40 weeks at night pulls and whines. How is abdominal pain diagnosed? How does the expectant mother feel?
If the 40th week of pregnancy is on the calendar and the woman continues to be in position, then she is inevitably haunted by such feelings as fatigue, excitement and anticipation of meeting the baby. The feelings of the expectant mother are easy to understand. It is becoming increasingly difficult for a woman to mentally and physically expect childbirth. A large belly puts a huge burden on the entire body. Everything is more difficult given once habitual actions. Toward evening, there is weakness, heaviness in the legs, drowsiness, aching pain in the back. Mood swings often occur. That mommy is sure that she is about to give birth, but nothing is ready for the baby. It seems to her that the painful expectation will never end. Inspiration is replaced by feelings and fears.
Psychologists advise not to dwell on negative emotions. It may not be easy, but you need to tune in to the positive.
The best way is to keep yourself busy. Then there will be no time for painful thoughts, and the wait itself will no longer seem so long. You can do your favorite hobby, go to shopping centers in search of clothes for the baby, do simple household chores.
Moms who have a tummy sagging may feel some improvement in well-being: it has become easier to breathe and their appetite has improved. However, the pressure of the uterus on the pelvic area leads to frequent urination and inflammation of the hemorrhoids. With trips to the toilet both during the day and at night, you will have to put up with and endure. To prevent exacerbation of hemorrhoids, it is necessary to monitor nutrition.
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Possible pain at 40 weeks pregnant
Pain of varying intensity often disturbs a pregnant woman at this time. Most of them are associated with the heavy load experienced by the expectant mother: a huge belly, uterine pressure on the pelvic region and lumbar region, swelling, etc. We list the most common ailments:
- abdominal pain caused by training contractions;
- pain in the lower back and in the perineum;
- pain in the legs due to circulatory disorders and swelling;
- pain in the anus due to hemorrhoids;
- pain in the sacrum after a pinched femoral nerve.
If the pain intensifies and does not recede, consult a gynecologist. Perhaps it's time for you to go to the maternity hospital, where they can stimulate the onset of labor, alleviating the condition of the mother and child.
Allocations
The beginning of the 40th week of pregnancy may be accompanied by changes in the discharge from the genital tract - they become a little more abundant. If you find a dense clot with a small amount of blood, then it is most likely a mucus plug. Throughout pregnancy, she performed the function of protection against pathogenic bacteria and microorganisms. Just before delivery, the cork comes off to make way for the fetus.
If the discharge at 40 weeks pregnant is bloody or too watery, you should go to the hospital.
The discharge of water is a clear sign of an imminent birth, and blood is an alarming symptom that may indicate a pathology in the placenta.
To exclude a threat to the life of the fetus, it is necessary to be under the supervision of an obstetrician-gynecologist.
baby movements
The woman still clearly feels the movements of the baby in the uterus. Movements at 40 weeks of gestation are no longer as active as before. It is quite difficult for the baby to move in the uterine space, given that he has occupied it almost completely, so he spends most of his time in a dream. Most often, the expectant mother feels the strongest shocks in the hypochondrium. The legs of the child adjoin this place. During waking hours, the baby tries to stretch and straighten his lower limbs. The tenderness of mothers expecting girls and expecting boys is caused by a slight rhythmic vibration of the abdomen - this is how the baby hiccups. A woman should daily count the number of movements of her child (normally at least 10 in half a day).
Possible Complications
In late pregnancy, the risk of complications is high. Therefore, a woman should be under weekly gynecological supervision. Among the most common pathologies of this period:
- hypoxia or oxygen starvation of the fetus;
- infectious diseases (more often all this is thrush);
- placental abruption;
- late toxicosis (gestosis).
Among all complications, preeclampsia is the most dangerous. Its main symptoms are nausea, vomiting, a sharp increase in pressure, severe swelling and weakness. If they are found, you should immediately seek medical help. A consultation will not hurt even if at least one symptom appears - for example, if a woman is constantly sick. With gestosis, doctors, as a rule, stimulate the onset of labor so that neither mother nor child suffers.
