How contractions occur in pregnant primiparas. Nesting syndrome and sudden mood swings. What are the feelings of a pregnant woman during labor pains, are they painless

25.06.2019

What sensations indicate the approach of childbirth

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

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

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

Training, precursor or prenatal contractions

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

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

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

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

Also, like training ones, they do not open the cervix of the uterus and do not threaten pregnancy, although they are brighter in terms of the strength of sensations and may well inspire excitement in primiparous women. Precursor contractions have intervals that do not decrease over time, and the strength of the spasms that compress the uterus does not increase. A warm bath, sleep, or snack can help relieve these contractions.

It is impossible to stop real or labor pains with the help of rest or change of position. Contractions appear involuntarily, under the influence of complex hormonal processes in the body, and are not amenable to any control by the woman in labor. Their frequency and intensity is increasing. In the initial phase of labor, contractions are short, lasting about 20 seconds, and repeating every 15-20 minutes. By the time of perfect opening of the neck, the interval decreases to 2-3 minutes, and the duration of contractions increases to 60 seconds.

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

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

Description and functions of contractions

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

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

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

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

After that, there are attempts - an active contraction of the muscles of the press and the diaphragm (duration 10-15 s.). Arising reflexively, attempts contribute to the advancement of the child through the birth canal.

Phases and duration of contractions before childbirth

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

Characteristic	Hidden phase	active phase	Deceleration phase
Phase duration	7-8 hours	3-5 hours	0.5-1.5 hours
Frequency	15-20 minutes	Up to 2-4 minutes	2-3 minutes
Contraction duration	20 seconds	Up to 40 seconds	60 seconds
Opening degree	Up to 3 cm	up to 7 cm	10-12 cm

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

Contractions before the first and subsequent births

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

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

The factor smoothing out the differences between the first and subsequent births is the time interval separating them. The probability of long-term disclosure is higher if more than 8-10 years have passed since the birth of the first child.

In articles on the topics of motherhood and pregnancy, there is information that contractions before the second birth often come not before, but after the water has broken, and this happens not at 40, but at 38 weeks. Such options are not excluded, but there is no scientifically confirmed data indicating a direct connection between the serial number of childbirth and the nature of their onset.

It must be understood that the described scenarios are only options, and by no means an axiom. Each birth is very individual, and their course is a multifactorial process.

Feelings in contractions

In order to determine the onset of contractions, you should pay attention to the nature of the pain: before childbirth, they are similar to menstrual. Pulls the lower abdomen and lower back. There may be pressure, a feeling of fullness, heaviness. Here it is more appropriate to talk about discomfort, not pain. Soreness occurs later, with an increase in contractions. It causes the tension of the uterine ligaments and the opening of the neck.

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

However, in the absolute majority of cases, women experience the peak of spasm as a contraction, a strong contraction, a “grasp”, which follows from the very name of the contraction.

Is it possible to miss contractions?

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

Some uncertainty in the expectations of expectant mothers can be introduced by the stories of women who have already given birth, in whom childbirth did not begin with contractions, but with a discharge of water. It must be understood that such a scenario in obstetrics is considered a deviation. Normally, at the peak of one of the contractions, intrauterine pressure pulls and breaks the membrane of the fetal bladder, the amniotic fluid is poured out.

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

Mechanism of action at the onset of contractions

It is important to understand what to do at home in the event of contractions and an approaching birth. A few recommendations:

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

Many expectant mothers, especially those pregnant with their first child, think about childbirth with anxiety. Frightens the unknown, thoughts of painful contractions or a negative experience of first birth. In a series of articles on optimal behavior during various stages of labor, we will describe in detail all stages of the birth process and give clear recommendations for each of them. Knowledge is power!
By reading this information, you will know what to do at different stages of labor. You will feel confident and calm, because childbirth is a wonderful, natural and healthy process!

