How it hurts during contractions. Feelings during false contractions. How contractions start

However, sometimes the safety of mother and baby can only be ensured with the help of medical intervention.

Changes may occur in your body, indicating that the crucial moment is approaching. Women feel them a few weeks before giving birth - with varying degrees of intensity - or do not feel at all.

The duration of the difficult process of the birth of a baby can be very different. For the first birth, it averages 13 hours, for repeated - about eight. The beginning of childbirth among physicians is considered to be the opening of the cervix with regularly repeated contractions.

Over the past 50 years, the average duration of this process has been halved, asin severe cases, a caesarean section is now done in a timely manner. Often spontaneous contractions begin at night, when the body relaxes. Many children prefer to look at this world for the first time in the dark. According to statistics, most births occur at night.

What exactly causes labor pains is a question, the answer to which is not yet known. What is clear is that the child himself plays an important role in this process. But which mechanisms give a decisive impetus remains a mystery.

Recent studies suggest that contractions begin under the influence of a protein substance produced by the child, the so-called SP-A protein, which is also responsible for the maturation of the lungs.

Gynecologist's consultation. Usually, Braxton-Hicks contractions are difficult to distinguish from real labor. In the third trimester, false labor pains become more intense and more frequent if you live an active life or if you are dehydrated. If you feel them, sit in a cool place, put your feet up, drink something and rest. If the intervals between contractions increase, and their intensity decreases, then they are false. If it gets more frequent and worse (especially if it happens every 5 minutes), call your doctor. I always tell patients that no one has ever described their feelings as "spastic" when giving birth. As a rule, the intensity of labor pains, in which the child passes through the birth canal, is described as follows: "I can not walk and talk."

You have seen it in countless films. Sudden realization: the woman in labor needs to be taken to the hospital URGENTLY! The woman becomes a real fury, spewing curses (“You did this to me!”). Doubled over in terrible pain, she stops moaning, only to issue another batch of curses at her unfortunate, panic-stricken husband, who suddenly forgets everything he learned in Lamaz's courses, loses the bag prepared for the trip to the maternity hospital, and inevitably sends the car straight into a traffic jam, where he eventually has to deliver himself.

The truth is that most couples have plenty of time to realize that labor has actually begun. No one knows for sure what triggers this mechanism, but they are approaching fast enough. Here are some signs that tell you that it's time to grab the bag and the woman in labor - and get into the car.

Childbirth begins - signs of childbirth

Most women give birth to their children earlier or later than the estimated date indicated on the exchange card.

Moreover, most often the deviation in both directions does not exceed ten days. In the end, the estimated date of birth only plays the role of a guideline. Only 3% to 5% of children are born exactly on this day. If the doctor said that your baby will be born on December 31st, you can be sure that you will not give birth on New Year's Eve.

loose stool

This is due to hormonal changes caused by prostaglandins.

And it makes sense: your body is beginning to cleanse the colon to make more space inside the body for the baby.

Estimated date of delivery (ED)

This is the day your baby is statistically likely to be born. Most give birth somewhere between 37 and 42 weeks. Although many women do not give birth exactly on the expected date, you should definitely know it in order to be prepared. The closer it is, the more attention you need to pay to your bodily sensations and possible signals of the onset of labor. Turning over a sheet of the calendar and seeing the month in which the birth is due, you will feel excitement (and a little panic). Soon!

Contractions - first signs of approaching labor

In 70-80% of cases, the onset of labor declares itself with the appearance of real labor pains. They are not immediately distinguishable from the training ones that you may have noticed for the first time a few weeks ago. At these moments, the abdomen hardens and the uterus contracts for 30-45 seconds.

The pain caused by contractions is initially well tolerated: you can even walk a little if you want. As soon as a certain regularity is established in contractions, you will put everything aside without any prompting and will listen to what is happening inside you.

As contractions gradually increase, it is recommended that you do the breathing exercises that you were taught in your childbirth preparation courses. Try to breathe as deeply as possible, inhale with your stomach. Your baby also has to do hard work during childbirth. And oxygen will be very useful to him for this.

Braxton Hicks contractions (preparatory). These contractions of the uterine muscles begin early, although you may not notice them. You will feel tension in the uterus. These contractions are short and painless. Sometimes there are several of them, they follow each other, but usually they stop quickly. Closer to childbirth, Braxton-Hicks contractions help prepare the cervix for the process.

Immediately to the clinic!

Regardless of the onset of contractions, when the baby stops moving, the rupture of the sac, or vaginal bleeding, you should immediately go to the clinic.

Braxton Hicks contractions are the warm-up before real contractions start. They can start and end several times and often stop when you are active (for example, when you are walking). Early labor pains will be uneven in intensity and frequency: some will be so strong that they will take your breath away, others will just resemble spasms. The intervals between them will be either 3-5 or 10-15 minutes. If for 15 minutes you talked with the doctor, discussing whether labor began or not, and never interrupted, this is most likely a false alarm.

Learn to recognize contractions

In the initial stage of labor, contractions lasting about 30 seconds may occur every 20 minutes.

• The first contractions are similar to spasmodic menstrual pain (radiating pain). The muscles of the uterus begin to contract so that the cervix opens all 10 cm.
  
• Late contractions feel like strong menstrual cramps or reach an intensity that you could not even imagine.
  
• When the contractions become very strong, and the rhythm of contractions is regular, it means that it has begun for real!
  

There are no mandatory rules for when you can come to the hospital. But if contractions occur every 5 minutes for an hour and make you freeze in pain, no one will prevent you from appearing in the maternity ward. Make an action plan with your doctor, taking into account the time it takes to travel.

• If you live near a maternity hospital, then wait for the contractions to be 1 every 5 minutes for an hour, and then call and tell your doctor that you are going.
  
• If the hospital is 45 minutes away from you, then most likely you should leave even when the contractions are less frequent.
  

