How does the fight feel? Birth pains. First stage of childbirth. Useful video on how to easily transfer contractions

13.06.2019

In the last months of pregnancy, a woman feels natural anxiety, because the time of childbirth is inevitably approaching, and it is difficult to predict how they will pass. Those who give birth for the first time can hardly imagine this process, although they theoretically know its sequence. The burning question is what the contractions feel like, because they, moreover, are false.

Contractions during pregnancy: physiology

An inexperienced woman in these matters needs to understand what contractions are and why they occur. The last weeks before the appearance of the baby are associated with the complex work of hormones that prepare the body for an important moment.
The level of progesterone, which ensures the safety and development of the fetus, as well as maintaining the tone of the uterus throughout pregnancy, gradually decreases, and oxytocin and estrogen begin to take the lead.
The main task of the uterus during childbirth is to open it so that the baby can pass through the birth canal. If before that she protected him, being in a closed state, before giving birth, her tissues become more extensible and pliable, thanks to estrogen. Contractions are contractions of the uterus trying to open up. These spasms allow the child to take the optimal position to facilitate the exit from the mother's body.
They are divided into:

False;
True.

Each contraction causes the cervix to stretch until it is fully dilated into the vagina. It is very important for the woman in labor to keep her presence of mind at this time, since the increased concentration of adrenaline and cortisol can interfere with this process, slow it down and even block it. It is fear that prevents normal childbirth.
Since the hormonal background of a pregnant woman is constantly changing, the first contractions can occur as early as 5 months. Of course, these are false spasms, they are also called training. They last no more than a minute and, in general, they are quite difficult to confuse with real contractions. But what they are, you need to know. After all, this will allow you to behave correctly, immediately, before childbirth.

Some moms start experiencing exercise contractions as early as 20 weeks or a little later. This doesn't happen to everyone. However, knowing how it feels, a woman will no longer go to the doctor every time without special need.
False spasms have their own characteristic features:

They are practically painless, can spread over the upper and lower abdomen, groin, and rather cause discomfort.
If there is a slight pain of a pulling nature, then mainly in the lower back.
Such fights are very short, can be provoked by a stressful situation or physical activity.
By frequency, they appear up to 5-6 times a day with different intervals.

A future woman in labor needs to remember that training contractions of the organ occur for the following reasons:

Unstable mental state;
When the body does not have enough fluid;
After intercourse;
With irregular emptying of the bladder;
During physical overload.
Sometimes the prerequisite is the activity of the baby.

If you describe what contractions feel like, then you can compare them with pulling spasms of low intensity. In such cases, you can cope with the situation by taking a more comfortable position, taking a walk in the fresh air or taking a warm bath.

Real labor pains appear at 9 months. They are distinguished by regularity, soreness, and the intervals between them tend to shorten. Right before the birth, the uterus is subjected to intense pressure from the baby's head, and this effect enhances the activity of the opening of the cervix.
Pregnant women often worry about what contractions feel like in the beginning. They can be understood, because a woman does not want to miss the very beginning of labor. Fortunately, this process cannot be confused with anything else.
Early labor spasms are much stronger than training ones, and cause significant discomfort to the woman in labor. In some cases, they are accompanied by pain in the lower back - this happens when the baby comes out with the back of the head. In this regard, a woman may feel quite severe pain.
Physiological signs of approaching childbirth may look like this:

The pain gradually increases, covering the abdomen and lumbar;
There are discharges with blood;
The amniotic fluid leaves;
Uterine contractions become more frequent;
There is a powerful pressure on the perineum.

According to women who have already passed such a test as childbirth, true labor pains can resemble:

Poisoning- in a sense, contractions at an early stage resemble the “mess” in the intestines, which happens with food intoxication. This state of seething covers the entire region of the abdomen.
The urge to the toilet in a big way- a woman in labor may feel a desire to empty the intestines, as she feels a strong load on the rectum. This feeling also occurs at the very beginning of labor.
Pain during menstruation when the uterus contracts, only 15-20 times stronger and more often. Of course, there is nothing to compare such sensations in terms of their strength, in comparison with labor pains.
Rising tide feeling- a completely appropriate description of true contractions. The pain syndrome of a pulling nature is able to increase and “roll down” again. Gradually, the waves become more powerful and longer.
Strong compression, that is, a spasm, many mothers note. The insides in the abdomen seem to freeze, turn to stone, and the pain syndrome increases with each new contraction.
Some compare the process of childbirth with a greatly increased toothache, and not sharp, but aching.

If you figure out why contractions are needed during childbirth, it will be easier for you to accept them and distinguish them from attempts or simple malaise in the lower abdomen.

It is no secret that all women in the position are afraid of the upcoming birth, but most of all they are afraid of missing their beginning, that is, the appearance of contractions. This is especially true for pregnant women who are expecting the birth of their first child. After all, they know about the harbingers only from the stories of mothers who have already taken place. What do they usually say? First, contractions appeared - which means that childbirth is just around the corner. This is a correct statement, but it’s worth considering that contractions may turn out to be false. Secondly, most women who have already given birth mention the incredible pain that occurs during contractions. Yes, indeed, pain is an integral part of childbirth, but, fortunately, it is quickly forgotten.

If we are talking about the first birth, then in addition to fear, women are tormented by ignorance. When to expect the appearance of cramping attacks? How not to miss them? What sensations accompany them? These questions often arise in women during their first pregnancy.

It’s worth noting right away that it’s quite difficult to miss contractions, but confusing them with false or, as they are also called, training ones is very possible. Therefore, there is nothing surprising in the fact that, expecting the first child, a woman experiences fear.

What do women feel before giving birth?

Usually 4-3 weeks before the most long-awaited and happy moment, the future mother begins to be disturbed by painful sensations, somewhat reminiscent of menstruation, in the lumbar region and lower abdomen, as well as a feeling of pressure in the pubic area. The appearance of all the above symptoms is considered normal. After all, the female body is preparing for the upcoming birth of the crumbs, and besides, the baby himself in the mother's womb begins to put more and more pressure on the lower abdomen of his mother.