Harbingers of childbirth and false contractions

As the long nine months of waiting come to an end, expectant mothers begin to feel the signs of a great event approaching. 1-2 weeks before birth, special symptoms appear - harbingers of childbirth.
1. The stomach drops and it becomes easier to breathe.
The baby goes down and frees up more space for mom's lungs.
2. Urination and stool become more frequent.
A drooping uterus puts more pressure on the bladder and intestines
3. Lower back pain and feeling heaviness and warmth in the lower abdomen.
Muscles and ligaments are preparing for the upcoming work
4. The mucus plug comes off, resembling a raw egg white
It might happen a few days before giving birth and maybe in the process.
5. The tone of the uterus changes. Irregular, rare contractions appear. But do not rush to go to the hospital. Distinguish training (they are also called false) contractions from true is pretty easy:
with false contractions it is easy to fall asleep;
the uterus does not necessarily become hard;
training contractions are usually irregular, but may be regular for 1–5 hours;
false contractions do not intensify and do not become more frequent;
practice bouts can disappear after taking a warm bath.
6. Begins psycho-emotional restructuring. It proceeds differently for everyone: from violent activity to apathy and drowsiness. Many mothers, for example, decide to urgently re-paste the wallpaper, while others, on the contrary, “hibernate”.
You don't have to feel all of these symptoms at once, some women notice only 1 or 2. However, childbirth is rarely a complete surprise. The expectant mother listens to herself and intuitively feels the approach of this wonderful event.

Water broke - what to do?

Sometimes, in about one in 10 pregnant women, labor begins with the outflow of amniotic fluid. If before that you did not feel absolutely any signs of labor, you need to take a special position on all fours with a raised pelvis. This . Hold this pose for 20 minutes to prevent strangulation of the umbilical cord. During this time, a tight belt of the uterus to the head of the child is formed, the posterior waters are preserved and the birth process proceeds normally. If the waters receded before the onset of labor, doctors recommend immediately going to the hospital. Most women in labor have amniotic water breaks at the end of the first stage of labor. In 20% - at the beginning of the first stage of labor. In these cases, the first stage of labor is best spent at home.
After the water breaks and before the start of contractions, Russian doctors usually recommend a “dry period” of no more than 6 hours. This is the time for labor to begin spontaneously. Then you need to go to the hospital.
In some maternity hospitals (For example, in "Rainbow", St. Petersburg), the "waterless period" is allowed up to 18 hours. This issue should be discussed with the doctor in advance.

The first stage of labor - the period of disclosure

The beginning of the first period is the appearance of true contractions. You can understand that contractions are real if:
Contractions are repeated regularly, through equal periods of time;
Contractions gradually intensify, become longer and more intense, and the intervals between them are shortened;
During the contraction, the uterus becomes very dense (this can be felt by placing a hand on the stomach);
Do you experience symptoms similar to painful periods? pulls the lower abdomen and back.
The dilation period lasts approximately 13 hours for those who give birth for the first time, and for multiparous - about 7.5. The cervix during this time should open by 10 cm. But significant deviations are possible. For example, there are rapid delivery in which the baby is born in less than 4 hours. This is a big test for the health of mother and child.
Too much prolonged labor - more than a day are also fraught with complications. Old obstetricians said: "The sun should not rise over the head of a woman in labor twice." Childbirth becomes too long if labor activity is weak or coordination of contractions of various parts of the uterus is disturbed.
All people are different and the course of childbirth in different women is very diverse. It is impossible to deduce a clear pattern of correspondence between the rhythm of contractions and dilatation of the cervix. Everything is very individual. Primiparous mothers can very roughly navigate by the figures given.
In the first stage of labor, many obstetricians distinguish 2 phases: early and active.

Early phase of the first stage of labor

This phase is also called latent or latent. This the easiest and the longest period (perhaps around 6 hours or more). Sometimes a woman in labor does not notice him, therefore she believes that she did not have this phase. initially contractions are pretty weak. at intervals of 20–30 min. By the end
phase, the duration of contractions increases to 45 seconds, and the intervals are shortened to 5
min. At this stage, the cervix can open up to 4-5 cm.
What can you do:
a) Start keeping a contraction diary. For this you need count duration contractions and intervals between them. You can simply write on a piece of paper, or you can install a special program on your phone or tablet. This information will help you determine which phase you are in, which means - when to go to the hospital.
An example of a diary in the normal course of childbirth. Early phase of the first stage of labor:

Time	Contraction duration, sec
00.00	15	20	0
04.00	30	15	1
11.00	45	7-10	3
13.00	50	5	4

