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How to understand that contractions have begun. What do contractions look like? Birth pains. First stage of labor

What most often scares a young woman preparing to become a mother for the first time (or what scares her most often)? The answer suggests itself - contractions. The anticipation of pain can cause more panic than the pain itself. And the closer the cherished date, the more obtrusively this fear haunts. The surest way to get rid of fear is to stop hiding from it and hide it from yourself, to meet it face to face, to “talk” to it. Are you afraid of contractions? So let's figure out what it is.

What are contractions?

In medical terms, birth pains- these are involuntary regular contractions of the uterus, along with attempts related to the birth forces that expel the fetus. Contractions indicate the onset of labor. (In addition to contractions, the onset of labor may be indicated by such symptoms as the rupture of amniotic fluid and the discharge of the mucous plug that closes the lumen of the cervix 1; the mucous plug can move away 2-3 days before birth, so its discharge does not always mean that it is time to go to the hospital). Many works have been written about what, in fact, provokes the onset of childbirth. Diverging in particulars, all researchers agree on the main thing: the organisms of the mother and child, being in close interaction, seem to “agree”, transmit the necessary impulses to each other. Shortly before the onset of labor, the woman's placenta and the baby's pituitary gland begin to produce specific substances (in particular, prostaglandins and the hormone oxytocin) that cause uterine muscle contractions, called contractions. During pregnancy, the cervix is ​​tightly closed. With the onset of labor pains, its disclosure begins: the pharynx of the uterus gradually expands to 10-12 cm in diameter (full disclosure). birth canal preparing to "release" the child from the mother's womb. Intrauterine pressure increases during contractions as the uterus itself shrinks. Ultimately, this leads to rupture of the fetal bladder and the outflow of part of the amniotic fluid. If this coincides in time with the full opening of the uterine pharynx, they speak of a timely outflow of water, but if the uterine pharynx did not open enough at the time of the rupture of the fetal bladder, such an outpouring is called early. The first, preparatory, period of childbirth takes, on average, 12 hours if a woman gives birth for the first time, and 2-4 hours less for those who have not given birth for the first time. At the beginning of the second stage of labor (the period of expulsion of the fetus), attempts are added to the contractions - contractions of the muscles of the abdominal wall and diaphragm. In addition to the fact that different muscle groups are involved in contractions and attempts, they have another important difference: contractions are an involuntary and uncontrollable phenomenon, neither their strength nor frequency depend on the woman in labor, while attempts to a certain extent obey her will , it can delay or strengthen them.

What to expect from fights?

Feelings during contractions are individual. Sometimes the first tremors are felt in the lumbar region, then spread to the stomach, becoming girdle. Pulling sensations can also occur in the uterus itself, and not in the lumbar region. Pain during contractions(in case you cannot relax or find a comfortable position), resembles the pain that often accompanies menstrual bleeding. However, do not be afraid of contractions. You can often hear from women giving birth that the contractions were either completely painless, or the pain was quite tolerable. First, during contractions, the body releases its own painkillers. In addition, relaxation and proper breathing techniques mastered during pregnancy help to get rid of painful sensations. And finally, there are medical methods of pain relief, but they are recommended only in extreme cases, since they all affect the baby to one degree or another. Real (and not false - see below) "exorcising forces" come at regular intervals. Initially, the intervals between contractions are about half an hour, and sometimes more, the contraction of the uterus itself lasts 5-10 seconds. Gradually, the frequency, intensity and duration of contractions increase. The most intense and long (and sometimes - although not always - painful) are the last contractions preceding the attempts. When to go to the hospital? In the case of the first birth (and if it is not far from the maternity hospital), you can wait until the interval between contractions is reduced to 5-7 minutes. If a clear interval between contractions has not yet been established, but the pain intensifies and becomes longer, then it is still time to go to the hospital. If childbirth is repeated, then with the onset of regular contractions, it is better to immediately go to the hospital (often repeated childbirth is swift, so it is better not to hesitate) 2. With the onset of contractions, mucous discharges with a slight admixture of blood may appear - this is the very mucous plug that "clogged" the entrance to the uterus. Blood (in a small amount) enters the mucus due to the smoothing and opening of the cervix. This is a natural process that should not be frightened, however, with heavy bleeding, an immediate examination is necessary.

True or false?

It should be borne in mind that after the 20th week of pregnancy, some (not all) women experience so-called false contractions, or Braxton-Hicks contractions, and 2-3 weeks before giving birth, women begin to feel premonitory contractions. Neither one nor the other, unlike true contractions, do not lead to the opening of the cervix. There are pulling sensations in the lower abdomen or in the lower back, the uterus seems to turn to stone - if you put your hand on the stomach, you can clearly feel it. The same thing actually happens when labor pains therefore, "Braxton Hicks" and harbingers often confuse women giving birth for the first time. How to understand whether labor is really starting and it's time to go to the hospital, or is it just false contractions?

  • Braxton Hicks contractions, unlike true labor pains, are rare and irregular. Contractions last up to a minute, can be repeated after 4-5 hours.
  • False contractions are painless. Walking or a warm bath most often helps to completely relieve discomfort. The role of false contractions has not yet been fully elucidated. Their appearance is associated with an increase in the excitability of the uterus, it is believed that shortly before the birth, precursor contractions contribute to the softening and shortening of its neck.

What to do during contractions?

It has been noticed that the more a pregnant woman is frightened, the less she knows about what is happening to her and what is ahead of her, the more difficult, longer and more painful her birth is. Even in the very recent past, the phrase "preparation for childbirth" seemed to be complete nonsense in Russia. Fortunately, over the past decade there have been qualitative changes in this area - many courses and schools for preparing for childbirth have been opened, where not only future mothers, but also future fathers are preparing for this important event. Enough books have been published. And most importantly, the psychology has changed. Now, if not all, then most women understand that they need to prepare for childbirth, as for any difficult and important work. And the main goal of such training is to get rid of fear and pain. What do experts usually recommend in order for contractions to be as easy and painless as possible? As already mentioned, you will not be able to control the frequency and strength of contractions, it does not depend on you. But you can quite help yourself and your child survive these contractions.

