Labor pains feeling interval. Trust in the doctor. When to come to the hospital

It's hard to put into words what contractions are like. But if you carefully listen to your feelings, then determine when and how the contractions before childbirth begin under the power of each.

Most women are afraid of pain, they say it can seem unbearable. But it is important to remember: the stronger the fear, the more painful the contractions will be felt. Against, positive attitude and the expectation of an early meeting with the baby will make it easier to survive the first stage of childbirth.

The nature of contractions

Every pregnant woman, especially a primipara, wants to lift the veil of secrecy and find out what awaits her during childbirth. Nature arranged everything so that the pregnant woman prepared for the upcoming test - they appear for half the term.

It is difficult to compare false contractions with real ones - they are painless, irregular, and the intensity and duration do not increase over time.

Many women even during training contractions feel pain, partly reminiscent of those that will then appear in childbirth. But it is almost impossible to confuse them.

Both the expectant first-born and the multiparous mother almost immediately understand what is happening. Finally, a walk or a warm bath helps to dispel doubts, in such conditions the body calms down.

Often the birth process begins at night. By the beginning of the fights, you will wake up anyway. Inner voice immediately prompt - the long-awaited moment is near. Shortly before the onset of contractions, you may have been worried about other signs of an approaching birth:

• aching pain in the lower abdomen
• long "silence" in the tummy - the child hardly moves
• painful pulling sensations in the lower back
• sanious secretions

We conduct observations

It is customary to call contractions involuntary regular contractions of the uterus, which, in conjunction with attempts, lead to the expulsion of the fetus from the uterus.

Most often, childbirth begins with contractions, and not outpouring of water, marking the beginning of the first period. labor activity. Thanks to painful contractions the cervix opens completely (we are talking about 10-12 cm).

In this state, the neck is ready for the baby to pass through it. The contractions will stop after the appearance of the child, and at the second stage of childbirth, attempts will also be added to them.

It is important to record the time when you felt the first contractions, especially if labor activity began with them, and not with the outpouring of amniotic fluid.

Immediately arm yourself with a pen and paper, note the time and duration of each contraction. Ideally, contractions should gradually lengthen and intensify, but the time intervals between them should be shortened.

Primiparas should not neglect the fixation of data. Recording and analysis will help you concentrate and distract from the pain, sometimes severe even in the first period.

And with the help of records, the doctor will understand at what stage the birth is and whether there are reasons that can interfere with the normal course birth process.

There are three stages in the period of contractions:

1. Initial or hidden stage.
   • The duration is on average eight hours, the interval between contractions is 5-10 minutes.
   • Opening up to three centimeters.
2. active phase.
   • The duration is from three to five hours, the interval between contractions is 2-4 minutes.
   • Opening up to seven centimeters. During this period, the duration of the contraction increases to a minute.
3. Transition or deceleration phase.
   • The shortest stage, from 30 minutes to an hour and a half, the interval between contractions is up to a minute.
   • Continues until full disclosure.

In the second and subsequent births, the time of each stage is likely to be less.

Irregularity is a sign of pathology

The duration of contractions can vary, and the "distance" between them is often the same. At the beginning of labor, contractions are mostly short, no more than 30 seconds, and happen every half hour - a sign that enough time will pass before the baby is born.

For primiparous best solution will spend some time at home. Contraindications: bleeding will not join the process, you are not pregnant with twins and there are no different kind pathology.

When the difference between contractions reaches 10 minutes, it is better to be in the hospital. Do not pull to the last - in the hospital you will have to fill out a number of documents, undergo preparation for childbirth (hygienic shower and enema, examination by a gynecologist on a chair).

It is better to undergo procedures being in a sane state, which severe pain will definitely not contribute to.

Keep in mind that if the contractions are very different in intensity and come at different intervals, it is possible that labor has not yet begun, but you just felt the Braxton Hicks contractions.

Another reason for the absence of all sorts of patterns is that labor activity is slowed down, and thus the first symptoms of pathology appear. Moreover, weakness is more often manifested precisely in primiparas - then mandatory stimulation will be required.

Otherwise, in such situations, childbirth does not occur soon. In anticipation, you can spend up to three days - the pain will exhaust the woman and she simply does not have enough strength to try.

First discomfort, then pain

Let's try to understand the feelings of a woman during contractions. Many mothers talk about their first sensations of contractions that have just begun - they can’t even really be called pain.

The contractions are more like a strong tension of the abdominal muscles with a periodically occurring pulsation - the tension gradually increases, and then everything calms down. Sometimes you just feel some discomfort, gradually developing into something painful.

The centers in which the first pains occur are different parts of the body. Some begin with lower back pain, while others primiparous or multiparous pain is felt first in the abdomen.