Also, a pregnant woman, shortly before the “X” hour, may feel how her tummy periodically hardens, then becomes soft again. This phenomenon is explained by uterine contractions - hence the occurrence of cramping attacks. The uterus begins to contract, and its muscle fibers thicken and shorten, which allows the cervical os to gradually open to the desired size. If the uterus has opened 12 cm, then a new little man will be born soon.

Contractions: how not to miss?

Each organism is individual, therefore it is impossible to say that all future mothers have contractions in the same period. In addition, the sensations that women experience before the onset of childbirth are also different for everyone. For some, contractions can begin four to two weeks before the planned date, for others - a few hours. Some pregnant women can fully experience all the "charms" of generic precursors, while others will experience only a slight "discomfort".

The appearance of contractions largely depends on the correctness of the deadline and the well-being of the woman in labor. Therefore, the period of occurrence of generic precursors can vary from 4 to 2 weeks before delivery. But training contractions can disturb a woman from the middle of the 2nd trimester, their main difference from real ones is chaotic periodicity. From time to time, the tummy will tense up, but there will be no regular occurrence of attacks.

But if you systematically have cramping sensations, the interval between them gradually decreases, while the pain intensifies - then childbirth is just around the corner. After all, it is these characteristics that indicate the onset of labor activity, which in general can be divided into three stages:

Initial (or secretive)- a woman may feel a slight cramping pain, while the attacks last no more than 45 seconds, and the frequency between them averages up to 8 hours.
Active- the duration of the attacks increases to a minute, and the intervals between them are reduced to 3-5 hours.
Transition. The fastest phase of labor activity, on average, its duration is from 30 to 90 minutes. The duration of uterine contractions reaches 90 seconds, and the interval between them is reduced not to hours, but to minutes.

The contractions began: a call to the doctor or immediately to the hospital?

Probably, many women will be surprised now, but the first thing they should do when cramping sensations occur is to calm down. Believe me, fuss and panic in this situation are not the best helpers.

First, relax and preferably sit down. Secondly, only by taking a comfortable body position, you can accurately record the duration of contractions and the intervals between them. By the way, it would be nice to write down all your observations. If you are unable to do this, then ask your family about it. With such data, you can accurately describe your feelings to the doctor, and he will already tell you when you need to go to the hospital.

As a rule, if contractions occur every half hour, there is no reason to panic. During the first pregnancy, doctors recommend going to the hospital when the attacks begin to recur every 5-7 minutes. Although some experts still insist on going to the maternity ward when the first contractions appear, that is, in the initial phase of cramping attacks. And this makes some sense, because it is quite difficult to predict their development. And besides, the amniotic fluid can leave earlier, and if this happens, then it is better to be under medical supervision at this time.

There are no fights: what to do?

When discussing contractions during the first pregnancy, one cannot fail to mention the "reverse side of the coin" - when the expectant mother is waiting for them to appear, but they still do not come. What then?

In this case, doctors have to stimulate uterine contractions and induce labor artificially. And if there is a threat to the fetus, then such measures are carried out immediately. As a rule, doctors use the following methods to stimulate labor:

introduction of a hormonal drug into the cervical canal;
intravenous administration of the drug;
opening of the fetal bladder.

In conclusion

Of course, all kinds of risks should not be ruled out. But at the same time, you don’t need to “try on” all the worst. When you realize that contractions have begun (and, believe me, you are unlikely to miss this moment), you will experience a range of a wide variety of emotions - from joy to fear and excitement. The most important thing in this case is to remain calm and follow the instructions of the doctor exactly, because the whole process of childbirth and the birth of a healthy baby depend on this.

Many pregnant women often wonder about the upcoming date. childbirth, and women who are about to give birth for the first time are especially worried. As a rule, they are very afraid of not recognizing the labor that has begun in time and confusing it with a temporary malaise. In many cases, a close observation of the woman for the changes that occur in her body will help to resolve these unrest.

Already at 38 weeks, the prenatal period begins, when the first harbingers of childbirth and the first, as yet irregular (training) contractions, appear. Such contractions appear irregularly, and they pass after a change in body position or a short rest. In nulliparous women, such training uterine contractions can continue for five, and in some cases even more, days before delivery. When they appear, you do not need to worry and urgently go to the hospital, but the expectant mother should inform her doctor, relatives and friends about such changes in her body.

When the first signs of leakage or outflow of amniotic fluid appear, which may indicate the onset of labor or premature labor, the woman should immediately notify the doctor or independently contact a medical institution to resolve the issue of further hospitalization.

If a woman has learned to recognize training contractions, then she will be able to distinguish them from the onset of labor, or true contractions. These sensations are difficult to confuse with any other symptom, since they are characterized by periodicity and rhythm. For example, a fight lasts 20-30 seconds, and then there is a 20-minute pause - this is repeated many times in a row, and the time intervals hardly change.

At the beginning of the onset of labor pains, a woman in labor or her relatives should inform the doctor about the onset of labor, call an ambulance or go to the maternity hospital on their own.

Reasons for the onset of labor

By the beginning of childbirth, a lot of complex processes take place in the body of a pregnant woman, which, being in close relationship, provide the beginning of such a reflex act as labor activity.

The main reason for the onset of labor is the readiness of the uterus for the birth of the unborn child and the maturity of the fetus.

Ready for childbirth uterus:

gaining sufficient weight and size;
her neuromuscular apparatus is ready for contractile activity;
fully mature placenta.

2 or 3 weeks before the onset of labor, the uterus is released from the excess of part of the nerve fibers. This provides a reduction in pain during childbirth and increases the contractility of the walls of the uterus.

Several factors influence the onset of labor:

neuro-reflex - as a result of a decrease in the excitability of the brain, an increase in the excitability of the spinal cord and an increase in the sensitivity of the muscle fibers of the uterus to oxytocin, an increased contractile activity of the uterus is produced;
hormonal- in the end pregnancy the production of progesterone decreases and the production of a complex of estrogens increases, which stimulate the onset of labor;
neurohumoral - at the end of pregnancy in the body of a woman, the synthesis of oxytocin, prostaglandins, serotonin and other bioactive substances increases, which increase the sensitivity of the uterus to substances that cause active contraction of its muscles;
bioenergy - a sufficient amount of substances (glycogen, ATP, phosphorus compounds, electrolytes and trace elements) accumulate in the mother's body, which make the uterus capable of increased contractile activity;
mechanical - the ripened uterus loses its ability to stretch, and in response to the motor activity of the fetus and an increase in the level of oxytocin-like hormones, it begins to actively contract;
trophic and metabolic - the accumulation in the body of a mature fetus of some waste products leads to its active movement, and degenerative processes in the mature placenta and the full maturation of the muscle fibers of the uterus contribute to the onset of labor.