  • At first, when the contractions have just begun, it is better not to lie down, but to move: this will speed up the process of opening the uterine os, which means it will reduce the time of childbirth.
  • Calmly focus and try to find the position of the body in which you are most comfortable.
  • Don't be shy if you feel like getting on all fours, lying on a big beach ball, or even…dancing. Believe me, it would never occur to anyone to condemn you for extravagance.
  • Circular and swaying movements of the pelvis help relieve tension and reduce pain.
  • If possible, try sleeping between contractions, or at least "pretending to sleep" (this will help your body relax).
  • You can lie down for about ten minutes in a bath with warm water - of course, if you are not alone in the apartment and if necessary you can be helped.
  • Lightly stroking the skin of the lower abdomen with fingertips facilitates contractions at the beginning of the journey.
  • With the beginning of the fight, you need to take a breath and direct the movement of the hands from the middle line to the sides, while exhaling, the hands move in the opposite direction.
  • With increased contractions, strong and frequent pressure with the thumbs on the points in the region of the anterior-superior iliac spines (these are the most protruding parts of the pelvis) helps well to relieve pain.
  • Hands are comfortably placed with palms along the hips. Very useful is the massage of the sacral zone of the spine. It is effective not only at the beginning of contractions, but also all the time while expelling forces are operating in your body.
  • As contractions intensify, proper breathing becomes more important.

But the most important thing is to tune in, listen to your own feelings and ... remember the child. You both have a difficult job, but the result will be a meeting!

Tatyana Kipriyanova

First contractions I recognized with difficulty. The fact is that they were very similar to “training” contractions - the so-called “Brexton-Hicks contractions”, which have haunted me since the 7th month almost every evening. And at first I could not understand whether it was still them or already the beginning of childbirth. It feels like the stomach freezes below, then “lets go”. The intervals between contractions were uneven: sometimes after 20 minutes, sometimes after 5; but still they walked regularly (for more than two hours) - this influenced the decision to still go to the maternity hospital. The first contractions were quite tolerable - just a feeling of slight discomfort. There were significant gaps between them, which made it possible to relax, and I even began to doubt that I was really giving birth. Upon arrival at the maternity hospital, the examination showed a dilatation of the cervix of 1 cm. When the bladder was pierced (by the way, it turned out to be completely painless), the contractions became more effective, the pain became quite noticeable, the intervals were about 5-10 minutes (opening 4 cm). I used to have quite painful periods, and this pain seemed to me similar to menstruation. Over the next hours (the child moved towards the exit) the pain got worse and worse. It was hard. I was helped a little by the lower back massage that my husband did, and the breathing that I read about in books (the medical staff also suggested how to breathe better). When the pain became simply unbearable, attempts began (by the way, I have heard from others more than once that when you feel that the limit has come and there is no more urine to endure pain, this means that everything will end soon). It is easy to recognize attempts - you involuntarily start to push (I could compare this process with the urge to go to the toilet). Attempts are also a painful thing, but the cardiographic apparatus began to listen poorly to the heart of the child, and I had to give birth as soon as possible. Therefore, from about the fifth attempt, I already gave birth to my boy (not without an episiotomy). The whole process took us 12 hours (this was my first birth).

Anna Goncharova

The contractions were like a very strong and painful menstruation. At first they were very weak, and I did not even feel discomfort. It was like a very mild (not painful) spasm inside the abdomen. Painful contractions became only four hours later. And it reminded me most of all of painful menstruation. But it only hurt for about an hour. It was possible to endure, but with difficulty. My husband helped a lot. Even at the most intense moment, the pain was not constant. Everything went about 5 minutes apart. At first, the pain grew rapidly, reached a maximum, and then disappeared just as quickly. Each contraction took two minutes. For three minutes there was no pain at all! The worst thing for me was at the beginning of a new fight - when it still doesn’t hurt, but you understand that everything started all over again. Unpleasant, but tolerable. And only one hour. As soon as I was allowed to push, the pain stopped. I didn’t have any more pains, which are sometimes written about (in the lower back, or somewhere else). By the beginning of the contractions, I was already in the hospital, so I immediately went to the doctor, and the doctor confirmed that childbirth started. The doctor and midwife told me when to start pushing. It didn't hurt at all, and giving birth didn't hurt at all. Although they made a cut, but I didn’t notice it at all. In general, I remember childbirth very well, but the pain is forgotten very quickly. I remember rather with pleasure - and first of all all sorts of funny moments. There was no feeling of horror and “never again” at all. Maybe because there was a good maternity hospital and I gave birth with my husband!

Elizabeth Samoletova

Unfortunately, to childbirth I was psychologically completely unprepared. Therefore, already being in the delivery room (I was in the hospital for preservation), I felt that my stomach hurts a lot, and I got scared. Of course, “theoretically” I knew that I would have contractions, but I had little idea what it was. Of course, there was no question of any calculation of the intervals between contractions (this was suggested by the midwife who was sitting next to the table and writing something). It seemed to me that I was dying, and in a weakening voice I asked for a caesarean section. The midwife laughed merrily for some reason. I ask: "What are you laughing at?" And she told me: “According to my calculations, every second woman in labor asks for a caesarean section.” I suffered for about an hour. I was very offended that the people who were around (nurses, midwives, head of the department and even some trainees to whom I was shown as an example of an “old primipara with a somewhat narrowed pelvis”) took my suffering for granted and as if nothing sometimes they tried to talk to me about some boring everyday topics (they asked where I work, where I got such a strange surname from and what I would name my unborn child). And when my stomach began to hurt especially badly, the midwife came up and mockingly (as it seemed to me then) told me how I should breathe. When the attempts began, it became easier and even, I would say, more interesting, because the “result of labor” was about to appear. He appeared. It contained 3 kg 600 g. Then I apologized to the doctors, but they laughed again and said that almost everyone behaves the way I do. And I decided that I would prepare for the next birth for a long time and seriously.