At this stage, almost all women easily tolerate these signs of labor that has begun. Most mothers, describing pain during contractions, they compare them with pain during menstruation, increased tenfold.

But time passes - contractions intensify and become more frequent. Now the pain occurs in the upper abdomen, capturing the lower back, and at the peak it can even “get” to the fingertips, passing through the legs.

Sometimes there will be confidence that at the moment when the fight reaches its peak, the whole body hurts. At this time, most women in labor require drugs to relieve pain.

How to ease the pain

Remember: it is best not to take drugs while you are able to do without painkillers.

Still, childbirth is a natural process, the body releases its own painkillers.

Yes, and it’s not so long to endure - it will appear soon long-awaited child. Don't forget, most public maternity hospitals simply won't give you pain medication. The anesthesiologist is put only when they are going to do C-section.

Pain can be reduced in several ways.

• Look for positions that can ease the pain of contractions.
• Sometimes pregnant women are given IV drops before giving birth - then you will not be able to take full advantage of this advice.
• If you have the opportunity to move freely along the generic, try to tilt the body forward and lean against the wall at the time of the fight - it helps a lot.
• Try to breathe according to the methods from the childbirth preparation courses - this method is one of the most effective. Your loved ones or doula can give you a lower back massage.
• A bath or at least a shower helps many to relieve pain; they have begun to be installed in modern maternity boxes.

When attempts begin, the pain will move closer to the perineum, as the child moves directly through the birth canal. All these signs speak of imminent birth baby - no more than 40 minutes left.

Most women have long been in a special chair surrounded by doctors. It will seem that there is no strength - in this case, try to use the intervals between attempts for maximum relaxation.

Childbirth: the baby also works

The duration of the periods of childbirth in primiparous women starts from several hours and reaches up to three days. For those who are expecting a second baby, childbirth is usually fast, since the body acts according to a well-known pattern.

And only at the third stage of the process you will not feel contractions.

By that time, childbirth is already taking place, now the placenta and other parts of the “house” in which the child lived for nine months will have to be born. Perhaps this moment in childbirth is one of the calmest.

The woman is resting after the work done, and the baby, tired from vigorous activity, may have fallen asleep. During childbirth, the baby also has a hard time - he does a serious job helping his mother.

At each contraction, the child rests his head in pelvic floor- he does this thanks to his repulsion reflex from the support. It will remain with him even after giving birth for a while - put your hand on the little heels and you can easily feel how the baby pushed off her.

another reflex, necessary for the baby during childbirth, is called posotonic. It enables the baby to turn the body following the turn of the head or the pelvic end.

This skill is very important precisely in the process of childbirth, since the child, passing through the birth canal, which has irregular shape forced to turn around several times.

As a rule, during childbirth, the mother does not feel how the baby moves. Firstly, the movements overlap the sensations of contractions, and secondly, the baby also rests in moments of “calm”.

If you feel that he is actively moving during or between contractions, then there are signs of fetal hypoxia. Be sure to tell your doctor about your feelings.

For nine months, the expectant mother has been waiting for a meeting with the baby. What will he be like? Who does he look like? Will he be calm or moody?

A lot of questions begin to spin in the head of a pregnant woman when the period approaches 38 weeks.

But, perhaps, the main ones: How will the contractions go? Does it hurt to give birth? And when is it time to go to the hospital?

Norms and figures for pregnant women

During observation at the obstetrician-gynecologist, every pregnant woman hears from the doctor the expected date of birth.

As a rule, it is calculated based on the date of the first day of the last menstruation, adding 38 weeks to it. This is the most common way, although there are others. That is, a woman should prepare to become a mother at a certain time.

But why exactly 38 weeks?

Pregnancy is considered full-term at 38 weeks. Starting from 41.5 weeks, pregnancy can already be called post-term.

Delivery should ideally occur between 38 and 41 weeks, but many women give birth to healthy babies at both 36 and 42 weeks.

Therefore, you need to talk not about a specific date of birth, but about expected interval.

The first swallows are the harbingers of childbirth

So, the woman calculated for herself the interval of dates on which the birth should occur.

Confidence in an early delivery can be given by the personal feelings of the expectant mother.

They are called harbingers of childbirth. This:

• Lowering of the abdomen;
• Expansion of the pelvic bones;
• Braxton Hicks contractions (more on that below)
• Departure of the mucous plug;
• Drainage of amniotic fluid;
• Lower back pain;
• Change in appetite.

Harbingers may not necessarily appear all, and some of them may well occur even 2 weeks before the onset of childbirth.