*This field can be completed if you have a midwife at home. If there is no one to check the disclosure, then information about contractions is quite enough.
b) Check is everything ready for childbirth. Make final preparations if necessary. Take an exchange card, policy and passport.
c) Try to rest, take a nap lying on your side. You need gather strength. Take a slow walk. Take an upright posture during contractions. You can view funny movie, listen to humorous stories, bake a pie.
d) Eat often, only a little. The food must be easily digestible(slag-free diet): tea, soft-boiled eggs, crispy toast with butter or crackers, baby food, empty broth, baked fruits, juices, honey; drink every hour between contractions.
e) Empty your bladder every 2 hours
f) If you want, you can do an enema so that at the last stage of childbirth you do not get into an awkward position.
g) Be sure to complete to prepare
birth canal and adjust your body to generic behavior.
What an assistant can do:
a) Save the strength of the wife, who is likely to feel burst of energy and wants to be active.
b) Ask her to take warm bath or have a bite to eat.
c) Pay attention to each other and communicate with the baby. Guard calmnesswomen in labor, provide her with rest in her secluded nest.

When to go to the hospital?

There is no need to rush to the hospital. According to statistics, women who enter the maternity hospital too early, there are more interventions in the birth process, more caesarean sections and more difficult births in general. It is very good if you are accompanied by a midwife or doula during childbirth, who will help determine the most opportune moment for a trip to the hospital. You can focus on your own feelings: if you feel that you would more comfortable in the hospital, so it's time to go.
Traditionally, domestic obstetricians recommend that a woman go to the hospital when contractions are repeated every 10 minutes. Until this time, the woman in labor spends the first stage of labor in calmhome environment. The recommendations of American specialists (W. Serz) about the optimal time of admission to the maternity hospital, when contractions are repeated every 4 minutes for an hour, the domestic scientific school of obstetrics considers unjustified (possible risk to the health of the mother and child).
If you are accompanied by an experienced midwife or doula, discuss the time of admission to the hospital with your doctor. It is possible that a healthy woman with a healthy pregnancy you can stay at homelonger. After all, the home environment is very conducive to relaxation, and the stress of an early move to the hospital can adversely affect the birth process.
You should go to the maternity hospital:
if a woman in labor feels that she will be more reliable in the maternity hospital;
on the recommendation of a doctor, obstetrician;
if the waters have broken;
if bleeding occurs.

What to pay attention to in the first stage of childbirth?

The behavior of the mother in the first stage of childbirth largely depends cervical healthnewborn spine. According to osteopathic doctors, 90% of injuries in this department occur at the time of insertion of the head into the mother's birth canal, that is, when the woman in labor is usually at home and has not yet left for the hospital.
If the child has developed correctly in the womb for 9 months, then during the first stage of childbirth, he will be able to right and enough bend your head, i.e. almost put the chin on the front surface of the neck. So he can insert into the birth canal with the smallest head size. If the baby has problems with the spine, nervous system, then he won't be able to bend his head well. This means that it goes down with a large head size and can be injured. (Read more about...)
However, in this case too proper parental behavior reduces the risk of injury to the baby and makes childbirth successful.
Correct behavior in the first stage of childbirth:

use of birth positions

relaxation

Active phase of the first stage of labor

Contractions at this time become more often, longer and more painful. The intervals between them are 3–5 min, and the duration reaches 1 min. The cervix of the uterus by this moment opens by 5–8 cm. The transition to the active phase can be seen by changes in the mother's behavior: she stops in mid-sentence, freezes in place as soon as the fight begins.
At this time, the rupture of the fetal bladder often occurs naturally, and the waters break. If this does not happen, when the cervix dilates 8-10 cm in the maternity hospital, the fetal bladder is opened. This helps to prevent possible premature detachment of the placenta and the birth of the fetus in the membranes. In the "shirt" children were rarely born alive, so they were called happy.
In modern maternity hospitals, a woman in labor at this stage of labor is transferred to a separate maternity ward. The duration of this phase is 3-4 hours.
An example of a diary of the active phase of the first stage of labor:

Time	Contraction duration, min	Interval between contractions, min	Cervical dilatation diameter, cm*
14.00	1	5	5
17.00	1	3	8
18.00	1.5	1-2	9