1 About the symptoms of the onset of labor, their periodization and course can be read in detail in No. 4/2001: L. Komissarov.
2 We also recommend reading the article by N. Zaretskaya in No. 1/2001 of the 9 MONTHS magazine.
3 About the technique of proper breathing during childbirth, which is recommended to be mastered during pregnancy, see: E. Pechnikova, No. 7-8 / 2001.

Real contractions before childbirth are involuntary contractions of the muscular layer of the uterus. During contractions, not only the baby is pushed out, but also the preparation of the birth canal. At this time, the cervix is ​​smoothed out and gradually expands to a diameter of 10-12 cm. There are real contractions before childbirth and false, or training ones. The latter occur in the second half of pregnancy and represent contractions of the uterus, during which it prepares for labor. In this article, you will learn how contractions begin before childbirth, what contractions look like, and how to distinguish real contractions from false ones.

How to recognize contractions before childbirth?

Basically, at the first birth, pregnant women are wondering how to recognize contractions before childbirth. Quite often, even before the start of contractions, women intuitively feel that childbirth will begin soon. During contractions, pain does not immediately appear, it usually starts with a feeling of discomfort in the abdomen or lower back, some women experience pain similar to menstrual pain. Gradually, these sensations become stronger, spread to the entire abdomen and lower back, pain appears, which can vary from quite strong pressure to twitching sensations.

The pain during contractions is paroxysmal, its occurrence, intensification, reaching a peak and a gradual decrease are clearly felt, then a period begins without pain. First, the contractions before childbirth come with an interval of 15-30 minutes and last 5-10 seconds. For the first few hours, they bring more minor discomfort than pain. Gradually, the duration and strength of contractions increase, and the intervals decrease.

Even before contractions begin, the baby begins to move less. If he moves very actively during contractions, this indicates fetal hypoxia. This must be told to the doctor.

Before childbirth, sanious discharge appears - this is how the mucous plug leaves. It should not be bright red with lots of blood. The cork can move away before the start of contractions. Sometimes the discharge of water also occurs before the start of contractions.

Just before the birth of a child, the contractions become so frequent that they pass one into the other almost without intervals. Further, attempts are added to them - contractions of the muscles of the uterus, abdominal wall and perineum. At this time, the child presses his head on the small pelvis, and the woman in labor has a desire to push, and the pain moves to the perineum. When the cervix is ​​fully dilated, the birth process begins.

How do fights happen?

Contractions before childbirth develop gradually, so three stages can be distinguished:

  • The first stage - initial, lasts 7-8 hours. At this time, contractions occur at intervals of about 5 minutes, and their duration is 30-45 seconds.
  • The second phase is active. Its duration is about 5 hours, uterine contractions become more frequent and last longer - with an interval of 2-4 minutes, the duration of contractions reaches 60 seconds.
  • The last, transitional, phase is from half an hour to 1.5 hours long. The contractions become more frequent and longer. They can occur at intervals of a minute and have a duration of 70 to 90 seconds.

If the birth is not the first, the process is faster.

How to distinguish real contractions from false ones?

False, or training contractions, which are also called Braxton-Hicks contractions, are uterine contractions, as a result of which its cervix does not open. They occur long before childbirth and, unlike real ones, are irregular.

Not every woman feels false contractions, everything is individual here - both their presence and absence are a variant of the norm. They are painless, but bring discomfort.

Training contractions are called because during them the uterus is prepared for contractions during childbirth. Also, with false contractions, blood rushes to the placenta, which is good for the fetus. False contractions are normal for pregnancy and do not pose any danger. False contractions start around 20 weeks.

Women who are expecting a baby for the first time are often afraid to confuse false contractions with the real onset of labor. What is the difference between training and real fights?

  1. False contractions can be repeated from several times a day to six times an hour. At the same time, they are non-rhythmic, and the intensity gradually decreases. Real contractions before childbirth are regular and are repeated at smaller intervals and with greater intensity, and their duration also increases gradually.
  2. The length of real contractions can vary, but the intervals between them are almost always equal.
  3. False contractions are painless, with a feeling of constriction in some part of the abdomen or in the groin. With real pain, sensations spread to the entire abdomen and hip joints.
  4. With real contractions before childbirth, other symptoms are also observed: discharge of water, mucous plug, pain in the lower back, diarrhea.

What to do when contractions start?

The time of the onset of contractions, their duration and the size of the intervals between them should be recorded. This information will be useful to obstetricians, in addition, keeping records will help to calm down and distract from pain.

You can easily go to the maternity hospital. If the contractions are repeated after 15-20 minutes, the birth of the baby will not happen soon. If there are no pathologies, the pregnancy is not multiple, it is better to spend this period at home: a familiar environment will help you relax better. You can do pleasant things: listen to music, watch a movie. If you are not going to have a caesarean section, you can have a light snack.

During contractions before childbirth, it is useful to move around. This reduces pain, allows the child to take a comfortable position in the uterus, and prevents fetal hypoxia. It is useful not only to walk, but also to make swaying movements with the hips. Thus, blood circulation improves, muscles relax, pain decreases.

