Such contractions and how. How to find out that contractions have begun. Contractions before childbirth: the frequency of the active phase

The contractions that accompany childbirth are the most frightening process for pregnant women. Even the birth itself, the advancement of the child through the birth canal, they are not so scared as it is pain during contractions, with the opening of the cervix. However, everything is very individual. Many women in labor describe their feelings during contractions as normal and quite tolerable.

Many women who give birth again spend the whole process of contractions at home and go to the hospital when the cervix is almost open. But for those who are very difficult to tolerate pain, there are medication painkillers that are used directly in the maternity hospital according to the doctor's indications.

Labor contractions take place in three periods. Let's look at how they start, how they proceed, and how this process can be facilitated by accelerating the opening of the cervix. Let's figure out how to do it birth process quite tolerable.

How do contractions start and go?

First stage

The onset usually resembles the onset of menstruation. Arises nagging pain in the lower abdomen. These sensations are also often referred to as false contractions. But the process of starting contractions is very important, as it prepares the neck for the beginning of disclosure.

At the first stage, the pain is not strong, with a frequency of 1 time in half an hour or an hour. Lasts only a few seconds. After that, in most pregnant women, the mucous plug, which is thick mucus mixed with blood. There is no need to be afraid of this. It just means that the cervix has begun to open. Then there is pressure in the pelvis and perineum.

Second phase

This stage is much shorter in time. The cervix opens more and more quickly, and opens by about 7 cm. In this period, the sensations can be quite painful and last up to 1 minute. And the intervals between them are only 2 - 5 minutes.

Third stage

During this period, attempts are added to the contractions. The neck opens to its maximum - 10-12 centimeters. This is quite enough for the birth of a child.

When should you go to the hospital?

The moment when you need to go to the hospital is very important and responsible. In order not to miss it, you need to take into account the nature of pain. When the moment comes for the beginning of a real birth process, the pain is no longer localized, but girdle. It is often compared to a wave. Pain passes from the lower back to the front wall of the uterus.

At this time, the contractions are the longest (1st stage of labor). In nulliparous women, it can last 6-7 hours. At this time, the neck opens up to 3-4 cm.

If the birth is the first, you can stay at home until the interval between contractions is reduced to 5-7 minutes, then you need to go to the hospital. But this is the case if the hospital is located next to the house. If the hospital is far away, it is better to leave early.

It is also necessary to go to the maternity hospital if the interval is still long, but the pain is very strong and prolonged.

If the childbirth is repeated, then as soon as regular contractions begin, it is better to go to the hospital immediately. The fact is that repeated births are often fast. Therefore, it is better not to delay.

True or false contractions. How to determine?

Of course, they need to learn to distinguish. Many expectant mothers recent weeks pregnancy, looking forward to when labor pains begin. And they often confuse true contractions with false ones.

False (Braxton-Hicks contractions) - appear in some pregnant women, but not in all, after the 20th week of pregnancy. But they, unlike the true ones, do not open the cervix. They represent pulling sensations in the lower abdomen, a manifestation of discomfort in the lower back. The mother is very tense. It is easily felt if you put your hand on your stomach. The same sensations accompany the onset of true contractions, so primiparous women often confuse them easily.

How to reduce pain during contractions?

Remember that pain can be reduced even by simply changing your position. At this time, it is not necessary to lie down. Many, for example, find it easier to be on all fours. Someone is easier to endure pain standing on their feet, someone dances a little. Get into a position that will help you relax and make you feel better.

While the contractions are rare and painless, you can try to get some sleep. Sleep will help you relax.

When the pain is strong, you need to take deep breaths, and then short exhalations (3-4 exhalations). When pushing, it will become easier if you breathe very often (like a dog).

At severe pain, push thumbs hands on points located in the region of the anterior superior iliac spines. Feel for the most protruding parts of the pelvis. This is what they are. At this time, place your hands along the hips.

And most importantly - tune in to childbirth. listen to own feelings and think about the baby. It is also very difficult and difficult for him to overcome the birth canal. But together you will definitely manage to finally meet.

Svetlana, www.site

The pregnant woman waits for the appearance of contractions and at the same time experiences animal fear in front of them. Popular rumor ascribes the most severe pain sensations to this stage of childbirth. If experienced mothers go to repeated or third births and already have a good idea of what awaits them, then women who are looking forward to the appearance of their first child are at a loss. We will talk about the features and sensations, the timing and duration of contractions in women giving birth for the first time in this article.

How does it all start?

Childbirth is the natural process of completing childbearing. Nature gave him exactly 10 lunar months in order to become a real man from one crushing cell, just still very small. Childbirth can begin both on time and earlier or later. According to statistics, the onset of labor in nulliparous women usually occurs either at 39-40 weeks or at 40-42 weeks of pregnancy. The date indicated in exchange card- only a guideline for a doctor and a pregnant woman, only 5% of pregnant women give birth strictly in the PDR.

