Contractions during pregnancy which sensations indicate the approach of childbirth. Optimal break between pregnancies

02.08.2019

Until recently, you could not even think about the second child, so fresh were the memories of childbirth. But some time passed, endless diapers and rompers ended, and there was a burning desire to give birth to another baby. And then the question arose: "What is the optimal age difference between children?"

What do the doctor's say?

From a physiological point of view, a woman can become pregnant almost immediately after childbirth, and, as you know, breastfeeding is not always a hindrance. So, for example, the earliest ovulation after childbirth is recorded at the 7th week in a breastfeeding woman and at the 4th week in a non-lactating woman. However, carrying a pregnancy immediately after childbirth is a great burden on the body that has not yet recovered.

After natural childbirth

To avoid complications, doctors recommend taking a break between childbirth and the next pregnancy for at least 1 year, but the optimal, from their point of view, is an interval of 2-2.5 years. Why exactly so many? The calculation takes into account breastfeeding for a year, recovery from lactation for nine months, and about half a year is allotted to replenish the supply of nutrients in the body. But this does not mean that non-lactating women do not need a "respite", because after childbirth, all organs of the reproductive system, the muscles of the pelvic floor, mammary glands, hormones, the amount and composition of blood should return to normal. And, of course, they also need to replenish the internal reserves of the body.

After a cesarean section

As for women who have undergone a cesarean section, according to doctors, they need to withstand an even greater interval, since it takes at least 2 years to form a wealthy scar that can withstand the stress of the next pregnancy and childbirth with dignity. A break of 3-5 years is considered optimal, since over time the scar tends to become thinner. In any case, before conception, the consistency of the scar should be checked using an ultrasound scan.

Possible problems

Due to too short intervals between pregnancies, especially if there were several of them, the following problems may arise:

thrombophlebitis and thrombosis of the legs and external genital organs
premature birth
impaired blood flow between the fetus and the placenta
low birth weight
bleeding during childbirth and the postpartum period.

If a woman "delays" too much with the birth of her second child (15-20 years), then the course of pregnancy is complicated by the "baggage" of diseases accumulated along with age.

What do moms say?

Some mothers believe that it is better to immediately "shoot" and give birth to the weather, and when the children go to kindergarten, it will be possible to continue building a career without interruption for the next maternity leave. At the same time, children will have more common interests than in the case of a significant age difference.

In contrast, opponents of a short break between childbirth talk about double stress for the mother. They note that a morally and physically exhausted mother is not able to fully care for the baby and at the same time pay enough attention to the older child.

Other mothers believe that with age, sleepless nights are tolerated much easier, an inner peace and a philosophical attitude to life appear, allowing them to raise their second child in a calmer psychological environment. In addition, “matured” fathers gladly take on part of the care of the baby, and the older child makes an excellent nanny.

Does the golden mean exist?

All of the above suggests that there is no consensus on the ideal time interval between pregnancies. It makes no sense to deliberately wait a few years, because, in someone's opinion, it will be better this way, but there is no need to force your body because it is so convenient from an organizational point of view. Each family independently determines the moment of readiness for the birth of the next child. The desired baby, whom the whole family loves and waits for, is true happiness. And how much time will pass after the birth of the previous "happiness" is not so important.

Canadian scientists have established the optimal interval that must pass between pregnancies. And this interval is one to one and a half years. The data were collected in Canada for ten years from 2004 to 2014 among local residents of different ages. Research has shown that 12-18 months is a suitable interval between two pregnancies.

What should be the interval between pregnancies

According to scientists, a period of 12-18 months is enough for a full recovery of a woman's body, as well as for preparation for a new pregnancy and childbirth. If less than a year has passed since the birth of the baby, complications may appear, both in the mother and in the baby. Moreover, the increased risk for women occurs over the age of 35. And for newborns, the age of the mother is 20-34 years old.

Studies have shown that women under 35 who become pregnant six months after giving birth have an 8.5% risk of having a baby prematurely. Then, as during pregnancy, after a year it drops to 3.7%. By the same principle, for an older mother, the risk of having a premature baby increases from 3.7% to 6%.

In addition, older women who become pregnant earlier than a year after giving birth have a 1.2% increased risk of maternal mortality and severe disability. If you wait a year and a half with a new pregnancy, the risk drops to 0.5%. Thus, the shorter the interval between these important events, the higher the risk to the life and health of both mother and baby.