Discuss this with your doctor ahead of time so you don't panic during labor. Remember that with the onset of the active stage, the cervix in most women opens at 1-2 cm per hour. So count: 6-8 hours before the start of attempts. (But if you were told at your last doctor's appointment that you were 4 cm dilated, it's best to arrive early at the hospital.)

Gynecologist's consultation. I warn expectant parents, especially if this is the first pregnancy, that there may be a few "false alarms". My wife is an OB/GYN and she made me bring her to the hospital 3-4 times while pregnant with each of our 3 kids! If she couldn't recognize for sure, then who could? I always tell patients that it's better to have them come and get checked out (if it's premature, they'll just be allowed to go home) than to give birth on the side of the road.

Time is everything

How to calculate the time and rhythm of contractions? There are two ways. Just pick one and stick with it as you watch it unfold.

Method 1

1. Note the start of one contraction and its duration (for example, from 30 seconds to 1 minute).
   
2. Then note when the next contraction begins. If within 9 minutes she was not felt, then the regularity of contractions is 10 minutes.
   
3. It can be confusing if contractions occur more frequently. Always note the time from the start of one contraction to the start of the next.
   
4. If the contraction lasts for a whole minute, and the next one begins 3 minutes after the end of the previous one, then the contractions occur 1 time in 4 minutes. When their frequency increases, it is difficult to concentrate on counting. Ask someone close to count the contractions for you.
   

Method 2

Almost the same, but here you start counting the time from the end of one fight to the end of the next.

Opening and flattening the cervix

Imagine your cervix as a big, plump donut. Before childbirth, it begins to thin and stretch. Expansion (opening) and thinning (smoothing) can occur within a few weeks, one day or several hours. There is no standard time frame and nature of the process. As the date of delivery approaches, your doctor will make conclusions about the condition of the cervix in this way: "Disclosure 2 cm, shortening 1 cm."

Prolapse of the abdomen

This happens when the fetus descends to the entrance to the small pelvis and, as it were, “gets stuck” there, i.e. no longer moves inside. With Braxton-Hicks contractions, it shifts even more into the lower pelvis. Imagine that the child moves into a "starter" position. This process begins for all women at different times, for some - just before the very birth. For many, the news of a fetal drop is both good news and bad news. Breathing and eating is now easier, but the pressure on the bladder and pelvic ligaments makes it necessary to run to the toilet more often. For some expectant mothers, it even begins to seem that the child can simply fall out, because he is now so low. During the exam, your doctor will determine how low the baby is in the pelvis, or what their "position" is.

The prolapse of the abdomen occurs when the child seems to "fall", descends to the entrance to the small pelvis. Head first, the baby moves into the pelvis, thereby preparing for the journey through the birth canal. However, for women who experience abdominal prolapse days or weeks before delivery, this symptom is "false evidence," and for some, this does not happen at all until the onset of active labor. Braxton-Hicks contractions become stronger, the baby gradually moves lower into the pelvis, the pressure on the cervix increases, and it softens and thins.

Rupture of the fetal bladder

In 10-15% of cases, the onset of labor is heralded by a premature rupture of the fetal bladder, which occurs before the first contractions appear.

If the baby's head is firmly established in the small pelvis, then the loss of amniotic fluid will not be so massive.

You will know about the rupture of the amniotic sac by the abundant discharge of a clear, warm liquid from the vagina.

The rupture of the fetal bladder does not cause any pain, since there are no nerve fibers in its membrane. Sometimes the amniotic fluid may be green in color: this means that the child has already allocated his first stool in them. Record the time of rupture of the amniotic sac and the color of the discharged fluid, report this to the midwife or the maternity ward of the clinic. Here you will receive instructions on your next steps.

Very rarely, a rupture of the fetal bladder occurs in its upper part, while the amniotic fluid leaves only drop by drop. Then they are easy to mistake for urine or vaginal discharge, especially with a slight weakness of the bladder. If you suspect that amniotic fluid is breaking, call your doctor right away or go to the hospital. A short inspection will bring clarity to the situation.

As a rule, rupture of the fetal bladder does not lead to dramatic consequences. Usually, in the next 12-18 hours, contractions spontaneously occur, and childbirth occurs naturally. In the absence of contractions, they are artificially stimulated with appropriate medications to reduce the risk of infection for the mother and child.

Outflow of waters

Sometimes the fetal bladder is called the strange, biblical-sounding term "fetal sac." When it bursts (naturally or pierced by a doctor), this means: childbirth will occur within 24-48 hours. As a rule, the doctor decides not to risk not waiting more than 24 hours after the bubble has opened, especially if the baby is born at term, because. there is a risk of infection.

If the waters broke

When the fetal bladder bursts, there is something like a small flood, and it is impossible to predict exactly when and where this will happen. In the third trimester, the amniotic sac, the soft and comfortable "place" of the baby, already contains about a liter of amniotic fluid. (Pour a liter of water on the floor - something like this might look like.) But remember:

• some women have very little "leakage".
• Fluid will continue to flow out of the amniotic sac even after the waters have broken because your body will continue to produce it.
• In some women, the water does not break spontaneously, and to stimulate the process of childbirth, the doctor performs an amniotomy by piercing the bag with a long plastic hook.
• The liquid should be colorless. If it is dark (greenish, brownish, yellowish), this may mean that the baby has defecated right in the uterus (such an original stool is called meconium). This may be a sign of severe stress in the fetus. Call your doctor right away.

Gynecologist's consultation. Abundant vaginal discharge in late pregnancy is absolutely normal. V 10-20% of women at this stage they are so significant that they have to wear pads all the time. The blood flow to the vagina and cervix increases in the third trimester, so the vaginal secretion also increases. You may not immediately understand whether it is discharge or water has departed. If you feel "wet", dry off and walk around a bit. If fluid continues to leak, call your doctor.

