Where it starts to hurt during contractions. Posterior occipital presentation. How to know when contractions have begun

26.08.2019

The very first contractions, what sensations do they cause, what does the expectant mother feel? It happens differently for every woman. Contractions are periodic painful contractions of the uterus, which can be accompanied by discomfort in the back in the lumbar region or in the lower abdomen.

How to determine that the first contractions before childbirth begin, what are their distinguishing features? The woman begins to feel something similar to pain during menstruation. But only the pain is not constant, but periodic. And during an attack of pain, the stomach is very tense.

The first contractions can have an interval and the sensation in primiparous and multiparous is approximately the same. They usually start weakly, with a frequency of 12-15 minutes and last no more than a minute. But the painful sensations will increase each time more and more, until they seem almost unbearable.

Do not confuse Brexton Higgs' prenatal contractions with labor pains. Some women, feeling heaviness and pressure in the lower abdomen, go to the hospital and declare that they are giving birth. And the doctor, upon examination, sees that the tone of the uterus is normal, and the cervix is still long and dense. That is, a woman is not in labor. The first contractions and the Braxton Hicks contractions are very easy to confuse. True, we must give the doctors their due, they do not swear at the patients who raise such a false alarm, because the preparatory work of the uterus can really be quite painful.

How to distinguish the first signs of real contractions from prenatal? If there is pressure in the lower abdomen, but there is no pain, then these are the harbingers of prenatal contractions. If the contractions are periodic and are accompanied by severe pain, and not just a little tension and petrification of the uterus, then this is a reason to call the doctor and go to the hospital. This is the most famous description of how contractions begin in women. Although some pregnant women may not realize that they are already in labor, because between contractions, the abdomen becomes relaxed and the pain subsides.

Important advice: if you suspect labor pains, if possible, you should call your doctor or obstetrician and tell about your condition. If there is no agreement with the doctor and the maternity hospital, you can call an ambulance and find out how to understand that contractions have begun in the first birth. Any more or less experienced paramedic according to your description will be able to understand - is it time for you to go to the hospital, or you just need to take measures to alleviate false contractions. Medical workers working in an ambulance, even if they do not have special education in obstetrics and gynecology, are well aware of the first birth about what sensations may arise during the first contractions. Usually, during the same period, a woman is very excited, sometimes, on the contrary, she is scared, convulsively going to the hospital, if the packages and documents have not been collected earlier.

The first contractions during pregnancy usually occur in the back or pubic area and may be described similar to menstrual cramps. In this case, the child can move very actively, which, apparently, is associated with the emotional state of his mother.

The pain and frequency of the first contractions can be compared to a wave that rolls in and then recedes. It all starts from the back, after the pain passes to the hips, and then it concentrates in the lower abdomen. As a rule, the onset of labor is not too painful, quite tolerable, and the duration of the first contractions is short. But then the pain grows with every minute.

Most often, in primiparous women, labor pains last about 12 hours, but there are also cases when childbirth is rapid, and their first period lasts only 2-4 hours. How long the first contractions last in women largely depends on the initial state of the cervix. If there was ischemic-cervical insufficiency, during pregnancy the cervix was greatly shortened and softened, the child can be born very quickly.

When should you get ready for the hospital? Frequency of contractions will help determine the time of travel to the hospital. If a woman lives near the birth ward, then she should go there when the painful sensations repeat at intervals of 1 time in 7-10 minutes. If the pregnant woman lives in a remote area, then you need to go to the hospital as soon as possible, because the cervix can open very intensively. It should be noted that even when the first contractions in multiparous women are short, less than 5 minutes, this does not mean at all that the woman is about to give birth. Firstborn childbirth is usually protracted, but nevertheless this is not a reason to wait it out at home, because an emergency situation may occur, for example, premature detachment of the placenta, when emergency surgery is required to save the life of the mother and child.

Do not forget about such a moment as amniotic fluid. The time of the trip to the maternity ward also depends on them. For many, contractions appear only after the amniotic fluid has burst. If this happened, or there is a suspicion of water leakage, you do not need to expect contractions at all, you should immediately go to the hospital, regardless of the gestational age. If the child is left without water for more than 12 hours, it is very dangerous. But, of course, there is no need to wait until these allowable 12 hours at home have passed.