When uterine contractions become more frequent and intensified, first of all, a woman needs to take a comfortable position and relax. Then the pain will be less. Real contractions before childbirth become longer and longer, and the intervals between them become shorter. The pain spreads from the abdomen to the lower back, does not weaken with a change in body position.

Signs of pathology during contractions

Sometimes, for various reasons, labor activity can be slowed down. It is not necessary for the first contractions to be followed by childbirth - uterine contractions can become regular only after a few days. This is more common in primiparous women. In such cases, in the maternity hospital resort to the stimulation of labor.

When is it time to go to the hospital?

If real contractions began before childbirth, then childbirth is approaching. Don't worry, you have time to calmly collect yourself while the contractions come at intervals of 20-30 minutes. Of course, it is desirable that the bag with things is already assembled in advance.

Already assembled, ready, the whole family is waiting - when will the most crucial moment come? When is it time for mom (a) to go to the hospital?
Childbirth usually begins with contractions - they mean that the birth process has begun. To understand that the birth is definitely going on, and you need to hurry, it is useful to know at what interval the contractions come and how long they last. Let's talk about it in more detail!

- these are periodic involuntary contractions of the muscles of the uterus, characterized by increasing dynamics and intensity. They allow the cervix to open - the "exit" for the baby.


Phases of labor pains

There are three stages (phases) of labor pains:

  1. initial (hidden) phase
  2. active phase
  3. transition phase (deceleration phase)

Each of the phases has its own duration, time intervals between contractions and the degree of cervical dilatation.


Initial phase

On average, the first phase of contractions lasts about 7-8 hours. At first, they can last 10-15 seconds, with an interval of 15-30 minutes. By the end of this phase, the duration of the contraction can be 30-45 seconds, with an interval of approximately 5 minutes between them.

During this time, the cervix opens up to 3 cm.

This phase is called latent, since the contractions in it are often painless, and you can simply not notice them - for example, “oversleep” or, conversely, do not pay attention to the periodic tone, actively doing business.
During this period, you can finish urgent business and get ready for the hospital.

JK1986: By evening, once an hour or two, the pain in the lower abdomen made itself felt. It looked like a short spasm. It sucked and then let go. I got ready. She shaved, washed, prepared and sorted the packages. Then the spasms became more frequent, once every half an hour, but the same short-term and, one might say, not painful. When these spasms became more noticeable and with an interval of 5-7 minutes, she went to surrender to the nurses. Then it was more frequent and more painful.


active phase

This phase lasts for primiparas from 3 to 5 hours. Uterine contractions become more frequent, prolonged and painful. Contractions in the second phase of labor last from 40 seconds to 1 minute. The interval between them in this phase can be from 5 to 2 minutes.

"The opening of the cervix by the end of the active phase already reaches 7 centimeters.

The onset of the active phase - that is, tangible contractions with an interval of 5 minutes - suggests that you can no longer hesitate, you need to go to meet the baby!


Transition phase (deceleration phase)

By the time the cervix is ​​fully dilated, the interval between contractions decreases to 2-3 minutes, and their duration, on the contrary, increases to 60 seconds. This means that the birth canal is almost or completely open and the pushing period of childbirth begins. At this stage, the woman may feel pressure on the anus and the beginning of attempts.
The transitional phase lasts from 30 minutes to 1.5 - 2 hours, and in women who give birth again, it may be practically absent, reduced to 2-3 contractions.


Why count contractions?

And why, in fact, do we need accurate calculations, is it not enough to understand what they are?

Firstly, at first - in order to make sure that the contractions are true, which means that the birth process has begun. After all, most expectant mothers have been familiar with since the middle of pregnancy, and closer to childbirth, so-called training contractions are felt. But training bouts are irregular, and the gap between them is not reduced. In addition, they usually stop completely within two hours.

The main features of the true ones are just their regularity and - an indispensable condition - more frequent, as well as an increase in duration.

zaichiha: On the day of birth, I thought for a very long time whether contractions or not. All morning was "training". And I also thought that there was a problem with the intestines. Then I decided that the training sessions were very intense, then I drank no-shpu, it did not help. And only when I began to suspect real contractions.

Secondly, with the help of calculations, you can approximately determine at what stage of childbirth you are, which means whether it is time to go to the hospital, and maybe even those around you need to urgently prepare to take delivery?!
There are different points of view on exactly when, at what intensity of contractions, a woman in labor should be in the hospital. This, of course, depends on the distance, and on traffic congestion, and, of course, on whether this is the first birth. It must be borne in mind that during the second and subsequent births, the cervix usually opens about 4 hours faster than during the first!

Multiparous women do not need to wait, it is enough to understand that the contractions are regular.


How to count contractions?

To begin with, note the time when you felt the first contraction, your doctor will need this. Then you need to arm yourself with a stopwatch or a watch with a second hand, paper and a pen. Record the start and end times of the contraction, and then the start and end of the next one. It might look something like this:

With an increase in the intensity of contractions, a woman may become “not up to it” - at this time, a husband or can record the beginning and end of contractions.
However, if a woman in labor is able to do this, she may well simply remember the intervals between the last contractions and their duration, without fixing anything - the main thing is to have a watch on hand.

There are also special programs that you can install on your phone and use them to count the number and duration of contractions. You just need to press the button at the beginning of the fight and another - at the end, and the program will automatically calculate the necessary data.


Fights don't go according to plan

Although contractions are an indispensable condition for natural childbirth, nevertheless, the classical scheme is not always waiting for the woman in labor. The above values ​​should be considered average and applicable only to the normal course of labor.
And no tables guarantee that your contractions will proceed exactly as “should”: this is still an individual process. For example, contractions can escalate from the very beginning to delivery, from two days to less than two hours! And after the discharge of the waters, the contractions sharply intensify and become more frequent.

However, all phases of dilation inevitably occur in every birth.