Noting the changes in well-being that are characteristic of the harbingers, a woman should understand that childbirth with contractions and other delights is just around the corner.

What are contractions?

Real labor activity begins with contractions. They are contractions of the muscles of the uterus, which are accompanied by aching pain lower abdomen or lower back. The pain may also be excruciating.

Something like a woman feels during menstruation.

During the contraction, the uterus comes into tone, that is, it becomes rigid and elastic. When the contraction ends, the stomach relaxes. Women with a high pain threshold may not even feel pain at the very beginning of the labor process. They can be seen only by periodically coming into tension in the stomach.

Contractions do not cause constant discomfort to a pregnant woman, they are periodic.

First, the pauses between contractions fluctuate in the range of 15-20 minutes. Then they become shorter (3-5 minutes), and the contractions become more intense. During contractions, the cervix dilates. Obstetricians observe the correctness and stability of the process of its disclosure.

How to understand that contractions are starting?

Typical story: a woman arrives at the maternity hospital, screams that she is having contractions, and after a while calmly leaves home. It underlies more than one gum about childbirth and the life of pregnant women.

What makes future mother race in maternity hospital with insistent demands for an immediate birth?

These are false contractions or Braxton Hicks contractions.

To avoid unnecessary unrest, not to frighten relatives and not to raise doctors on their feet for no reason, you need to be able to distinguish false contractions from real ones:

1. False contractions are not periodic.
2. False contractions do not get worse over time.
3. Pain from false contractions disappears with a change in body position, taking a bath, etc.
4. With false contractions, the cervix does not open. Even if it is slightly open, false contractions do not provoke its further expansion.
5. To understand that real contractions begin, you need to pinpoint the intervals between them. At first, they can be 15-20 minutes, then they decrease to 5 minutes, later - to 3 (at this time the woman should already be in the hospital).

   Also, real contractions can be accompanied by bloody discharge - this is a mucous plug.

Pain during contractions

It so happened that women give birth to children in suffering. The most severe are the pains during contractions that accompany the first stage of childbirth. Their result is the opening of the cervix, through which the child will subsequently exit.

Pain during contractions increases gradually.

At first, the intervals between contractions are long, and the pain is practically not felt. Over time, the intensity of contractions increases, the intervals are reduced.

However, no matter how strong the pain is, everything is organized by nature in such a way that a woman can rest for it. a short time when the fight subsides.

If you objectively look at the nature of pain during contractions, it becomes noticeable that only 30% of painful sensations have a real basis.

When passing through the birth canal, the fetus presses on soft tissues, the ligamentous apparatus of the uterus, the perineum, when the uterus contracts, the nerve endings burst, which provokes severe pain.

The remaining 70% are caused by fear of childbirth. The expectant mother is afraid of suffering, fears for her life and the health of the baby. Horror stories told by more experienced friends also play a significant role.

So one of the most important things before giving birth is the right emotional state.

Help during fights

ABOUT painless childbirth every woman dreams. How would it be nice to kind doctor made an injection at the beginning of childbirth, and the child was born without torment and suffering!

To be honest, there is this kind of pain therapy, but it should be used only in emergency cases as directed by a doctor.

And for women in labor, in whom the physiological process of delivery goes without problems, there are methods of self-anaesthesia:

• Breathing techniques.
• Special postures practiced in active labor.
• Massage.

Self-anaesthesia techniques are quite simple to perform. Their implementation does not require special abilities, but you still need to train before childbirth.

Pregnant women can get acquainted with these techniques in the classes at motherhood schools, which are quite often conducted during women's consultations, or in specialized centers for effective parenthood.

When to go to the hospital

So, it's time to answer one of the main questions: when is it time to go to the hospital.

You can’t be late here, but getting to the maternity hospital early is also undesirable.

Firstly, scary stories of neighbors in the ward do not benefit a pregnant woman about to give birth.

Secondly, the constant expectation of childbirth negatively affects emotional state women.

Third, it is quite possible that doctors will begin to stimulate labor with the help of medications.

You need to go to the hospital in one of the following cases:

1. When there are regular contractions.

   WITH this moment a pregnant woman can already be called a woman in labor. As soon as the intervals between contractions have reached 10-15 minutes, you can go to the hospital.
   

We talked about fights in detail above.


When bleeding occurs.

The appearance of bloody discharge may indicate the discharge of the mucous plug, which accompanies the opening of the cervix. However, blood in the discharge can also indicate placental abruption, which is life-threatening for both mother and baby.

Therefore, contacting this case in the maternity hospital should be immediate.


2. When amniotic fluid breaks.

   In this case, you should not wait for the start of contractions, since any delay can be dangerous for the life of the child.

