Even during pregnancy, a woman is told that the contractions that await her during childbirth should lead to the dilatation of the cervix so that the baby, when the time comes, can leave the uterus into the reproductive tract and ultimately be born. But do contractions always lead to dilation of the cervix? In this material we will try to understand this in detail.

Process and stages

Normally, labor begins with the appearance of contractions. There may be other options, for example, the water will break first, but they are not considered the norm at all. The first contractions are very rare: they last no more than 20 seconds and repeat approximately once every 30–40 minutes. Then the duration of the spasm increases, and the time between contractions decreases. With each contraction, the walls of this reproductive organ are involved, as well as the circular circular muscle, which is essentially the cervix.

During the first stage of labor, which is called latent, the cervix dilates up to 3 centimeters (or about 2 fingers, in the language of obstetricians). Unfolding during the 8–12 hour latency period proceeds at a rather slow pace. But already at the stage of active contractions, the uterus opens by about a centimeter per hour.

The active period lasts about 4–5 hours, contractions repeat every 4–6 minutes, spasms last about a minute. During this time, the uterus dilates to approximately 7 centimeters. Then, for half an hour to an hour and a half, the period of transitional contractions lasts, the strongest ones, which last more than a minute and are repeated every 2–3 minutes. But the dilation at the end of the period is 10-12 centimeters, which is quite enough to pass the baby’s head. Attempts begin.

Thus, normal labor contractions are always associated with dilatation of the cervix.

If there are contractions, but there is no dilatation, they speak of labor weakness, and the birth is considered abnormal.

Causes of weakness

If there is no dilation or it proceeds at a very slow pace and clearly does not correspond to the periods of labor, the reason usually lies in the weak contractility of the uterus. If the contractions are weak, the cervix cannot dilate. In this case, usually the periods of relaxation between contractions exceed the norm in time, the woman “rests” more, and the contractions themselves lag behind the required values ​​in duration. This complication occurs in approximately 7% of women giving birth; most often, primiparas experience it.

Primary weakness of labor forces most often develops in women:

• with a large number of abortions in the past;
• with a history of endometritis, fibroids;
• with the presence of scars on the cervix after inflammation or erosion;
• with hormonal imbalance;

• in case of premature birth;
• in post-term pregnancy;
• with polyhydramnios;
• for obesity;
• during childbirth against the background of gestosis;
• in the presence of pathological conditions of the fetus: hypoxia, Rh conflict, placenta previa, etc.

A reason that deserves special attention is a woman’s psychological unpreparedness for childbirth. Doctors are often surprised to encounter the weakness of labor forces when contractions occur and the cervix does not dilate in a healthy woman without pregnancy pathologies. Wide pelvis, normal weight of the fetus, all tests are in order, but the cervix does not want to dilate. This may be the result of a woman in labor’s strong fear of childbirth, reluctance to give birth (an unwanted child), if the woman has been subjected to psychological pressure, conflicts in the family, she is tired, does not get enough sleep, is very nervous or worried. Sometimes weakness becomes a consequence of an excessive amount of painkillers that were used to relieve contractions.

How does the uterus open in this case? The excitability of the female reproductive organ is reduced. Periods of uterine tension are followed by periods of “rest,” which are 1.5–2 times higher than normal for a particular stage of labor.

What are they doing?

In order to speed up the dilation of the cervix, sometimes it is enough to simply perform an amniotomy - puncture the amniotic sac and ensure the outflow of amniotic fluid. To replenish lost energy, a woman may be prescribed a short medicated sleep. If within 3-4 hours after amniotomy the contractions do not intensify and the cervix does not open or the opening continues to proceed slowly, labor-inducing therapy is performed.

The woman is given hormones (oxytocin, dinoprost) that stimulate uterine contractions. At the same time, monitoring of the fetal condition using CTG is established.

If contractions become faster under the influence of drugs and dilatation begins, childbirth is then carried out as usual. If stimulation does not bring the desired effect, the woman undergoes an emergency caesarean section.

About pain

Painful sensations due to weakness of labor can be different. Contractions can be both painful and less painful. The weaker the smooth muscles of the female reproductive organ contract, the less pain the woman will feel, although here everything is very individual.