The reason that sometimes a woman gives birth “suddenly” is most often the painless nature of contractions in the first, and sometimes partially in the second phase of their birth.

Very often, contractions begin in a dream: the hormone oxytocin, which is responsible for their onset, is most actively produced at night. And they notice that they are giving birth, women in such cases are already closer to the straining period.

jelina: if there are contractions, then do not confuse with anything - I thought so until the second birth, when I realized that I was already giving birth, by attempts with an interval of 7 seconds. Only managed to jump from prenatal to generic.

Little mod: There were no "increasing contractions", strong ones immediately went, 40 seconds each with an interval of 15 seconds, and so on for 6 hours. I periodically passed out from the pain.

But even in such cases, counting contractions will be beneficial: a woman will understand that childbirth is very close, and she needs help.

And yet, most often, contractions increase gradually, giving the expectant mother to prepare for difficult work and the subsequent meeting with the baby!

The expectant mother needs to know in advance about all possible "scenarios" for the beginning of the birth process and have a clear action plan for each of them.

In modern obstetrics, pregnancy is considered full-term at 38 weeks. Carrying a baby for more than 42 weeks is considered overbearing. Thus, urgent, that is, on-time births fit into the interval from 270 to 290 days of pregnancy. Only some women prefer to go to the hospital a few days before the expected date of birth - most are going to come there with the onset of labor, so it is important for the expectant mother to know what can be considered the beginning of childbirth. This moment is determined by two events - the appearance of contractions and / or the departure of water. Moreover, some births begin with the appearance of contractions, some - with the discharge of water, and sometimes these events occur simultaneously.

Scenario one. The contractions have begun

Contractions - These are rhythmic contractions of the uterus. They are felt as a feeling of pressure in the abdomen, which can occur throughout the abdomen. A pregnant woman can feel such contractions even a few weeks before the baby is born: they are called precursor, or false, contractions.

false contractions- this is a kind of training of the muscles of the uterus before childbirth. With them, the expectant mother, in response to the movement of the fetus or physical activity, periodically feels tension in the abdomen, it seems to “reduce” it, it becomes harder to the touch than usual, and there may be pulling sensations in the lower abdomen or lower back. They do not cause any particular discomfort, more often these sensations are painless, irregular, quickly pass at rest and when taking antispasmodics - NO-SHPY, PAPAVERINA, MAGNE B6.

The purpose of preterm contractions is to prepare the muscles of the uterus and the birth canal for childbirth: they contribute to the maturation of the cervix.

True contractions- this is a contraction of the uterine muscle, which causes shortening and opening of the cervix by stretching its circular muscles. With each contraction, the cervix shortens, then flattens. The channel, or opening, of the cervix at the same time stretches - opens. A fetal bladder is introduced into it, expanding the pharynx like a hydraulic wedge. True contractions increase in frequency, strength, and duration over time. They occur regardless of the position of the body, taking antispasmodics, without regard to physical activity, at any time of the day or night.

Is there severe pain during contractions?

Due to the contraction of the muscles of the uterus during contractions and pressure on the cervix of the fetal bladder or the presenting part of the fetus after the outflow of amniotic fluid, the cervix is ​​shortened to smoothing. This continues for 4-6 hours and is called the latent phase of labor.

At first, true contractions are weak and painless, the intervals between them are about half an hour, although longer or shorter intervals are possible. Uterine contractions themselves last 5-10 seconds. Gradually, the intensity and duration increase, and the intervals between them decrease. Between contractions, the abdomen is relaxed.

Pain during contractions is due to the opening of the cervix, compression of nerve endings, tension of the uterine ligaments. Sometimes the first tremors are felt in the lumbar region, then spread to the stomach, becoming girdle. Pulling sensations can also occur in the uterus itself, and not in the lumbar region. Pain during contractions in cases where a woman cannot relax or find a comfortable position, resembles pain during menstruation. Its strength depends on the individual characteristics of the threshold of pain sensitivity, the emotional state of the woman and her attitude to the birth of a child. It is important not to be afraid of childbirth, because the whole process takes only a few hours, and labor pain is quickly forgotten.

You can often hear from women giving birth that the contractions were either completely painless, or the pain was quite tolerable. The fact is that during contractions, the body releases its own painkillers. In addition, relaxation and proper breathing techniques mastered during pregnancy help to get rid of painful sensations.


If contractions start...

The woman has a little time to take a shower, put on clean underwear, cut her nails and wash off the varnish from them. For many expectant mothers, shaving the perineum upon admission to the hospital is a very unpleasant moment. However, this procedure is necessary, as it allows you to control the degree of stretching of the perineum during childbirth, to prevent its rupture, and in case of injury, it is better to match the tissues during suturing. Feelings of embarrassment can be avoided if you shave at home yourself. To do this, you need to take a completely new razor and treat the skin well with an antiseptic solution - CHLOROHEXIDINE, CITEAL, MIRAMISTIN - or antibacterial soap. If it is difficult for a woman to do this herself, you can ask her husband for help.

You should go to the hospital when the contractions become regular and will go every 10-15 minutes. If a clear interval between contractions has not yet been established, but they are accompanied by severe pain, it is also necessary to go to the maternity hospital. If the childbirth is repeated, then with the onset of regular contractions it is better to go to the hospital immediately: often repeated childbirth is swift, so it is better not to hesitate.

Can you move during contractions?

During fights, you can choose a comfortable body position: you can lie on your side, walk, stand on all fours or kneel, swing on a large ball - a fitball. It is necessary to monitor the duration of contractions and the intervals between them. It is recommended to remember, write down or note the time of the start of contractions on the phone.

During contractions, you need to slowly, deeply and rhythmically inhale air through the nose and exhale it through the mouth. If the contractions become very strong, frequent shallow breathing, in which the inhalation is also made through the nose, and the exhalation through the mouth, will help.