Childbirth can start in different ways. From the discharge of water, from the exit of the mucous plug, from the beginning of rhythmic contractions of the uterus - contractions. The latter option is considered the most preferable, since premature outflow of water always complicates childbirth, even if they occur just in time. It is from contractions that the process of childbirth manifests itself in the vast majority of expectant mothers. Only 10% of women start giving birth when the water breaks.

Contractions are called contractions of the muscles of the uterus. Labor pains occur simultaneously with the opening of the cervix. This dense muscle ring was tightly closed throughout the pregnancy, and the cervical canal inside it was closed with a mucous plug. The beginning of the opening of the neck is accompanied by contractions that grow and become stronger as it expands.

Contractions begin suddenly, but develop gradually. True labor pains may be preceded by false, training ones. They can be observed as early as the 20th week of pregnancy, or appear later, or not appear at all. But before giving birth - a couple of weeks or less - almost all women can feel a short-term uterine tension from time to time. That's what it is preparatory work female body before childbirth.

The purpose of labor contractions is obvious - at the first stage, they are needed in order for the cervix to open and free the passage for the child, who will have to go through the birth canal and be born. They compress the space inside the uterus, leading to rupture amniotic sac; in the stage of active contractions, the waters depart and this is considered quite timely. Rhythmic contractions of the uterus slightly "push" the baby to the exit. His time has come, there is no need to remain in the mother's womb any longer.

How to understand that childbirth has begun?

The first birth is always a lot of questions, the main one of which is how to recognize whether the birth has begun and whether it is time to go to the hospital. On this subject, experienced obstetricians have an old joke that says that if a woman has doubts whether she is giving birth, then she does not give birth, since it is impossible to confuse childbirth and training uterine contractions. But mostly women who are pregnant for the second or third time agree with obstetricians in this, they know for sure that the doctors are not disingenuous.

And it seems to a primiparous woman that at any moment she can miss something important and be late for the hospital. As already mentioned, a few days before giving birth female body begins to prepare for the upcoming event. In the cells of the uterus, the amount of a special protein, actomyosin, begins to increase. It is responsible for the ability of cells to contract. At the same time, the placenta and pituitary gland of a woman begin to produce oxytocin and relaxin. The first hormone increases the contractility of the female reproductive organ, and the second is responsible for softening the ligamentous apparatus, because during childbirth the uterus will change shape.

With these changes, the final preparatory stage, during which women are anxiously trying to find some “harbingers” in themselves, about which she read on women's forums, and which can make it clear that childbirth is just around the corner. Harbingers include anxiety, mild depression, mood swings, sleep disturbance, insomnia, more active training contractions. They appear like this: the stomach turns to stone, slightly “sips” in the sides and lower abdomen (due to the tension of the ligaments), and then they pass and can be repeated after half an hour, and after 5 hours, and after a day.

Contractions-harbingers do not differ in regularity, they come on their own and disappear in the same way. A woman can easily relieve discomfort by simply taking a shower, drinking a glass of milk or a No-Shpy tablet, or even changing her body position. With a training bout, a pregnant woman can go to bed and doze off quite successfully.

Is it possible to skip the moment of the onset of real contractions? Obviously not. After all, true contractions are rhythmic from the very beginning, they are repeated at regular intervals, the pain is no longer pulling, but light girdle in nature, the back and lower back are drawn into it, the pain increases with each contraction. You won’t be able to fall asleep, the No-Shpy tablet or the shower won’t have any effect. If labor pains have begun, it is unlikely that it will be possible to stop them or weaken them. The duration of the fight will be the same each time. And this is the main difference between "harbingers" and real fights.

Latent stage - sensations

As soon as a woman notices that the tension of the uterus becomes regular and obeys a certain rhythm, we can say that the first stage of childbirth is already underway. It is called latent (hidden).

If there is no bloody discharge, the water has not broken, you do not need to rush to call " ambulance”and urgently rush to the maternity hospital with special signals. The latent period at the first birth is usually the longest. It lasts up to 10-12 hours, on average, about 7-8 hours, and therefore there is plenty of time to put your nerves and feelings in order, psychologically tune in to a positive outcome of events and check things and documents collected in the maternity hospital in advance.

During this period, the pain is moderate, increasing gradually. At the very beginning, they are felt as habitual pains during menstruation, then they intensify, but the character remains the same. During pregnancy, women are taught proper breathing in childbirth. The latent period is the time to start applying theoretical knowledge in practice - to breathe correctly, taking deep breaths and exhalations in order to relax as much as possible. You can walk, sing, chat. Lying in one position horizontally is not worth it.

Feelings are undulating in nature. The fight usually "originates" in the back, covers the lower back and goes first to the bottom, and then to the top of the abdomen. Then the tension subsides, the woman gets the opportunity to rest a bit until the next fight.