Signal bleeding - a symptom of the onset of labor

Usually, throughout pregnancy, the uterine os remains closed with viscous mucus, which protects the fetal bladder from inflammation. With the shortening of the cervix and the opening of the uterine os, the so-called mucous plug comes out. This is also a sign of approaching childbirth. However, labor pains do not necessarily occur on the same day. Sometimes it takes a few more days or even weeks before the onset of real contractions.

Closer to childbirth, the mucus may lose its viscosity and come out as a clear liquid. In most cases, this is accompanied by a small, so-called signal, bleeding. It is much weaker than menstrual and completely harmless. And yet, to be sure, you should talk to your doctor or midwife about this - you need to make sure that the bleeding is not caused by other causes that could threaten you and your baby. Very often, a woman does not notice the separation of the mucous plug at all.

Small spotting or spotting

May appear due to changes occurring in the cervix - it is preparing for disclosure. The contractions soften the cervix, the capillaries begin to bleed. Contractions intensify and bleeding occurs. Any pressure on the cervix can cause some bleeding (due to exercise, sex, straining to have a bowel movement, or tension in the bladder muscles). If you're not sure if this bleeding is normal, call your doctor.

Removal of the mucous plug

The cervix softens and begins to open, while the mucous plug is released. Sometimes the mucus flows out slowly or the plug can come out in the form of a knotty thick flagellum. Up to this point, mucus acts as a protective barrier in the cervix and is constantly produced by the body, especially a lot of it closer to childbirth. It's not a sign of upcoming labor - some women have mucus a few weeks before - but it's definitely a sign that something is starting to change.

Backache

Pain may occur if the child is facing forward, and not towards your back. If the baby does not turn to the back, they may intensify. Pain can also occur due to the pressure of his head on your spine at the start of contractions.

Cozy nest: not only for birds

Pregnant women often have a strong desire to make a cozy nest even before the onset of childbirth. The burst of "nesting" energy, so contrasting with the exhausting fatigue of the last trimester, is forcing expectant mothers to equip their habitat, turning it into a nice and clean "incubator". Another sign that you have begun a period of "nesting" is the speed with which you try to do all the work, the exactingness with which you make requests to your family. "Nesting" is usually expressed as:

• painting, cleaning, arranging furniture in the nursery;
  
• throwing away rubbish;
  
• organizing things of the same kind (food in the buffet, books and photographs on the shelves, tools in the garage);
  
• general cleaning of the house or the completion of "renovation projects";
  
• buying and laying out children's clothes;
  
• baking, cooking and stuffing it in the refrigerator;
  
• packing bags for a trip to the hospital.
  

An important caveat: some pregnant women never “nesting”, and if such impulses appear, the expectant mother feels too lethargic to do anything.

Labor symptoms

False contractions are a pulling pain in the lower abdomen, similar to pain during menstruation. If such contractions are not strong and not regular, you do not need to do anything on purpose: this is just preparing the uterus for childbirth. The uterus, as it were, tries its hand before the upcoming important work, gathering and relaxing its muscles. At the same time, you can feel the tone of the uterus - sometimes it seems to be going into a lump, it becomes more solid. The uterus can come into tone without pain, since the closer the birth, the more sensitive and irritable it becomes. This is fine.

The third important harbinger of childbirth may be the discharge of the mucous plug. This is the mucous content that "lives" in the cervix, as if clogging the "house" of the baby. The mucous plug may come out in the form of thick and sticky secretions of a transparent pinkish color.

A woman may not feel the harbingers of childbirth, although most often the expectant mother still feels preparatory contractions.

A normal first birth lasts approximately 10-15 hours. Subsequent births usually proceed somewhat faster than the first, but this is not always the case. I am an example of such an exception, since my second birth lasted 12 hours longer (20 hours) than the first (8 hours).

If a woman's amniotic fluid has broken, then you should immediately go to the clinic. The amniotic fluid protects the baby, and he should not be without them for a long time. Therefore, if you feel lukewarm transparent water flowing out, call the doctor and get ready for the maternity hospital.

Usually, after the waters have broken, contractions begin (or they increase dramatically if you have been in labor before). If contractions do not start, most likely in the maternity hospital they will try to induce labor (with the cervix ready) so as not to leave the baby for a long time without protection.

Labor usually starts with contractions. Usually, women often begin to feel pain in the lower abdomen and an ache in the lower back about a couple of weeks before giving birth. But how then to understand what it is: preparatory contractions of Braxton-Hicks or the onset of labor ?! Such a question and concerns almost always arise in women who, theoretically or practically, face the harbingers of childbirth.

It’s not at all difficult to distinguish preparatory contractions from the onset of labor! When your stomach starts to sip, be a little more attentive to yourself: is it such a pain as usual, perhaps the painful sensations dragged on a little, or something else intuitively seems unusual to you?

If you feel that these painful sensations are regular (appear and disappear with a small frequency), it makes sense to start timing, counting the contractions and writing them down.

Let's say around 5 o'clock in the morning you decide that your stomach hurts a little in a special way or for quite a long time. Stock up on a stopwatch (it's on your phone) and start counting.

At 5 o'clock in the morning pain appeared, the contraction began, it lasted 50 seconds, then there was no pain for 30 minutes.

At 5:30, the stomach starts to pull again, the pain lasts 30 seconds, then nothing bothers you for 10 minutes, etc.

When you see that the pain is regularly repeated, intensifies, the duration of the contractions increases, and the interval between them decreases - congratulations, you have started labor.

Even very calm and balanced women experience quite natural anxiety before childbirth. No matter how the sequence of contractions, frequency and duration are memorized in courses for expectant mothers, fear still remains and is associated with the unknown. What will the contractions be like, how much will it hurt, what can they be compared to? We will give answers to these questions in this article.

What it is?

Contractions is the process of tension of the muscles of the uterus, in which the cervix opens. The walls of the uterus at this time exert pressure, under which the baby takes the correct position based on its presentation, which is optimal for passing through the birth canal after the cervix opens completely.