From the very beginning of the contraction, stroking the lower half of the abdomen should be performed. fists or open palm on both sides of the spine, up and down, to the base of the coccyx. After a contraction, there is always a period of time when there is no pain, you can relax and unwind. It is necessary to empty the bladder regularly - this stimulates contractions.

What can not be done during fights?

During contractions, you can not sit and lie on your back. In the supine position, the pregnant uterus compresses large vessels, in particular the aorta and inferior vena cava, which leads to a deterioration in the return of blood to the heart and a drop in blood pressure. This is accompanied by a violation of the blood supply to all organs of the pregnant woman, including the placenta and, as a result, oxygen starvation of the fetus. This is the so-called inferior vena cava syndrome. In the sitting position, the ratio of the pelvic bones changes, which makes it difficult to move the fetal head along the birth canal, and at the end of the first stage of labor can lead to fetal injuries.

You can’t eat during childbirth: this is due to two points. Firstly, in the first stage of labor - during contractions - many women experience a gag reflex, and a full stomach provokes repeated vomiting. Secondly, during childbirth, a situation may arise when the expectant mother will need an operation using general anesthesia. If the patient's stomach is full during anesthesia, then gastric contents can be thrown into the respiratory tract, which leads to very serious, sometimes fatal complications.

It is forbidden to take painkillers on your own: they will not relieve normal labor pain, but they can mask important symptoms.

You can not stay at home in the following cases:

  • If there were bloody issues. Uterine bleeding during childbirth begins due to the pathology of the placenta - its premature detachment or improper location. These bleedings are life-threatening not only for the fetus, but also for the woman herself.
  • If the expectant mother is worried about headache, blurred vision, tinnitus, flashing "flies" before the eyes, nausea, vomiting, pain in the stomach and right hypochondrium. All this can be symptoms of a severe form of late toxicosis - preeclampsia. This condition requires immediate medical attention, and the woman needs complete rest in a dark, well-ventilated area with a minimum level of noise until it is provided. Without treatment, these disorders can lead to a deadly complication - eclampsia, which is characterized by the sudden onset of convulsions and loss of consciousness due to cerebral edema.
  • If baby stirring become very stormy or, on the contrary, are badly felt. Changes in the motor activity of the fetus may be a sign of its oxygen starvation. In all these cases, it is necessary to get to the hospital as quickly as possible, ideally by an ambulance with a medical escort.


What should a husband do when labor begins?

Usually, the expectant mother endures the first contractions quite easily: they last 15-20 seconds and repeat every 15-20 minutes. At this time, the future dad can talk with his wife about something abstract, create a reserve of good mood, joke and dream. You can help the spouse use her imagination, for example, imagine that the fight is a wave that she overcomes.

It's good if the future dad will be, especially if she gets out of rhythm. To set your spouse up for proper breathing, you can first breathe in unison with her, and then gradually change the frequency of your breathing, and then the woman in labor will unconsciously copy her husband's breathing. In order to properly help his wife in childbirth, the husband needs to master the techniques of proper breathing, analgesic massage and relaxation even at the stage of pregnancy, which can be done at special courses in preparation for partner childbirth.

During contractions, you should remind your wife of techniques that relieve pain. You can try to save your spouse from unpleasant sensations by massaging her back in a circular motion from the lower back and below, or tapping her fingertips on pain points, stroking her stomach from the bottom up and to the sides.

A man can persuade his wife to walk around the room by offering her to lean on his arm: walking speeds up the process of childbirth, this is especially important at their initial stage.

Before leaving for the maternity hospital, it is necessary to check whether the wife has documents: a passport, an exchange card, an insurance policy, a contract for the management of childbirth (if any). If a contract for childbirth has been concluded with a specific doctor, after the start of contractions, you need to call him.

For partner childbirth, the husband needs rubber slippers and specially prepared clean clothes - jeans or trousers, a T-shirt or shirt. Also, you should have the results of a medical examination with you: what studies you need to undergo, you need to find out in advance at the maternity hospital.

Before giving birth, the husband needs to develop an algorithm for transporting his wife to the hospital. It is necessary to clarify the telephone numbers of emergency services - state and commercial. If the family lives outside the city, you need to ask how long it usually takes an ambulance to get to the place of residence of the expectant mother. It is good if there are several transportation options and a car with a full tank of gasoline in stock. If the husband is often on business trips by occupation, then you should think in advance who will help the wife get to the hospital if the birth begins in the absence of the spouse.

Scenario two. The waters have broken

Normally, amniotic fluid is poured out in the first stage of labor - until the cervix is ​​fully dilated, but not before the cervix is ​​4 cm dilated. At the height of one of the contractions, it becomes tense and breaks. As a result, the anterior waters are poured out, which are located between the head of the fetus and the membranes of the fetal bladder, in this case the volume of the departed waters will be small - up to 0.5 liters. If the fetal head is high or there is a transverse or pelvic position, then a lot of water flows out - up to 1.5 l. When the rupture of the fetal bladder pain is not felt.

If the opening of the cervix is ​​complete, and the bladder is still intact, then the obstetricians themselves open it, since at birth, whole membranes block the access of oxygen to the fetus.

Quite often, women have doubts: did the amniotic fluid or the mucous plug move? Both those and other secretions are liquid and at first observation seem to be similar. But they also have significant differences.

As can be seen from this table, unlike the mucous plug, the waters are clear, warm and constantly leaking. The outflow of water before the onset of labor, i.e. before contractions, is considered prenatal or premature, and if they are poured out during regular contractions, but with insufficient opening of the cervix, they speak of an early outflow of water. Before the onset of contractions, water often breaks in multiparous women. In case of premature outflow of water, the fetal bladder can burst high above the cervix, then the water slowly flows out, or maybe directly above the opening of the cervix, then the water will immediately leave in large quantities. Labor activity after the outpouring of water develops over the next few hours.