The position of the baby in the uterus
When the 40th week of pregnancy comes, the child has already taken a position in the uterus that is convenient for exit - longitudinal with head presentation. The head is tightly pressed against the pelvic bones in order to penetrate the birth canal during childbirth. There are frequent cases when the child does not have time or does not want to take a safe position, located across the uterus or legs forward. Doctors most often do not take risks and prescribe a caesarean section. Sometimes mothers may allow themselves to give birth if the fetus is small and there is no entanglement with the umbilical cord.
Tummy size
The size of the uterus is approximately 36-40 cm in height. Due to the fetus, which continues to grow in the womb, the abdomen becomes so voluminous that the skin on it is greatly stretched. From time to time, tubercles appear on it - parts of the baby's body that protrude during movements. The mother and father of the child can, with a hand, assume that this is a heel, shoulder, head or elbow.
- By the 40th week of pregnancy, Braxton-Hicks contractions become daily. Regularly exercising the muscles of the uterus, which tense and relax, will make it easier to endure childbirth.
- The uterus descends lower and lower into the pelvic floor. Outwardly, it looks like a prolapse of the tummy. If in earlier periods it was located immediately under the breast, now it is much lower.
- Due to the fact that the uterus has shifted, the woman breathes more freely, heartburn disappears.
- The skin continues to stretch. Uncomfortable sensations may appear - from slight itching to soreness. It is necessary to moisturize the skin in the area of \u200b\u200bthe abdomen and thighs.
A large belly makes it difficult to move freely and quickly. On a walk, mom needs to be more careful not to stumble and not injure herself. It is best to walk in the company of relatives or friends.
Childbirth is a physiological process. According to Hippocrates, the formed fetus, due to the onset of hunger at the end of pregnancy, seeks to exit the mother's womb. Also, ancient healers believed that the fetus, reaching a certain size by the end of pregnancy, does not fit in the uterus, it has to go outside.
Modern science describes the process of childbirth as the expulsion of the fetus from the mother's womb after it reaches a certain maturity, vitality.
Be that as it may, during this period a woman is left alone with her nature. She impatiently, at the same time fearing the irresistible force of the process, is waiting for the accomplishment of the natural sacrament of the birth of a new person.
Time runs inexorably, the last week of pregnancy comes, during this period a woman needs to listen very carefully to her body, psychologically prepare herself for the birth process. This is a very important period in a woman's life. And therefore, we will consider how the 40th week of pregnancy proceeds: discharge, pain, pulling the lower abdomen and other harbingers of childbirth.
What are they, harbingers of childbirth?
It should be remembered that childbirth will definitely begin when the baby is ready for birth. This usually occurs between 38 and 40 weeks of gestation. It is at this time that the first harbingers of childbirth appear. Usually there are several of them, all of them are physiologically interconnected.
2-3 weeks before the onset of childbirth, "the stomach drops." This makes it easier to breathe. At this time, the lower part of the uterus is stretched, due to the advancement of the baby's head into the entrance to the small pelvis. The bottom of the uterus descends. After that, the navel protrudes a little.
For the days remaining before the birth, the mood of the expectant mother can change dramatically: From a state of unusual mental excitement, to a state of complete apathy. This is due to changes in the central nervous system before the birth process.
Due to changes in the water balance, hormonal changes, a couple of days before the expected event, the weight of the pregnant woman decreases by 1-2 kg.
1-2 days before childbirth, discharge from the genital tract may appear in the form of thick, viscous mucus. There is no need to be scared, this is the mucous birth plug. This is normal, because it is already 40 weeks pregnant. Brown discharge simply contains minor bloody inclusions. In principle, the color of the detached mucous plug can be from yellowish to dark brown.
Also, when the 40th week of pregnancy comes, it pulls the lower abdomen. There may be pulling, cramping sensations in the lower abdomen and sacral region. Usually, such sensations are painless, or the pain syndrome is very weak. Most often this happens at night, telling the woman that the cervix is prepared for childbirth.
Before childbirth, all organs, systems of a woman's body undergo certain changes. Usually, at the next examination, obstetricians judge the readiness of the body for an early birth process according to the state of the cervix. It is significantly shortened, becomes soft, easily stretched, its channel becomes elastic, passable for the fetus.
