When to go to the hospital for the second birth. What symptoms indicate an imminent onset of labor? With repeated childbirth

19.06.2019

Re-pregnancies are believed to proceed somewhat differently. Therefore, even experienced mothers do not know when to go to the hospital for a second birth, so as not to miss the right moment. It is necessary to understand the main features of re-delivery.

For a timely visit to the hospital, you need to familiarize yourself with the main aspects of the period of contractions. As a rule, a woman manages to get to the maternity hospital before the onset of labor.

How to understand that the second birth begins? The expectant mother will feel the harbingers of the imminent birth of the child, such as the discharge of the mucous plug, the lowering of the abdomen and the rupture of the fetal bladder. Contractions are noticeable with small interruptions, which gradually intensify.

Messengers of the second kind are different from the first time. It is about the time of the baby's manifestation into the world. This means that the plug comes out an hour before the birth of the baby, just like the belly, it goes down right in the delivery room.

Training contractions are not a reason to go to the hospital during a second pregnancy. They are noticeable even a couple of weeks before the birth process. If regularity is visible in the uterine contractions and the intensity increases, this indicates that the birth cramps are real. In such a situation, the main thing is to remain calm and not to panic.

If a partner delivery is expected, it is important to place the older child in advance with relatives in case of hospitalization. It is required to tune in to positive emotions and wait for the interval between uterine contractions of 7-8 minutes.

When to go to the hospital for the second birth? In multiparous, the stages of labor are shortened, so it is better to go to the maternity hospital early, when the interval between uterine spasms is 10 minutes.

Mandatory hospitalization is required for the discharge of amniotic fluid. This applies to any pregnancy, the gestation period does not matter.

The expectant mother needs a trip to the hospital in case of an emergency (bleeding, green or red waters, lack of fetal motor activity) or with regular uterine cramps every 7-8 minutes.

True and false contractions

If this is the second pregnancy, the training contractions of the uterus are noticeable from as early as 20 weeks. Over time, their intensity increases, but nevertheless, Braxton-Hicks contractions can be really distinguished from real ones.

Training spasms are irregular, and there is no pattern in their duration. The intensity of fake contractions depends on the physical activity of the expectant mother (during the day they are palpable, and at night everything is calm), the tone is removed with the help of a warm shower.

True birth contractions of the uterus cannot be stopped or affected by their strength. Over time, real contractions become more intense and longer, the lower abdomen pulls, the lower back aches and the sacrum is felt. The woman is surrounded by pain, which gradually increases.

Labor activity during the second birth proceeds quickly. On average, with a second delivery, the procedure takes no more than 8 hours. For this reason, you should try to start recording contractions in time so as not to miss the right moment to travel to the maternity ward.

You can count the intervals and duration of uterine contractions using a notebook, pen and watch, or a special application for a smartphone. Both methods are correct, but the virtual counter of contractions is more practical to use. It is enough to press the button at the beginning of the spasm and at the end of it. The program will independently calculate the duration and interval.

After the first true contractions, it is important to dress in a spacious and comfortable sundress or robe that can be easily removed. In winter, wear a dress or warm nightgown.

The road to the hospital

As soon as the expectant mother realizes that it is time to go to the hospital for the second birth, it is necessary to decide on what and how soon she needs to go there. A woman in labor should make a choice based on the current situation. With the normal course of the period of contractions, without pathologies and bleeding, it is quite possible to go to give birth on your own (by car or taxi). If the expectant mother sees green, brown, scarlet water or spotting, an ambulance must be called immediately.

When it is not possible to go to the hospital by car, it is better to go there before the second birth begins. This is the only way to get to the right hospital. An ambulance will be lucky to be nearby or on duty.

Collecting bags. It is important to pack your things properly before going to the hospital for the second birth. Usually, expectant mothers are given a list in the antenatal clinic, according to which they need to put things together for their stay in the maternity ward. These are personal hygiene products, clothes for a newborn, diapers and diapers. As a rule, overpricing people are already filtering everything that is written in the required items, according to personal experience.

With a post-term second pregnancy, you should contact the hospital as early as possible (no later than 40 weeks). Then the woman is stimulated with drugs. But due to the peculiarities of the second birth, namely the shortened stages of labor, it is necessary to know the secrets to prevent tears and cracks.

How not to tear during a second birth:

train the vaginal muscles;
lubricate the perineum with vegetable oil (olive, almond);
try to eliminate drug stimulation

If you adhere to the recommendations of the gynecologist, the chance of injury to the genitals during childbirth decreases. The cause of cracks and tears may be the age of the woman in labor or her physiological characteristics (lack of tissue elasticity). In such a situation, the advice of obstetricians will not help prevent the complication.