Sensations during contractions can be different, and largely depend on the period of childbirth, the individual pain sensitivity of the woman in labor. Those who sell methods of childbirth without pain are somewhat cunning, because there are no contractions without pain. Another issue is that some women tolerate pain relatively easily, while others are worse.

The first contractions are rare and short. They are called latent. They last no more than 8-10 hours. This is the longest period of childbirth, and contractions feel sore.

This is followed by a period of active contractions, when they are repeated every 5 minutes and last up to a minute. This is already more painful, but the opening of the cervix at the end of the period is about 7 centimeters, and there is very little left before attempts. After 3-5 hours of active contractions, transitional contractions occur, with them the opening increases to 10-12 centimeters, the uterus opens completely. These are the most tangible contractions that are protracted, last about a minute each and are repeated after a minute, a maximum of two. This period lasts from half an hour to an hour and a half and turns into attempts when the baby begins its journey through the mother's birth canal.

Recognizing real labor pains is easy. They differ from false and training ones in that they are repeated at certain intervals, develop and intensify.

With what to compare?

Often, women compare the initial contractions with pain during menstruation, with the ebb and flow of the surf. Indeed, contractions are similar to this in their rhythm - the uterus tenses and relaxes. Spasms occur at regular intervals, in the intervals between them you can relax. Naturally, the longer the rest period at the very beginning, the easier it is to endure a short spasm.

With pain during menstruation, labor pains are similar only in localization. Bursting pain arises when the tone of the uterus occurs in the back, smoothly descends and envelops the lumbar region, lower abdomen, and spreads throughout the abdominal wall. Then, in the reverse order, relaxation occurs.

Pain - what is it?

It is believed that pain during childbirth is of psychogenic origin, because there are no nerve endings in the uterus. The main cause of painful contractions, experts call overexcitation of the nervous system. Therefore, women who remain calm have a good idea of ​​what exactly happens in her body at one or another moment of childbirth, give birth easier and faster, and claim that they did not experience transcendental unbearable pain.

It should be noted that pain is a very subjective concept. What is unbearably painful for one woman in labor is quite bearable for another. It all depends on the pain threshold - an individual threshold beyond which the human nervous system simply ceases to perceive pain as pain.

In world practice, there was a proposal to measure pain in dol. These conventional units allow us to determine the threshold values ​​of pain from a particular impact, but, alas, only for a particular person. On average, pain at the very peak of labor, during the transition from contractions to attempts, is estimated at 9-10.0 dol.

To understand whether this is a lot or a little, a woman needs to know that the average limit of patience beyond which the perception of pain as such stops is 10.5 dol, that is, labor pain is at the limit of human capabilities.

The experiment was carried out in 1948 in one of the American clinics, where drops of boiling water were dripped onto the skin of 13 women in childbirth between contractions. It was then that it turned out that the burn, which was previously considered the most painful, was not at all like that - childbirth would be more painful. Many women did not respond to a drop of boiling water after a contraction, but not all. And this proves that the pain threshold is different. Those who felt the hot water had pain that was below 10 dol, although they were in the same stage of the birth process.

There is no consensus about these units of measurement, and there is an assumption that they are so subjective that they cannot act as a single measure of pain. If we talk about some kind of scale by which labor pain and pain during real contractions can be assessed, then it is easier to focus on the usual 10-point scale adjusted (solidly!) For individuality.

So, surveys conducted in several clinics in France, Great Britain and Canada, when women were asked to describe the pain after childbirth in numbers, showed that many estimate the initial stage of childbirth at 0-2 points. Active contractions received higher marks from women in labor - 5-7 points. Transitional contractions - up to 8-10 points. But after giving birth, an hour later, the women rated their well-being at 1-2 points on a ten-point scale of pain.

If you want to determine your own pain threshold before childbirth, you should ask any anesthesiologist to test you with a special algesimeter device - this is the only more or less accurate way to understand what your pain sensitivity is. All people are divided into four types of pain sensitivity and susceptibility.

What influences perception and how to facilitate?

As already mentioned, it's all about the nervous system of a woman. Pain is a controlled process, which is why yogis and special forces soldiers are able to regulate their own pain, walk on glass, not feel pain from a burn or cut. A woman, of course, is not a yogi or a special forces intelligence officer, but absolutely any woman in labor can learn to perceive pain correctly and reduce it.

For a long time, explanatory work was based on this, which was carried out with all pregnant women in Soviet antenatal clinics. The development of a method for reducing pain belongs to Soviet scientists, it formed the basis of exclusively all international methods for reducing pain.

The right attitude includes auto-training, meditation training, self-hypnosis, breathing techniques and muscle relaxation techniques. Calmness, confidence that the female body has enough natural wisdom and strength to give birth to a child will help to feel contractions more easily. It's true.

From the first contractions, you need to move, not lie down, inhale deeply and exhale slowly, this will help you relax, and the relaxed muscles of the uterus contract less painfully. If the contractions have become active, a change of position will help, some are more comfortable standing, some are sitting on a fitball, someone is walking or standing on all fours. Strong contractions are better to “breathe” finely (“dog-like”), and when trying, it is important to take in air and hold your breath, “squeezing” the baby’s chest outward.

Pain is aggravated by fear, panic, screaming, groans, hectic spontaneous breathing, lack of contact with medical personnel (the woman does not listen to the requests of the obstetrician, does not fulfill them).

What sensations indicate the approach of childbirth

From the grip before childbirth - periodic spasms of the muscles of the uterus, characterized by increasing dynamics and intensity. Understanding the mechanism of this process and its purpose will help overcome fear and act consciously during childbirth.

In the modern practice of obstetrics, childbirth begins precisely with the appearance of rhythmic uterine contractions of increasing intensity. It is important to know the difference between true contractions in order to be in the hospital in a timely manner.