Pregnancy - 40 weeks. When will the birth start?
A normal pregnancy usually lasts 37 to 42 weeks. Its duration directly depends on the woman's menstrual cycle. If it usually lasted 21 days, labor will probably begin after 38-39 weeks. If the cycle was longer, up to 36 days, the pregnancy will last up to 41-42 weeks. This is the so-called prolonged pregnancy.
A woman should remember that if the pregnancy exceeds 40 weeks, she must visit her doctor regularly to rule out possible pathology and complications of the birth process. With a protracted pregnancy, if it is caused by a pathology, the unborn child suffers first of all. He lacks oxygen. Therefore, after the 40th week of pregnancy, the doctor carefully monitors the condition of the fetus with the help of ultrasound and Doppler studies.
During the period of 40 weeks, before childbirth, premature rupture of amniotic fluid (the fluid surrounding the unborn baby inside the uterus) may occur. This is one of the main harbingers of an early birth. True, the waters must break during the birth of a child in order to help him pave the way. If the integrity of the fetal bladder is broken earlier, you should not hesitate to leave for the hospital. Since there is a high probability of infectious complications with a long anhydrous period.
If regular increasing contractions have begun, this is the main sign of the onset of childbirth. First there is a dull pain in the back, radiating to the thigh. This harbinger of childbirth tells the expectant mother that her baby will be born within 12 hours. Contractions become more frequent. At first, their frequency is 10 minutes, then repetitions occur after 4-5 minutes.
The most important thing is to meet these harbingers of the most important miracle in the world with joy, without fear and worries. Trust your feminine nature, she will do everything for you. And the kind, attentive hands of doctors will help make this process as safe as possible for you and your baby.
Good luck and be healthy!
Svetlana, www.site
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At 40 weeks pregnant, a woman feels tired and exhausted. Various pains become her constant companions. It is the nature of the pain syndrome and secretions from the genital tract that will be able to tell in time what is happening.
We will talk about what pain in the abdomen and unusual discharge at this time can mean in this material.
Physiological features
Week 40 is the end of your baby's pregnancy. At its end, the expected date of birth is planned. Pregnancy is considered full-term, childbirth can occur at any time. The uterus has increased more than 500 times its original volume. She weighs about 1300 grams without taking into account the weight of the baby, placenta, water.
This week, the uterus occupies almost the entire abdominal cavity, and the baby in it - all the free space. His body is tightly wrapped around the walls of the uterus, so the movements of the fetus are perceived very noticeably and even painfully. The internal organs, the usual "inhabitants" of the abdominal cavity, are pressed, pushed aside by the uterus in different directions.
For example, the stomach is pressed by the bottom of the uterus from below, and the intestinal loops are displaced by the uterus back and squeezed along the anterior wall.
It becomes more and more difficult to carry such a burden every day, the load on all organs and systems of a woman in the last days of pregnancy is enormous. The center of gravity changes, because of this, the back hurts and pulls the lower back. The belly looks huge, and the woman becomes clumsy.
Under the influence of special hormones, for example, relaxin, the ligaments and bones of the pelvis soften, which leads to pain in the pubic region, backache in the sacrum.
The child at 40 weeks almost in all cases sank, his head pressed against the exit from the small pelvis. He braced himself, tucking his chin to his chest, crossing his arms. He is ready to start.
After lowering the abdomen, the expectant mother began to breathe easier, but the pressure on the bladder increased, so she constantly runs to the toilet for small needs.
If the stomach has not yet lowered (which is rare at the 40th obstetric week), then the baby has not yet risen to the desired pre-launch position, its head is above the entrance to the small pelvis. There is no need to worry, apparently, the baby is in no hurry to be born, and his time has not yet come.
At week 40, global hormonal processes take place in the woman's body. Previously, the hormone progesterone was responsible for maintaining pregnancy, now it is being replaced by large amounts of estrogen, oxytocin, which prepare the body for childbirth, restructuring the work of many systems.
From a hormonal "attack" a woman may feel tired, drowsy, her mood is unstable, often changing for no apparent reason. A variety of pain and discharge are also mostly due to changes in hormonal levels..
