of this, the gait of the pregnant woman changes, the shoulders are laid back - the proud gait of a woman.
Navel protrusion. Before childbirth, due to the increased influence of estrogens, the tone of the muscles of the anterior abdominal wall decreases, the navel becomes more pliable.
Behavior changes pregnant woman: increased nervous excitability or, conversely, a state of weak apathy. This is explained by a change in physiological processes in the cerebral cortex in connection with the formation of a generic dominant.
Weight loss pregnant up to several kilograms. Before childbirth, the amount of amniotic fluid decreases, the metabolism changes, and the retention of excess fluid in the woman's body decreases.
Decreased fetal movement. This phenomenon is due to a decrease in the amount of water, fixation of the head to the entrance to the small pelvis.
Discomfort or pulling pain in the lower abdomen and waist. Estrogens increase the elasticity of the ligaments, there is a slight expansion of the pelvic bones.
. During the period of maturation of the cervix, its canal is shortened and the activity of the mucous glands increases. Within a few days, the discharge from the genital tract becomes more plentiful, similar to thick mucus, transparent or slightly brownish, sometimes with pink streaks.

The manifestation of all these first signs of the onset of labor is not necessary for every woman. Some may be more pronounced, and some may not be at all.

When do they start? Starting at 37 weeks, duration harbingers of the onset of labor varies in women and can be - from several hours to several weeks.

Six to eight hours before delivery some women have a preliminary period. This time is characterized by the appearance of irregular in frequency, strength and duration of uterine contractions.

At the same time, a woman should not experience any particular discomfort, sleep disturbance or lack of appetite. There may be a slight brown spotting discharge from the genital tract.

Gradually, uterine contractions intensify, become regular - childbirth begins.

How to understand that childbirth has begun?

The presence of regular labor activity, characterized by repetitive painful contractions of the uterus - contractions.