As obstetricians note, the behavior and mood of the woman in labor has a noticeable effect on the course of childbirth. The right attitude gives a woman an understanding of the processes taking place in her body. Contractions are indeed one of the most difficult periods in childbirth, but they are the force that contributes to the birth of a child. Therefore, they should be taken as a natural state.

Training, precursor or prenatal contractions

From the fifth month of pregnancy, expectant mothers may feel episodic tension in the abdomen. The uterus contracts for 1-2 minutes and relaxes. If at this moment you put your hand on your stomach, you can feel that it has become hard. Pregnant women often describe this condition as a "petrification" of the uterus (stone belly). These are training contractions or Braxton Hicks contractions: they can occur constantly until the end of pregnancy. Their characteristic features are irregularity, short duration, painlessness.

The nature of their appearance is associated with the process of gradual preparation of the body for childbirth, but the exact causes of occurrence have not yet been clarified. In addition, there is an opinion that “training” is provoked by increased physical and emotional activity, stress, fatigue, and they can also be a response of the muscles of the uterus to fetal movements or sexual intercourse. The frequency is individual - from once every few days to several times per hour. Some women do not feel them at all.

The inconvenience caused by false contractions is easily eliminated. You need to lie down or change your position. Braxton Hicks contractions do not open the cervix and do not cause any harm to the fetus, so they should be considered only as one of the natural moments of pregnancy.

Approximately from the 38th week of pregnancy, the period of precursors begins. Along with the omission of the bottom of the uterus, weight loss, an increase in the amount of discharge and other processes noticeable for a pregnant woman, it is distinguished by the appearance of precursor or false contractions.

Also, like training ones, they do not open the cervix of the uterus and do not threaten pregnancy, although they are more vivid in terms of the strength of sensations and may well inspire excitement in primiparous women. Precursor contractions have intervals that do not decrease over time, and the strength of the spasms that compress the uterus does not increase. A warm bath, sleep, or snack can help relieve these contractions.

It is impossible to stop real or labor pains with the help of rest or change of position. Contractions appear involuntarily, under the influence of complex hormonal processes in the body, and are not amenable to any control by the woman in labor. Their frequency and intensity is increasing. In the initial phase of labor, contractions are short, lasting about 20 seconds, and repeating every 15-20 minutes. By the time of perfect opening of the neck, the interval decreases to 2-3 minutes, and the duration of contractions increases to 60 seconds.

In order to make sure that real contractions begin, it is worth correctly calculating the interval between them. As a rule, false contractions are chaotic, the interval between the first and second can be 40 minutes, between the second and third - 30 minutes, etc. While in the process of real contractions, the interval becomes stable, and the length of contractions increases.

Description and functions of contractions

The contraction is a wave-like movement of the muscles of the uterus in the direction from the bottom to the pharynx. With each spasm, the neck softens, stretches, becomes less convex, and, thinning, gradually opens. Having reached a disclosure of 10-12 cm, it is completely smoothed out, forming a birth canal that is one with the walls of the vagina.

Visualizing labor pains can help you cope with pain and uncontrollable emotions.

In each period of childbirth, the spastic movements of the organ are aimed at achieving a certain physiological result.

1. In the first period, contractions provide disclosure.
2. In the second, along with attempts, the function of contractions is to expel the fetus from the uterine cavity and move it along the birth canal.
3. In the early postpartum period, the pulsation of the uterine muscles promotes separation of the placenta and prevents bleeding.
4. In the late postpartum period, spasms of the muscles of the uterus return the organ to its previous size.

After that, there are attempts - an active contraction of the muscles of the press and the diaphragm (duration 10-15 s.). Arising reflexively, attempts contribute to the advancement of the child through the birth canal.

Phases and duration of contractions before childbirth

There are several types: latent, active and deceleration phase. Each of them differs in the duration of the period, intervals and the contractions themselves.

The given parameters can be considered averaged and applicable to the normal course of labor activity. The real time of contractions strongly depends on whether the woman is giving birth for the first time or is it a repeated birth, her physical and psychological readiness, the anatomical features of the body and other factors.

Contractions before the first and subsequent births

However, a common factor affecting the duration of contractions is the experience of previous births. This refers to a kind of "memory" of the body, which determines the differences in the course of certain processes. In the second and subsequent births, the birth canal opens on average 4 hours faster than in the first. This is due to the fact that in women giving birth to a second or third child, the internal and external os open at the same time. At the first birth, the opening occurs sequentially - from the inside to the outside, which increases the time of contractions.

The nature of contractions before repeated births may also differ: women in labor note their intensity and more active dynamics.

The factor smoothing out the differences between the first and subsequent births is the time interval separating them. The probability of long-term disclosure is higher if more than 8-10 years have passed since the birth of the first child.

In articles on the topics of motherhood and pregnancy, there is information that contractions before the second birth often come not before, but after the water has broken, and this happens not at 40, but at 38 weeks. Such options are not excluded, but there is no scientifically confirmed data indicating a direct connection between the serial number of childbirth and the nature of their onset.

It must be understood that the described scenarios are only options, and by no means an axiom. Each birth is very individual, and their course is a multifactorial process.

Feelings in contractions

In order to determine the onset of contractions, you should pay attention to the nature of the pain: before childbirth, they are similar to menstrual. Pulls the lower abdomen and lower back. There may be pressure, a feeling of fullness, heaviness. Here it is more appropriate to talk about discomfort, not pain. Soreness occurs later, with an increase in contractions. It causes the tension of the uterine ligaments and the opening of the neck.

The localization of sensations is quite subjective: in some women in labor, the spasm has a girdle character, its spread can be clearly associated with a wave that rolls from the bottom of the uterus or from one of the sides and covers the entire abdomen, in others the pain originates in the lumbar region, in others - directly in the uterus .

However, in the absolute majority of cases, women experience the peak of spasm as a contraction, a strong contraction, a “grasp”, which follows from the very name of the contraction.

Is it possible to miss contractions?