Why does my stomach hurt?
Reasons for the occurrence of pain in the abdomen can be enough. A large and heavy uterus creates the prerequisites for the appearance of quite unpleasant symptoms.
Not all abdominal pain at this time indicates that labor has begun. Therefore, let's look at what abdominal pain can be, and what it "beeps" about.
Training bouts
Until the end, medicine and science do not know the purpose of false contractions, which are also called training. It is believed that they "prepare" the muscles of the uterus for the real test that will soon be experienced.
In primiparas, such contractions appear earlier than in women who are going to become mothers for the second or third time. If the pregnancy is the first, false contractions may disturb the expectant mother a month before the birth, and if the birth is not the first, then training contractions usually occur shortly before the onset of real labor.
There are such contractions as pulling pains in the lower abdomen - on the right and left, in the ovarian region. At the same time, the lower back slightly ache, and the stomach becomes hard, “hardens”. If you lie down a little and rest, the training contractions recede, everything calms down. Many compare the nature of pain during false contractions with moderate pain, like during menstruation.
Some women claim that they did not experience pain at all, only a slight discomfort associated with the arrival of the uterine muscles in a state of increased tone.
True contractions
Real fights only begin as training, their further development is of a completely different nature. They grow, become more painful, frequent, prolonged. At the very beginning, it pulls the lower abdomen, and then the pain "encircles", capturing the lower back.
During the fight, the uterus hardens, the stomach becomes like a stone. At the end of the contraction, the muscles of the uterus relax, the pain recedes. After a certain time-fixed break, the contraction returns.
At the initial stage, contractions last no more than 30 seconds, repeat every 5-7 minutes, the pain increases gradually. This stage in a primiparous woman can last up to 7-8 hours.
The cervix during this time can open up to 3 centimeters.
At the next stage, the contractions last for about a minute and are repeated every 3-4 minutes, and sometimes less. The pain is noticeably stronger. At this stage, and preferably even earlier, you need to be in the hospital under the supervision of doctors, since this period lasts less than the previous one.
At the last stage before the attempts, the contractions last for a minute and a half and are repeated approximately every 30 seconds.. A woman should go to the maternity hospital when the contractions are repeated every 7-10 minutes. Don't wait until they get stronger. With rapid childbirth, you may not have time to go to the hospital, and with prolonged waters, they can leave right at home, and then the risk of infection of the fetus will increase.
At this point, it is best to be in a maternity facility under the supervision of doctors.
Digestive problems
The organs involved in the process of digestion are now working at the limit of their capabilities due to compression by the uterus. Therefore, the last days of pregnancy are often marked by severe heartburn, indigestion, loose stools or constipation.
Pain in the abdomen due to gastroenterological problems is also often manifested.. Women complain that the stomach "twists", there is heaviness. A variety of tingling and even cutting pains can occur due to the accumulation of intestinal gases in the compressed intestinal loops.
In this case, the abdomen can also be hard, with upheavals and movements it often boils, there is a feeling of bloating, fullness.
If the pain is localized in the navel and in the iliac region, we can talk about colitis. Colitis develops on the background of food allergies, and in pregnant women in the later period it occurs quite often. When moving or emptying the intestines, such pain intensifies and is often mistakenly perceived by women as a harbinger of childbirth.
Allocations - the norm and options
At week 40, it is imperative to use daily pads so as not to miss the beginning of changes in the nature of the discharge. In general, at this time, clear, white or yellow discharge without odor and such unpleasant accompanying symptoms as itching are considered normal. It is also normal for a slight increase in the amount of vaginal secretion this week.
The following "surprises" can expect a pregnant woman.
Mucus plug exit
The mucous plug is located in the cervical canal of the cervix. From the very beginning of the period of bearing a baby, mucus forms and accumulates in it, the task of which is to tightly close the communication with the uterine cavity and prevent foreign microorganisms - viruses and bacteria - from entering its sterile environment.
If the birth is already very close, the cervix begins to smooth out, shortens, the internal os begins to open slightly. All this leads to the fact that the cervical canal expands, the cork ceases to be held in it and goes out. If the cork has come off completely, then it looks like a clot of mucus with blood streaks.