In the active phase, it's time to apply the knowledge that you have acquired during preparation for childbirth. Do not forget to agree in advance with your doctor and with the staff of the maternity hospital about your free childbirth behavior, about the methods you will use.
What can you do:
a) Use .
b) between contractions move actively, and if you are tired - lie on your side, corresponding to the position of the back of the child.
c) During the fight, take birth positions, sing. This contributes to faster and soft opening cervix. Upright postures speed up labor.
d) back, stomach, hips and an anesthetic point on the palm between the bases of the third and fourth fingers.
e) Empty your bladder often.
f) Accept warm shower, bath.
g) Remember to rest periodically between contractions. Save your strength for the second stage of labor.
h) Sometimes in the first stage of labor, even before full disclosure cervix pushes appear. Resist the urge to push. Use restraint methods:
a pose with a raised pelvis (birth position No. 3),
sobbing groaning breath (2-3 short breaths with a long exhalation)

What an assistant can do:
a) Help your wife to accept comfortable postures.
b) Breathe with her, make sure that the breath does not quicken, and the face is relaxed.
c) Do the sacrum and lower back. Let the wife tell you what helps her better.
d) take care of warm soul.
e) Treat your wife's frequent mood swings with understanding (at first she may irritably refuse your massage, but at some point you will have to rub her lower back for more than one hour).
Gradually contractions become long (up to 1.5 minutes) and strong.
It's getting harder and harder to deal with them. The intervals between them are reduced to 1 min. The cervix is almost completely open (8–10 cm). You may feel very tired. It may seem that the fights will never end. You may be annoyed by talking, touching. Someone already can feel the first push but it's too early to push.
There may be trembling in the limbs, feeling like you can't take it anymore. This is a sign that soon (perhaps in 0.5–1.5 hours) the 2nd stage of labor will come, much less painful. Hold on! There is already a little left.
What can you do:
a) Do not become limp, just try to do what you learned during pregnancy. Remember that your baby will be born soon.
b) During a fight - generic postures (see and), painkiller sounds.
c) If there is a desire to push, take the birth position number 3 and use your breath to restrain the efforts (see above).
d) Between contractions, try relax as much as possible.
What an assistant can do:
a) Remind your wife that very soon she sees the baby.
b) Be indulgent: now the touch of your hands, which until recently brought relief, can be annoying.
c) Circular massage of the lower back can cause discomfort, but direct pressure on the sacrum facilitate pain.
d) Make sure that the face of the woman in labor is relaxed. A tense face interferes with the opening of the cervix. The best way relax face - kisses.
Sometimes at the end of the first stage of labor slow down a little. Some obstetricians even highlight another phase - delayed labor phase, at which there is a weakening of contractions (10-20 minutes). This is the best moment to relax and gain strength before the 2nd stage of labor.
Check out our video on Proper Generic Behavior. Practice in advance, discuss all questions with an assistant and a doctor. Do not forget . And may your childbirth be easy and harmonious! Many pregnant women often wonder about the upcoming date. childbirth, and women who are about to give birth for the first time are especially worried. As a rule, they are very afraid of not recognizing the labor that has begun in time and confusing it with a temporary malaise. In many cases, a close observation of the woman for the changes that occur in her body will help to resolve these unrest.

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

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

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

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

Reasons for the onset of labor

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

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

Ready for childbirth uterus:

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

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

Several factors influence the onset of labor:

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

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

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

Harbingers of the onset of labor

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

Harbingers of childbirth:

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

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

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

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

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

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

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

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

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

The pregnant woman waits for the appearance of contractions and at the same time experiences animal fear in front of them. Popular rumor ascribes the most severe pain sensations to this stage of childbirth. If experienced mothers go to repeated or third births and already have a good idea of what awaits them, then women who are looking forward to the appearance of their first child are at a loss. We will talk about the features and sensations, the timing and duration of contractions in women giving birth for the first time in this article.

How does it all start?

Childbirth is the natural process of completing childbearing. Nature gave him exactly 10 lunar months to become a real man from one crushing cell, just still very small. Childbirth can begin both on time and earlier or later. According to statistics, the onset of labor in nulliparous women usually occurs either at 39-40 weeks or at 40-42 weeks of pregnancy. The date indicated in the exchange card is only a guideline for the doctor and the pregnant woman, only 5% of pregnant women give birth strictly in the PDR.