   The outflow of amniotic fluid should occur when the cervix is ​​dilated by 4-5 cm. However, in 15% of pregnancies it happens even before the onset of contractions.

You should remember the time when the waters broke, and immediately go to the hospital. Long anhydrous period dangerous for the baby by the development of infections.

In fact, being "late" to the hospital is very difficult - rather, this is the lot of third-rate Hollywood comedies. Your body itself will give an unambiguous signal to the mind!

Moms, remember that childbirth is a normal physiological process. With the right theoretical, physical and emotional preparation, childbirth will take place without problems.

Childbirth is just a road leading to a meeting with your child - the most loved person in the world!

First stage of labor: contractions

The first stage of labor is the longest, especially during the first birth. Usually in primiparous it lasts an average of 10 to 12 hours, in some cases it can be a little less or drag on up to 16 or more hours. Sometimes the period of contractions can stretch up to one and a half days, then in the maternity hospital, as a rule, labor stimulation is used.

The goal of the first stage of labor is to dilate the cervix to about 10 cm.

Most often, childbirth begins with the first regular contractions. Usually, the increase in the birth process is noticeable already in the first hours from its onset: contractions become more frequent and more intense, and the pauses between them are shortened.

What is a fight

Since the uterus is a completely muscular organ, we say that a contraction is a contraction of the uterus, meaning by this its muscle. The uterus at the same time for some time (usually up to a minute) becomes dense, tense, well contoured, there is a feeling of heaviness in the lower abdomen and in the sacrum.

Each fight has two tasks.

• The first is to limit the space in the uterus for the baby, forcing him to move into a zone of less resistance - the internal os.
• The second is the stretching of the muscle fibers located in the cervix and breeding them to the side and up.

With each contraction, the child falls lower and lower, which contributes to the opening of the cervix. By the end of the first period, when the cervix is ​​completely smoothed and fully opened, it is ready for the birth of a child.

Outflow of amniotic fluid

Another option for the onset of labor is the outflow of amniotic fluid or their leakage in small portions. In this case, you no longer need to wait for the start of contractions, but it is better to immediately go to the hospital, because. the longer the anhydrous interval, the greater the likelihood of a complicated course of childbirth, the penetration of infection into the uterus and to the fetus.

Fine amniotic fluid should pour out in the middle or end of the first stage of labor. The fetal bladder ceases to be a hydraulic wedge dilator of the cervix and a shock absorber for the fetus, the physiological need for it disappears, and it opens. Otherwise membranes become an obstacle to the advancement of the fetus, and then the obstetrician will be forced to open amniotic sac. The fetal bladder can leak very slowly, or it can burst suddenly and completely unexpectedly, and then the water will rush in a strong stream. Although no pain is felt when the membranes rupture, it can be frightening for a woman.

If the waters break, then it is imperative to notify the doctor or midwife about this. Rhythmic contractions themselves, if they are not yet available, can occur only after one to two hours.

By the way, after the discharge of the waters, it is necessary to pay attention to their color and inform the doctor about it. normal waters they are odorless, transparent, yellowish in color, they may contain a very small amount of blood. Green amniotic fluid is caused by meconium (fetal feces) and may be a sign oxygen starvation baby.

Sometimes a baby is born in a shell (this can be with premature and rapid birth). They say about this: "Born in a shirt." We use this expression in everyday life when we want to say that a person was lucky, and he escaped a dangerous situation or, faced with it, overcame it, remained safe and sound, escaping with a slight fright. The shirt is symbolically called the fetal bladder. And “to be born in a shirt” means to leave the birth canal in the whole fetal bladder, with amniotic fluid not flowing out. In this case, the child is exposed to a far from imaginary danger of taking the first breath not of air, but of water and choking. It is necessary to quickly open the fetal bladder. And if the child has not suffered, has not yet had time to swallow water, then he is lucky - he was born in a "shirt" and survived.

Phases of the first stage of labor

The first phase is latent.

Latent means hidden. From whom? Sometimes from a woman. At first, the sensations are so minimal that they are almost not recognized as rhythmic regular labor pains. It is important to listen to your body. Sometimes there are doubts: “Are you worried about the intestines? Any pulling sensations in the sacrum and lower abdomen? Is it childbirth? If childbirth begins in the morning, then the first contractions can be overslept, as they are hardly noticeable. Gradually, after two or three hours, the contractions will be felt as rhythmic compactions of the uterus. It's like tensing any other muscle in the body. Tighten your biceps, touch the muscle. What do you feel about her now?

Similar sensations appear in the uterus in the latent phase of childbirth. The first contractions are short and rare: 20-30 seconds, after 10-15 minutes. You can take a stopwatch and mark contractions on it. As their frequency and intensity increase, doubts that labor has begun disappear.