During the latent phase, the contractions become longer. The very first signs of labor pains can be determined by measuring the duration of the spasm and the interval between episodes of spasms. In this first period, the average duration of one contraction from the moment of tension to the moment of relaxation is 20-25 seconds. Spasms are repeated at first once every half an hour, then once every 20 minutes.

By the end of the latent stage of labor, contractions last 25 seconds and repeat every 10-15 minutes. It is on this optimistic note that you should arrive at the hospital. The cervix at this point reaches a dilatation of 3 centimeters. The next phase of contractions is active, it should take place in the conditions of the maternity home. This will make everyone safer.

active phase

After opening the cervix by 3 centimeters, the contractions become quite painful, and in time they begin to occur more often. The duration of the contraction is 25-60 seconds, between contractions takes place within 3 minutes.

If you breathe correctly, keep calm, massage the sacral zone, the second stage of contractions can be experienced more easily.

Contractions at this stage look like a protracted spasm, the peak of the contraction becomes long. Usually at this stage, normal delivery the waters come off.

The duration of such a period is 3-5 hours. At this time, it is desirable for a woman to be under the supervision of a doctor. Usually at this stage, they begin to monitor the condition of the fetus with the help of CTG, the woman is already in the antenatal ward.

Behind active period contractions, the uterus opens up to an average of 7 centimeters. This is already quite a lot, but not yet enough for the baby's head to pass.

Transition period

This period is final. After him, attempts start - the shortest period of childbirth. Transitional contractions are also called the deceleration phase. The spasms themselves reach their maximum value for the entire period of childbirth. Each contraction lasts at least a minute and spasms are repeated every 2-3 minutes.

In general, the transitional period lasts from half an hour to an hour and a half. During this time, the cervix opens up to 10-12 centimeters (depending on the size of the pelvis). This dilation is considered complete as it allows the baby's head to pass through.

IN transition period a woman begins to feel a pronounced pressure on the bottom, as it is usually felt if you really want to empty your intestines.

But you can't push yet. The obstetrician will give the appropriate command already in the second phase of childbirth - in attempts.

If a woman in labor is not under the constant control of a doctor, then a feeling of pressure and a great desire to go to the toilet in a big way is a signal to call the medical staff and go to the delivery room.

What will happen next?

Next, the pushing starts. A woman needs to remain calm, breathe correctly, do not exhale sharply until the end of the attempt, push only at the command of the obstetrician. During attempts, the baby will turn, bend his head, he also tries very hard to be born as soon as possible. Wrong behavior of a woman in this situation can lead to a child getting birth injury, the emergence acute hypoxia extremely dangerous for him.

If you push on command, do not scream, do not bring your legs together, do not pinch your perineum, breathe deeply, holding your breath at the time of the attempt and making a long smooth exhalation at the end of the attempt, then the child can be born in the very near future.

The period of attempts under a favorable set of circumstances and the impeccable behavior of the woman in labor can last 20-30 minutes. Less often, primiparas push for an hour and a half, and it is very rare that the period of attempts is extended to 2 hours.

As soon as the baby is born, the woman can relax. Ahead is still the birth of the placenta, but it will no longer be so painful and unpleasant, especially since the baby is being applied to the breast and the mother can already examine the baby, hug, so for many, the birth of the placenta is relatively easy. This period takes from 20 to 40 minutes.

This completes the birth. The woman is sent to the postpartum ward for rest, the baby is sent to the children's department in order to be processed, washed, and examined by neonatologists. They will meet in a few hours, if there are no contraindications either from obstetricians or from children's doctors.

Features of the first birth

Very often you can hear the opinion that the first birth is always harder and more painful than the next. To some extent, it is true, but not in terms of pain, but rather because of the fear that a woman in labor experiences during her first birth. Lack of birth experience makes it difficult for a woman to choose comfortable posture during contractions, from time to time she forgets what she was taught in preparatory courses in antenatal clinic. At times like these, some people start to panic. From point of view psychological readiness women who gave birth earlier behave more disciplined in subsequent births.

The birth canal of a primiparous woman is narrower and less elastic. They are more difficult to stretch, and therefore even attempts are felt differently and last longer. The cervix also takes longer to open, and with that physiological aspect nothing can be done.

The first births are more often accompanied by complications. It cannot be said that during the second birth, unforeseen difficulties will not appear, there are always chances, but it is the primiparas who most often face such a phenomenon as primary or secondary weakness of the birth forces, when contractions do not lead to the opening of the cervix, and attempts do not move the baby forward . In primiparas, ruptures or tears of the perineum and cervix are more common.

Complications to a lesser extent depend on the physiology of the primogeniture, to a greater extent - this is a consequence of the erroneous actions of the woman in labor, disobedience to the commands of the midwife or doctor leading the birth.

Women who are preparing to become mothers for the first time need to prepare for childbirth in advance. Preparation must be consistent and constructive. It is a clear understanding of the upcoming process without unnecessary fear and emotions, as well as understanding the order of their own actions on different stages childbirth will be the key to a successful delivery.