Also, you should urgently consult a specialist when spotting appears. They should not be confused with the release of the so-called cork. It leaves the cervix a few hours, and sometimes even days or weeks before childbirth. Thus, the birth canal is freed. The mucous plug is a light or dark brown discharge, but not bright red.

The speed of the baby's birth and his health largely depend on how the woman will behave during contractions and the birth itself. Do not panic when contractions appear. You need to calm down, pack up, call the doctor and go to the maternity ward.

For nine months, the expectant mother is waiting for a meeting with the baby. What will it be? Who do you look like? Will he be calm or moody?

A lot of questions start to spin in the head of a pregnant woman when the term approaches 38 weeks.

But, perhaps, the main ones are: How will the contractions go? Does it hurt to give birth? And when is it time to go to the hospital?

Rates and numbers for pregnant women

During observation by an obstetrician-gynecologist, every pregnant woman hears from the doctor the estimated date of birth.

As a rule, it is calculated based on the date of the first day of the last menstruation, adding 38 weeks to it. This is the most common way, although there are others. That is, a woman must prepare to become a mother at a certain time.

But why exactly 38 weeks?

A full-term pregnancy is 38 weeks. Starting from 41.5 weeks, pregnancy can already be called post-term.

Delivery should ideally occur between 38 and 41 weeks, but many women give birth to healthy babies at both 36 and 42 weeks.

Therefore, we need to talk not about a specific date of birth, but about estimated interval.

The first swallows are the harbingers of childbirth

So, the woman calculated for herself the interval of dates on which childbirth should take place.

Confidence in an early delivery can give the personal feelings of the expectant mother.

They are called harbingers of childbirth... It:

Lowering the abdomen;
Expansion of the pelvic bones;
Braxton Hicks contractions (more on that below);
Discharge of the mucous plug;
Discharge of amniotic fluid;
Back pain;
Change in appetite.

Harbingers may not necessarily appear all, and some of them may well take place even 2 weeks before the onset of childbirth.

Noting the changes in well-being, characteristic of the harbingers, a woman should understand that childbirth with contractions and other delights is just around the corner.

What are contractions?

Real labor activity begins with contractions. They are contractions of the muscles of the uterus, which are accompanied by aching pain in the lower abdomen or lower back. Also, the pain can be shingles.

A woman feels something like that during menstruation.

During the contraction, the uterus becomes toned, that is, it becomes rigid and elastic. When the contraction is over, the abdomen relaxes. Women with a high pain threshold may not even feel pain at the very beginning of the labor process. They can only be noticed by the periodically stressed belly.

Contractions do not cause constant discomfort to a pregnant woman, they are periodic.

At first, the pauses between contractions range from 15 to 20 minutes. Then they get shorter (3-5 minutes), and the contractions become more intense. During contractions, the cervix opens. The obstetricians monitor the correctness and stability of the process of its disclosure.

How do you know when contractions are starting?

Typical story: a woman arrives at the hospital, shouts that she has contractions, and after a while quietly leaves home. It underlies more than one gum about childbirth and the life of pregnant women.

What makes the expectant mother rush to the maternity hospital with insistent demands for urgent childbirth?

These are false contractions or Braxton-Hicks contractions.

To avoid unnecessary worries, not to frighten relatives and not to raise doctors without a reason, you need to be able to distinguish false contractions from real ones:

False contractions are not periodic.
False contractions do not get worse over time.
The pain from false contractions disappears with a change in body position, taking a bath, etc.
With false contractions, the cervix does not open. Even if it is slightly open, false contractions do not provoke its further expansion.
To understand that real contractions are beginning, you need to pinpoint the intervals between them. At first, they can be 15-20 minutes, then they decrease to 5 minutes, later - to 3 minutes (at this time the woman should already be in the hospital).
Also, real contractions can be accompanied by bloody discharge - this is a mucous plug that comes off.

Pain during labor

It so happened that women give birth to children in suffering. The most severe pains during labor, which accompany the first stage of labor. Their result is the opening of the cervix, through which the child will subsequently exit.