In general, the period of contractions is considered the most painful in childbirth. This statement sometimes frightens women so much that they cannot cope with fear even after the first contractions begin.

The period of contractions cannot be painless. Neither anesthetic drugs nor natural pain relief techniques using breathing and acupressure can guarantee that there will be no pain at all. But both medications and alternative pain relief help reduce the intensity of pain, which allows a woman to give birth more easily.

In order for dilatation to proceed at the desired pace and reach 10–12 centimeters (at which attempts begin), a woman needs to know from the very beginning how to behave, how to relate to what is happening. Proper breathing from the very beginning of contractions is deep and slow inhalations and exhalations, allowing you to relax as much as possible. At the stage of active contractions, a series of short and quick inhalations and exhalations at the peak of the contraction helps.

When the body is saturated with oxygen, the release of endorphins increases. These hormones have a certain analgesic effect. In addition, proper breathing helps saturate all organs with oxygen, improves blood circulation, and prevents fetal hypoxia during childbirth.

Regarding drug pain relief, a woman has the right to decide for herself whether she needs it and wants to refuse the proposed epidural anesthesia if she considers it unnecessary.

The very mechanism of pain during childbirth is difficult to explain, because there are no nerve receptors in the uterus. Therefore, experts tend to consider pain psychogenic, which means it will be possible to cope with it.

Prevention

To avoid non-dilatation of the cervix during childbirth, doctors recommend that pregnant women calm down, not be nervous, and, if necessary, visit a psychologist if there are problems or a strong fear of labor pain. In the later stages of pregnancy, a woman is recommended to have moderate, but still physical activity. Lying on the sofa can be of little use for the upcoming labor.

There is a popular belief that having sex increases the likelihood of successful disclosure. This is partly true: semen contains prostaglandins, which soften the cervix, but they do not affect contractility.

For more information about cervical dilatation, watch the following video.

When a woman enters the last weeks of pregnancy, along with preparing the children's dowry and packing things for the maternity hospital, she involuntarily thinks about how everything will really be.

The main question is how will labor begin? With the breaking of the waters or with the appearance of characteristic labor pains? In this article we will try to answer this difficult question.

How does this happen?

And it happens in different ways. Children are not alike, pregnancies cannot be identical, and any obstetrician-gynecologist will confirm this. Carrying a child is a purely individual process, with its own difficulties and nuances. Childbirth also begins differently for everyone. The most preferable, from the point of view of doctors, is the sequence in which regular true contractions begin first.

They should not be confused with training ones. Unlike false ones, true contractions cannot be relieved by changing the position of the body or taking the No-shpy tablet; a warm shower will not help, and there will be no benefit from a horizontal position of the body. True contractions, if they have begun, occur with simultaneous smoothing and opening of the cervix, which has been tightly closed throughout pregnancy.

This process is not controlled by the woman’s will and cannot be reversible, and therefore true contractions constantly grow, intensify, become longer, and the intervals between them become shorter.

As soon as the contraction repeats every 10-15 minutes, you need to go to the maternity hospital. There is no point in waiting for your water to break.

If labor proceeds correctly, according to the classic pattern described in all obstetrics textbooks, then the waters break without medical intervention when contractions become sufficiently frequent and strong. The pressure of the walls of the uterus at the moment of tension (at the peak of contraction) provokes a violation of the integrity of the fetal bladder, as a result of which the water flows out and the baby begins to move forward along the birth canal. The attempts begin.

In general terms, ideal births have the following sequence:

• the cervix becomes smoother, it becomes comparable to the body of the uterus, dilatation begins;
• smooth muscle fibers become shorter with each subsequent contraction;
• the walls of the uterus become denser;
• the external pharynx opens, the opening increases with each contraction;
• pressure on the bladder increases;
• under pressure from the fetal head and the amniotic sac itself, the internal pharynx opens;
• water is poured out and attempts begin - the uterus “pushes” the baby out.

The pushing ends with the birth of the baby, then the placenta comes out within 20-45 minutes. With this, the correct textbook childbirth ends, to the great joy of all participants in this process.