You need to start preparing from the middle of pregnancy. Already at week 20, it makes sense to enroll in a school for expectant mothers who work in any antenatal clinic. Practicing gynecologists, pediatricians, psychologists will help prepare for major event in the life of a woman as best as possible. Preparation includes the following information.

Expansion of the theoretical knowledge base about the physiological processes and biomechanism of childbirth.

Technique training correct breathing during fights and in attempts. To practice breathing exercises during pregnancy, you need to be careful, half-heartedly, but it is recommended to devote at least 10-15 minutes a day to this. Then proper breathing will be natural and when childbirth begins, the woman will not have to remember how and when to inhale and exhale in order to relieve pain and help herself and the child. Breathing techniques help to feel the period of contractions less painfully, because due to the saturation of the body with oxygen, there is an increased production of endorphins, which have an analgesic effect.

Training in the technique of massage and self-massage. Starting from the latency period and up to the very attempts to relieve tension and pain, massage of the sacral zone will help, acupressure hands and faces. All techniques will be shown and told during the preparation by experienced obstetricians.
Psychological consultations. They will help shape right attitude to childbirth and labor pain. It has long been noted that the stronger a woman's fear of contractions, the more painful and longer they last. The psychologist will talk about some techniques that allow a woman to be more confident in her strengths and abilities.
Learning postures that make it easier to survive contractions. IN real childbirth before the period of attempts, a woman will be able to change the position of her body, adjusting to her own feelings.

Legal and domestic assistance. During the courses, the expectant mother will be told about what benefits and payments she can count on after the birth of the baby, how to apply maternity leave, as well as tell you what things you need to collect in the hospital, when to do it, what documents in without fail will need to be provided during hospitalization in a maternity facility.

If there are no prejudices against partner childbirth, and you want to give birth in the presence of your husband or close relative, you need to take care of this in advance. The spouse or other accompanying person must pass all the necessary tests.

The question of how to understand when contractions begin is relevant mainly for primiparous women who have no idea how this period of childbirth proceeds. Contractions are expected with trepidation and excitement, with fears, and therefore pregnant women with special attention"Listen" to your body last trimester pregnancy. In this article, we will talk about how contractions begin and whether they can be confused with something else.

What it is?

In the name itself lies physiological essence what is happening. A contraction is the moment when the muscles of the uterus contract. They used to say "grabs", "grabs". This folk definition also migrated to textbooks on medicine, and the word became the official medical definition.

Before giving birth, large-scale changes begin in the body of a pregnant woman. The cells of the uterine tissue - myocytes, in themselves do not have a great ability to contract, compress or stretch. In order for contractions to begin, they must accumulate a sufficient amount of a special protein - actomyosin. It is he who is actively produced a few days before childbirth, more often 48 hours. Simultaneously with this process, the placenta and pituitary gland begin to produce a special hormone - oxytocin, which puts the muscles of the uterus on high alert and provokes contractions.

With the first labor pains, the important process of opening the cervix begins. The fight, appearing from one part of the uterus, extends to the entire genital organ. The round muscle, which is the neck, begins to gradually open up. It is necessary that the fetus, when the time will come was able to leave the mother's womb. The baby's head is larger than the cervix, and therefore the latter needs to open up to 10-12 centimeters for the entire period of contractions, then the baby will be able to leave the cozy space, which has become too small for him.

Uterine contractions "compress" the fetal bladder. Therefore, at a certain stage of childbirth, the amniotic membranes do not withstand, burst, and amniotic fluid flows out. Without full contractions, natural childbirth is impossible.

If the cervix does not dilate or it occurs very slowly, labor is stimulated or a caesarean section is performed.

False and true - differences

The purpose of true labor pains is clear and obvious. But with false contractions, women often have reasonable questions. Physicians and scientists today do not understand the true purpose of false contractions (contractions according to Braxton Hicks). But it is absolutely certain that short-term uterine tension in pregnant women at any time from the 20th week cannot in any way affect the date of birth.

They do not lead to the opening of the cervix, do not put pressure on the fetal bladder. False contractions are not accompanied by the production of oxytocin and actomyosin protein. There is a version that with the help of short-term contractions, the uterus prepares for childbirth, as if “rehearsing”. Training contractions are not observed in all women, they are practically painless and completely safe.

Such contractions are felt as irregular episodes of increased uterine tone.

Unpleasant sensations quite possible, but they will not be painful. Rather, they can be described as sipping or aching in the very bottom of the abdomen on the left and right. The sensation is due to tension and tension in the ligaments that hold the uterus. The stomach stiffens and after a few seconds or minutes it “lets go”. The next fight can be repeated in five minutes, and in five hours, and in a few days. Training bouts have no regularity, cyclicity, orderliness.

This main feature, which will allow you to recognize false contractions from true ones, which always have a certain frequency, duration and sequence. In other words, contractions at the beginning labor activity will be repeated at certain intervals, last a certain number of seconds, increase as they develop.