Pain during labor increases gradually.

At first, the intervals between contractions are long, and the pain is practically not felt. Over time, the intensity of the contractions increases, the intervals decrease.

However, no matter how strong the pain has, nature is organized in such a way that a woman may well rest in that short time when the contraction subsides.
If you objectively look at the nature of pain during labor, it becomes noticeable that only 30% of painful sensations have a real basis.

When passing through the birth canal, the fetus presses on the soft tissues, the ligamentous apparatus of the uterus, the perineum; when the uterus contracts, nerve endings burst, which provokes severe pain.

The remaining 70% are due to fear of childbirth. The expectant mother is afraid of suffering, fears for her life and the health of the baby. "Horror stories" told by more experienced friends also play a significant role.

So one of the most important things before childbirth is correct emotional attitude.

Help during contractions

Every woman dreams of painless childbirth. How nice it would be for a kind doctor to make a baby at the beginning of childbirth, and the child was born without torment and suffering!

To be honest, there is this kind of pain therapy, but it should be used only in emergency cases as prescribed by a doctor.

And for women in labor, whose physiological process of delivery goes without problems, there are methods of self-anesthesia:

Breathing techniques.
Special poses practiced in active labor.
Massage.

Self-pain relief techniques are quite simple to perform. Their implementation does not require special abilities, but you still need to practice before giving birth.

Pregnant women can get acquainted with these methods in the classroom at maternity schools, which are often conducted at antenatal clinics, or in specialized centers for effective parenting.

When to go to the hospital

So, it's time to answer one of the main questions: when is it time to get ready for the hospital.

You can't be late here, but early admission to the maternity hospital is also undesirable.

At first, the scary stories of the roommates are not good for the pregnant woman about to give birth.

Secondly, the constant expectation of childbirth negatively affects the emotional state of a woman.

Thirdly, it is quite possible that doctors will begin to stimulate labor with medications.

You need to go to the hospital in one of the following cases:

When regular contractions appear.
From now on, a pregnant woman can already be called a woman in labor. As soon as the intervals between contractions have reached 10-15 minutes, you can go to the hospital.

We talked about fights in detail above.

When bloody discharge appears.

The appearance of bloody discharge may indicate the discharge of the mucous plug, which accompanies the opening of the cervix. However, blood in the discharge can also indicate placental abruption, which is life-threatening for both mother and baby.

Therefore, in this case, the appeal to the maternity hospital should be immediate.

With the discharge of amniotic fluid.
In this case, one should not wait for the onset of contractions, since any delay can be dangerous for the child's life.

Rupture of amniotic fluid should occur when the cervix dilates by 4-5 cm. However, in 15% of pregnancies, it happens even before the onset of contractions.

You should remember the time when the waters broke, and immediately go to the hospital. A long anhydrous period is dangerous for the baby by the development of infections.

In fact, "being late" to the hospital is very difficult - rather, it is the lot of third-rate Hollywood comedies. Your body itself will give an unambiguous signal to the mind!

Mom, remember that childbirth is a normal physiological process. With the right theoretical, physical and emotional preparation, childbirth will go without problems.

Childbirth is just a road leading to a meeting with your child - the most beloved person in the world!

Many primiparous women are interested in the question of how to understand that contractions have begun? Normally, childbirth begins with the appearance of systematic contractions at certain time intervals. However, labor can start incorrectly, with the amniotic fluid flowing away, and not with contractions. In such a situation, everything is clear, as soon as the waters have departed, you should: calm down and not worry, get together, notify your relatives, call an ambulance or get there on your own. With the escape of waters, everything is clear, but what about when the contractions come? It is very important here to know exactly how to recognize the first contractions. Let's talk about this in more detail.

First birth: how to understand that contractions have begun

Contractions are signs of labor during pregnancy. Therefore, there is an adequate question, how to understand that the contractions will begin? To answer the question posed, you need to understand what contractions are and what they are for. Contractions are the process of contraction of the longitudinal smooth muscles of the main female organ, which provokes the dilatation of the cervix.

All childbirth is characterized by the following periods:

Dilation of the cervix;
Expulsion of the fetus;
The birth of the placenta.