It is not difficult to recognize the second birth, since the woman already has an idea of what lies ahead for her. The basic rule is to get to the hospital on time so as not to have a baby on the road. When the amniotic fluid is poured out at any time, you need to immediately go to the hospital, because the baby should appear no later than 12 hours after the rupture of the fetal bladder. The contractions and their duration should be recorded correctly. Then you can count on a positive outcome of the birth process and the appearance of a healthy baby.

First, you need to know the estimated calendar due date. The duration of pregnancy is different for each woman; on average, it is 280 days, or 40 weeks, fluctuations from 38 to 42 weeks are considered normal.

How to find out the due date?

There are various ways of calculating the due date. Some try to determine the day of conception and count the days from it. However, the day when sexual intercourse occurred and the day of conception itself may not coincide, since the sperm cells are able to maintain their viability and "wait" for the egg in the woman's genital tract for several days.

Determining the date of birth by menstruation

The most common way to calculate due date is “by menstruation”. This is usually a well-documented event. It is necessary to remember exactly the first day of the last menstruation, from the beginning of which it is proposed to count 280 days. And even easier - add another 7 days to the date of the first day of the last menstruation and count back three months. For example, the last period started on September 5th. Then childbirth can be expected on June 12 (5 + 7 days = 12, 9th month September - 3 = 6th month June). But this method will be unreliable if the woman has an irregular menstrual cycle or does not remember the date of her period.

Our Date of Birth Calculator will help you calculate your due date by your period.

Determining the date of birth by ultrasound

In modern conditions, the date of birth is determined quite accurately, focusing on the data of an ultrasound scan (ultrasound) performed before the 12th week of pregnancy. In the later stages of pregnancy, the error in determining the term using ultrasound increases. This is due to the fact that the size of the fetus, which the doctor is guided by in his calculations, at the end of pregnancy has large individual fluctuations.

Likewise, the calculation is made based on the date and duration of pregnancy, established at the first visit to the doctor (method "at the first visit to the antenatal clinic"). The sooner your doctor determines the gestational age, the more accurate your future predictions for the date of birth will be.

Determining the date of birth by fetal movements

You can roughly calculate the date of birth and the first movement of the fetus: in primiparous women, this occurs on average at 20 weeks, and in multiparous women - at 18 weeks. Of course, these are very subjective sensations, because the moment of the first movement of the child is not always clearly distinguishable.

You can find out about full-term pregnancy and the approaching birth by several signs. In about 1 - 2 weeks, the so-called "harbingers" of childbirth appear.

Harbingers of childbirth

Most women at the end of pregnancy notice that their belly has "dropped" and it has become easier to breathe. This is because during a full-term pregnancy, the amount of amniotic fluid decreases slightly, and the fetal head is pressed against the entrance to the woman's pelvis. The uterus becomes more excitable, she "trains", prepares for the upcoming big work. Irregular painless tension of the uterus and a feeling of heaviness in the lower abdomen and lower back are called "contractions of pregnant women." Not always even a doctor can say with certainty whether this is the onset of labor or preparatory contractions occur. If such a state of increased irregular excitability of the uterus lasts 1 - 2 days, then it is better to contact maternity hospital, where they will be able to assess whether the child is suffering at the same time.

A few days before delivery (or on the day of delivery), light mucous discharge may appear from the genital tract, sometimes with small streaks of blood. Usually they say that "the mucous plug has come off." This is a favorable sign of softening and “ripening” of the cervix.

In many women, by the end of pregnancy, colostrum, the precursor of breast milk, is secreted from the nipples.

A healthy woman with a favorable pregnancy can be at home before the onset of labor. If there are deviations in the woman's health status, pregnancy has complications, if signs of fetal suffering are established, then, of course, the last 1 - 2 weeks (and, if necessary, more) should be in the maternity hospital under the supervision of specialists. Recently, many women, especially urban women, prefer to go to the maternity hospital in advance. This is obviously due to a general deterioration in the health of the population, the desire of the family, if possible, to insure itself against various accidents.

When is it time to go to the hospital?

So, at home you felt some change in your condition. There was heaviness, a slight pain in the lower back, in the lower abdomen, the uterus tensed and became very dense to the touch. At first, contractions and relaxation of the uterus are irregular, last 5 - 10 seconds with long breaks (up to half an hour). Then their frequency and intensity increase. It was the contractions that began. If you give birth for the first time and live near maternity hospital, then you can wait until the contractions become regular - every 5 - 7 minutes. If childbirth is repeated, then immediately with the onset of contractions, you should go to maternity hospital... Repeated births are usually faster than the first, there is a risk of giving birth outside the hospital.