Painful sensations during a real fight are localized in the back, lower back, over the entire area of \u200b\u200bthe abdomen. The pain begins from the back and lower back and gradually “encircles” the stomach below and above. When changing the position of the body, taking No-Shpy or papaverine tablets, when taking a shower, false contractions usually recede. Real ones cannot be slowed down, delayed or stopped.

Determining the difference will not be difficult, obstetricians say. Real labor pains feel completely different. The nature of sensations, the place of pain, cyclicity and regularity - these are the main signs that will help a woman to orientate in what is happening in time.

Today, women have access to special applications for smartphones, the so-called counter programs, which will notify their owner that her contractions are real, they will also indicate when it is time to go to the maternity hospital.

Harbingers

Almost always, labor pains are preceded by so-called symptoms - precursors. They can appear during pregnancy both a few days before the birth of the baby, and just a few hours before the birth. As already mentioned, before childbirth, serious hormonal, biochemical and physiological changes. And these changes can be manifested by the following signs.

Dropping of the abdomen. It is considered a harbinger only conditionally, since in some the stomach drops long before childbirth.
Weight loss. A week before giving birth, on average, a woman can lose 1-3 kilograms due to a decrease in the amount of water, due to hormonal changes and a decrease in progesterone levels.
Diarrhea. loose stool occurs in every second pregnant woman. It is believed that this is how a woman's body is "cleansed" before childbirth.
Mood swings, depression, anxiety, insomnia- usually increase 3-4 days before delivery.
Removal of the mucous plug. This is a lump of yellowish, transparent, pinkish mucus, with or without blood streaks. After the cork is released, childbirth can begin in a few hours or a few days.
Strengthening the frequency of training contractions.
Increased vaginal discharge.

It is not necessary that all these "harbingers" are felt in the complex. But even 1-2 signs from the list may well serve as a signal for readiness. When harbingers appear, you should not immediately grab a bag with things and documents and run to the maternity hospital. It can be quite a long time before giving birth. It all depends on how a particular female body will perceive hormonal changes, with what speed the preparation of the uterus, the maturation of the cervix will proceed. It should soften, and it is this process in the precursor stage that can lead to the discharge of the mucous plug from the cervical canal.

The cork may not come out, there is no need to be afraid of this. More precisely, she will definitely come out, but a woman may not notice this, since this can happen during urination. Often, the cork leaves its place in the cervical canal along with the waters or at the first stage of labor pains.

Start

Pregnant women are very suspicious, and therefore any changes in their well-being before childbirth can be perceived as a sign that contractions are starting. On this topic, experienced obstetricians like to say that it is impossible to skip contractions, and if there is any doubt, then the birth has not yet begun.

You can understand that they have begun by the regularity of contractions. Already from the very first there will be a noticeable definite pattern. The latent period always starts first, the longest. In primiparas, it can last up to 10-12 hours, in women who have given birth earlier - up to 8 hours. During this period, the uterus should open up to 3 centimeters. The opening is slow, the uterus contracts and relaxes. The fight begins involuntarily, without the participation of the will of the woman, and ends after a certain period of time with relaxation.

In the latent stage, the contractions will increase gradually. At first, they can occur every 30-40 minutes. The duration of the contraction itself is small - no more than 20 seconds. Feelings during real contractions leave no doubt about what is happening - a woman feels girdle painful compression of the uterus both in the back, and in the lower back, and along the entire abdominal wall. This means that the very first contractions will occur relatively infrequently. Between them, the woman will have about half an hour to rest.

Since the stage is long, there is still time to check all the things that were collected in the maternity hospital, the presence of all required documents, you can not rush to go to the medical facility. You can walk, take a shower, change clothes, some even sing to distract themselves. You need to try to relax as much as possible and tune in to a positive and easy birth. With all this, a woman should monitor the frequency of contractions and the duration of the breaks between them, either using a stopwatch or a watch with a second hand, or using a special program on a smartphone.

You need to go to the hospital when the contractions are repeated every 10-15 minutes.

At the end of the latent period, the period of active contractions begins. It lasts about 4-5 hours, during which time the cervix will open a little more and the opening will be up to 7 centimeters. Contractions intensify, repeat on average every 3-4 minutes and last up to 60 seconds. This period will require a woman's concentration, attention and certain knowledge of the rules of behavior in childbirth - breathing, postures that facilitate the strength of contractions.

The active period ends with a deceleration period. The strongest contractions for all childbirth appear - transitional. They lead to the full disclosure of the cervix up to 10-12 centimeters. This period lasts from half an hour to an hour and a half. In primiparous - longer than in multiparous. After that, there is a feeling of downward pressure, as if the woman suddenly wanted to empty her intestines. This is the beginning of attempts and the end of the first stage of childbirth.