Since the pauses between contractions are still quite large, you can continue to go about your usual business. You can doze off (childbirth often begins at night!), or drink tea, take a walk, take warm bath or a shower (which is quite acceptable if the amniotic fluid has not yet poured out), listen to music, draw. Usually it is in this phase of childbirth that a woman begins to gather in the maternity hospital.

During the initial contractions, thick, viscous mucus with blood streaks may be released from the vagina. This mucous plug, filling the cervical canal and protecting the contents of the uterus from the penetration of infections.

Under the influence of gravity and as a result of a decrease in the uterine cavity with each contraction, the lower pole amniotic sac, surrounding the fetus, begins to gradually wedge into the cervical canal, further contributing to its opening. At this point, the fetal membranes may rupture and the amniotic fluid may begin to leak or pour out.

Important!
If water has poured out or bleeding has begun, you should immediately go to the hospital!

At the moment when the cervix opens about 4 cm (rice), the contractions will be repeated every 5-7 minutes and last for 30-50 seconds. On average, the duration of this phase is 6-9 hours for the first pregnancy and 3-5 hours for repeated ones.

active phase

From this point on, the rate of cervical dilatation is approximately 1 cm/hour. Contractions become more intense and more frequent, their duration changes: from 30 to 60 seconds. Pauses are shortened to 3-4 minutes. During this time, the uterine pharynx opens up to 8 cm. Tension increases, fatigue during the contraction, pain in the lower back and sacrum may appear. This is the phase when self-pain techniques clearly help, breathing exercises and other relaxation techniques you learned during pregnancy. It is in this phase that doctors offer medical pain relief.

If the cervix opens more slowly, then the contractions are not coordinated and affect the cervix ineffectively. In this case, it is recommended to walk around the room, take a shower or bath (if the water has not yet broken), this usually helps to speed up the process. Sometimes, if physiological measures do not help, obstetricians use stimulant medications, For example pitocin.

The active phase lasts an average of 3-5 hours for the first birth and about 2 hours for subsequent ones.

transitional phase

After the opening of the cervix opens about 8 cm (rice), i.e. enough to start skipping a baby who has a head diameter of about 11 cm, the contractions become very strong, lasting about 90 seconds and occur every 2 minutes. These are the last 10-20 contractions that will completely open the cervix for the remaining 2-3 cm (up to 10-12 cm). Because they are long, intense, and frequent, you are less aware of when they come on, climax, and leave, despite the fact that they are equal in duration to pauses. It seems that you are experiencing a continuous climax of contractions. Such intensity, of course, also affects the emotional state. The woman in labor no longer thinks about anything but the next contraction. It is also likely that you will be impatient, tired, and at the same time excited. Perhaps you will be angry with your assistants.

The end of the first stage of labor can be physically and emotionally devastating, but the transition period is the turning point in labor and typically lasts 15 minutes to 1 hour.

Many women experience this stage of the first period differently than the onset of labor. This is the time when some women begin to doubt that they will be able to give birth. This is facilitated by the severe fatigue that a woman experiences.

This period is transitional not only physically, but also psychologically. You have almost passed the first stage with especially strong contractions and are approaching the second, the long-awaited birth of your child.

When not to bother

Sometimes the cervix dilates unevenly. When the midwife checks your dilation, she may notice that there is an undiscovered area of ​​the cervix between the baby's head and pubic bone. Attempts in this case will be ineffective and only the energy of the woman in labor will be wasted. In addition, trauma to the cervix can occur. You may feel the need to push, but your doctor will advise against it. Usually a couple more contractions - and there comes a full opening of the cervix. Breathing shallowly can distract you from your efforts. You can try getting on all fours with your head down and your pelvis up. This will reduce the pressure on the cervix and the intensity of contractions, save energy.

During this period of time, you may experience other intermittent sensations, such as:

• reflex nausea . It appears when the uterine zone is opened by 5-6 cm. What should I do? - Ask for a basin;
• Chills. It is associated with energy consumption during muscle exercise. You should relax, take a deep breath, cover yourself with a blanket;
• Pressure in the lower abdomen. Since the baby's head is already down and pressing on the rectum, you feel the urge, as if you should have a bowel movement. Remember to empty often bladder(about every hour!).

Your feelings

So, let's ask ourselves a question: what is the first stage of childbirth? Often answer: "Conflicts." Is it just contractions? What about pauses? There are exactly as many pauses in labor as contractions! During a contraction, the uterus tenses, during a pause it relaxes.