Childbirth can start in different ways. From the discharge of water, from the exit of the mucous plug, from the beginning of rhythmic contractions of the uterus - contractions. The latter option is considered the most preferable, since premature outflow of water always complicates childbirth, even if they occur just in time. It is from contractions that the process of childbirth manifests itself in the vast majority of expectant mothers. Only 10% of women start giving birth when the water breaks.

Contractions are called contractions of the muscles of the uterus. Labor pains occur simultaneously with the opening of the cervix. This dense muscle ring was tightly closed throughout the pregnancy, and the cervical canal inside it was closed with a mucous plug. The beginning of the opening of the neck is accompanied by contractions that grow and become stronger as it expands.

Contractions begin suddenly, but develop gradually. True labor pains may be preceded by false, training ones. They can be observed as early as the 20th week of pregnancy, or appear later, or not appear at all. But before giving birth - a couple of weeks or less - almost all women can feel a short-term uterine tension from time to time. This is the preparatory work of the female body before childbirth.

The purpose of labor contractions is obvious - at the first stage, they are needed in order for the cervix to open and free the passage for the child, who will have to go through the birth canal and be born. They compress the space inside the uterus, leading to rupture of the fetal bladder; in the stage of active contractions, the waters depart and this is considered quite timely. Rhythmic contractions of the uterus slightly "push" the baby to the exit. His time has come, there is no need to remain in the mother's womb any longer.

How to understand that childbirth has begun?

The first birth is always a lot of questions, the main one of which is how to recognize whether the birth has begun and whether it is time to go to the hospital. On this subject, experienced obstetricians have an old joke that says that if a woman has doubts about whether she is giving birth, then she does not give birth, since it is impossible to confuse childbirth and training uterine contractions. But mostly women who are pregnant for the second or third time agree with obstetricians in this, they know for sure that the doctors are not disingenuous.

And it seems to a primiparous woman that at any moment she can miss something important and be late for the hospital. As already mentioned, a few days before giving birth, the female body begins to prepare for the upcoming event. In the cells of the uterus, the amount of a special protein, actomyosin, begins to increase. It is responsible for the ability of cells to contract. At the same time, the placenta and pituitary gland of a woman begin to produce oxytocin and relaxin. The first hormone increases the contractility of the female reproductive organ, and the second is responsible for softening the ligamentous apparatus, because during childbirth the uterus will change shape.

With these changes, the final preparatory stage begins, during which women are anxiously trying to find some “harbingers” in themselves, which she read about on women's forums, and which can make it clear that childbirth is just around the corner. Harbingers include anxiety, mild depression, mood swings, sleep disturbance, insomnia, more active training contractions. They appear like this: the stomach turns to stone, slightly “sips” in the sides and lower abdomen (due to the tension of the ligaments), and then they pass and can be repeated after half an hour, and after 5 hours, and after a day.

Contractions-harbingers do not differ in regularity, they come on their own and disappear in the same way. A woman can easily relieve discomfort by simply taking a shower, drinking a glass of milk or a No-Shpy tablet, or even changing her body position. With a training bout, a pregnant woman can go to bed and doze off quite successfully.

Is it possible to skip the moment of the onset of real contractions? Obviously not. After all, true contractions are rhythmic from the very beginning, they are repeated at regular intervals, the pain is no longer pulling, but light girdle, the back and lower back are drawn into it, the pain increases with each contraction. You won’t be able to fall asleep, the No-Shpy tablet or the shower won’t have any effect. If labor pains have begun, it is unlikely that it will be possible to stop them or weaken them. The duration of the fight will be the same each time. And this is the main difference between "harbingers" and real fights.

Latent stage - sensations

As soon as a woman notices that the tension of the uterus becomes regular and obeys a certain rhythm, we can say that the first stage of childbirth is already underway. It is called latent (hidden).

If there is no bloody discharge, the water has not broken, you do not need to rush to call an ambulance and urgently rush to the hospital with special signals. The latent period at the first birth is usually the longest. It lasts up to 10-12 hours, on average, about 7-8 hours, and therefore there is plenty of time to put your nerves and feelings in order, psychologically tune in to a positive outcome of events and check things and documents collected in the maternity hospital in advance.