The state of the nervous system of the woman in labor is of primary importance in the formation of all mechanisms for the onset of labor, since it is she who ensures the readiness of the uterus for natural childbirth.

All of the above factors, being in close relationship, contribute to the appearance of contractions, which are replaced by attempts and end with the expulsion of the fetus from the uterine cavity and the birth of the placenta.

Harbingers of the onset of labor

Harbingers of childbirth are a set of signs that indicate the imminent onset of active labor activity. There are many harbingers of the onset of childbirth, but for each woman their totality is individual and depends on the characteristics of the body of the expectant mother.

Harbingers of childbirth:

Dropping of the abdomen.
Such a change, which is determined externally by a slight downward displacement of the abdomen, is individual for each pregnant woman, and may not always be noticed on its own. In nulliparous women, this harbinger may appear 2-4 weeks before the day of delivery, and in multiparous women, a few days or immediately before childbirth.

Gait changes.
The nature of the gait changes after the prolapse of the abdomen. The woman begins to walk "waddling" due to the pressure of the baby's head on the pelvic bones and the bottom of the uterus.

Changes in the nature of urination and defecation.
A prolapse of the abdomen can cause more frequent urination or urinary incontinence as the uterus puts more pressure on the bladder. The mechanical impact of the pregnant uterus on the intestinal wall can provoke constipation, and in some cases diarrhea, a few weeks or days before delivery.

Change in the nature of secretions from the genital tract.
Discharge from the vagina under the influence of hormonal changes becomes more abundant and liquid. In some cases, to exclude the discharge of amniotic fluid, a special test is performed by an obstetrician.

Removal of the mucous plug.
This harbinger of labor can occur 2 weeks before the onset of labor, and a few hours before it begins. In some cases, the mucous plug does not come off entirely, but in small portions. In practice, this sign looks like a discharge of vaginal discharge (sometimes mixed with a small amount of blood). A pregnant woman should inform her obstetrician-gynecologist about the discharge of the mucous plug.

Decrease in the body weight of the expectant mother.
A few days before giving birth, a pregnant woman may notice that she weighs 1-2 kg less. This weight loss can be explained by the removal of excess fluid from the body under the influence of changes in the hormonal background.

Reducing the number of fetal movements.
The fetus, a few weeks before birth, moves less frequently. This is due to its rapid growth. The future baby becomes crowded in the uterine cavity, and its movements are difficult.

Training bouts.
Closer to the date of birth, the uterus begins to increasingly come into increased tone, which is expressed in the feeling of training contractions. They differ from labor pains in a number of features: short duration, irregularity, weak pain sensations (reminiscent of pain during menstruation), spontaneous disappearance after a change in body position or rest.

The manifestation of the instinct of "nesting".
Many women in the last days and even hours before childbirth begin to prepare their homes for the upcoming birth of a child. These actions can be expressed in the fact that a woman begins to diligently clean, wash, and even start repairs.

Changes in the cervix.
Only an obstetrician-gynecologist can notice such a harbinger of an approaching birth when examining a woman on a gynecological chair. Under the influence of estrogen hormones, the cervix shortens and becomes more elastic by the 38th week. The external os of the cervix begins to open before the onset of labor pains.

Harbingers of childbirth in primiparous and multiparous women have their own characteristics.

Harbingers of the onset of labor - video

Signs of the onset of labor

Reliable signs of the onset of labor are:
1. contractions;
2. Outflow of amniotic fluid.

These two signs always indicate the onset of labor and every pregnant woman should know how they proceed.

Contractions

True, or labor pains are called contractions of the muscle fibers of the uterus, which occur at regular intervals, and which a woman cannot control. It is this sign that indicates the moment of the onset of childbirth.

The first true contractions are accompanied by minor pain, which most women compare with pain during menstruation. The pain is tolerable and can be given to the lower back or localized in the lower abdomen. Most women in labor begin to feel contractions at night. Some women note that during labor pain the uterus “hardens”, i.e. if during the contraction the woman in labor puts her hand on her stomach, then she can feel a hard, tense uterus.

You can determine the truth of contractions using a stopwatch. Their periodicity and constant occurrence, which is not eliminated by a change in body position, taking a warm bath or rest, indicates the onset of labor.

At first, contractions occur at intervals of half an hour (in some cases more often). With each contraction, the woman in labor begins to feel not only soreness, but also rhythmic contractions of the muscles of the uterus. Gradually, contractions become more noticeable, and their frequency, duration and intensity increase. With each contraction, the amniotic sac and the head of the fetus press against the fundus of the uterus, causing a gradual opening of the cervix.

Outflow of amniotic fluid

In the classical course of childbirth, the outflow of amniotic fluid occurs after the opening of the cervix to 3-7 cm. Under the pressure of the fetus, the amniotic membrane is torn, and part of the amniotic fluid is poured out.

A woman in labor, with a classic outpouring of water, may seem to have involuntarily urinated. In some cases, water is poured out gradually, in small portions. In this case, a woman may notice the appearance of wet spots on her underwear or bedding and experience such sensations as when separating vaginal or menstrual flow.

Sometimes the rupture of amniotic fluid can occur before the onset of regular contractions and dilatation of the cervix, or much later than the full opening of the os of the uterus. These conditions do not always mean that there will be a pathology of childbirth or the fetus, but usually gynecologists use various special tactics for the further conduct of such labor to prevent possible complications.

Signs of the onset of labor - video

Contractions at the beginning of labor

Obstetrician-gynecologists distinguish three phases of labor pains:

Initial (hidden) phase:

the duration of the fight is 20 seconds;
the frequency of contractions is 15-30 minutes;
opening of the cervix - 0 or up to 3 cm.