The opening of the uterine os is possible only through contractions. After tension, relaxation comes and the woman has the opportunity to rest a little. The duration of rest after the contraction is longer than the duration of the contraction itself. The universe took care of the woman! The duration of the bout is calculated in seconds, and the pauses are in minutes. By the amount of time in childbirth, there are more pauses than contractions!

However, the woman's attention is focused on contractions, while pauses are taken for granted. Psychologically, relaxation is more desirable for a person. Then why do you focus so much of your attention on the fight, the less desirable thing?

Agreeing with the process, staying in it, observing your feelings, the ability to relax or tense up in time is the way to a successful delivery.

But what about the pain? Is there pain during childbirth? Eat. They appear in the middle of the first stage of labor (in the active phase). But like any sensation in childbirth, this has its own expediency. Relaxation practices, breathing exercises, and self-pain relief techniques are designed to reduce pain and make contractions feel more comfortable.

It is important to remember that pain during contractions is a completely normal and correct process, and there is no need to be afraid and pinch, because tension will only increase pain or even provoke more severe pain.

Important:
The woman in labor, as well as her husband, should be aware of the symptoms that need to be brought to the attention of a doctor or midwife. This sharp deterioration well-being, the appearance of a sharp pain in the abdomen, cold sweat, weakness, headache; deterioration of vision: the appearance of flashes and “flies” before the eyes; the appearance of bright bloody discharge from the genital tract. All of these signs may indicate the need for urgent medical attention.

What happens to the child?

In the first stage of labor, the baby continues to receive oxygen and nutrients through the placenta.

The child fully feels the contractions while in the uterus. Some children sleep on early stage childbirth. But as the contractions become more intense, the baby feels the walls of the uterus contract around him and the cervix presses against his head. During contractions for modern diagnostics intrauterine hypoxia and the risk of fetal death, it is necessary to constantly monitor its condition. For this purpose, every 15 minutes, the doctor listens to the heart of the fetus.

When the uterus contracts, the blood supply through the placenta slows down, after the end of the contraction, everything returns to normal. In response to the reduced blood flow, the baby's heart begins to slow down during the peak of each contraction. When the contraction stops, the heartbeat speeds up. A slow heartbeat does not threaten any complications for a healthy child ready for childbirth. The average number of heartbeats per minute in a child in the first stage of labor is from 120 to 160, although the midwife is unlikely to be bothered by the fact if the number of beats varies from 110 to 170. healthy child always varies slightly, as the heart responds to factors such as changes in position, eating or drinking, or abdominal massage, and, in addition, to the stimulation of contractions. These variations indicate that the heart is functioning normally, responding to the tension of the birth process and trying to adapt its beat rate to it.

Pregnancy and childbirth is the most milestone in every woman's life. He divides the whole existence into before and after the appearance of the child. For those who go to the hospital for the first time, it is very important to know when to go there and how to count contractions in order to determine the time until delivery.

What are contractions?

The whole process of labor activity can be divided into three periods:

• opening of the cervix - contractions;
• attempts;
• the birth itself.

Contractions themselves are vigorous activity uterus. These muscle contractions help the child to accept correct position and prepare the cervix for full disclosure. There are "training" fights and real ones.

Before answering the question of how to correctly count contractions, it is worth understanding whether they are real or preparatory.

Training bouts

The normal time for childbirth is the period from the 38th to the 40th week of pregnancy. By this time, the fetus is fully formed and ready to be born for independent life.

Some women, a few weeks before the onset of labor, may feel small uterine contractions - these are training contractions (Braxton-Hicks).

It is also a process of preparation for normal labor activity, moreover closer birth the more tangible they become. They may appear once or several times a day. For some expectant mothers, this period may be absent or completely invisible.

If there is still a lot of time left before the birth, and training contractions began to repeat more often (several times per hour) and appeared bloody issues- contact your gynecologist immediately. This can be a serious symptom for hospitalization to avoid preterm labor.

If you have “false” contractions after the 36th week, then there is nothing to worry about, on the contrary, this indicates normal flow pregnancy. Your stomach sinks down, making it easier to breathe.

real contractions

When real contractions begin, they can no longer be confused with "false" ones. They do not stop and do not become less painful. It is at this point that the question arises of how to count contractions.

The birth contractions of the uterus proceed sequentially: first in the upper part, then the tension spreads to the very cervix. At the peak of activity, tone with female organs doesn't come off.

There are several main types of contractions during labor:

• With the opening of the cervix. They continue until the opening is 10 cm.
• Attempts. They serve to push the fetus to the exit.
• "Postpartum". Necessary for the placenta to exit.
• After childbirth. May appear some time after the birth of the baby. They also should not be feared, they help the proper contraction of the uterus.

There are several signs so that you can pinpoint the onset of labor.