WHO opinion

The World Health Organization recommends planning a new pregnancy no earlier than one and a half to two years. It is important that nutrients are fully restored in the body and internal reserves are replenished, hormones, mammary glands and organs of the reproductive system return to normal. It takes up to four years to fully recover.

After a cesarean section, severe pregnancy and childbirth with complications, it is recommended to increase this interval. It will take at least two years to restore the body and form a wealthy scar. A break of four to five years is considered suitable, when the scar is maximally reduced.

It is also important to consider the period of breastfeeding. Many experts advise planning a pregnancy after lactation is complete. quite difficult both physically and psychologically.

By the way, experts advise against stopping breastfeeding right away if you find yourself pregnant. This should be done two to three months before childbirth, as well as with severe toxicosis or chest pains, with an increased tone of the uterus.

But you should not drag out too much with the second or next baby. Since after ten or more years, pregnancy and childbirth can be complicated by age-related diseases of the mother. As for a too short interval, various complications may arise.

Possible complications with short intervals

Premature birth and the birth of premature babies;
Maternal and Child Mortality;
The birth of a small baby;
Thrombosis and thrombophlebitis of the legs or external genital organs;
Heavy bleeding during and after childbirth;
Impaired blood flow between the placenta and the fetus.

Is it possible to get pregnant immediately after childbirth and during lactation

Many women are convinced that it is impossible to breastfeed and immediately after childbirth. However, it is not. Indeed, there is the concept of lactational amenorrhea, which implies the postpartum state of a woman. It suppresses ovulation and reduces the risk of a new pregnancy. But this method works only 98-99%.

The action of lactational amenorrhea is individual and depends on the woman's body, as well as on the organization of the breastfeeding process. As a rule, ovulation occurs one and a half months after childbirth, sometimes earlier. Moreover, the first ovulation cycle can occur before menstruation. Therefore, the likelihood of a new pregnancy exists, even in the absence of menstruation.

It was noted that the risk of a new pregnancy and a more rapid onset of ovulation in the first six months after childbirth is increased in women who refuse to breastfeed.

What should be the optimal gap between pregnancies and why?

The likelihood of conception after childbirth

Many mothers are sure that pregnancy will not occur immediately after childbirth or during lactation. This is not true. Such beliefs lead to repeated conception and new pregnancies. Some parents don't mind this set of circumstances. It's a personal matter for everyone, however, you need to understand that during the period of gestation, its birth, the mother's body is like a squeezed lemon, and in the full sense of the word. He loses blood, nutrients, strength, nerves, tries to recover, and then again the load.

How long does it take to recover from childbirth?

In labor, all systems and, in practice, the organs of the mother are involved. 9-month physiological and hormonal changes, plus labor, require a certain amount of time to recover. Recovery means menstruation, metabolism, genitals and pelvic floor muscles, urinary tract, intestines, cardiovascular system. It takes 2 and a half to 3 years for everything to return to normal. It all depends on how the baby was born.

Physiological break between pregnancies

After natural childbirth

Natural childbirth is different. If they passed without complications, there are no breaks, then even 1.5 years is enough for physiological recovery. But doctors do not recommend taking such a short break and extending it to at least 2 or 2.5 years, ideally 3. So the female body will have time to fully return to normal and gain enough strength for a normal next pregnancy.

After a cesarean section

Surgical intervention, even if it is minor, is still an intervention. The incision during cesarean section is not so important as the scar. It poses a danger to future pregnancy, especially the internal one. The connective tissue will fully grow and strengthen in at least 2-3 years. Depends on the characteristics of the woman's body. Experts advise against planning the next conception earlier than 3 years after the operation.

Optimal birth spacing

The minimum gap between conceptions should be at least 1.5 years. This time is enough for the body to come back to normal, but not enough for full recovery. A break of 3 years is considered ideal, maybe 2.5. By the way, the big gap is also bad. Researchers believe that after a 5-year interval between pregnancies, the risk of complications increases, regardless of the age of the woman in labor.

What problems can arise due to too short a break

A short interval between pregnancies can lead to the following consequences:

Profuse bleeding during delivery and before.
Insufficient weight of the baby at maturity.
Disruption of communication and blood circulation between the placenta and the unborn child.
Fetal rejection or premature labor.
Increased blood clotting, the occurrence of blood clots.