During this period, the pain is moderate, increasing gradually. At the very beginning, they are felt as habitual pains during menstruation, then they intensify, but the character remains the same. During pregnancy, women are taught proper breathing in childbirth. The latent period is the time to start applying theoretical knowledge in practice - to breathe correctly, taking deep breaths and exhalations in order to relax as much as possible. You can walk, sing, chat. Lying in one position horizontally is not worth it.

Feelings are undulating in nature. The fight usually "originates" in the back, covers the lower back and goes first to the bottom, and then to the top of the abdomen. Then the tension subsides, the woman gets the opportunity to rest a bit until the next fight.

During the latent phase, the contractions become longer. The very first signs of labor pains can be determined by measuring the duration of the spasm and the interval between episodes of spasms. In this first period, the average duration of one contraction from the moment of tension to the moment of relaxation is 20-25 seconds. Spasms are repeated at first once every half an hour, then once every 20 minutes.

By the end of the latent stage of labor, contractions last 25 seconds and repeat every 10-15 minutes. It is on this optimistic note that you should arrive at the hospital. The cervix at this point reaches a dilatation of 3 centimeters. The next phase of contractions is active, it should take place in the conditions of the maternity home. This will make everyone safer.

active phase

After opening the cervix by 3 centimeters, the contractions become quite painful, and in time they begin to occur more often. The duration of the contraction is 25-60 seconds, between contractions takes place within 3 minutes.

If you breathe correctly, keep calm, massage the sacral zone, the second stage of contractions can be experienced more easily.

Contractions at this stage look like a protracted spasm, the peak of the contraction becomes long. Usually at this stage, during normal childbirth, the water breaks.

The duration of such a period is 3-5 hours. At this time, it is desirable for a woman to be under the supervision of a doctor. Usually at this stage, they begin to monitor the condition of the fetus with the help of CTG, the woman is already in the antenatal ward.

During the active period of contractions, the uterus opens on average up to 7 centimeters. This is already quite a lot, but not yet enough for the baby's head to pass.

Transition period

This period is final. After him, attempts start - the shortest period of childbirth. Transitional contractions are also called the deceleration phase. The spasms themselves reach their maximum value for the entire period of childbirth. Each contraction lasts at least a minute and spasms are repeated every 2-3 minutes.

In general, the transitional period lasts from half an hour to an hour and a half. During this time, the cervix opens up to 10-12 centimeters (depending on the size of the pelvis). This dilation is considered complete as it allows the baby's head to pass through.

In the transitional period, a woman begins to feel a pronounced pressure on the bottom, as it is usually felt if you really want to empty your intestines.

But you can't push yet. The obstetrician will give the appropriate command already in the second phase of childbirth - in attempts.

If a woman in labor is not under the constant control of a doctor, then a feeling of pressure and a great desire to go to the toilet in a big way is a signal to call the medical staff and go to the delivery room.

What will happen next?

Next, the pushing starts. A woman needs to remain calm, breathe correctly, do not exhale sharply until the end of the attempt, push only at the command of the obstetrician. During attempts, the baby will turn, bend his head, he also tries very hard to be born as soon as possible. The wrong behavior of a woman in this situation can lead to a birth injury for the child, the occurrence of acute hypoxia, which is extremely dangerous for him.

If you push on command, do not scream, do not bring your legs together, do not pinch your perineum, breathe deeply, holding your breath at the time of the attempt and making a long smooth exhalation at the end of the attempt, then the child can be born in the very near future.

The period of attempts under a favorable set of circumstances and the impeccable behavior of the woman in labor can last 20-30 minutes. Less often, primiparas push for an hour and a half, and it is very rare that the period of attempts is extended to 2 hours.

As soon as the baby is born, the woman can relax. Ahead is still the birth of the placenta, but it will no longer be so painful and unpleasant, especially since the baby is being applied to the breast and the mother can already examine the baby, hug, so for many, the birth of the placenta is relatively easy. This period takes from 20 to 40 minutes.

This completes the birth. The woman is sent to the postpartum ward for rest, the baby is sent to the children's department in order to be processed, washed, and examined by neonatologists. They will meet in a few hours, if there are no contraindications either from obstetricians or from children's doctors.