Not all women in labor have uterine muscle tension that causes unbearable pain. How a woman tolerates it depends on the threshold of sensitivity, emotional maturity and special preparation for childbirth. Someone endures contractions, for someone they are too painful to hold back a cry. But it is impossible not to feel contractions. If they are not, then there is no labor activity, which is an essential condition for physiological childbirth.

Some uncertainty in the expectations of expectant mothers can be introduced by the stories of women who have already given birth, in whom childbirth did not begin with contractions, but with a discharge of water. It must be understood that such a scenario in obstetrics is considered a deviation. Normally, at the peak of one of the contractions, intrauterine pressure pulls and breaks the membrane of the fetal bladder, the amniotic fluid is poured out.

Spontaneous discharge of water is called premature. This situation requires the immediate intervention of a doctor; it is unacceptable to wait for contractions at home.

Mechanism of action at the onset of contractions

It is important to understand what to do at home in the event of contractions and an approaching birth. A few recommendations:

• First, don't panic. Lack of concentration and unconstructive emotions interfere with concentration, lead to unreasonable actions.
• Feeling the onset of contractions, you need to determine their type: are they really contractions before childbirth or harbingers. To do this, you need to use a stopwatch or special applications on your mobile phone to record the time and calculate the duration of intervals and contractions. If the frequency and duration do not increase, then there is nothing to worry about. Harbingers usually subside completely within two hours.
• If spasms have become regular, the time of pauses between them is clearly defined, you can start going to the hospital. Departure should be planned in such a way as to be examined by a doctor by the time the frequency of contractions reaches 10 minutes. In the normal course of childbirth, this will happen approximately no earlier than after 7 hours. Therefore, if the contractions began at night, you should try to get at least a little rest.
• You can take a shower, do hygiene procedures.
• In case of repeated births, you should go to the hospital immediately after the contractions become regular, without waiting for the contraction of their interval.

Labor pains Feelings during contractions What happens to your uterus We detect the time of contractions.

Many women worry that they will not be able to determine when they will go into labor. Therefore, it will be useful to learn more about what contractions are and why they develop.

◄ Are you ready for childbirth?
It will be much easier for you to time contractions if you make sure that you have a watch with a second hand or a stopwatch at hand. The midwife will ask you to tell me how long the contractions themselves and the pauses between them are.

Contractions are the contraction of the muscles of the uterus, followed by relaxation. In the first stage of labor, contractions become regular and the cervix opens. Reinforced by the pressure of the baby's head, they enable the child to move through the birth canal. In most cases, the onset of contractions means the approach of childbirth.

Feelings during contractions
Each contraction starts at the top of the uterus and spreads down through the muscles.. The sensations in them are described as muscle tension, which reaches its peak, and then gradually weakens.
In the early stages of labor, contractions may be more likely to cause discomfort. rather than cause severe pain. Some women experience contractions with lower back pain. which gradually becomes stronger. Severe pain during contractions may mean that the baby is in the so-called posterior occipital presentation, that is, he moves forward with the back of his head, but is turned to face your sacrum.
As labor progresses, contractions become more frequent and painful, their duration increases, and the pauses between contractions decrease. Having reached the very peak, contractions may look like a continuous stream of pain, spreading throughout the body.
What's going on with your uterus
Each contraction begins at the highest point of the uterus and, gradually capturing all the muscles, spreads down. The longest and most painful contractions are at the top of the uterus, but the pain is felt simultaneously in the entire uterus and also subsides.
After each contraction, the upper part of the uterus becomes much smaller in size and thickens, its internal cavity contracts, which contributes to the gradual progress of the child through the birth canal. After childbirth, the muscles of the uterus still continue to contract and relax until the uterus returns to its normal size and is in the proper position it was in before childbirth.
You may experience mild contractions for about 6 weeks. Breastfeeding will provoke such contractions, which is why it contributes to the fastest recovery of shape after childbirth.
Timed fights
At the very beginning of labor, the duration of each contraction can be about 30 seconds, and the pause between contractions usually lasts about half an hour. It is important to know not only the duration of each contraction, but also the duration of the pauses from one contraction to the next, so that the midwife can determine at what stage the birth is.

To correctly determine the duration of the contraction, mark the time from the first attack of pain. When the pain has completely subsided, press "stop" and write down the time. To find out how often do contractions occur, mark the time from the moment when you feel the first signs of pain, and click on "stop", when will the next fight start. Record this time. You may notice that contractions can vary in duration, but their frequency is more or less constant. To calculate the average duration of a contraction, time four contractions., and then divide the result by 4.
Delivery time
Contractions become more intense as you get closer to the birth of your baby. When they occur every 3-5 minutes and last for about 45-60 seconds, this means that soon you will be ready to give life to your baby. But you should not wait for this house, otherwise you risk giving birth in the car on the way to the hospital.

PAIN DURING BIRTH

The muscles of the uterus are very strong. With each contraction, the muscles of the uterus contract strongly, helping the baby move through the birth canal. The strength and soreness of contractions will depend on what stage the birth is at.

First stage of labor

1 When contractions are just starting, they may look like bouts of pain. The pain is most felt at the top of the uterus and in the lower back. At this stage, most women can tolerate pain without resorting to pain medication.
The end of the first and the beginning of the second stage of labor 2 At this time, the contractions become stronger. You feel intense pain, concentrated at the top of the uterus and in the lower back. The pain then spreads down the legs, down to the fingertips. At this time, many women need funds to relieve pain.
Fetal Expulsion Period 3 At this final and climax of labor, pain moves from the uterus to the perineum as the baby moves through the birth canal. You may also experience back pain.

Before we begin to study what contractions are and how they differ from each other, we need to decide on the very concept of “fight”. After all, expectant mothers who are expecting their first child have never experienced such a sensation before and are most worried that they will not notice it, miss it or confuse it with something else. So, what is a fight, or rather, what is common to all, without exception, types of fights that will be discussed in this article?