Often, before the onset of labor, amniotic fluid can drain. The normal water content in the uterus by the end of pregnancy is up to 1.5 liters. You may feel a light, warm fluid flowing out of the vagina (no connection with urination). A little liquid may spill out, or all 1.5 - 2 liters. Be that as it may, if you notice unusually wet laundry, this is a situation in which you need to go to maternity hospital... If the water is completely poured out or leaks slightly, this means that the integrity of the membranes is violated, and the child is no longer protected from the effects of the external environment, primarily from infectious agents. Time is counted on the clock, it is advisable for a child in such a situation to be born no later than 12 hours after the outpouring of water. Doctor in maternity hospital must determine if you have a chance of having a vaginal birth, or whether it is better to have a caesarean section. In most cases, following the outpouring of water, normal contractions begin, and labor ends safely.

Above, we have discussed typical normal situations at the end of pregnancy. But complications are also possible. There are situations that require special attention and emergency care that a woman with a full-term pregnancy needs to know about. Call an ambulance immediately and drive to maternity hospital, if:

Bloody discharge appeared from the genital tract, smearing or “like menstruation”;

Water stained with blood leaks;

Painful sensations are very strong, the uterus is painful to the touch, does not relax between contractions;

Fetal movements become unusually strong, or weak, or painful;

worried about a headache, vision has become indistinct (“flies flicker” before the eyes), pains appear in the epigastric region, blood pressure has increased, and you cannot urinate.

In any case, if you feel any discomfort, then be sure to consult with the doctor who monitors your pregnancy, and at night, contact maternity hospital... Practice shows that it is better to play it safe than underestimate the seriousness of the situation and endanger the life of the child and your own.

1. Determine in advance in which institution you will give birth. Many women prefer to have the same doctor lead and deliver the pregnancy. In practice, this is far from always feasible. The state system for monitoring pregnant women is organized in such a way that the doctor does not necessarily have to be present at the birth of his patient. And in non-state clinics, the obstetrician who observed you, due to various circumstances, may not be with you at this very moment. However, it should not be perceived as a tragedy when an unfamiliar doctor is giving birth to you. Choose a reputable institution for delivery; if you are not “assigned” to him on a territorial basis (formal objections may arise during hospitalization), decide in advance for yourself whether you agree to a paid service. It is advisable to undergo a set of examinations adopted at this institution, to conclude a service contract.

2. Keep your documents collected, namely:

Exchange card with the data of all analyzes and ultrasound examination in the III trimester;

The passport;

Insurance policy.

IT IS BETTER TO ALWAYS HAVE THESE DOCUMENTS WITH YOURSELF!

In the absence of medical documents, childbirth should be carried out in the II obstetric (observational department) or even in a specialized infectious maternity hospital! If you do not have a passport or insurance policy with you, then problems may arise with the possibility of free delivery (for compulsory health insurance). Be careful.

3. Prepare a package with things: 2 - 3 cotton shirts, 3 - 4 diapers (preferably special disposable), 3 - 4 pairs of cotton panties, pads (the largest), a bathrobe, washable slippers, 2 - 3 pairs of cotton socks, toiletries, towels ...

However, in the maternity ward itself, you will not need anything other than slippers: usually for the time of childbirth, the necessary underwear and clothes are given out in maternity hospital... Relatives will bring you everything else, including things for the baby, after the birth.

What to take with you to the hospital will be suggested by our service List of things in the hospital

Doctors, and you too, will be more comfortable if, having felt the approach of labor, you will not overload your stomach. While waiting for labor at home, limit your diet to light crackers, a cup of broth, and tea.

Trim your nails; you can shave your pubis yourself - these are mandatory procedures before childbirth.

Do not lose your presence of mind, be decisive and collected - you will have a difficult but joyful work. Remember that you are primarily responsible for yourself and your child.

Timely delivery occurs at 37–42 weeks of gestation. Most of them start with regular contractions. Less often, amniotic fluid is poured out first.

By the end of pregnancy, training contractions appear, which do not lead to the onset of labor. These contractions are necessary to prepare the body of the mother and baby for the upcoming process. There are a number of differences between preliminary fights and real ones. You need to know them in order to go to the hospital on time.

Childbirth and their harbingers

During childbirth, several periods are distinguished:

1. dilatation of the cervix;
2. expulsion of the fetus;
3. the birth of the placenta.