Like everything ideal, classic childbirth is a rarity.

There are quite a lot of variants of the norm, and therefore the sequence may be different. We answered the question of whether contractions can begin without the water breaking, but not completely. Very rarely, the water breaks at the very last moment, and the child is born in the amniotic sac, in which it passes through the birth canal.

In this case, they say that the baby was “born in a shirt.” Popular rumors and omens attribute to such people incredible luck and great luck throughout their lives.

The waters have broken, but there are no contractions

This type of birth is considered unfavorable. But everything will depend on how ready the woman’s body was for the upcoming birth and how quickly the contractile activity of the uterus begins.

If contractions begin to develop immediately after the water breaks, they are strong enough, and the cervix dilates at an optimal pace, then the prognosis is more favorable. If labor is weak, painful, and the cervix dilates slowly or does not dilate, then an urgent emergency caesarean section is considered the optimal solution.

A long stay of a baby in an anhydrous environment (more than 8-12 hours) can lead to acute hypoxia, the death of the child, and irreversible consequences for his health resulting from post-hypoxic disorders in the functioning of the brain. The 48-hour water-free period is considered critical (deadly), although even here everything is ambiguous, and miracles happen.

Situations where the water breaks first do not tolerate even a minute's delay.

The woman needs to be taken to the hospital of a maternity facility as soon as possible, where doctors will be able to assess the condition of the child, record his cardiac activity, motor activity, assess the degree of cervical maturation and make a quick and correct decision - to stimulate labor or surgically deliver the patient.

The main danger of the waterless period lies in the possibility of infection of the fetus. The fact is that the waters are sterile. If they move away, the baby is deprived of protection. Without amniotic fluid and mucus plug, bacteria and viruses can penetrate directly to the baby, and he is clearly not ready to meet them yet.

The rupture of water before contractions is usually caused by inflammatory or viral diseases that a woman suffered during pregnancy, the presence of isthmic-cervical insufficiency, polyhydramnios, pregnancy with twins or triplets, thin membranes (for idiopathic reasons that cannot be established). Also, early rupture of water before contractions can lead to falls on the stomach, butt, or back in the later stages of pregnancy.

Simultaneous process

Sometimes contractions begin almost simultaneously with the release of amniotic fluid. In this case, hospitalization should also be urgent. Staying at home and waiting for contractions to reach the required frequency and frequency, which was discussed so much in courses for expectant mothers, is dangerous.

The risks are the same as in the case of premature rupture of water. First, the baby may experience acute hypoxia; intrauterine infection often occurs, especially if some infections remain untreated in the woman herself.

A situation in which contractions began almost simultaneously with the water breaking is dangerous due to the development of rapid, fast labor, which, in turn, is dangerous due to birth injuries, premature placental abruption, massive bleeding and other serious complications for the child and mother.

There are contractions, but there is no effusion

In some situations, when the membranes in which the baby is located are too dense, doctor intervention is required. When there is no longer time to wait and an attempt is approaching, the cervix is ​​fully dilated, the whole fetal sac is punctured, and a so-called amniotomy is performed.

Use a long hook to pierce the bubble and make sure that the water does not pour out too intensely. Rapid rupture of water can lead to prolapse of umbilical cord loops and prolapse of a fetal arm or leg into the genital tract.

Such childbirth increases the likelihood of the baby receiving a birth injury tenfold. Everything that happens afterwards, after the prolapse, is a real delicate and almost jewelry art performed by the obstetrician; he needs to quickly and carefully set the child’s limbs back or deliver the child with the prolapsed limb first.

Monitoring the passage of water after amniotomy is an important condition for the prevention of prolapse and complications of childbirth. The reason for the pathological endurance of the fetal bladder, due to which it does not rupture at the right time, may be polyhydramnios, weak dilatation of the cervix, incorrect position of the baby in the uterine cavity, as well as a large fetus.

Conclusions

Modern women want to know a lot about the process of childbirth, but unnecessary knowledge, according to obstetricians, only harms them during the birth process. Therefore, the best thing is to trust your doctors, and everything will be fine.