The duration of the initial phase is from 7 to 8 hours.

Active phase:

the duration of the fight is 20-60 seconds;
the frequency of contractions is 2-4 minutes;
opening of the pharynx of the uterus - 3-7 cm.

The duration of the active phase is from 3 to 5 hours. Usually it is in this phase that the amniotic fluid is poured out.

Transitional (transient) phase:

the duration of the fight is 60 seconds;
the frequency of contractions is 2-3 minutes;
opening of the pharynx of the uterus - 7-10 cm.

The duration of the transition phase is from half an hour to an hour and a half.

Labor pains occur in the first stage of labor (the period of disclosure).

Beginning of labor in primiparas

Probable harbingers of childbirth in primiparas have their own characteristics. As a rule, they have a more pronounced time difference between the day of birth and the date of the appearance of precursors. Some expectant mothers are overly emotional and take any slight ailment for the harbingers of childbirth. If they do not know about this or that sign, they may not notice them.

Contractions of the muscles of the uterus, involuntary and uncontrollable, are called contractions. Sensations of contractions can occur from the 20th week of pregnancy, change before childbirth, during childbirth. The last contractions can last up to several days postpartum as a response to the hormone oxytocin produced, helping to shrink the uterus. However, the main goal of the process of contractions is the expulsion of the fetus, the implementation of the process of giving birth to a child. MedAboutMe tells about the types of false and real contractions, their features, methods of stimulation and sensations during contractions.

Contractions - definition, concept

Contraction is a contraction of the muscles of the uterus, which contributes to the opening of the cervix and the forward movement of the fetus through the birth canal, as well as the expulsion of the placenta in the third stage of labor.

Distinguish between real contractions and false, Braxton-Hicks contractions, which are not the precursors of childbirth, but affect the preparation of muscle tissue.

Labor contractions prepare the birth canal for the baby to move forward. The tension of the muscles of the uterus helps the opening of the cervix in the first period of delivery.

In the second period, contractions are accompanied by the laboring efforts of the woman in labor, ensuring the effective advancement of the child through the birth canal and the most successful completion of the process of expulsion of the fetus.

Labor contractions do not end at the moment the baby is born: a woman can feel uterine contractions during the third period, the birth of the placenta, and also after childbirth. Oxytocin, a hormone produced by the mother's body, is responsible for the contractile activity of the uterine muscles, helping the uterus to recover in the first postpartum period. The last contractions may occur spontaneously within a few days, intensify when breastfeeding a child, since stimulation of the nipples causes a natural increase in the level of oxytocin in the blood. Also, contractions after childbirth can be artificially induced with injections of oxytocin if the contraction of the uterus does not occur in accordance with the norms.

False contractions preceding the birth period occur during the second half of pregnancy and are different in nature and sensations from contractions during childbirth.

Types of fights

There are three types of contractions, depending on their effect on the woman's body, sensations, frequency and exposure to external factors:

false contractions, they are also called training or Braxton-Hicks contractions;
contractions before childbirth;
contractions during childbirth in the latent, active and straining period.

During pregnancy, expectant mothers who are expecting their first child may at first confuse the sensations of contractions and the tone of the smooth muscles of the uterus. The general principle of the process is similar - tension and relaxation of the muscles of the walls of the uterus. However, with tone there is no rhythm of contraction, intervals, and the sensations themselves are rather weakly expressed compared to the impact of contractions.

From about 20 weeks, the expectant mother may feel short-term muscle tension in the abdomen, which is described as "petrification". The tension of the walls of the uterus and relaxation, which do not bring pain, are repeated several times and do not last longer than 90 seconds, are called training or false contractions.

More rhythmic contractions, lasting for an hour or more, but without an increasing duration of contractions, subsiding with a change in position, walking, taking medication, are harbingers of labor.

These two types of contractions during pregnancy are a natural part of the gestational period. They are usually felt by every pregnant woman with more or less intensity.

First Braxton Hicks contractions

A doctor from the UK, John Braxton Hicks, at the end of the 19th century, described the false contractions that accompany each. Most often, these first contractions appear in the third trimester, but they can start from the 20th week of the gestational period.

Not all women feel these training first contractions, but experts say that they are an integral part of the process of bearing a child. The absence of subjective sensations of the first contractions does not mean an incorrect course of pregnancy, this is an individual feature of a woman.

The tension of the smooth muscles of the uterus causes a special sensation - as if the stomach is pulling with a dense tissue, and this condition is visible from the outside. A dense, “petrified” belly, some expectant mothers claim that during training fights, the outlines of the child inside become visible.

Contractions last up to 90 seconds (most often no more than 30 seconds), can occur several times an hour or a couple of times a day. 98% of women note the frequency of the first contractions no more than 4 per hour. However, the first contractions are distinguished from the real ones by the absence of an increase in the intensity of sensations, there is no decrease in the interval between contractions, an increase in the duration of the contraction.

Braxton-Hicks contractions themselves bring some discomfort rather than pain. In this case, tension is expressed in one part of the abdomen: at the top, bottom of the abdomen or in the groin area, without pain spreading to the lower back or upper legs.

The appearance of the first contractions can also be influenced by the behavior and well-being of mother and baby. For example, more often the first contractions occur if:

a woman is actively moving, playing sports or there is any physical activity;
the expectant mother worries, worries, is in a state of stress;
there are signs of dehydration of the body, the drinking regime is not observed;
the baby is active, moves a lot, touching the walls of the uterus;
mom's bladder is full and the uterus is under pressure;
a woman is having sex and/or experiencing arousal, orgasm.

With increased excitability, the training first contractions can even provoke touching the stomach or moving the mother. To reduce the number of false contractions, it is necessary to drink enough, avoid a long waiting time before urinating, try to avoid stress and unrest.

Experts have not yet quite accurately determined the meaning of false contractions. The main accepted opinion in scientific circles is that false contractions during pregnancy are part of the preparation for childbirth, a kind of body training that allows you to change the state of the cervix in advance, helping it to ripen, and train the muscles of the body before the upcoming delivery process.