The labor process usually begins at 37–42 weeks of gestation. The appearance of a baby for a period of less than 37 weeks is premature birth, for a period over 42 - belated. In aggregate, the duration of all periods in primiparas is 12-16 hours, in multiparous - 8-10 hours.

When registering a woman for pregnancy, the doctor determines the expected date of birth (PDD). Since the time of conception is difficult to establish, the countdown is made from the first day of the last menstruation. According to statistics, only a small percentage of children are born on time. The calculated date is approximate and serves as a kind of reference point for the woman and the doctor. It is permissible for a child to be born 10 days before and after PDD.

Objective research data helps to determine the gestational age - measurement of the abdominal circumference, the height of the uterine fundus. The time of childbirth can also be clarified with an ultrasound examination. When the PDR does not coincide with the ultrasound results, the latter is preferred.

A few weeks before childbirth, symptoms of an imminent birth of a baby appear. They are called harbingers. The work of a woman's body is being rebuilt, changes are taking place in the nervous, endocrine and reproductive systems. The placenta "grows old", the child prepares to move through the birth canal. The stomach goes down, the cervix "ripens", training contractions begin.

At the end of pregnancy, the expectant mother is regularly examined by an obstetrician-gynecologist. If there are no contractions before the 40th week, and the time to give birth has approached, the woman is placed in a specialized department. There she is under constant supervision of the medical staff. After 42 weeks, labor is induced artificially.

The beginning of labor

The main signs of the onset of labor:

Regular contractions.
Outpouring of amniotic fluid.
Bleeding from the genital tract.

If they occur, a woman needs to call an ambulance and go to the maternity hospital. Childbirth should take place under the supervision of a healthcare professional.

Birth pains

Spontaneous labor begins with regular contractions. Due to them, the cervix opens. It should stretch up to 10-12 cm so that the head of the fetus can pass through the birth canal.

At first, uterine contractions are short, rare and do not disrupt the normal lifestyle of the pregnant woman. Their duration does not exceed 20-30 seconds, and the intervals between them can be 15-20 minutes. Over time, the duration of the contraction increases and reaches 60 seconds. The pauses gradually decrease, the intensity increases. There is pain in the sacral region, which then spreads to the perineum. The opening of the uterine pharynx occurs with regular contractions at intervals of 10 minutes.

During the first pregnancy, it is time to go to the hospital with contractions that recur regularly at intervals of 5-7 minutes. With the second, third and subsequent births - when the pauses between contractions are 10 minutes.

During the contraction, the upper part of the uterus contracts, which spreads in waves down to the internal pharynx. In this case, the muscle fibers are displaced relative to each other. At some point, tension engulfs the entire organ. After - the muscles relax.

The walls of the uterus gradually thicken, the circular muscles of the cervix are stretched, which contributes to its opening. In primiparous, the internal pharynx opens first, and then the external one. With repeated childbirth, these processes occur simultaneously.

Full dilation of the cervix during the first birth takes 8–12 hours. With the second birth, this period ends faster. At the moment of the complete opening of the uterine pharynx, the fetal bladder bursts. After the amniotic fluid is poured out, the contractions may cease or weaken for a while, and then become strong again.

Differences between real fights and preliminary

Starting from the 20th week of pregnancy, training contractions of the uterus appear. They are felt by a woman in the form of tension of the genital organ for a short time. Closer to childbirth, the contractions become more frequent and stronger. Under their influence, the cervix is shortened and softened, the fetus moves lower, to the entrance to the small pelvis. This is necessary for further successful delivery.

The preliminary bouts are irregular. Physical activity, emotional stress can provoke their development. They do not lead to childbirth, since the uterine pharynx does not open. Painful sensations arising from contractions are localized between the navel and the pubic joint.

To understand when the real contractions began, you need to count their number and duration. Labor contractions are always regular, over time their strength increases, and the pauses between them are reduced:

Premature rupture of amniotic fluid

In the womb, the baby is inside the membranes and is surrounded by amniotic fluid (amniotic fluid). They contain a large amount of hormones and other biologically active compounds. The liquid is a natural environment for the development of the fetus, participates in metabolism and protects against mechanical stress. As a rule, rupture of the fetal bladder occurs immediately after the opening of the cervix.

In 10-15% of women, childbirth begins with the discharge of amniotic fluid. In this case, the membranes rupture even before the onset of contractions. There is an abundant flow of clear (sometimes pinkish) warm fluid from the birth canal. If the baby's head is firmly installed in the entrance to the pelvis, the amount of water to be separated will be small.