The period of cervical dilatation includes several phases: latent, active, deceleration phase. The first phase is the longest. This is the time of the onset of the contractions. After a while, they lead to the smoothing of the uterine cervix and its opening. But for this you need to wait a certain period of time.

Therefore, if contractions begin, then in order to assess the process of changes in the structure of the uterine cervix, you should wait 2-3 hours.

To the end, to figure out that the contractions have come, will help the study of the woman's vagina. Prenatal examinations of pregnant women help to find out the degree of dilatation of the uterine pharynx, as well as to understand whether the uterine cervix has smoothed. CTG should be done by an obstetrician in a maternity hospital, necessarily according to strict indications. The onset of labor is not a reason for examining the vagina. As already mentioned, the development of full-fledged labor should be monitored for several hours.

Signs of labor

The main symptom of approaching delivery is the lowering of the abdomen. The fact is that the child must go downstairs to prepare for his birth. If carrying a baby goes well, then this process will begin at 36-37 weeks. At the same time, the pregnant woman even begins to breathe more freely, but many experience discomfort, discomfort due to frequent going to the toilet and the development of edema. The lower and upper limbs may swell.

This is explained by the fact that the baby, going downstairs, presses on the paired organ / bladder, so you should not be afraid of swelling, this condition only indicates that childbirth is close.

Another sign of near delivery is a decrease in body weight. During the entire period of gestation, a woman is gaining kilograms, but suddenly realizes that she has thrown off a couple of kilos, you should not panic, this means that labor will begin soon, which is why it is so important to systematically weigh yourself and record the weight. The reduction in body weight occurs due to the fact that the amniotic fluid is absorbed, and there is no need to panic. Symptoms that labor will soon begin are different.

One of the main signs is a change in tastes. If a pregnant woman has lost her appetite, and suddenly stopped eating for pleasure, this means that it is time to get ready for the hospital.

The approach of childbirth can also accompany an increase in appetite, if during the entire period of gestation, the woman ate moderately. The second sign that allows you to determine that delivery will begin in a few days is a pulling pain in the pubic area. If back and lower back pain during pregnancy were considered normal, now all pain is coordinated precisely in the pubic region. The fact is that for delivery, it is necessary for the bone tissue to soften in order to facilitate the process, so there is some kind of softening, which is accompanied by a dull pain syndrome. You should not be afraid of such manifestations, you must: prepare to go to the hospital. In addition to physiology, there are also psychological changes.

The nature and mood of a pregnant woman changes:

Then she cries;
It becomes irritable;
He laughs.

A woman may have apathy, she behaves unusually. During the gestation period, this is not so noticeable than the other day before delivery, therefore, attention should also be paid to this symptom of the upcoming birth. A woman is tormented by insomnia, or she can sleep for a very long time, she is worried about trifles, has become aggressive or, on the contrary, indifferent to everything. You should not worry - this is how labor is approaching. As soon as you give birth and see your baby, these symptoms disappear, with the exception of postpartum depression.

The beginning of labor: what to do

If the pregnant woman noticed several of the symptoms described above, and if these signs intensify, then it's time to give birth.

After about 7 days. But, in the last trimester, you should behave carefully.:

Lead a healthy lifestyle;
Do not lift weights;
Relax more and walk in the fresh air.

But, light physical activity will be useful, otherwise you can go over pregnancy, that is, the baby will be born later than it should. As doctors say, this negatively affects the body of a woman and a baby. It would be right for 2-3 hours to walk on the street, in a park area, in a garden, to do light household chores - to wipe dust, wash dishes, “fiddle” with food, iron, but there is no benefit from washing floors in a slope or hand washing will.

It is better to shift these matters to your beloved relatives, let relatives help you, or you can wipe the floors with a mop with a comfortable long handle, and wash the linen in the washing machine.

Attention! The main thing, before giving birth, is positive emotions that the pregnant woman should experience as often as possible, so that the child feels the wonderful state of the mother, he should not feel any stress, so that nothing will scare him before birth. The emotional state of the child also depends on the state of the woman.