Pregnancy, which has arisen more than 10-15 years after the first, is complicated by chronic diseases, which are exacerbated when carrying a child.
Nobody succeeds in adhering to the "schedule" of conception. Children come to this world when they need it. Modern medicine can help give birth to a healthy baby, even if less than a year has passed between pregnancies. Especially if the woman is healthy and has enough strength for more than one child. The only thing to remember is the complications that are possible with condensed conceptions. Therefore, if a woman had a difficult birth or some pathological condition, then with a small gap between pregnancies, the likelihood of a second complication remains very high.

What sensations indicate the approach of childbirth

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

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

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

Training, precursor or prenatal contractions

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

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

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

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

Also, like training ones, they do not open the pharynx of the uterus and do not threaten pregnancy, although by the strength of the sensations they are brighter and may well inspire excitement in primiparous women. Harbinger contractions have intervals that do not diminish over time, and the severity of the spasms that compress the uterus does not increase. A warm bath, sleep, or snack can allay these contractions.

It is impossible to stop real or labor pains with rest or change of position. Contractions manifest themselves involuntarily, under the influence of complex hormonal processes in the body, and cannot be controlled by the woman in labor. Their frequency and intensity is increasing. In the initial phase of labor, contractions are short, last about 20 seconds, and repeat every 15 to 20 minutes. By the time the cervix is fully opened, the interval decreases to 2-3 minutes, and the duration of the contractions increases to 60 seconds.

Characteristic	Braxton Hicks contractions	Harbinger skirmishes	True fights
When it starts to feel	From week 20	From 37-39 weeks	With the onset of labor
Frequency	Single abbreviations. Occur sporadically.	Approximately every 20-30 minutes. The interval is not shortened. They subside over time.	Approximately once every 15-20 minutes in the first phase and once every 1-2 minutes in the final of labor.
Duration of contractions	Up to 1 minute	Does not change	From 20 to 60 seconds depending on the phase of labor.
Soreness	Painless	Moderate, depending on the individual sensitivity threshold.	Increases with the course of childbirth. The severity of pain depends on the individual threshold of sensitivity.
Localization of pain (sensations)	The anterior wall of the uterus	Lower abdomen, ligament area.	Small of the back. Girdle pain in the abdomen.

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

Description and function of contractions

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

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

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

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

After that there are attempts - active contraction of the muscles of the press and diaphragm (duration 10-15 seconds). Arising reflexively, attempts help the child to move along the birth canal.

Phases and duration of contractions before childbirth

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

Characteristic	Latent phase	Active phase	Deceleration phase
Phase duration	7-8 hours	3-5 hours	0.5-1.5 hours
Frequency	15-20 minutes	Up to 2-4 minutes	2-3 minutes
Duration of the fight	20 seconds	Up to 40 seconds	60 seconds
Disclosure degree	Up to 3 cm	Up to 7 cm	10-12 cm

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

Contractions before the first and subsequent childbirth

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

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

The factor that smooths out the differences between the first and subsequent births is the time interval separating them. The likelihood of prolonged disclosure is higher if more than 8-10 years have passed since the birth of the first child.

In articles devoted to the topics of motherhood and pregnancy, there is information that contractions before the second birth more often come not before, but after the waters have departed, and this happens not at 40, but at 38 weeks. Such options are not excluded, but there is no scientifically confirmed data indicating a direct connection between the serial number of genera and the nature of their onset.

It is necessary to understand that the described scenarios are only options, and by no means an axiom. Each childbirth is very individual, and their course is a multifactorial process.

Feelings in contractions

In order to determine the onset of contractions, it is worth paying attention to the nature of the pain: before childbirth, they are similar to menstrual pains. Pulls the lower abdomen and lower back. You may feel pressure, a feeling of fullness, heaviness. It is more appropriate here to talk about discomfort rather than pain. Soreness occurs later, with increasing contractions. It is caused by the tension of the uterine ligaments and the opening of the cervix.

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

However, in the vast majority of cases, women experience the peak of spasm as compression, strong contraction, "grasping", which follows from the very name of the contraction.

Is it possible not to notice the contractions?

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

Some uncertainty in the expectations of expectant mothers can be introduced by the stories of women who have already given birth, in whom childbirth began not with contractions, but with the passage of water. You need to understand that this scenario in obstetrics is considered a deviation. Normally, at the peak of one of the contractions, intrauterine pressure pulls and tears the membrane of the fetal bladder, the amniotic fluid is poured out.