Features of the first birth

Very often you can hear the opinion that the first birth is always harder and more painful than the next. To some extent, it is true, but not in terms of pain, but rather because of the fear that a woman in labor experiences during her first birth. The lack of birth experience makes it difficult for a woman to choose a comfortable position during labor, from time to time she forgets what she was taught in preparatory courses at the antenatal clinic. At times like these, some people start to panic. From the point of view of psychological readiness, women who have given birth earlier behave more disciplined in subsequent births.

The birth canal of a primiparous woman is narrower and less elastic. They are more difficult to stretch, and therefore even attempts are felt differently and last longer. The cervix also takes longer to open, and nothing can be done about this physiological aspect.

The first births are more often accompanied by complications. It cannot be said that during the second birth, unforeseen difficulties will not appear, there are always chances, but it is the primiparas who most often face such a phenomenon as primary or secondary weakness of the birth forces, when contractions do not lead to the opening of the cervix, and attempts do not move the baby forward . In primiparas, ruptures or tears of the perineum and cervix are more common.

Complications to a lesser extent depend on the physiology of the primogeniture, to a greater extent - this is a consequence of the erroneous actions of the woman in labor, disobedience to the commands of the midwife or doctor leading the birth.

Women who are preparing to become mothers for the first time need to prepare for childbirth in advance. Preparation must be consistent and constructive. It is a clear understanding of the upcoming process without unnecessary fear and emotions, as well as an understanding of the order of one's own actions at different stages of childbirth, that will become the key to a successful delivery.

You need to start preparing from the middle of pregnancy. Already at week 20, it makes sense to enroll in a school for expectant mothers who work in any antenatal clinic. Practicing gynecologists, children's doctors, psychologists will help prepare for the most important event in a woman's life as best as possible. Preparation includes the following information.

Expansion of the theoretical knowledge base about the physiological processes and biomechanism of childbirth.

Learning the technique of proper breathing during contractions and attempts. It is necessary to practice breathing exercises during pregnancy carefully, half-heartedly, but it is recommended to devote at least 10-15 minutes a day to this. Then proper breathing will be natural and when childbirth begins, the woman will not have to remember how and when to inhale and exhale in order to relieve pain and help herself and the child. Breathing techniques help to feel the period of contractions less painfully, because due to the saturation of the body with oxygen, there is an increased production of endorphins, which have an analgesic effect.

Training in the technique of massage and self-massage. Starting from the latency period and up to the very attempts to relieve tension and pain, massage of the sacral zone, acupressure of the hand and face will help. All techniques will be shown and told during the preparation by experienced obstetricians.
Psychological consultations. They will help to form the right attitude towards childbirth and labor pain. It has long been noted that the stronger a woman's fear of contractions, the more painful and longer they last. The psychologist will talk about some techniques that allow a woman to be more confident in her strengths and abilities.
Learning postures that make it easier to survive contractions. In real childbirth, before the period of attempts, a woman will be able to change the position of her body, adjusting to her own feelings.

Legal and domestic assistance. During the courses, they will tell the expectant mother what benefits and payments she can count on after the birth of the baby, how to apply for maternity leave, and they will also tell you what things you need to pack for the maternity hospital, when to do it, what documents you will need to provide upon hospitalization to a maternity facility.

If there are no prejudices against partner childbirth, and you want to give birth in the presence of your husband or close relative, you need to take care of this in advance. The spouse or other accompanying person must pass all the necessary tests.

All expectant mothers experience anxiety before childbirth. The primiparous representatives of the weaker sex are especially afraid of this process. They have a lot of questions about their own behavior, the duration and pain of the procedure. If you are interested in what periodicity they have, then the article is written about this.

There are several types of contractions before childbirth. They all differ in strength, frequency, duration and final outcome of the process.

Involuntary uterine contractions

To tell how labor contractions feel (frequency, duration and intensity of the process), you need to define this concept. Contractions are called involuntary contractions of the reproductive organ - the uterus. A woman is not able to independently manage this process or somehow control it.

Actomyosin, a contracting protein, starts contractions. It is produced by the placenta, as well as the pituitary gland of the embryo under the action of certain hormones. The process of contractions is very complex, and it is quite difficult to understand it for an inexperienced person in this area. In violation of the synthesis of actomyosin or its incorrect spatial distribution, various complications in childbirth occur. These include weak, unproductive contractions, a decrease in the forces of the woman in labor.