How labor begins

All the precursors of childbirth, manifested in pregnant women, make it clear that childbirth is about to occur, that it is necessary to be on the alert, the necessary things should be prepared that will be required in the maternity hospital. But, the closer the time of the upcoming birth, the more the woman worries, whether she will be able to determine that labor is beginning. How not to miss the beginning?

To determine that the onset of delivery is taking place, you need to pay attention to the obvious symptoms of a change in the state of the pregnant woman:

There is an adrenaline rush, her palms and feet become wet, she begins to worry a lot.
A certain fluid is necessarily released from the genital organ, sometimes with blood - this is a special mucus that resembles a cork, which protected the fetus throughout the entire gestation period. But, sometimes, when she leaves a couple of days before delivery, but usually this happens right before childbirth.
There are contractions. The first contractions are a slightly painful sensation, a pain syndrome that moves from the lower abdomen to the lumbar region. If a woman does not immediately understand that she has contractions, do not panic, the first birth can last up to 14 hours, there will be even more prolonged ones, there will be time to get to the doctor. Gradually, the strength and duration of the contractions increase. What are the intervals between contractions? Prenatal are at intervals of about 5 minutes. and more and more.
It must be understood that when the waters recede, it is already necessary to prepare for childbirth. You can't hesitate. Why? The most negative consequences can ensue. If the pregnant woman, when the waters did not leave the hospital, should record the time when the waters left, how they looked, how many there were, how they smelled. This data is needed by the obstetrician.

For multiparous women, contractions are normal, and primiparous from excitement can be very worried, they can have chills and heartburn.

Preterm labor symptoms

How much is the bearing rate? Pregnancies are considered normal when the baby is carried for about 40 weeks.

A doctor should be consulted if:

Contractions began, which are repeated every 10 minutes.
A watery liquid was released, which may mean damage to the bladder with amniotic fluid.
Cramps began in the lower abdomen, similar to those that occur with menstruation.
Pain syndrome developed in the lower back. The types of pain can vary.
Presses in the pelvic region.
Abdominal cramps are observed.

If these symptoms are found, no matter during the first, second, third or subsequent pregnancy, you should call your doctor. This will help prevent premature birth.

If a pregnant woman already regularly has contractions, gradually the interval between them becomes smaller and smaller, and the pain syndrome increases - then delivery is about to begin.

Childbirth is divided into 3 stages:

Elementary... A pregnant woman may feel mild cramping pain, while the attacks last no more than 45 seconds, and the interval between them is about 8 hours.
Active... The duration of the attacks increases to a minute, and the intervals become shorter - 3-5 hours.
Transition... The most rapid stage of delivery, on average it lasts 30-90 minutes. The duration of contractions of the uterus is about one and a half minutes, and the interval between them is not hours, but minutes.

It is important to immediately call an ambulance at the onset of contractions or quickly arrive at the hospital on your own. Labor is being prepared long before the baby is born.

The beginning of labor (video)

Attention! As soon as there is a delay, you need to do a test and visit a gynecologist. Pregnancy should be monitored by doctors before the baby is born.

Contractions are involuntary contractions of the smooth muscles of the uterus. They are necessary for the baby to be born. With the onset of regular contractions, the first stage of labor begins. There are also false contractions, which can also be called training. They prepare a woman's body for the upcoming birth.

information If we imagine that the uterus is an inflated ball, inside which there is a child, then with the help of cramping contractions, the tied part of the ball is stretched and the baby is pushed out. In order for a child to be born through the natural birth canal, the cervix must flatten, and its canal must expand to 10-12 centimeters. It is the contractions that provide this complex process.

How the contractions begin

If a woman is about to give birth for the first time, then the sensations during contractions are not familiar to her, but during subsequent births they cannot be confused with anything. How to understand that contractions have begun before childbirth? The onset of labor can occur in different ways.

In some women, before childbirth, contractions begin in the form of pain in the lumbar region;
In others, they resemble menstrual pain;
Still others have cramping weak pains all over the abdomen.

But what unites all these manifestations of contractions at the beginning of labor is their regularity and the inevitable end with the birth of a child.