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

Mechanism of action at the onset of contractions

It is important to understand what to do at home in case of onset of labor and impending labor. A few recommendations:

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

For the overwhelming majority of women, motherhood is the most joyful event, the meaning of life. Some women want to have many children and successfully make their dream come true, giving birth one after another. Others come to understand their purpose in adulthood. Still others, after the early birth of a baby, is a career and a relationship. But after many years they feel an urgent need to give birth, as the people say - for the soul. However, the body reacts differently to women's desires. After all, there is an optimal break between pregnancies, the violation of which can lead to complications.

According to doctors, the optimal break between pregnancies should be at least two years. During this time, the mother manages to breastfeed the baby and prolong lactation for at least another year. This has the most beneficial effect on the health of the baby and mother. During these two years, the hormonal background returns to normal. If there was a cesarean section, then the scar has time to heal enough to withstand the new load.

According to the observations of doctors, when a woman gives birth with a break of less than two years, she often develops complications of pregnancy (late gestosis, anemia, toxicosis), the risk of miscarriage is higher. In this case, it is not easy for a previously born child. He may lack nutrients, vitamins, rare minerals due to the termination of breastfeeding. As a result, the child grows up a little weakened, with lowered immunity.

But it is not worth delaying the break between pregnancies. A difference of 2-5 years is considered ideal. This is the optimal break, both in the opinion of doctors and in the opinion of child psychologists. After all, giving birth to the weather, a woman is forced to cope with two small children at once, requiring unconditional attention. And when the first child is more than five years older than the second, the children grow up in different generations. Because of the decent age difference, it can be difficult for them to really get close.

When giving birth again, a woman should prepare for a heavier gestation and childbirth. Since 2-4 children are slightly larger and heavier than the previous one. But starting from the fifth, the children become smaller, as the mother's body wears out. The main reason is non-observance of the optimal interval between pregnancies.

Too long a break between pregnancies (more than ten years), according to doctors' observations, equates a woman with primiparous. It is believed that the body already forgets how to carry a child. This cannot be called a bad factor, because instead of the biological memory of the body, experience is saved, the skills of caring for a child are quickly recalled. But the problem can be the age of the woman. If the expectant mother is well over thirty, there may be health problems for both the woman in labor and the developing fetus.

They say that the course of the second late pregnancy is more difficult than the first. In fact, this is not an axiom. The course of pregnancy depends on many reasons. For example, the gender of the child. It is noticed that the manifestations of toxicosis in mothers of girls and mothers of boys are different. If the second child is conceived by another man, he too may develop in a completely different way than the first. But more often the second pregnancy, even with an interval of more than five years, is easier than the first. A woman knows what awaits her, so she experiences less stress. Mental well-being is very important.

By the way, women feel the movement of the second child a couple of weeks earlier. Biological memory affects. They will learn the joy of touching a child already at 16-17 weeks. During the first pregnancy, only the most sensitive expectant mothers feel fetal movements before the 18th week of pregnancy.

The cervix is shortened after the first birth. It should close completely. If a woman had ischemic-cervical insufficiency during her first pregnancy, and even more so there was an injury to the cervix, a new pregnancy should not be allowed. It is imperative to take the necessary break between pregnancies.

After the previous birth, antibodies remain in the mother's blood for some time, which can provoke hemolytic disease of the fetus. Therefore, if during the previous birth there was a Rh-conflict, the next pregnancy must be planned. Before conception, it is imperative to undergo a complete examination. A blood test for antibodies during pregnancy will have to be taken monthly. Regularly undergo an ultrasound scan, it helps to control the condition of the amniotic fluid and the placenta.

A break after pregnancy is vital for women who have had a caesarean section. Up to two or three years, the next pregnancy is dangerous - the stitches may disperse. The optimal break is 3-5 years. But still it is worthwhile to play it safe and check the condition of the scar with ultrasound.

Also, in women after cesarean, the area of attachment of the ovum may coincide with the scar. This is a dangerously complicated attachment of the placenta and fetoplacental insufficiency of the fetus. On the other hand, the placenta does well in most cases. Many women give birth to two or more babies after a cesarean section. But all the same, the more the scar has time to overgrow, smoothen, the better.

Another pleasant reason for an optimal break is to reduce toxicosis. On the one hand, the body still "remembers" this state, on the other hand, it manages to recover. Moreover, there may be no toxicosis at all. But if the interval between pregnancies is less than two years, toxicosis may be even more pronounced. Especially if the previous pregnancy was overshadowed by high blood pressure, edema, the presence of protein in the urine. You will have to follow a diet and water regime, monitor weight and pressure, and regularly take tests.

As you can see, maintaining the optimal interval between pregnancies is very important for the course of pregnancy, childbirth, and the health of the baby and mother.