Preterm labor is often accompanied by early or prenatal outflow of water. If the waters have broken and the contractions have not come, the woman does not need to wait for them to appear. You should immediately go to the maternity hospital, because a long anhydrous period extremely dangerous for both the child and his mother. And after a spontaneous rupture of the fetal bladder and after its opening (amniotomy), a woman should be under the supervision of doctors.

Contractions can begin at any time of the day - day, night, morning or evening. But in most cases, women note that they felt the first contractions in the afternoon. They are more pronounced when lying down.

In 10% of cases, childbirth begins with the discharge of amniotic fluid. In only 5% of cases, labor begins on the day indicated as the expected day of delivery (EDD). In the rest, the appearance of contractions can be expected from 37-38 weeks of pregnancy and later. Childbirth before 37 weeks is considered premature.

How to act?

If a woman feels that contractions have come, and determines that they are real, true, there is no need to panic. There is plenty of time to calmly drink tea, take a shower and come to the hospital with things without haste. You need to tune in correctly, remember everything that was taught in the courses for expectant mothers.

Already from the first latent stage of contractions, a woman can take control of her condition in own hands. Proper breathing will help her. You need to inhale deeply and slowly and exhale slowly. As the pain intensifies, the contraction can be "breathed" by applying shallow short breathing based on deep breath and private exhalations, as well as breathing “like a dog”.

It is important to breathe in this way and not scream, because as the blood is saturated with oxygen, the woman's body begins to produce endorphins, which are not only "hormones of happiness" and improve mood, but also have a pronounced analgesic effect. There are even entire methods of labor pain relief based on breathing, aromatherapy, warm and cold compresses, and massage (the Lamaze method).

Description different methods women receive in the classes at the antenatal clinic, where they are taught to breathe, correct posture, in which it will be more comfortable to survive the active phase of contractions.

Try not to eat or drink a lot of fluids at the very beginning of contractions. Do not take any medication. Move to speed up the opening of the cervix, do not lie or sit in one place.

So, with proper breathing and Spartan calmness (in panicked women, those who are very afraid, contractions are usually longer and more painful), you need to check the documents and call an ambulance or ask relatives to take you to the maternity hospital. The option with "ambulance" is preferable. If something goes wrong, then in the ambulance a woman can always get timely help.

Do not wait for a certain frequency of contractions, but immediately go to the hospital if there are bloody issues from the genitals, water broke.

Especially you need to hurry if the departed waters have a green or any other color. dark color. This is always a sign of the child's trouble, hypoxia, so you need to get to the doctors as soon as possible, who will decide how to help the baby.

Anesthesia

To relieve pain in the active and transitional stages of labor in modern maternity hospitals, the method of epidural anesthesia is often used, in which the anesthetic is injected directly into the spinal canal. To agree to such anesthesia or not, each woman is free to decide for herself. According to women who have gone through childbirth with pain relief, the effect is not always as expected. The injection does not relieve pain at all.

Much more positive reviews O natural anesthesia fights by the Lamaze method and "Kobas-breathing". Women who tried to approach each stage of childbirth from the first contraction to the last attempt from the standpoint of natural behavior, proper breathing, obedience in childbirth, claim that childbirth was quite easy, fast and the sensations were quite tolerable.

For information on how to understand that labor has begun and determine contractions, see the following video.

Some women don't feel contractions before giving birth, while others may experience contractions days before the baby arrives. In order not to be mistaken, you need to know the main signs of real and false contractions.

The first harbingers of future childbirth (false contractions)

During pregnancy, women may experience pain from time to time. i related to various types contractions of the uterus, the so-called false contractions.

How to understand that they have begun, and You can determine how soon the time of childbirth will come by the following precursors:

Not all of these precursors may appear, but the presence of at least one may indicate early delivery.

Features of "training" fights

Contractions that occur long before labor are called training.

They are characterized by such features:

occur in the second half of pregnancy;
duration varies from a second to several minutes;
with increasing gestational age, the frequency of training contractions may increase without changing their duration.

Such fights differ from the real ones in that they are less painful and disappear with a change in position or while walking. Also, they are not regular and there is no tendency to increase them.

Braxton Hicks contractions

From about 20 weeks long before the expected birth, contractions occur for reasons that are not fully explained. There's a tension going on abdominal cavity. The woman complains of discomfort, but pain is not felt.

Back in the 19th century, Dr. John Braxton Hicks, living in England, described this phenomenon. He explained this by saying that the body prepares the cervix for the upcoming dilation for the expulsion process.

If the birth is not the first, then such contractions may be accompanied by pain. The nature of contractions is most accurately determined using a cardiotocogram.

The occurrence of premature contractions, their danger

If contractions occur in the first months of pregnancy, a miscarriage is possible.

If contractions began after 6 months of pregnancy, then birth is possible premature baby. It will take a lot of effort to get the baby out.

That's why if contractions occur before 38 weeks, medical intervention is required to eliminate them.

It is possible that strong contraction uterus, pain in the lower abdomen and bleeding over time will cause the so-called training contractions. How to understand that they have begun was described above, but you should not worry - if the contractions are rare with an interval of several hours and lasting only a few seconds.