The placenta and fetal membranes provide a barrier that is usually completely impervious to bacterial (purulent) infection. Throughout pregnancy, the fetus develops in a sterile environment. The key to this sterility, and hence the intrauterine well-being of the fetus, is the integrity of the amniotic membranes. Immediately after the outflow of amniotic fluid, bacteria begin to enter the uterine cavity from the vagina and cervix, the child is no longer protected from possible infections, so childbirth should occur no later than 12 hours after the rupture of the fetal bladder. For this reason, in the event of an outflow of water, it is necessary to go to the hospital without delay, even if there are no contractions yet. You should remember the exact time of the discharge of the waters and their color: this will help the doctor decide on the tactics of childbirth. In case of premature discharge of amniotic fluid in the maternity hospital, infection of the fetus is prevented.

It is necessary to pay attention to the color of the departed waters. Normally, they are transparent or light pink, odorless. The greenish, brown or black color of the amniotic fluid indicates that there has been a release of meconium - the original feces - from the baby's intestines, which happens during oxygen starvation of the fetus. If the waters are colored with bright blood, then placental abruption is likely. In this case, immediate hospitalization is necessary.

Before the ambulance arrives or before leaving the house on another transport, the expectant mother needs to take a horizontal position and put a diaper under her, since from the moment the water drains, they will continue to flow. After the outflow of water, the fetal head is inserted into the uterine cavity and in some cases can press the umbilical cord. The position of the woman in labor standing and sitting speeds up the process of inserting the head.

The rest of the recommendations are the same as those that were described when it came to contractions. If there is no certainty that the waters have departed, it is necessary to conduct a cough test: with coughing and tension of the abdominal wall, the water will flow more strongly, and the amount of mucous plug will not change. If doubts remain, you should consult a doctor at the maternity hospital.

What can not be done?

Unlike the option when childbirth begins with contractions, you can’t stay at home when the water breaks. This is associated with the risk of infection, and with the risk of hypoxia - oxygen starvation of the fetus. It is impossible to carry out hygiene procedures, this is also associated with the risk of infection of the fetus.

What should a husband do?

The main thing is to help the wife quickly get ready for the hospital. The future dad should take care of preparing documents and bags and help his wife get dressed. It is better to deliver a woman with broken waters to the maternity hospital in a horizontal position.

Have with you

Given that childbirth often begins suddenly, it is better to carry medical documents with you at all times in the last weeks of pregnancy - a passport, an exchange card, a policy after 30 weeks - or a birth contract - after 36 weeks. It is necessary to know or have with you the emergency numbers, the doctor, the address of the obstetric departments or other medical institutions closest to the house and work.

The expectant mother should not rely only on herself - in the event of an emergency, it is necessary to seek help from others, warning about her condition. It should be remembered that police officers, subways, stewardesses and train conductors take courses in medical care and can urgently contact doctors.

Maternity hospital bag

The expectant mother needs to put separately the things that she would like for the time of childbirth, and separately those that will be useful to her immediately after the birth.

In the first bag you need to put a T-shirt or cotton nightgown, socks, washable slippers, a bathrobe, a small terry towel, drinking water, personal hygiene items - a toothbrush and paste, soap, a comb, toilet paper. The maternity ward is usually not allowed to take anything else. In some maternity hospitals, you can take a mobile phone and a player, a camera and even a video camera with you, but it's better to find out in advance.

The second bag should contain 2-3 packs of highly hygroscopic breathable sanitary pads, disposable mesh panties or regular cotton panties, a nursing bra, clothing - at the discretion of the woman. For the baby, you will need clothes, baby diapers, baby cream, baby soap, a compact package of wet wipes.

The first stage of labor is characterized by increased uterine spasms with the development of the process of childbearing. It is important to learn how to count the interval between contractions for timely departure to the hospital. Applications or a special table are used, the main thing is to calculate correctly.

The pattern in repetitions of uterine spasms indicates the onset of labor. The first contractions of the uterus are irregular and rare - 1-2 times per hour. It is important to learn to distinguish between the preparation of the uterus for delivery from true spasms. There is a method for calculating the interval between labor pains. Obstetricians recommend representing uterine spasm as a sea wave, which periodically rolls ashore, and then recedes. It is necessary to fix the duration of the stage of retreat of the uterine tension.

How long do the first contractions last? The duration of the spasm is short - 20-30 seconds. The calculations are approximate, because every woman experiences childbirth in her own way. The first stage of the birth process in women in labor with the second and third pregnancy develops rapidly.

How long does it take for the first contractions to start? Usually the initial interval for the first contractions is long - 30-40 minutes. At this stage, women are at home and doing business.

In order not to confuse true uterine contractions with training ones, pay attention to the presence of an increase in pain. Real contractions come with a periodic interval, which gradually decreases. Another marker of the onset of labor is a thick discharge from the genitals - a mucous plug. False contractions have an uneven interval, with chaotic repetitions of spasms.

A woman in labor needs to know the duration of the intervals in order to understand whether labor activity is developing or whether she already needs the help of a doctor. This is a kind of beacon that tells the woman in labor when to go to the hospital.

Correct calculations

Childbirth consists of three stages: contractions, attempts to expel the fetus, and the birth of the placenta. The very first uterine contractions, repeated at some intervals, indicate that labor has begun. In order to correctly calculate the intervals, they begin to record data from the first labor spasms. For calculations, you need a stopwatch, watch or phone.

It is recommended to write the time of the beginning and end of the spasm on paper. If it is not possible to do this, remember the time of the very beginning of the contractions. The repetition of uterine contractions every 10 minutes is considered the beginning of a full-fledged labor activity. At this stage, the mucous plug leaves - thick discharge from the vagina interspersed with blood.