Feel

At the beginning of the contractions, the painful sensations are of a mild short-term nature, come in 15-20 minutes and last about 5-10 seconds. Usually for the first 2-3 hours, they do not cause severe discomfort to the woman. At this time, it is better to rest as much as possible and gain strength. Further, the pain becomes stronger, and the contractions themselves become more frequent and longer. At the end of the first period, the contraction of the uterus lasts about a minute, and the periods between them decrease to 1-2 minutes. What characterizes the pain during contractions is their gradual increase, reaching a peak and the same gradual extinction. In between contractions, a woman can take a breath and rest, since the pain goes away altogether.

At the end of the period of cervical dilatation, it seems that one contraction is replaced by another with an almost imperceptible period of relaxation. Usually at this time, attempts are made (contraction of the muscles of the diaphragm, abdominal wall and perineum, which the woman can control a little). They are manifested by a strong desire to push in response to the pressure of the fetal head in the pelvic area. With the appearance of attempts and full disclosure of the cervix, the second stage of labor begins - exile... If before this the maximum pain was felt in the lumbar region and abdomen, then with the onset of the second stage of labor, its peak falls on the perineal region.

False contractions

Throughout pregnancy, a woman may experience irregular mild cramping abdominal pain. They can occur during physical exertion, sudden movements, an overflowing bladder, activity of the baby, and during intercourse. Do not worry if these sensations do not last long and disappear when the cause that caused them is eliminated.

The closer the date of birth, the more the frequency of cramping pains usually increases. However, what distinguishes true contractions during pregnancy from is their regularity. If you have cramping pains, you need to note the time of their onset, observe the interval between them, their duration.

important A watch with a second hand will help you identify contractions. If these sensations continue for an hour or two, and the interval is not less than 15-20 minutes with a duration of about 20 seconds, then it is necessary to get ready for the maternity hospital.

What to do if contractions have begun

If you are about to give birth for the first time (and you have determined for yourself that the first signs of true contractions have begun), you have time to calmly get ready for the maternity hospital. It is better, of course, that the bag to the hospital was ready in advance (from 34-35 weeks of pregnancy), since in a hurry you can forget something. What to do at home before giving birth:

Tune in to a good mood and easy childbirth. Think about the fact that very soon you will hug and kiss your long-awaited baby, attach him to your chest. It is important to understand that it depends on you how the birth will go, and you must do everything to make the baby easier during this crucial period. Of course, the pain during labor and childbirth is, to put it mildly, unpleasant, but the end justifies the remedy. Try to do your best, and doctors and midwives will help you with this.
It would be nice to take a warm relaxing shower or bath, shave your genitals.
If there are no complications of pregnancy, and the contractions are not too intense (after 15 minutes), then you can stay at home for some time, because the familiar environment will help you cope with the pain more easily. You can turn on pleasant music or a movie. At the beginning of labor, it is recommended to move so that everything goes faster. You can also prepare food for your beloved husband. But do not delay the trip to the hospital if it is far away or in a short time (half an hour) you cannot reach it.
If the doctor did not say that you have indications for a cesarean section, you can have a little snack: drink a cup of tea, juice or water, eat something light, but rich in complex carbohydrates (durum wheat pasta, banana, vegetables), because you will need a lot of energy.
While the contractions are not very strong, try to rest more, especially if they started late in the evening, since you may have to give birth only in the morning.
Of course, if yours is not your first birth, but the previous ones were rapid, then you should not delay the trip to the hospital. Better to call an ambulance right away.

Breath

It is very important for both the woman and the child. It helps to cope with painful sensations during contractions and pushing. Sometimes, feeling severe pain, it seems that it is easier to endure it with bated breath, but this is only an imaginary relief. If a woman at the peak of the contraction holds her breath, then at this time oxygen does not enter the body, and, as a result, fetal hypoxia (oxygen starvation) develops. This is especially dangerous during the period of exile, because the child is already squeezed by the bones of the mother's pelvis. It can also lead to the production of large amounts of lactic acid in the muscles, which will manifest itself even more soreness and weakness.