Often, women pay attention that the discharge becomes mucous or with clots of mucus, sometimes blood blotches are also noticeable in the clots. This is a sign of a gradual discharge of the mucous plug.
From this moment on, you should not take a hot bath, have sex, in order to exclude the possibility of infection entering the uterine cavity through the cervical canal.
Leakage and discharge of amniotic fluid
The discharge of the waters is difficult to confuse with anything else. The warm fluid stream simply flows out. This is an indisputable sign of the onset of labor, a woman should go to the hospital.
Sometimes pregnant women notice that at week 40 they have liquid, rather abundant discharge of a watery nature. This is the leakage of amniotic fluid. The perforation of the fetal bladder is insignificant, therefore, a complete outflow does not occur, the amniotic fluid leaves the fetal bladder gradually, in small portions.
Leakage may increase with movement. The discharge is odorless and colorless. Pharmacy tests for the determination of amniotic fluid, according to expectant mothers, are often mistaken.
It is better to immediately go to the gynecologist to establish the fact of leakage reliably, using ultrasound to determine the level of loss and the amount of fluid remaining. All this will definitely be done in the maternity hospital, where you also need to go if there is a leak.
If the watery discharge is colored greenish, this indicates that the original cal-meconium from the baby's intestines has entered the water. This can happen when the umbilical cord is entwined, with fetal hypoxia and other intrauterine suffering of the crumbs.
Pathological discharge
Discharges that speak of a particular pathology at this time are considered to be all discharges that have a sharp and unpleasant odor, as well as a different color.
Greens and dark grays
Spotting discharge of this color usually has a pronounced fishy smell. They do not fit into the normal discharge, because they do not appear as a harbinger of childbirth, but as a symptom of a genital tract infection.
It is urgent to do smear tests, establish the pathogen and try to have time to treat the infection, to sanitize the birth canal.
Bloody and bloody
Such secretions include pink discharge, and rich bloody, bright color. Normally there should be no blood. The appearance of such secretions may be a sign of problems with the placenta, cervix.
Bloody discharge after sex and orgasm at this time may indicate injury to the cervix. Urgently need a doctor's consultation and hospitalization.
Weight: 3000 to 4000 g
The time has come when childbirth can begin at any time, although a child who appeared in the period from to 42 weeks of pregnancy, i.e., is considered completely normal and full-term. your condition may still last for 1-2 weeks. At this time, many mothers notice that the child kicks hard in the stomach - this is a natural process.
In the event of a prolonged pregnancy, the doctor may decide to artificially induce labor. To do this, a pregnant woman is injected with oxytocin intravenously and they are waiting for her to start contractions. The decision to induce labor is most often made if the cervix is already ajar and stretched. The baby is in a head down position. Although you will be examined first to determine the condition of the baby and the placenta, on the basis of which they will decide to continue monitoring and wait for the natural onset of the process, induce labor by administering oxytocin, or perform a caesarean section.
Signs of overdue pregnancy:
1. More than 42 weeks or 294 days have passed since the last period.
2. A post-term baby has no hair, the skin is dry, flaky. There is no original lubrication, which usually completely or partially covers the body of a newborn. Older babies have long fingernails.
3. When overcarrying, most often there is a risk of fetal hypoxia, since the placenta has already worked out its term and begins to age rapidly, which makes it worse for performing its function of providing the child with nutrients and oxygen. The amniotic fluid becomes greenish.
Perhaps you have already begun. Most likely, the stomach dropped, there were false contractions, sometimes it hurts and pulls the lower abdomen, the uterus began to tone up more often. In nulliparous women and women who have a big difference between children, a mucous plug comes out before birth, which closes the cervical canal. This usually happens 1-2 days before the onset of labor activity itself. But maybe in a week. In order to determine whether the mucous plug has come out or amniotic fluid has begun to leak, wear non-factory cotton pads so that the doctor can determine the intensity and nature of the discharge, this is very important. Sometimes the amniotic sac bursts at the top, and the fluid begins to slowly leak, this can be found on an ultrasound. You may need to induce contractions, as the baby cannot go more than 12 hours without water. Amniotic fluid is usually clean, transparent, odorless, with fetal hypoxia may have a green tint.