When the time of birth approaches, a pregnant woman begins to worry and worry: how and when everything will happen, how successful the delivery process will be... Also, many women are afraid of contractions. Indeed, they can be quite painful, although contractions during pregnancy and the sensations during them are quite individual.

The cervix is ​​a muscular ring that is normally closed around the os of the uterus. Longitudinal smooth muscles extending from this ring form the walls of the uterus. As labor approaches, the fetal pituitary gland and placenta begin to produce special substances - childbirth provocateurs(for example, the hormone oxytocin), under the influence of which the uterine pharynx opens to 10-12 cm in diameter.

The uterus contracts in volume, intrauterine pressure increases, and all these factors contribute to the fact that the baby begins to move along the birth canal. Under the influence of hormones, the cervix relaxes, smoothes out from weak contractions, and opens from strong contractions.

False contractions during pregnancy

By the way, have you ever heard of false contractions? They are also called training contractions during pregnancy or Braxton Hicks contractions. They are similar to real contractions: the uterus also becomes toned, and you can even feel it - but the cervix does not open and labor does not begin.

False contractions during pregnancy are a kind of training for the body before the onset of labor; they usually begin several weeks before birth. However, their complete absence is not a pathology: women who have not experienced training contractions during pregnancy give birth no less successfully than those who are familiar with this phenomenon.

How to distinguish real contractions from false ones? As a rule, this question is asked only by first-time mothers: more experienced mothers already know that real mothers cannot be confused with anything. Training contractions take place irregularly, randomly, with varying durations and frequencies. Doctors recommend that expectant mothers calm down, relax, take a warm shower and drink juice or warm milk.

If contractions become periodic, their intensity increases, and the intervals between them decrease—most likely, labor begins.

Contractions during pregnancy: sensations

If you are giving birth for the first time, contractions may last from 5 to 12 hours. In multiparous women, this period is usually 2-4 hours shorter. They also join the fights attempts- contractions of the muscles of the diaphragm and abdominal wall. They involve different muscle groups than during contractions.

But the main difference between pushing and contractions is that pushing is at least to some extent amenable to volitional control on the part of the woman in labor (she can strengthen or, conversely, delay them), while the process of contractions cannot be controlled with all the desire.

The pain during contractions is vaguely reminiscent of the pain experienced during menstrual bleeding. For those who usually have painful periods, such pain will seem quite tolerable and familiar.

There is no need to be panicky about contractions: firstly, during childbirth, a woman’s body produces painkillers. Secondly, there are many ways to self-help during childbirth, which we will discuss below. And finally, as a last resort, doctors will use medications to relieve pain.

Start of contractions

How do contractions begin? Most often, real contractions begin after the release of a plug - mucus, which, throughout pregnancy, seems to clog the cervix, protecting it from infections entering the body. Therefore, if a large amount of mucous and bloody discharge appears, immediately call an ambulance.

Contractions occur at precise intervals (at first it is 30-35 minutes, but then the pause time between contractions is reduced). The first contractions last from 1 minute, and then last longer and longer.

So, contractions have begun, the sensations during them are quite individual, but most women describe the beginning of contractions as tremors somewhere in the lumbar region. Then the pain moves to the stomach, becomes encircling, and there is a feeling as if the bones of the sacrum and pelvis are moving apart.

As long as the contractions are not too painful and not frequent (up to 5 minutes), there is no point in rushing to the maternity hospital: the first birth, as mentioned above, lasts a long time, and part of this time it is better to stay at home, slowly walking around the apartment. But if your water breaks, call an ambulance as soon as possible: during this period the risk of infection is high.

Breathing during contractions during pregnancy

It's time to remember everything that was said about breathing in prenatal training courses, because proper breathing during childbirth is very important: it helps the woman in labor relax, relieves pain, and ensures a full flow of oxygen to the fetus.

IN first period during labor (when contractions become regular), at the beginning and end of each contraction, inhale air through your nose and exhale through your mouth. At the peak of the contraction, breathe through your mouth, often and shallowly, but not for too long - such breathing may make you feel dizzy.