Signs of childbirth

Many women are concerned about the question of how to count contractions before childbirth. To understand if your birth process has begun, look at the signs by which its beginning is determined:

1. The duration of one contraction is more than 30 seconds, and the frequency of repetition increases.
2. The period between contractions begins from 20-30 minutes, then it reaches 10 or less, which means that the process of opening the cervix has begun.
3. Bleeding appeared, they indicate the process of opening.
4. With all the above symptoms, nagging pain in the back and lower abdomen.

When the future woman in labor has all these symptoms, we count the contractions (when to go to the hospital depends on their frequency).

We count the intervals between contractions

The main process has begun - labor activity, now the question of how to count contractions is relevant.

The interval between contractions determines whether you will be accepted at the hospital. For example, if you went there too early, that is, the contraction of the uterus occurs less than once every 10 minutes, then you will be advised to stay at home.

If a woman in labor attended courses, then she knows that they are sent to the hospital at the moment when the interval between contractions has decreased to one minute. Except those situations when you medical indications stored in advance.

The count itself is very easy. To do this, you will need a stopwatch (usually such a function is in mobile phones). Preferably next to future mother there was one of the relatives who could write down everything on a piece of paper.

For example, it could be written like this:

In this case, the interval is two minutes between the start of one and the second contraction. At this point, you should already be in the hospital. Optimal time for departure - a gap of 5 minutes, it will be enough to get to the hospital on time and undergo the necessary examination before delivery.

In our time of technological development, various online programs for counting contractions have appeared. They allow not only to record the intervals between real contractions, but also to calculate "false" ones. To use them, a computer is not required, installation on your favorite gadget is possible.

Situations when you urgently need to go to the hospital

• the waters broke;
• the uterus has contracted and remains in good shape for more than 30 seconds;
• severe pain during contraction, but the nature of the contractions is irregular;
• your state of health decreased and you began to distinguish objects poorly;
• bleeding of any intensity began;
• strong fetal movement or, conversely, a sharp cessation of activity.

In any of these situations, you should immediately go to the hospital, and not think about how to count the contractions during childbirth.

In any case, do not be afraid of labor activity. This pain is the process that helps your baby to be born.

IN last trimester pregnancy, a woman increasingly feels special cramps in the abdomen, which are called training or "false" contractions. These are irregular contractions of the uterine walls that do not form the start of the birth process and do not lead to the opening of the cervix, however, they prepare the uterine walls for an early birth. Many pregnant women are afraid, due to training contractions, to miss the labor that has begun outside the hospital if they fail to recognize the true contractions that have begun. This fear is especially typical for those women who are carrying their first child. Doctors are in a hurry to reassure expectant mothers, saying that they will not confuse true contractions at the beginning of labor with training contractions and will immediately understand that labor has begun. What sensations do true contractions bring, how to determine that they have begun and what sensations will there be, is the pain strong, can it be alleviated?

Harbingers of childbirth

Childbirth does not occur suddenly, without any preliminary "bells", the body conducts a full preparation for a difficult and lengthy birth act, forming precursors early delivery. These include an increase in training contractions and their intensification, although also without any regularity of occurrence, as well as a shortening of the cervix, due to which the fetal head descends into the small pelvis with a lowering of the abdomen. It becomes easier for a woman to breathe and eat. In addition, the discharge of the mucous plug from the vagina is typical both for several days and at the same time in the form of a lump of pinkish mucus.

The beginning of labor: how to understand that contractions have begun?

When such manifestations appear, childbirth is expected in the coming days, so you need to be prepared for them by collecting all the necessary things and bags with documents. Labor activity can begin with (their gradual or outpouring at once with a large volume) or with contractions, at first rare and not intense, then more and more strong and frequent.

It is the contractions that mark the beginning of childbirth, or rather their first period, during which, due to contractions, a smooth and gradual opening of the cervix will occur. They begin as quite tangible and painful, but short-term sensations in the lumbar region and lower abdomen, which form at certain intervals. Gradually, uterine contractions become more frequent and longer, and the relaxation intervals between them are getting shorter, which indicates that the cervix is ​​\u200b\u200balmost open and there will soon be attempts.

What is called contractions

In obstetrics, contractions are called periodically arising contractions of muscle fibers in the area of ​​the uterine wall. During each of the contractions inside the uterus, the processes of stretching and contraction of the muscles occur, while the stretching of the fibers in the cervical region (circular) is formed, against the background of the tension of the longitudinal fiber.

As the contractions intensify and become more frequent, the cervix opens and smoothes, by the time of the attempts, the opening of the cervix reaches 10 cm. The baby, against the background of contractions, gradually moves along the birth canal.

note

During the period of opening of the cervix, one of the contractions may open the fetal bladder, which leads to the outflow of water, or in certain period to stimulate labor activity, it is opened by a doctor.