Doctors advise multiparous people to go to the hospital, because childbirth can proceed rapidly. If the contractions are repeated every 5 minutes, and their intensity increases, the woman in labor needs to call an ambulance and go to the hospital.

How to determine the contraction interval:

  1. write data manually;
  2. use the application;
  3. using a table;
  4. build a graph.

There are special programs that consider the interval of contractions during childbirth. You can install applications on your phone, tablet or laptop and make calculations for the duration of spasms and the intervals between them. There are also online programs, you do not need to download them, it is enough to have access to the Internet. Programs capture data and determine the truth of uterine contractions.

If there is no gadget at hand, use the table. It describes what should be the interval between contractions, and how to behave correctly at each stage of labor activity.

Strengthening contractions is depicted as a graph of contractions during childbirth.

The data is provided to the doctor to compile a complete picture of labor activity. If the interval increases, then the alarm is false.

Intervals between contractions according to stages

The initial period of labor activity is divided into three stages: hidden, active, passing. Each of them has features.

How is the interval between contractions shortened? The interval between tensions of the uterus decreases with the development of delivery, that is, according to the frequency of the first stage of childbirth.
The latent or latent phase in a primipara lasts about 7 hours. The first interval at the very beginning of labor can be from 40 minutes to an hour. The duration of uterine contraction in this case is 30-40 seconds. The regularity of spasms of this stage is up to 10 minutes.

The active phase lasts 2-3 hours. The time intervals become shorter, about 5 minutes, and the labor spasm itself lasts a minute. At this stage, the woman in labor should already be in the hospital, especially if she has a second pregnancy.

The transitional stage is the shortest, lasting about an hour. Contractions have already become long up to 90 seconds, the interval of contractions before attempts is 2-3 minutes. It becomes more difficult for a woman in labor to possess herself, because there is very little time left to take a breath between uterine contractions.

At what interval of contractions does labor begin? From the moment when the contractions become longer than a minute, and the gap between them is almost equal to the spasm itself, the final stage of the birth act begins - attempts. As a result of several prolonged contractions, the baby is born.

Multiparous women should keep their finger on the pulse, because they may have contractions immediately with a small interval. In the second and subsequent births, all periods of delivery are shortened, so it is required to go to the hospital at the stage: 10 minutes break between spasms.

Complications

It is allowed to stay at home if the contractions pass without anomalies. It is extremely rare, but there are complications in the initial phase of delivery.

The following pathologies may appear:

  • development of rapid childbirth;
  • too weak generic activity;
  • absence of labor spasms;
  • painless uterine contractions;
  • bleeding.

If the spasms immediately become strong, and the interval between them decreases excessively actively, this is a sign of rapid labor. In this case, you need to quickly go to the hospital and be under the constant supervision of a doctor.

Perhaps the attenuation of the birth process. It is very dangerous if this happened after the discharge of amniotic fluid. After all, the child should be born within a day after the outflow of amniotic fluid. In this case, it is necessary to discuss with the doctor, medical stimulation of childbirth, otherwise they will end promptly. Oxytocin or prostaglandins are used to induce labor activity. Their effectiveness is high, but there is no strong harm to the child.

It also happens that contractions disappear completely. This suggests that the birth process is abnormal. The reason is that false abbreviations are confused with real ones. But only the doctor has the right to make a conclusion. The basis for the pathological development of delivery is the pregnant woman's fear of future difficulties, exhaustion of the body (with too long weak contractions) and no rash. Therefore, if prenatal contractions have already begun, you should not be afraid of them, you need to perceive everything adequately.

Some women have a high pain threshold, so they cannot detect the time interval between the first contractions before childbirth. Sometimes women in labor do not feel severe pain up to attempts. The problem is that the pregnant woman does not understand at what stage the process of labor activity is. In this scenario, it is better to contact the obstetrician, who, with the help of an internal examination, will determine how long the attempts will come.

There is no spotting during the initial stages of delivery in the norm a priori. If a woman notices that scarlet blood is secreted from the vagina, an ambulance should be called immediately. The cause of this pathology is placental abruption, uterine rupture, and other terrible anomalies, some of which are incompatible with the life of the mother, if not reacted in time.

Relief of labor spasms

Contractions are considered a painful and painful period of childbirth. Women plan to get through this stage without pain medication, but not everyone succeeds.

In order for the reductions to be productive and painless, you need to prepare for them in advance. The third trimester of pregnancy should be devoted to this activity. In antenatal clinics there are special schools for future parents, where they teach how to behave in childbirth, and tell partners how to help women in labor reduce pain.

How to ease the pain of contractions:

  1. finding a loved one (mother, husband, girlfriend) with a woman in labor who can distract and calculate the interval between uterine contractions;
  2. correct breathing. It is worth learning the breathing technique for each stage of labor. Then success is half guaranteed. It is forbidden to breathe often and unevenly, it is better to do it calmly and inhale deeply to supply the baby with oxygen;
  3. self-relief. Women in labor perform certain massage movements on the sacrum. They slightly reduce pain during spasms. A partner can also massage the lower spine, it is more useful and pleasant than self-massage.

Some maternity hospitals practice being in the water during labor. Such an environment is considered physiological for delivery, and pain is reduced (swinging on a fitball is suggested). This exercise will unload your back and help reduce pain during uterine contractions. If a woman feels uncontrollable pain, she should discuss with the obstetrician the method of pain relief.

It is necessary to measure the interval between contractions before childbirth in order to determine the degree of development of the birth process. Also it is necessary to get information about when to go to the hospital. For calculations, use the application on the phone, a table, or build a graph according to the duration and regularity of uterine spasms.