Wherein must be taken medications to reduce the resulting tone. With the threat of miscarriage, before contacting the honey. institution can, for example, take "Ginipral".

Do not take a hot bath if you have early contractions because it can cause placental abruption.

It is important to know! If there is profuse spotting, and the pain is quite high, then an ambulance call is required.

Signs of contractions just before childbirth

Understand that the contractions have begun, and should you can go to the maternity hospital as soon as in the body of a woman:

the uterus changes position to facilitate the expulsion of the fetus;
the cervix softens and shortens;
the cervical canal opens, connecting the uterus to the vagina.

In this case, additional pronounced signs appear.

Regular uterine contractions

Frequent and regular contractions testify to an early birth. How to understand that they have begun and it's time to go to the hospital worries almost all primiparas.

The intervals between contractions, unlike training ones, are the same tending to temporarily decrease the gap between them. At the time of contractions, the volume of the uterus decreases, increasing inside her pressure, and contributing to the advancement of the child through the birth canal.

Prenatal contractions are very painful. You can understand that they have begun by the pain that spreads through the abdomen and in the lumbar region.

The duration of contractions, indicating an imminent birth, is at least 20-30 seconds. The break between them is constantly shrinking. And it can be from 2 to 5 minutes. The active birth phase averages from 2 to 5 hours.

Drainage of amniotic fluid

Usually the fetal bladder ruptures during prenatal contractions. and fluid leaks from the vagina. After that, the birth process goes faster.

Timely discharge of water occurs during regular contractions, when the cervix opens more than 4 cm. If the water leaves earlier, then the child may be infected with bacteria in the birth canal.

Carefully! The process in question can occur at any stage of pregnancy. It is considered normal if the water has broken after 38 weeks. At this time, the child is already fully formed and ready for birth.

The discharge of water can occur as a result of a complete rupture of the bladder. At the same time, about 200 ml of liquid can flow out at the same time. But if the hole in the fetal bladder is small and it is located at the top, then the water leaves gradually.

When a woman is expecting contractions, how to understand that they have begun is possible by several symptoms, including severe pain in the abdomen.

They are often confused with urinary incontinence or leucorrhoea. To establish the nature of the discharge, you should contact the honey. institution or do the analysis yourself using a test purchased at a pharmacy.

Often, the birth process starts within 3-4 hours after the removal of amniotic fluid from the uterine cavity. But if this does not happen, then after 12 hours the birth process begins to be stimulated.

By the standards of some European countries auxiliary stimulation is resorted to only a day after the opening of the fetal bladder

Removal of the mucous plug

At the end of pregnancy, the entrance to the uterus is gradually clogged with a clot of mucus formed in the cervix. This serves as a barrier against the penetration of infections.

Prenatal production of estrogen in the body softens the plug, and she spontaneously comes out of the birth canal. This fact serves as a signal that labor activity is entering the active phase.

Sometimes the release of the mucous plug can only occur during childbirth or a few hours before this process. A gynecologist's examination can also provoke a cork exit. In this case, the mucus can come out all at once (20-30 ml) or throughout the day in the form of mucous secretions.

Physicians believe that Normally, the mucosal plug comes out no earlier than 2 weeks before delivery.

Note! After the discharge of the mucous plug, it is not recommended to swim in the reservoirs and take a bath. It is also better to avoid intimate relationships and carefully follow the rules of hygiene.

Nausea and diarrhea

Sometimes diarrhea occurs a few days before delivery. At this time, there may be frequent urge to urinate. This is due to the fact that the baby's head gradually descends into the small pelvis, causing discomfort to the woman.

The urge to defecate can be caused by uterine contractions during contractions. Bowel cleansing before childbirth does not lead to dehydration if the stool is mushy stool 3 to 5 times a day.

It is necessary to consult a doctor with a problem of diarrhea if the diarrhea is accompanied by vomiting, the temperature rises, and the stool is mixed with blood or foam and pungent odor. Perhaps the cause of this condition is an intestinal infection.

Shortly before giving birth, pregnant women may experience nausea. Usually, this is a natural process, but in some cases, testify to serious problems with health.

On later dates pregnancy, often nausea can be a manifestation of toxicosis. The cause of this condition may be changes in the kidneys or in the cardiovascular system.

risk group for complications due to late toxicosis include women:

with a negative Rh factor;
over 35 years of age;
with problems cardiovascular system and kidneys.

You should consult a doctor if nausea is accompanied by vomiting, fever, pain in the abdomen or head.

Directly before contractions, with the help of vomiting, the body is freed from food in the stomach to facilitate labor. Therefore, you should not worry about this.

Contractions during childbirth

Contractions testify to the process of preparing for the birth of a baby. How to understand that they have begun and how to behave correctly at this time, a woman should be familiarized in advance.