The rupture of the membranes is painless. As a rule, contractions occur in the next 12 hours, and labor takes place naturally. If labor does not begin, it is stimulated with medication.

When the bladder ruptures in the upper pole, there is a leakage of amniotic fluid, which is difficult to distinguish from vaginal discharge. For this, there are special amnio tests. You can use them at home. But if doubts remain, it is necessary to consult with your doctor. A long anhydrous period is dangerous for the fetus.

If the water has receded, it is necessary to go to the maternity hospital even in the absence of contractions.

The rupture of the membranes may be preceded by the passage of the mucous plug. During pregnancy, it is in the cervical canal and closes the entrance to the uterine cavity. Its release is sometimes accompanied by a slight discharge of blood. If the bleeding is profuse, this is another reason for calling an ambulance and hospitalization.

You have been waiting for so long for your child to be born, and at the same time it’s so scary, because it’s hard to imagine ahead, but everyone knows that it’s very painful. And not only this is scary. It is scary that childbirth will begin suddenly, and you will not have time to get to the hospital. And friends, acquaintances, and in general everything in a row and spur this fear with stories about the store and the entrance. And after that the question "When to go to the hospital?" rises unusually sharply.

However, you should not take all these tales seriously, provided, of course, that you listen carefully to your body and feel the approach of childbirth in time. Indeed, even a rapid birth is 3-4 hours, and normal in primiparous lasts from 8 to 10 hours, in second-births a little faster, 6-8, but they already know what to expect.

When to go to the hospital? Normal, full-term, however, are considered, mentally ready for them should be already at 36 weeks, especially when it comes to multiple pregnancies. It is advisable that by this time you already have a bag with things that you definitely need to take with you. Believe me, when the contractions begin, it will be very difficult to concentrate and put together the package, even if you do it according to the list. And the documents (passport, policy and, most importantly, an exchange card) should always be at hand, even when you are away from home. Naturally, you will be admitted to the hospital without them, but, firstly, without an exchange card, doctors will not be able to correctly build a strategy for childbirth, and may miss something important, especially if there were some complications during pregnancy. Secondly, a woman without an exchange card is likely to be placed in a block for the unexamined, since, theoretically, she can have infectious diseases. And here it is difficult to decide which of these two factors is more terrible. That is why, when you need to go to the hospital, the first thing you have to remember is the documents.

When the bag is assembled, all that remains is to carefully monitor what is happening to you. Usually, although not always, the body warns of an impending birth in advance. Some signs can be felt 2-3 weeks before delivery. In particular, the precursor or uterus begins to contract weakly, preparing its muscles. These contractions are most often painless and irregular. This is their main difference from true fights.

In a few days or directly on the day of childbirth, abdominal prolapse can occur: the abdomen shifts lower, changes shape, it becomes easier to breathe. At this time, the child moves to the birth canal and sets the head opposite the entrance to the cervix. This means that he is already ready to get out, and labor can begin at any time. At the same time, mucous discharge from the vagina sometimes appears, possibly with blood streaks. It's okay, it goes away, which suggests that the cervix is starting to prepare for childbirth.

If you observe any of these phenomena in yourself, it means that only a few days, or even hours, are left before the onset of labor. Be ready.

So when to go to the hospital? When the true contractions begin. They should be regular, that is, at regular intervals, most often they are painful. In addition, over time, the periods between contractions will decrease and their intensity will increase. If you are not sure whether your contractions are true or training, then it is better to get to the hospital, no one will scold you in case of a mistake, you will feel calmer. In general, in all controversial situations, it is better to go than not to go.

Often in the classroom at school, expectant mothers are advised to wait a few hours, and only then go. Such advice is motivated by the fact that childbirth is a long process and there is no need to spend too much time hanging around in the hospital. This opinion is not entirely correct. Of course, if your childbirth is normal, then why not sit an extra hour at home, and if specifically in your case, there will be a rapid birth? If you go right away, you will have time for sure, and if you spend an extra two hours at home, then there is a real chance to give birth in the car.

In some cases, even before the start of the contractions, sometimes everyone leaves at once, and then this phenomenon obviously cannot be confused with anything, sometimes the water only leaks a little. When to go to the hospital in this case? There is only one answer, right away. From the moment the fetal bladder ruptures, your baby becomes vulnerable to various infections, and the sooner he is born in this case, the better it will be for both the mother and the baby.

To summarize, there is no general answer to the question of when it is time to go to the hospital, however, if you feel the need for this, then it is better to go.