What most often scares a young woman preparing to become a mother for the first time (or what is most often scaring her)? The answer is obvious - contractions. The anticipation of pain can cause more panic than the pain itself. And the closer the cherished date, the more obsessive this fear haunts. The surest way to get rid of fear is to stop hiding from it and hiding it from yourself, to meet it face to face, to “talk” with 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 generic forces expelling the fetus. Contractions indicate that childbirth has begun. (In addition to contractions, the onset of labor may be indicated by symptoms such as the outpouring of amniotic fluid and the discharge of a mucous plug that closes the lumen of the cervix 1; the mucous plug can also come off 2-3 days before childbirth, so its discharge does not always mean that it is time 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 the child, being in close interaction, as if "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), which cause contractions of the muscles of the uterus, called contractions. During pregnancy, the cervix is tightly closed. With the onset of labor pains, its opening 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 labor as the uterus itself contracts in volume. Ultimately, this leads to rupture of the fetal bladder and the outpouring of part of the amniotic fluid. If this coincides in time with the complete opening of the uterine pharynx, they talk about the timely outpouring of water, but if the uterine pharynx did not open enough at the time of 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 participate 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 , she can delay or strengthen them.

What to expect from contractions?

Feelings during contractions are individual. Sometimes the first tremors are felt in the lumbar region, then spread to the abdomen, become encircling. Pulling sensations can occur in the uterus itself, and not in the lumbar region. Pain during labor(in case you cannot relax or find a comfortable position), resembles the pain that often accompanies menstrual bleeding. However, you should not be afraid of contractions in panic. You can often hear from women giving birth that the contractions were either completely painless, or the pain was quite bearable. First, during contractions, the body secretes its own pain relievers. In addition, the techniques of relaxation and proper breathing learned 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, to one degree or another, affect the baby. Real (and not false - see below) "banishing forces" come at regular intervals. At first, 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 prolonged (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 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 more and more prolonged, then it's 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 rapid, so it is better not to hesitate) 2. With the onset of contractions, mucous discharge with a slight admixture of blood may appear - this is the very mucous plug that "clogged" the entrance to the uterus. Blood (in small amounts) enters the mucus due to the smoothing and dilation of the cervix. This is a natural process that should not be intimidated, but if there is profuse bleeding, immediate evaluation is necessary.

True or False?

It should be borne in mind that after the 20th week of pregnancy, some (not all) women develop so-called false contractions, or Braxton-Hicks contractions, and 2-3 weeks before childbirth, women begin to feel precursor contractions. Neither one nor the other, unlike true contractions, does not lead to the opening of the cervix. There are pulling sensations in the lower abdomen or in the lower back, the uterus, as it were, turns to stone - if you put your hand to the stomach, you can clearly feel it. The same, in fact, happens with labor pains therefore, Braxton Hicks and the harbingers often confuse first-time women. How to understand if 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 taking 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 they, shortly before childbirth, precursor contractions contribute to the softening and shortening of its neck.

What to do in case of contractions?

It has been noticed that the more a pregnant woman is scared, the less she knows about what is happening to her and what she is facing, the more difficult, longer and more painful her childbirth is. Even in the very recent past, the phrase "preparation for childbirth" seemed in Russia to be complete nonsense. 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 expectant mothers, but also future fathers are preparing for this important event. Enough books have been published. And most importantly, psychology has changed. Now, if not all, then most women understand that they need to prepare for childbirth, as for any difficult and important job. And the main goal of such training is to get rid of fear and pain. What do experts usually recommend to make contractions 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 to 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 pharynx, which means it will shorten the time of childbirth.
Concentrate calmly and try to find the position of your body in which you are most comfortable.
Do not hesitate if you feel like standing on all fours, lying on a large inflatable ball, or even ... dancing. Believe me, no one would ever think of condemning you for being extravagant.
Circling and swaying your pelvis can help relieve tension and relieve pain.
If possible, try to sleep between contractions or at least "pretend to be asleep" (this will help to relax the body).
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, they can help you.
Lightly stroking the skin of the lower abdomen with the pads of the fingers eases the contractions at the beginning of the path.
With the beginning of the fight, you need to inhale and direct the movement of the hands from the midline to the sides, while exhaling, the arms move in the opposite direction.
When contractions intensify, strong and frequent pressure with thumbs on points in the region of the anterior-superior spines of the iliac bones (these are the most protruding parts of the pelvis) helps to relieve pain.
Place your hands comfortably with your palms along your hips. Massage of the sacral area of the spine is very useful. It is effective not only at the beginning of labor, but as long as the expelling forces are at work in your body.
As the contractions intensify, proper breathing becomes more important 3