Contractions in the early stages: a threat

Not always there are timely contractions before childbirth. What is the frequency of pathological uterine contractions? Even an experienced gynecologist will probably not be able to answer this question. Much depends on the duration of pregnancy.

The threat of interruption may occur in the first trimester. This happens most often. At the same time, the sensations in women are as follows: pulling pain in the lower abdomen, liquefaction of the stool, often at these times associated with insufficient release of progesterone. With appropriate therapy, the signs of pathology, like the problem itself, can be eliminated.

In the second trimester, the onset of contractions may already indicate the threat of premature birth. There can be many reasons for this: physical activity, sexual contact, cervical insufficiency, stress, and so on. At this time, contractions are already felt more clearly. Some patients can even talk about the frequency and time of uterine contractions.

or harbingers

From about the middle of pregnancy, expectant mothers can notice new sensations. False contractions before childbirth, the frequency of which is very different, most often do not pose any danger. At the moment of uterine contraction, a woman feels tension in her stomach, which does not cause her pain. This state lasts from a few seconds to a minute. A false contraction may repeat in a few hours or days.

Harbinger contractions of the reproductive organ become more frequent with an increase in the term. Before giving birth, a woman notes Braxton-Hicks contractions daily. Such spasms help prepare the cervix for childbirth: soften and shorten it. If you feel false contractions, then be sure to tell your doctor about it. You need to make sure they are really safe.

signs

How do labor contractions manifest? What is the frequency of uterine contractions? Here are the main signs of the onset of labor:

frequent and thinning of the stool;
outflow of amniotic fluid;
girdle aching pain;
shootings in the back;
pressure on the pelvis;
nausea and vomiting;
feeling of tension, petrification in the abdomen;
decreased fetal movement.

The frequency of contractions during childbirth can be from 2 minutes to an hour. It all depends on the stage of the process. Let's consider them.

latent phase

How do labor contractions feel? The frequency of uterine contractions is always steadily decreasing. At the very beginning, a woman may notice a slight pulling sensation in the lower abdomen and lower back, lasting up to 20 seconds. The interval between contractions is 15-30 minutes.

The expectant mother can take a shower and prepare for childbirth. Subject to the integrity of the fetal bladder, the woman in labor does not experience severe discomfort. However, do not stay at home. Go to the medical facility of your choice.

Contractions before childbirth: the frequency of the active phase

Such uterine contractions last at least 20-30 seconds (up to a minute). They are repeated regularly, the interval is gradually reduced and ranges from 2 to 5 minutes. Painful sensations in this period become more pronounced. It is already difficult for the expectant mother to move around. Often it is at this stage of childbirth that the fetal bladder bursts and water pours out. If so, then the process will now go much faster.

The duration of the active phase may be different. On average, it is from 2 to 5 hours. If the integrity of the fetal membranes is maintained, then the painful sensations are significantly dulled, and the process is slower.

attempts

There is an interesting feature that contractions before childbirth have. The frequency of uterine contractions decreases by the time the cervix opens. In other words, as soon as the birth canal is ready for the passage of the child, the frequency of contractions will decrease. If in the active phase you can feel painful contractions every two minutes, now the break will be 3-4 minutes. An increase in the term will allow the woman in labor to extrude the fetus using each contraction.

During attempts, the expectant mother feels strong pressure on the bottom. Many compare it to the urge to defecate. During this period, it is very important to listen to the doctor. Incorrect and untimely straining can lead to ruptures of the birth canal of varying degrees.

Let's make a conclusion

If you have contractions before childbirth (frequency of 20 minutes or less), you need to collect all the necessary things and go to the maternity hospital. Tell your doctor about all your feelings. Describe the duration and frequency of contractions. A gynecologist or obstetrician will definitely conduct an examination and will be able to say for sure whether you are giving birth or whether these are only harbingers.

Doctors remind patients that the second and subsequent births always go faster than the first. Therefore, if you are preparing to become a mother again, do not delay a visit to the maternity hospital. Surely you already know about and what their frequency is. In the event of a rupture of the fetal bladder and outpouring of amniotic fluid, you need to go to the maternity hospital even in the absence of contractions. Easy childbirth and good health!