There is also an opinion that false contractions occur in response to ongoing hormonal changes, and these contractions do not entail any important consequences.

It has been absolutely established that the presence of false contractions provides a better supply of oxygen to the child, especially in situations that threaten fetal hypoxia. Also, these irregular contractions help the baby to take the optimal position for the birth and move closer to the birth canal.

Regardless of the meaning inherent in nature, training contractions during pregnancy provide an opportunity to learn and prepare for childbirth, to master and consolidate a skill that helps to survive the period of a real fight. These skills will help the expectant mother to quickly navigate the process of giving birth and help her body breathe properly and relax between contractions.

Contractions before childbirth: harbingers of delivery

Prepartum contractions can be difficult to distinguish from real contractions, especially for nulliparous women. Their main differences from real contractions are less pain, both in the intensity of sensations and in the areas of the body involved in the process, as well as in the absence of an increase in the intensity of contractions, a decrease in the interval between them and an increase in contraction time.

About two weeks before delivery, Braxton-Hicks contractions may become more pronounced, frequent, and sensitive. This is the reaction of the body to changes in tissues, the production of substances necessary for the onset of labor.

Often, the contrast compared to previous training contractions worries expectant mothers so much that they decide to visit a maternity hospital or call a doctor. An increase in the duration of contractions, a decrease in the intervals between contractions for some time is natural for contractions before childbirth.

Unlike real contractions, such contractions normally stop on their own, especially when changing body position, walking, in a warm shower, or when taking antispasmodic drugs. However, if a woman believes that the interval, soreness and other harbingers of labor mean the onset of labor, it is better to contact the maternity ward. Even if it has not yet begun, experts will be able to assess the situation and give the necessary advice. Confidence in your health and the condition of the baby has a beneficial effect on the process of bearing, and the expectant mother does not need extra stress.

If training contractions are accompanied by significant pain, bleeding, unusual vaginal discharge, diarrhea, regardless of the increase in intensity, intervals or frequency of contractions, urgent medical attention should be sought.

Real contractions, unlike false ones, mean the beginning of the birth process. The muscle fibers of the uterine wall contract, shortening and thickening under the influence of substances produced by the mother and child. These contractions help open the cervix and move the fetus toward the birth canal.

Real contractions, unlike false ones, mean entry into the first phase of the birth process. These contractions are rhythmic, the time interval between them decreases. Depending on the strength of labor, the time between contractions can decrease quite slowly or quite quickly. In the average norm, especially at the first birth, 15-20 minutes pass between the first real contractions.

The time of contractions increases, from a few seconds to minutes, and the sensations increase. As a rule, the onset of a contraction is felt in the muscles of the lower back, gradually covering the abdominal wall and spreading to the groin and upper thighs.

The pain of contractions depends on the woman's ability and skill to relax during the spasm. The walls of the uterus have practically no nerve endings, and contractions of this organ bring discomfort. However, during the fight, the muscles of the anterior wall of the abdomen, back, and hips are involved, and their tension brings pain. The ability to relax the muscles, not to add new spasms to the existing contractions caused by anxiety, fear, fear of increased pain, are the key points for successful labor activity.

Contractions: how to understand that they have begun. Differences from training fights

Many expectant mothers who are expecting their first child are concerned about real contractions: how to understand that they have begun and distinguish them from training ones?

There are several significant differences, thanks to which you can quickly distinguish real contractions from false ones. So, labor pains: how to understand that they have begun:

with false contractions, the initial sensation is tension in the muscles of the abdomen, the walls of the uterus. Labor pains, as a rule, begin with pain in the lower back or lower abdomen, resembling severe cramps during menstruation;
training bouts are irregular. If you detect the interval between them, you can note different periodicity: 2, 8, 6, 15 minutes. Labor pains are distinguished by fairly accurate intervals, and gradually these breaks between contractions decrease;
the duration of the bout is steadily increasing, which also does not happen during training bouts;
false contractions are easy enough to stop. If, when changing the position of the body, walking, a warm shower directed to the lower back, after a glass of water, going to the toilet or taking antispasmodic medications (Papaverine, No-Shpa), the contractions do not stop, and their rhythm is preserved, this is the beginning of childbirth;
during labor pains, the mucous plug that protects the cervix often comes out, and amniotic water can drain. However, such signs may either precede delivery, ahead of the onset of contractions, or be absent. In any case, the discharge of mucous contents (possibly with the inclusion of capillaries and a small amount of blood) is a sign of the maturation of the cervix, and the discharge of water requires a trip to the maternity hospital, regardless of the presence or absence of contractions, this is an absolute reason for medical supervision and, possibly, medical assistance in childbirth.

Proper contractions are judged by their effectiveness. In most cases, muscle contractions lead to the opening of the cervix and the advancement of the child through the birth canal. However, in some cases, due to the state of the physical, mental health of the woman in labor or her emotional state, regular contractions are replaced by irregular and / or chaotic muscle spasms, leading both to fatigue and a decrease in the physical strength of the mother, and to a long stay in a stressful state of the child, which can complicated by fetal hypoxia and require medical intervention in the natural process.

In order to learn how to more easily experience muscle contractions and help yourself and your baby with “correct contractions”, you need to master breathing and relaxation techniques in advance, prepare yourself psychologically, make a plan, and pack your things. Panic and fear weaken the effectiveness of contractions and lengthen the birth process, increasing pain.

Fear of childbirth is best removed when attending courses that prepare the expectant mother for the process of the birth of a child. Being fully aware of what can be expected from the body, how to cope with unpleasant phenomena, how best to prepare for them, and what exercises, techniques, movements and tools at hand help in various stages of childbirth, greatly reduces fear.

Often, the fears of expectant mothers are based on distrust of doctors and the fear of being left alone in a helpless state. Such issues are resolved with the help of partner childbirth, however, the partner (husband, mother, relative, girlfriend or specially invited midwife) also needs to know about the main stages of childbirth, methods of helping the woman in labor and be fully informed about the wishes of the woman (the use of auxiliary, stimulating medications, procedures for mother during delivery and the child after it).