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

Tatiana Kipriyanova

First contractions I hardly recognized. The fact is that they were very similar to "training" contractions - the so-called "Braxton Hicks contractions", which followed me from the 7th month almost every evening. And at first I could not understand - is it still they or already the beginning of labor. Feels like - as if the belly freezes below, then "lets go". The intervals between contractions were uneven: now after 20 minutes, then after 5; but still they walked regularly (longer than two hours) - this influenced the decision to go to the hospital. The first contractions were quite bearable - just a little bit of 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 an opening of the cervix of 1 cm.When the bladder was pierced (by the way, it did not hurt at all), the contractions went more efficiently, 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 menstrual pain. Over the next hours (the child moved towards the exit), the pain became stronger and stronger. It was hard. The massage of the lower back, which my husband did, and breathing, which I read about in books, helped me a little (the medical staff also suggested how to breathe better). When the pain became simply unbearable, attempts began (by the way, I heard more than once from others that when you feel that the limit has come and there is no more urine to endure the pain, it means that everything will be over soon). Attempts are easy to recognize - you involuntarily begin to push (I could compare this process with the urge to go to the toilet). Attempts are also painful, but the cardiography machine began to listen poorly to the baby's heart, and I had to give birth as quickly as possible. Therefore, from about the fifth attempt, I already gave birth to my boy (not without an episitomy). The whole process took us 12 hours (this was my first birth).

Anna Goncharova

The contractions were like a very violent and painful period. At first they were very weak and I didn't even feel discomfort. It looked like a very mild (not painful) spasm inside the abdomen. Painful contractions became only four hours later. And it most resembled painful menstruation. But it only hurt for about an hour. It was possible to endure, but with difficulty. My husband helped a lot. Even in the most intense moment, the pain was not constant. Everything went on with a frequency of 5 minutes. At first, the pain grew rapidly, reached its maximum, and then disappeared just as quickly. Each fight took two minutes. For about three minutes there was no pain at all! The worst thing for me was at the moment of the beginning of a new fight - when it didn't hurt yet, but you understand that everything started from the beginning. Unpleasant, but bearable. 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 time the contractions began, I was already in the hospital, so I immediately went to the doctor, and the doctor confirmed that childbirth started. The doctor and midwife said when to start pushing. It didn't hurt at all, and it didn't hurt at all to give birth. Although they made an incision, I did not notice it at all. In general, I remember childbirth very well, but the pain is forgotten very quickly. I remember more with pleasure - and first of all all sorts of funny moments. The feeling of horror and "never again" was not there at all. Maybe because there was a good maternity hospital and I gave birth with my husband!

Elizaveta Samoletova

Unfortunately, to childbirth I was psychologically completely unprepared. Therefore, already being in the delivery room (I was in the hospital for storage), I felt that my stomach ached very badly, and was frightened. Of course, "theoretically" I knew that I was going to have labor, but I had little idea of what it was. Of course, there was no question of counting 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 cesarean section. For some reason, the midwife laughed merrily. I ask: "What are you laughing at?" And she told me: "According to my calculations, every second woman in labor asks to do her caesarean." I suffered for about an hour. I was very offended that the people who were around (nurses, midwives, the head of the department and even some trainees who showed me as an example of an "old primiparous woman with a slightly narrowed pelvis") took my suffering for granted and like nothing sometimes they tried to talk to me about some boring everyday topics (they asked where I work, where did I get such a strange surname and how I would call my unborn child). And when my stomach started 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 had 3 kg 600 g. Then I apologized to the doctors, but they laughed again and said that almost everyone behaves like me. 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, you can read in detail in №4 / 2001: L. Komissarova.
2 We also recommend to read the article by N. Zaretskaya in No. 1/2001 of the magazine "9 MONTHS".
3 For the technique of correct breathing during childbirth, which is recommended to be mastered during pregnancy, see: E. Pechnikova, No. 7-8 / 2001.