Contractions are the sensations associated with a short-term increase in the tone of the uterus during pregnancy and childbirth. At its core, a contraction is a single contraction of the muscular wall of the uterus. This contraction usually lasts a few seconds. At the time of the contraction, the expectant mother feels a gradually increasing, and then gradually decreasing tension in the abdomen. If at this moment you put your hand on your stomach, you will notice that it becomes very hard - “like a stone”, but after the fight it completely relaxes and becomes soft again. In addition to involuntary tension of the uterus, other changes in the well-being of the expectant mother during false contractions are usually not noted.

Braxton Hicks contractions

These contractions are named after John Braxton-Hicks, an English physician who lived in the late nineteenth century and first described them in 1872. The contractions that Hicks mentioned are short, light, and completely painless contractions of the muscles of the uterus that last no more than a minute. They can appear most often after the 20th week of pregnancy. They differ from other types of Braxton-Hicks contractions by the complete absence of periodicity: these are just short single contractions of the myometrium (uterine muscles) that appear normally during the day and are separated by significant time intervals: for example, a couple of times in the morning, one in the middle of the day, three at dinner and another before bed.

At first, of course, new sensations can excite the expectant mother, but pretty soon most women get used to these contractions, fortunately, they appear rarely and irregularly, and completely stop noticing them. As the term increases, the number of such training contractions that occur during the day usually increases, but even then they still remain short and completely painless. The need for Braxton-Hicks contractions for the body of the expectant mother is explained simply: the uterus is a muscular organ that at least occasionally needs to work, strain, contract, in a word, train in order to prepare for childbirth. Many pregnant women note that such contractions often appear in a certain uncomfortable situation, for example, when walking fast, bending over, or staying in an uncomfortable position for a long time. If the sensations are associated with physical activity, you can try to take a more comfortable position: sit down or lie down on your side. If the contractions arose due to an uncomfortable posture, it is better to move a little: get up, stretch, walk, or even take a short walk. These contractions are also called training contractions, and this is no coincidence: after all, they gradually prepare the body and nervous system of the mother for the new sensations that she will face during childbirth.

Training bouts

It is customary to call the harbingers of childbirth external, really tangible for the expectant mother, manifestations of those changes in the body that become direct preparation for the onset of labor.

Harbinger, training or false contractions are those that occur shortly before childbirth and are not actually labor activity, since they do not lead to the opening of the cervix. These are the very contractions that future parents so often, due to inexperience, take for the beginning of real labor activity. In fact, distinguishing training fights from real ones is quite simple: you need to find three differences.

Large intervals. False contractions are repeated at significant intervals; between adjacent sensations there can be intervals of 20, 30, 40 minutes and even an hour.

Irregular contractions. “Imaginary” contractions feel similar to real ones, but the intervals between them can differ significantly from each other. For example, the first labor pains will go clearly every 20 minutes. And the “false alarm” is characterized by an uneven rhythm of contractions and intervals: 20 minutes - 15 minutes - 30 minutes - 10 minutes - 45 minutes, etc.

Lack of dynamics. Training contractions, unlike real, generic ones, will neither intensify nor lengthen, and the intervals between them will remain uneven. Even if the "training sessions" go quite often and alternate at regular intervals, they do not develop into something more: the interval and the sensations from the fight itself remain the same after an hour, and two, and three.

Training bouts can have two different outcomes. In the first case, they will stop by themselves. It should be noted that this scenario is the most common for a woman who is preparing to become a mother for the first time. After all, the uterus is a muscular organ and has the right to train before a decisive event. Much less often, such a “rehearsal” may turn out to be a general one. Then the initially irregular intervals between contractions will gradually become regular, and the training contractions will gradually turn into regular labor activity. In any case, if it becomes obvious that the contractions that have arisen are irregular (and in order to understand this, it is enough to compare a couple of intervals between adjacent contractions), the best thing to do ... go to bed. Indeed, before childbirth, it is especially important to save strength - after all, they will be so useful for this, the most important event in life! Even if events develop according to the second scenario, and the harbingers turn out to be a “dress rehearsal”, it is impossible to oversleep the birth! In the first case, the expectant mother will simply get enough sleep and will calmly wait for the real start of childbirth. In the second, he will also get enough sleep and wake up already with a good regular labor activity.

When is it time to go to the hospital?
, as soon as the interval between contractions is reduced to 10 minutes, but no later! Until this moment, the expectant mother can stay at home. However, this is only possible if she is in good health. If a woman's amniotic fluid begins to drain, her blood pressure rises, or spotting occurs from the genital tract, go to the hospital immediately!

Birth pains

The classic onset of labor activity is the occurrence of contractions that are insignificant in duration and sensations. The former are usually not associated with pain or significant discomfort. In fact, they are practically no different from the harbingers. Describing their feelings at this moment, women in labor say that the stomach is very strong, but not painfully tense and becomes hard as a stone for one or two dozen seconds. At the same time, a feeling of pressure is felt inside the abdomen - also completely painless, but rather strange and unusual. Then all new sensations pass, as unexpectedly as they appeared, and the belly of the expectant mother completely relaxes until the next contraction. Many women are waiting and very afraid of pain at this moment. However, these fears are completely in vain: the first contractions can be called an unusual sensation, perhaps unpleasant, definitely exciting, but certainly not painful. The only subjective sensation in this variant of the onset of labor may be a slight "sipping" in the lower abdomen and in the lumbar region. Most women experience similar sensations during the premenstrual period (PMS).

They come periodically, at certain intervals of time. The intervals between uterine contractions are called intervals. During the pause, the uterus relaxes and the expectant mother rests without experiencing any unusual sensations. Due to contractions, there is:

• opening of the cervix, necessary for the baby to leave the uterus (I stage of labor);
• the movement of the fetus through the birth canal and its birth (II period of childbirth);
• separation of the placenta from the wall of the uterus and the birth of the placenta - the placenta with the remnants of the fetal bladder and umbilical cord (III stage of labor).