If courses with a specialist and choosing a partner did not help overcome the fear of childbirth, it is reasonable to use the help of a psychologist.

Weak labor activity is one of the conditions that occur for various reasons during childbirth. Most often it is observed in women giving birth for the first time, as well as in those whose body is weakened by frequent childbirth or bearing children with short intervals between pregnancies (up to 3-4 years).

The weakness of labor is also affected by diseases of the mother: endocrine, metabolic diseases, preeclampsia, obesity, diabetes, hypothyroidism, anemia of various etiologies. The effectiveness of contractions is weakened by dystrophic and structural changes in the uterine walls due to pathologies of development, surgical interventions, stiffness of the cervix, phenomena of sexual infantilism (underdevelopment), various deviations from the norm in the structure of the genital organs.

The size of the fetus, especially in combination with the narrow pelvis of the woman in labor, the wrong position of the child, placenta previa, polyhydramnios, multiple pregnancies and premature rupture of amniotic fluid can also have a significant impact on the delivery process.

Other reasons for the decrease in the effectiveness of labor activity include mental illness, the psycho-emotional state of the woman in labor, excessive mental and physical stress during pregnancy.

A good contraction, intensively affecting the entire organ of the uterus, contributing to the opening of the cervix and the promotion of the fetus, is characterized by the involvement of all muscle fibers. With the weakening of labor activity, contractions occur only in the lateral, upper or lower parts of the uterus, the contractions subside or stop altogether. This condition is accompanied by an excessive duration of delivery, which can lead to complications of the birth process, fetal hypoxia, infection, swelling, necrosis of internal organs, trauma in the child, postpartum hemorrhage.

Depending on the period of labor in which the weakness of labor was diagnosed, in order to restore the effectiveness of the process, “good” contractions can be stimulated by administering drugs that enhance uterine contractions, immersing the woman in labor in a medical sleep in the absence of contraindications, or making a decision about the need for surgical intervention.

A woman can independently make efforts to improve the situation. Calm behavior, breathing, physical activity (walking, using a gymnastic ball, changing posture, if necessary, lying - choosing a position on the side where the back of the child is facing), timely emptying of the bladder helps with contractions subsiding.

Of considerable importance are a healthy lifestyle during pregnancy, taking vitamin complexes in the last weeks of pregnancy, enriched with folic and ascorbic acid, vitamin B6, daily routine, rest, both physical and psychological comfort.

Weak labor activity is a condition that threatens the health of the mother and child. With this diagnosis, about 20% of births end with an emergency caesarean section, with natural delivery, there is often a need for medical assistance in the pressing period.

Childbirth is divided into three main periods:

the stage of opening the cervix, preparing the birth canal;
attempts, the birth of a child;
stage of birth of the afterbirth (placenta).

Start of contractions

The onset of contractions in childbirth means the stage of cervical dilatation. This period is divided into a latent stage, which ends with the opening of the neck up to 4 centimeters, and an active one. In the active stage, the cervix opens by 10-12 cm, depending on the structural features of the woman.

The beginning of contractions of the active period is characterized by their increased, compared with the previous stage, intensity, frequency, change in sensations. This is due to the influence of uterine contractions on the cervix: during the latent stage, the opening occurs at a speed of 0.3-0.5 cm per hour, during the active period, the cervix smoothes and opens at a speed of 1-2 cm per hour.

The end of the active period is noticeable by some decrease in the intensity of contractions, which is associated with the entry of the body into the second stage of labor. At this point, there may be a physiologically justified weakness of labor activity that does not require intervention.

How long contractions last in the first period depends on several factors. The main one is the order of birth. The duration of the period of the first stage of labor is from 9 to 12 hours for women giving birth for the first time, and from 6 to 8 hours from the onset of labor for multiparous women.

The shorter time of contractions of the first period is called, depending on its length, fast or rapid labor. Despite the preference of some women to shorten the first period, speeding up the process can lead to serious injuries to the mother's birth canal and negative consequences for the fetus.

Other factors also influence how long the contractions last: the woman’s health, her emotional state and readiness for childbirth, the ratio of the size of the child and the mother, the characteristics of the course of pregnancy, the activity of the woman in labor during childbirth, the intake of certain medications during the gestational period and during delivery.

Contractions: sensations in the phases of childbirth

If you ask women who have already given birth how they experienced contractions, the sensations can be described in different ways. Someone feels contractions as a feeling of strong spasms, similar to pain during the first days of menstruation, someone notes significant pulling pains in the lower back, upper thighs, the epithets “as if a wave is covering” can be used.

Specialists who study the occurrence of sensations during contractions note that normally a woman’s body produces a significant amount of natural endorphins during contractions, pain sensations under the influence of these natural analgesics are dulled, consciousness is concentrated on muscle work, breathing.

With panic, fear of an upcoming contraction, pain sensations intensify, strong, good contractions that spread to the entire body of the uterus and help speed up the process, reduce efficiency and cause weakness in labor.

Childbirth is a rather active physical labor, the work of giving birth to a child, which requires considerable dedication and effort. Contractions, the sensations of which can be frightening, are a physiological process that helps mother and child get through the moment of delivery with the least effort, and you need to help your body and baby without fear and without trying to stop the work of the body.

The time of contractions depends on the period of labor and is measured both in the duration of the contraction and in the interval between contractions. There is an increase and change in the rhythm of contractions in the latent, active, straining and postpartum periods, as well as the presence of uterine contractions on the first day after childbirth, which helps to reduce the body of the uterus, narrow the cervix and get rid of accumulated blood clots.

Duration of contractions

The duration of contractions varies from 15 seconds to 1.5-2 minutes, depending on the stage of delivery. The first contractions in childbirth at the initial stage are quite short and almost not painful, they last 15-30 seconds.

Gradually increasing, the duration of contractions reaches one and a half minutes by the end of the active period and the beginning of the expulsion of the fetus. Attempts are rhythmic contractions that ensure the transportation of the child through the birth canal and help him leave the uterus. On attempts, the duration of the contraction does not correspond to the time of the effort, since in one period of stress of the woman in labor, 2-3 contractions or attempts should take place, contributing not only to the advancement of the child, but also to keep the fetus from moving backward.