40th week of pregnancy - Now let's talk about the birth itself.
How to determine the moment when you need to go to the hospital? Before giving birth, the doctor will conduct an examination to determine the condition of the cervix, perhaps it has already begun to open and in the case of the first birth or pathology, you may be advised to go to the hospital in advance so as not to worry and be constantly under the supervision of doctors.
The first birth can last 3-4 hours, and 10-12 hours, and a day. It all depends on the speed of opening the neck. Of course, contractions are an exhausting and painful process, so it’s good if you have a person next to you who will support you: husband, sister, mother, girlfriend, midwife. The first contractions last for 10-20 seconds with an interval of 10-15 minutes. During this period, the cervix usually opens by 3 cm.
Then the second period begins: regular contractions for 20-30 seconds every 5-7 minutes. During this period, if you are not yet in the hospital, it is advisable to call an ambulance and go to the hospital. If you are already in the hospital, you will usually be transferred from the antenatal ward (pathology department) to the delivery room. We advise you to shave your groin and pubis in advance at home. You will also be given an enema so that the baby is not born with stool.
In the process, the uterus can already open by 6-7 cm. Now the most intense and painful contractions begin, which last for 50-60 seconds with an interval of 1-1.5 minutes. During this period, the final opening of the cervix to 10 cm occurs. Usually, when opened by 7-8 cm, the amniotic sac itself breaks and the baby's head is installed in the birth canal. If this does not happen, this procedure is done by a midwife.
After opening the cervix by 10 cm, the next period of childbirth begins - straining. Now it is very important to listen to the doctor and follow all his instructions. Attempts are felt stronger than contractions, as they are associated with the progress of the child through the birth canal. You will feel pressure on your rectum as you push. First, the midwife will ask you not to push so that the head settles and the bones of the baby's skull move so that the baby can more easily pass through the vagina. Otherwise, you will complicate the work for yourself and the baby and increase the risk of breaks. When the baby's head begins to come out, you will be given the command to push. Listen carefully to the midwife to make the birth process easier for you and your baby. After the head has come out, it is the turn of the shoulders. Mom must help the baby with her work to get out without the help of doctors. Once the hangers are out, the process will speed up and the rest of the baby's body will come out faster. You are about to hear the first cry of your son or daughter! The child will be laid out on your stomach and applied to the breast for the first time, so that he sucks out the first most valuable droplets of colostrum. It happens that after protracted contractions and difficult childbirth, the child is so tired that he does not respond to the breast. Then ask to be sure to attach it after the end of childbirth, or upon arrival in the postpartum ward.
10-15 minutes after the birth of the baby, the third phase of labor begins - the placenta passes. For the birth of the placenta, 1 attempt is usually enough. The doctor will carefully monitor that the placenta has passed completely, it happens that it comes out in parts. If it does not completely come out, then bleeding begins, and then you have to do an urgent cleaning of the uterus from parts of the placenta. The umbilical cord is cut for the child and a special bracket (clothespin) is applied for the speedy healing of the umbilical wound, and the placenta and umbilical cord are placed in a special bag and sent for a histological analysis, which will show how the birth went, and whether there are any health abnormalities in the child and mother.
After giving birth, ice will be placed on your stomach to help your uterus contract faster.. You will stay in the delivery room for 2 hours with the baby, and then you will be taken on a gurney to the postpartum ward. In the past, the child and the mother were in different wards, now neonatologists practice the joint stay of the mother with the child in the ward. This is relevant, because already from birth a new period in a woman’s life begins - lactation, and for its successful start, it is often necessary to put the baby to the breast.
Congratulations! You have become a mother! Now a new beloved man has appeared in your life, who will bring you a sea of \u200b\u200bjoy and worries.
And finally, an anecdote in the subject: Immediately after the birth of a child, a young mother asks the midwife: “Is the hardest already over?” Midwife: "No. The hardest part awaits you for the next 18 years!”
Happiness and health to you and your children!