At this time, the woman in labor feels pain. At first, contractions occur after about 15-20 minutes. Then increase to a 5-minute break. Their duration ranges from 40 to 60 seconds.

Pain is not eliminated even with a change in position. Wherein pressure starts at the top of the uterus and then spreads to the entire organ, pushing the baby towards the cervical canal.

The position of the fetus inside the uterus can affect the intensity of pain. So, if the child lies with his back to the back of the mother, the woman experiences severe pain.

Opening the cervix

To distinguish false contractions, and to understand that labor has begun, doctors examine the walls of the cervix. During pregnancy, they are dense, and top part The cervix, called the cervical canal, tightly closes the entrance to the uterus.

While, when the cervix dilates, labor begins. Its disclosure at short terms of pregnancy threatens premature birth or miscarriage.

The stage of preparing the cervix for childbirth begins at about 32-34 weeks. It softens, allowing the baby's head to sink into the small pelvis. In multiparous, this process is faster and easier.

At the beginning of labor, the cervical dilatation is 2 fingers, but by the time the fetus is released, the opening should be from 10 to 12 cm, for the baby's head to pass through.

Strong pain from contractions is noted at the time of cervical dilatation from 8 to 10 cm. This stage can last from several minutes to several hours.

attempts

In the process of childbirth, contractions are accompanied by attempts. In a normal birth process, their total duration is only a few minutes. You can understand that they have begun by the maximum tension of intra-abdominal pressure.

As the women point out, pain from contractions during attempts is felt less strongly. The woman begins to push when the cervix is dilated enough to allow the baby's head to pass through.

The force of the attempts should be directed to the diaphragm and abdominals. The feeling of pushing is similar to that of a bowel movement.

At this moment, regardless of the desire of the woman in labor, emptying of her bladder and intestines can occur. Such cases are not uncommon and the medical staff is ready for such "embarrassment". All secretions will be immediately removed and there will be no contact with the child.

Women are required to listen carefully to medical staff and act on their request. Obstetricians closely monitor the process of childbirth, advising the woman in labor to push or hold back the urge a little, trying to relax. For this, a woman is advised to take frequent shallow and short breaths.

Sometimes it happens that attempts do not occur. But the medical staff knows what to do in such a case. Therefore, you must carefully follow their commands.

Subsequent contractions

At the next stage of childbirth, after the baby comes out, the last i.e. the placenta. At this point, the woman may again feel the urge to push. But this is no longer such a powerful and almost painless process.

With a little effort, the woman pushes the placenta out. After that, it is considered that the birth process is completed.

Afterpains

If after childbirth began cutting pains, such as during contractions, it can be understood that a process has begun aimed at restoring the volume of the uterus. It is noticed that afterpains in multiparous patients. They increase during breastfeeding.

This is due to the production of oxytocin, a hormone responsible for the formation of milk, which simultaneously stimulates uterine contractions in the postpartum period.

The uterus returns to its original state by about the sixth week after birth. Its size, which accommodated during pregnancy the child, the placenta and amniotic fluid, should by this time be equal to approximately a woman's fist.

When to call an ambulance and go to the hospital

You can go to the hospital in advance, but if you can quickly get to the hospital, then it is enough to come to the medical facility shortly before the birth.

If you haven't gone into labor before 40 weeks, don't worry. Normally, childbirth occurs from 38 to 43 weeks of pregnancy. But if after the maximum allowable period, childbirth does not begin, the intervention of doctors will be required.

Call an ambulance if you experience the following symptoms:

Acute pain in the abdomen or bloody discharge of a scarlet color.
The waters have receded.
The interval between contractions is about 10 minutes.

What to do before the ambulance arrives

If there are signs of the onset of childbirth, and you need to call an ambulance, it is recommended to do the following:

Usually, a maternity ambulance arrives immediately., so if the fees are over, then you can call an ambulance.

It is believed that if a pregnant woman is psychologically prepared in advance for childbirth, then this process takes place quickly and without complications for both the mother and the baby. At the same time, they endure even the painful period of contractions more easily.

In this video, you will learn how to understand that contractions have begun and childbirth after them.

This video will tell you what false contractions are and how they differ from real ones.

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. Different from other types of Braxton-Hicks contractions total absence 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 one more before bedtime.

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 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 are due to uncomfortable posture, it is better to move a little: get up, stretch, walk or even take a short walk. These fights are also called training, and this is not accidental: after all, they gradually prepare the body and nervous system mothers to 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 various options outcome. 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 it wellness. If a woman begins to depart amniotic fluid, pressure rises or spotting occurs from the genital tract - immediately leave for the hospital!

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 feeling with this variant of the onset of labor, there 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 gaps 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 contraction of the muscle wall is minimal, then it gradually increases, reaches a peak ( the highest degree), and then also evenly and gradually subsides. 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 expectant mother it is necessary to avoid premature attempts, which often lead to an increase intracranial pressure 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 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 - filled 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

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!
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.
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?

Very important sign 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.