By the presence of a fairly clear and definite interval between contractions, preparatory, training contractions and entry into childbirth are distinguished. If contractions are noted, the interval between which is uneven: 6, 15, 8 minutes, then these contractions are not considered as the beginning of the birth period.

If during the process of childbirth, the expectant mother or a specialist registers a change in the rhythm of contractions, the interval between contractions becomes uneven, this indicates a weakness in labor activity.

Contractions, the interval between which is stable and gradually decreasing, indicate the beginning of delivery. If the sensations intensify, it is necessary to make a decision about a trip to the maternity hospital or calling specialists. If the clinic is close to the house, there are no possible obstacles on the way (active traffic, difficulties with transport) and the expectant mother feels well, doctors should be consulted with contractions, the interval between which has reached 7-8 minutes. In case of difficulties on the road, it is necessary to start gathering at the maternity hospital at an interval of 10-12 minutes.

If a woman or her immediate female relatives have a history of rapid or rapid labor, second labor, complications of the gestational period, or other factors affecting the timing of delivery, doctors should be consulted as soon as a stable interval between contractions is established.

The interval between contractions gradually decreases during delivery, starting from 15-20 minutes in the first period and ending with an interval of 1-2 minutes at the stage of childbirth.

Last contraction: contractions of the postpartum period

After the second stage of labor comes the third, which most women in labor already evaluate as the postpartum period. However, contractions are also present at this stage, although their strength decreases, since there is no pressure from the child's body on the birth canal, and the interval between them increases. The appearance of the baby helps to reduce the concentration of the mother's attention on her feelings and focus it on the newborn.

However, at the third stage, the body has to make another birth, the expulsion of the afterbirth: the placenta with the umbilical cord, the membranes of the amniotic sac. As a rule, in obstetric practice it is customary to help the birth of the placenta, since the independent separation of the placenta from the walls of the uterus can cause bleeding.

In the third period, the doctor waits for the contraction and gently pulls on the umbilical cord, helping the placenta to separate and exit the birth canal completely. After the release of the placenta, childbirth is considered completed, but the last contraction that the puerperal will feel is still ahead.

The contraction of the uterus is influenced by the hormone oxytocin. The expulsion of the placenta helps to stop the production of prostaglandins, substances that provoke the synthesis of oxytocin receptors in the walls of the uterus, but this does not happen immediately.

During the first day after childbirth, their number decreases by 7 times, and at this time, especially when breastfeeding the baby, the mother may notice uterine contractions, last contractions, which help to reduce the body of the uterus and narrow the blood vessels in its walls. Some women, when applying the baby to the breast, are able to feel contractions that are much less intense compared to the birth period, in the first 2-3 days after the birth of the baby, since lactation causes an increase in the amount of oxytocin in the blood plasma.

To stimulate the process and better heal the walls of the uterus, oxytocin injections can be used, which also contributes to the appearance of sensations of minor contractions.

In conditions where the condition of the woman and the child does not cause concern, but there are circumstances that force the delivery or preparation of the birth canal to be accelerated (for example, with a post-term pregnancy, delayed cervical maturation, etc.), specialists can resort to several methods of stimulating the onset of labor.

In the activation of the birth process, three factors matter: physical impact, pressure on the cervix of the fetal bladder and the head of the child, the level of prostaglandins and the level of oxytocin in the blood.

Thus, if there are indications for labor induction, drugs that cause contractions, help soften the cervix and prepare the birth canal, as well as amniotomy, opening the membranes of the fetal bladder, can be used.

Amniotomy causes not only an increase in the pressure of the baby's head on the cervix, but also provokes the production of prostaglandins. As a rule, this method of stimulation is used with a smoothed neck or during childbirth instead of using drugs that cause contractions.

The method of preliminary preparation, which also contributes to the acceleration of the onset of labor, includes kelp preparations containing prostaglandins. They are injected directly into the cervix, affecting its maturation.

If it is necessary to activate the process of contractions of the smooth muscles of the uterus, drugs that cause contractions are prescribed: Oxytocin, a substitute for the natural pituitary hormone, or Enzaprost. Without medical necessity, such medications cannot be used, and their administration should be monitored by specialists in a clinic setting.

Folk beliefs about actions that start contractions and contribute to the onset of labor

There are many different customs and beliefs about actions, substances, products that contribute to the onset of childbirth. Some of them are based on ancient traditions that are not supported by scientific evidence, others have a physiological or psychological basis.

However, it is worth noting that coordinated actions of both the mother and the child are necessary for the onset of childbirth: both in the body of the mother and in the pituitary gland of the fetus, substances begin to be produced that contribute to the onset of the birth period. Without the readiness of two organisms, no actions and products that “start contractions” will not only not help, but can be harmful.

The physical activities that contribute to the onset of labor include almost all types of physical activity that are allowed during pregnancy: walking, cleaning the house, climbing stairs. Specialists, as well as experienced obstetricians of the past, note the effectiveness of upward movement with increased pressure on the uterine womb (climbing up the hill, walking up the stairs), as well as the use of activity in certain postures: on all fours, in inclinations (the old method of stimulation childbirth through washing floors throughout the house).

Cleaning the house has two more factors: the direct preparation of the premises for the life of the baby contributes to the psychological preparation of the expectant mother, all the "dowry" is collected, the house is clean, the bed is made, you can finally give birth. In addition to this moment, observers note the “nesting effect”, the desire of a woman to equip a “nest”, to clean the room, accompanied by increased physical activity, may be dictated by hormonal changes indicating an imminent birth.

Another method recommended both by the people and in the medical environment is sex. The influence of physical caresses, touching the skin, touching the nipples on the growth of oxytocin in the blood is confirmed by scientific research. The very process of sexual arousal promotes blood flow to the groin, uterine contractions, and can also speed up the onset of labor.

Well, if sexual intercourse with unprotected contact is acceptable, then sex with a partner brings another “bonus”: semen contains prostaglandins that positively affect the maturation of the cervix.

The rest of the home methods and techniques that start contractions are usually based on the action of substances that cause increased intestinal motility. Although this process - increased peristalsis - can affect the contractile activity of the uterus, the use of castor oil, especially in combination with alcoholic beverages, is more likely to cause harm and add discomfort.