Muscle contractions during childbirth are regular and intensifying; during the contraction period, the muscles spasm in the lower abdomen, which causes it to become very tense and stiff. A woman has sensations of pain in the lower back, inside the abdomen and in the perineal region, radiating to the coccyx.

note

Sometimes the sensations are described as painful periods, only increasing in duration.

Pain sensations are undulating, initially light and barely perceptible, gradually increasing in intensity, reaching a maximum for a few seconds and receding until the next contraction.. You can compare it with spasms in the calf muscle during a cramp, but with a gradual increase in pain. During fights, due to special techniques and practices, pain can be significantly reduced; for this, both medicines and anesthesia are used, as well as methods of relaxation, massage, etc.

Emotional components of contractions, sensitivity to pain

Each woman perceives childbirth in her own way, therefore, the sensations in contractions are different for everyone. Someone is talking about severe pain, but for some it is quite tolerable, facilitated by simple techniques. This largely depends on the pain threshold and sensitivity, the degree of preparation of the woman for childbirth. Strong influence have emotions, attitude to what is happening and fear, fatigue and nervous tension. If a woman is afraid of childbirth, due to fear and panic, pain can intensify, if she is collected and prepared, contractions are easier to bear.

Recognizing contractions before childbirth

Sometimes before childbirth, false contractions become strong and subjectively unpleasant enough, because of which they can enter future mother misleading about the onset of labor.

The first single training contractions are formed after 20 weeks, but by the end of the period they occur frequently and can be quite strong. Their distinctive feature is an irregular character, a short period of contractions and painlessness (they do not lead to the opening of the neck). Reception helps to relieve such tension during false contractions. warm bath or sleep, rest in lying position and sedation, taking antispasmodics or a rectal suppository with papaverine.

True contractions have equal intervals between contractions, are not eliminated by bathing and rest, and increase in intensity of sensations and duration. It is worth distinguishing them from aching or stomach due to the position of the fetus in the uterus and loads on the lower back, sprains and divergence of the pelvic bones in the area of ​​the pubic joint. There may be aching weak pains in the lumbar region, pelvis and abdomen, encircling in nature. At the same time, there is no tension as such in the muscles of the uterus, the stomach is quite soft.

Phases of the birth process, the nature of contractions

Between the first contractions, the interval can be 30-20 minutes, they are short and not very painful. This is the very beginning of labor activity. Then the intervals are reduced, and, based on this, three phases are distinguished in the first stage of labor:

• Latent (initial) may be hidden or little expressed in sensations
• Active
• transitional.

For initial stage a typical time period is about 8 hours, at which time the contraction does not exceed 30-45 seconds in duration, the intervals with it start from 30 minutes and gradually decrease to 10-5 minutes. At this time, the opening of the cervix occurs from 0 to 3 cm. At this time, the woman needs to get to the maternity hospital.

active phase lasts up to five hours, during this period the length of the contraction reaches a minute, they occur at intervals of 2-4 minutes, the cervix opens from 3 to 7-8 cm.

transitional phase in the first period, the shortest, it lasts up to an hour and a half and the contractions last up to 90 seconds. They are strong and painful, compared to previous periods, the relaxation period is gradually reduced to one minute, contractions follow one after another, which leads to the opening of the cervix up to 10 cm, when it can already miss the fetal head.

In the second and subsequent births, the intervals are divided in the same way, but their duration is shorter, and the contractions themselves are stronger and more productive.

Actions of a woman at the start of contractions

If contractions have begun, you should not immediately panic and shout “I am giving birth”, you need to calm down, mark the intervals between them and get ready for the hospital. It is worth arriving at the maternity hospital when the interval between contractions leaves about 10 minutes. You should not get hung up on fights, during them you need to breathe measuredly and calmly, be distracted. If it gets cold for 20-30 minutes between contractions, you can slowly collect all your things, take a shower and go to the hospital.

You need to urgently go to the maternity hospital when the water breaks, when blood or other disturbing symptoms appear, if the waste water has a green or pink tint.

What can be done to ease contractions?

During contractions, for some women, pain is painful and unpleasant. To relieve pain and relieve stress, doctors may offer labor pain relief (, injections), but if there are contraindications, pain relief cannot be done (drug allergies, back skin problems, spinal deformities, fetal threats).

To improve the condition and relieve pain in contractions, there is relaxation techniques and correct breathing . They are also taught in courses to prepare for childbirth, as well as in the maternity hospital upon admission, midwives usually help to set up proper breathing.