Each fight develops in a certain sequence. At the beginning of the fight, the contraction of the muscle wall is minimal, then it gradually increases, reaches a peak (the highest degree), and then also evenly and gradually decreases. At the end of the contraction, the uterus relaxes. It can be said that the sensations during contractions are undulating: any contraction, no matter how significant it feels, begins with a barely noticeable feeling of tension in the abdomen, which gradually increases towards the middle of the contraction and also smoothly “fades away” towards its end. . At the beginning of physiological (natural) childbirth, each contraction usually lasts no more than 10-15 seconds. As labor activity develops, contractions gradually intensify and lengthen; By the end of labor, one contraction lasts about a minute. And the intervals between contractions, at the beginning of the process, are quite long (15 minutes or more), gradually shorten and at the end of labor last no more than 2-3 minutes. Contractions at any time of childbirth occur involuntarily, the expectant mother cannot control them at will.

Pushing contractions

In the second stage of labor, when the cervix is ​​fully opened, each new contraction pushes the baby forward, and he begins to move through the birth canal. From this point on, each contraction is accompanied by a false urge to defecate (the desire to empty the intestines). This sensation is so similar to the desire to go to the toilet "for the most part" that many expectant mothers believe that it arose in connection with a poorly done enema. This misconception is explained quite simply: it is caused by the pressure of the fetal head on the rectum, located next to the vagina. At this stage, the expectant mother needs to avoid premature attempts, which often lead to an increase in intracranial pressure of the fetus, and for the woman in labor, they are fraught with ruptures of the tissues of the birth canal. At the beginning of the pushing period, it is enough for the expectant mother to relax as much as possible, helping the baby to descend through the birth canal due to uterine contractions. And only at the very end, when the head of the baby drops as much as possible, at the command of the staff, the woman in labor will begin to push - hold her breath and tighten her press, pushing the baby out.

This stage is also associated in most expectant mothers with the fear of unbearable pain, but even here the expectations will not come true. The very moment of the birth of a baby is accompanied for the mother, rather, by strong physical stress than by pain. The fact is that the child's head stretches the tissues of the perineum so much that the blood supply to them is temporarily disturbed. Without a blood supply, it is impossible to transmit a nerve impulse, which is a pain signal. Therefore, there is no pain in the perineum, which future mothers are so afraid of, at this moment! There is only a feeling of fullness inside the vagina, created by the baby.

Afterpains

After the birth of the newborn, the contractions stop for a while, but after 5-10 minutes the newly-made mother feels the contraction again, which marks the separation of the afterbirth - the placenta, umbilical cord and fetal membranes. Following this, the placenta is born and childbirth is considered completed.

However, even after the completion of labor for several days, the woman continues to experience postpartum contractions. The main criterion for the recovery of the body of a young mother after childbirth is the rate of return of the uterus to its normal size, the state of the muscle and mucous layer, which is typical for her outside of pregnancy. The involution of the uterus occurs due to its periodic contractions, or postpartum contractions. During such contractions, the uterus decreases in size, its cavity is cleared of excess mucous membranes formed during pregnancy, and the healing of the placental site (the wound left at the site of attachment of the placenta to the uterus) is accelerated.

These contractions are significantly different from labor: the feeling of tension in them is almost not noticeable, and the pain is more like an intestinal spasm than menstrual pain. In order for the uterus to quickly return to its “pre-pregnancy” size, and postpartum contractions stop bothering the young mother, the process of uterine involution can be stimulated as follows:

• Lie on your stomach more - in this position, the tension of the abdominal muscles occurs, which is transmitted to the muscles of the uterus (myometrium) and stimulates its contractions.
• Monitor regular urination - a full bladder prevents the uterus from contracting and clearing secretions.
• Apply the baby to the breast on demand, every 1.5–2 hours: during suckling, the mother’s body produces oxytocin, a hormone that stimulates uterine contractions.

What you need to know about the harbingers of childbirth

1. The appearance of premonitory contractions as early as 35-37 weeks is the norm and does not require an unscheduled visit to the doctor, calling emergency medical care or hospitalization. Harbingers of childbirth are just manifestations of a planned restructuring in the body of a future mother, the “finishing touches” of preparation for the upcoming joyful event!
2. The absence of premonitory contractions closer to the expected date of birth is also not a pathology. Not all expectant mothers celebrate on the eve of childbirth those changes in well-being that are commonly called harbingers. This does not mean that someone is not preparing for childbirth. It’s just that the “final preparations” sometimes go completely unnoticed by the pregnant woman. Thus, the subjective (that is, associated with the feelings of the pregnant woman) absence of forerunners of childbirth should not cause the expectant mother to worry and contact specialists overtime.
3. The appearance of precursor contractions indicates the likelihood of regular labor activity developing within the next two hours - two weeks. Consequently, the absence of labor activity an hour, a day, or even a week after the forerunner phenomena noted for the first time is not considered a violation and does not require special medical advice.

Real contractions or not?

A very important sign of true labor activity, or real contractions, is the regularity of sensations, that is, neighboring contractions should be the same in strength, duration and intervals between them. At the same time, intervals between contractions of equal duration are considered the main criterion for their regularity - after all, the contractions themselves are initially so short and insignificant in sensations that it may be difficult for the expectant mother to objectively compare them.

Another property of true generic activity is growth, or the ability to develop dynamically. From the moment of the onset of labor, contractions should gradually increase in sensation and lengthen in time; while the intervals between contractions, on the contrary, will become shorter and shorter. If at the beginning of labor the contractions last about 5–7 seconds, and the interval is 20 minutes, then by the time the cervix is ​​fully opened, when the baby is already beginning to descend through the birth canal, the duration of the contraction may increase to 40–50 seconds, and the interval may decrease to 1–2 minutes.