Pain as during an intestinal disorder
Lower back pain
Pain in unexpected places
Contractions without pain

How to recognize contractions?

QEAna: There are such hard beds in the pregnancy pathology department that every morning I thought that I had contractions (pain in my back, as during menstruation, was definitely observed), but when real contractions began, I realized that you couldn’t confuse them with anything, that’s for sure!

mama_Levika: Two weeks before the birth, it starts to prick a little in the lower abdomen, it seems that the contractions, but, girls! You can’t confuse contractions with anything, don’t rush to call an ambulance ...

What are contractions

So, there comes a time when your child is ready to be born. Labor begins, which many expectant mothers recognize by painful contractions. But what is a “fight” and what happens at this moment?

” A contraction is an involuntary contraction of the smooth muscles of the uterus of a wave-like nature. It is they who allow you to open the cervix - the only "way out" for the child.

To imagine how the muscles of the uterus move, remember a crawling snail: a wave passes along its sole from tail to head, and tensed muscles push it forward. The same thing happens with the uterus: not all of it tenses at the same time.

The upper part of the uterus is more "muscular". It is she who squeezes the fetal bladder. As you remember from the school physics course, a liquid easily changes shape, but practically does not change volume. So the fetal egg begins to press with all its might on the lower part of the uterus - there are fewer muscle fibers here, so that it does not shrink, but, on the contrary, stretches. The main pressure falls on the cervix - the "weak link" of the muscle bag. The fetal bladder literally wedges in there: the anterior waters (amniotic fluid in front of the baby) press the fetal bladder into the birth canal and push it apart.

” It is believed that in the uterus there is a dominant focus of excitation, localized more often in its right corner (“pacemaker”), from here the wave of contractions spreads to all muscles and goes in a downward direction.

A woman cannot control contractions, unlike attempts, in which both muscles, perineum, and muscles of the abdominal wall, and the diaphragm are involved. That is why, in the last period of labor, the midwife asks the woman to push or, on the contrary, to hold back for a few seconds. Indeed, we all can tighten the muscles of the press, but it is absolutely impossible to strain, for example, the muscles of the stomach by willpower.

During tension and stretching of the uterus, blood flow to its muscles is blocked (if you clench your fist with all your might, you will see how certain areas of the skin turn white), and the nerve endings leading to the uterus are compressed. This is what determines the sensations that arise: the pain is dull, periodic (“it will grab it, then it will let go”), and most importantly, it is perceived by all women in different ways (depending on the location of the child, the uterus, and also on where the nerve endings are most compressed ). But the pain during attempts, which is caused by the movement of the child through the birth canal, is perceived by all women in labor in the same way: discomfort is concentrated in the vagina, rectum, perineum, and the pain is quite acute.

That is why the sensations during contractions raise so many questions - is it really contractions or, for example, osteochondrosis? Let's look at the most typical examples of pain!

Pain like period

Unpleasant sensations are localized in the lower abdomen and resemble pain during the onset of menstruation.

Lyalechka: the pain is like during menstruation, only worse.

CB1980: contractions were similar to menstruation at the beginning.

As a rule, women in labor who perceive contractions as “pain during menstruation” also feel the occurrence - "petrification" of the abdomen.

Pain as during an intestinal disorder

Pain in the abdomen during contractions for many expectant mothers resembles the discomfort of an intestinal disorder, cramping attacks that accompany diarrhea.

ANelli: at the beginning it didn’t hurt, just a feeling that you want to go to the toilet in great need, and when you go to the toilet early in the morning with an interval of 20-30 minutes, but there is no result, you understand that the intestines have nothing to do with it!

Zuleyka: I thought that I was poisoned by something the day before, my stomach was twisting so much ...

By the way, immediately before childbirth, the work of the intestine is really activated, the stool can be repeated.

Lower back pain

Quite often, the lumbar region becomes a source of pain: “pulls”, “grabs”.

vedetta: I had such pains - it seized the lower back and the pain rose from the bottom up the back and stomach. And then she also went down and passed. To be honest, it doesn't look like a period...

Tanyusha_I will be a mother: unexpectedly, my lower back began to ache every 15 minutes and then decrease a little bit ... I immediately did not wait and went to the maternity hospital.

The phenomenon of back pain has two explanations: the pain can radiate to the lower back, or be felt lower, in the coccyx area - most likely it is caused by the divergence of the pelvic bones.

Pain in unexpected places

Sometimes the pain can radiate to the most unexpected places, so that the woman in labor complains that, for example, her hips or ribs hurt.

Alma: contractions began - and it hurts in the side and gives to the kidney and leg!

Most often, women identify radiating pain as "kidney pain", especially if they have experienced them before. Pain in the hips, knees, numbness of the legs - may be the result of clamping large blood vessels in the lower abdomen.

Contractions without pain

This also happens, especially at the very beginning of childbirth. Feelings, however, are rather unpleasant. Expectant mothers usually feel how the uterus comes into tone for a few seconds - the stomach “stiffens”, then relaxes again. Similar sensations arise if, during contractions, you make .

Ksyusha_SD: I kept walking and thinking, but how will I understand that this is it, it has begun? I felt good, with appetite, too, there were no changes. Really understood, only when the contractions began - just periodically the tone of the tummy began.

Of course, not everyone is so lucky, but it happens that a woman is not very susceptible to pain. So at the beginning of labor, while the pressure on the cervix is small (or, for example, she has a flat fetal bladder, in which ), the sensations may be unpleasant, but not painful.

As you can see, the descriptions of the fights are very different. How to recognize them?

Periodicity. Contractions, no matter how they feel, occur at regular intervals. This labor contractions differ from "training" - .

increased frequency. During childbirth, contractions occur more and more often.

Gain. The intensity of pain increases.

Lack of response to your actions. Unpleasant sensations do not disappear if you change the position of the body, walk, lie down, take a shower.

Displacement of pain. Gradually, the pain shifts to the perineal region, on which the head of the child begins to press.

Did everything match? It's time for you to go to the hospital!