Breathing in second period depends on what the doctor or midwife tells you: push or, conversely, be patient (if the cervix is ​​not yet fully dilated, you need to try to hold back your pushing, otherwise cervical swelling is possible). If you need to hold back your pushing, take two short breaths and then one long exhale. When the pushing stops, exhale slowly and evenly. If, on the contrary, you are told to push, you need to, feeling the urge to push, take a deep breath, lean forward and hold your breath. When the effort passes, try to breathe more evenly and deeply, relax, calm down.

How to relieve pain during contractions

In addition to breathing exercises, there are many ways to relieve labor pain for a woman in labor. You must know how to help yourself. Obstetricians advise:

• in the intervals between contractions, it is better to walk rather than lie down; during contractions, take a comfortable body position;
• stay straight: in this position, the baby’s head rests against the cervix, contractions become stronger;
• in between contractions, relax to save your strength;
• try to distract yourself and not think about the pain - you can look at some object, etc.;
• focus on breathing to distract yourself from the pain;
• Urinate more often so that a full bladder does not interfere with the baby's progress.

If your husband is next to you, ask him to massage your back and lower back: this will help relieve the pain. The massage is done with soft circular movements with the back of the hand on the lower back, then, expanding the range of strokes, on the back. You can use talc.

What can you advise a man in this situation? The husband must be an intermediary between the wife and the medical staff - as a rule, in the presence of one of the relatives, the woman in labor is treated much more attentively. Take your spouse's side in everything: for example, if she asks for a painkiller. Encourage and support your wife in every possible way, even if she is irritated or does not pay any attention to you.

Pain relief during childbirth

If contractions become too painful, your doctor may prescribe pain medication. Do not be angry that you are forced to endure pain: any anesthesia is not completely harmless, and therefore is used only in extreme cases.

It is believed that the process of contractions is irreversible. If they started during childbirth, then it is not possible to stop or weaken them.

If we talk about external influences, then contractions are really almost impossible to control. But for a variety of reasons they can stop and weaken. In this article we will talk about why labor weakness develops and what to do if this happens.

Reasons

During normal childbirth, contractions increase in time and duration, in strength and intensity. This is necessary to open the cervix so that the baby can leave the mother's womb. A situation in which contractions are not strong enough or were regular and then stopped is considered a complication of the birth process. If contractions slow down, they speak of primary labor weakness. If the attempts stop, they speak of secondary weakness of the labor forces.

Cessation of uterine contractions during childbirth is not normal. And the reason for this is hypotension of the smooth muscles of the uterus. Reduced uterine tone can result from:

• uterine hypoplasia;
• myoma;
• endometritis;
• uterine anomalies – saddle-shaped or bicornuate uterus;
• failure of the uterine tissue due to previous abortions or diagnostic curettages;
• scars on the cervix in nulliparous women caused by treatment for erosion;
• high level of progesterone in a woman’s body, reduced level of oxytocin;
• hypothyroidism, obesity;
• the age of the woman giving birth is under 20 years or over 36 years;
• gestosis.

Most often, this complication occurs in women who give birth to their first child; during the second or subsequent births, the likelihood of developing weakness of labor forces is minimal, although not completely excluded.

According to statistics, up to 7% of all primiparous women experience weakening contractions or pushing; among multiparous women this occurs in 1.5% of cases. Most often, contractions suddenly stop during premature birth or post-term pregnancy. At risk for sudden weakness of labor forces are women who are carrying a large baby or several babies at the same time, since the walls of the uterus in this case are overstretched.

Stopping labor threatens both women with polyhydramnios and those whose pelvic size does not correspond to the size of the fetal head. Too early release of amniotic fluid is also the cause of weak contractions. In addition, factors such as placenta previa, fetal hypoxia, and malformations of the baby may also affect the condition.

Quite often, doctors cannot determine the reasons for the sudden stop of contractions or their slowdown. With good tests and ideal health, a woman’s labor may slow down for psychogenic reasons.

If the child is unwanted, if there is a strong fear of childbirth, if the woman was very nervous in the last days before giving birth, was in the midst of family conflicts, did not get enough sleep, did not eat well, the development of so-called idiopathic weakness of labor is possible.

Sometimes the cause is too many painkillers, which the woman took on her own initiative, fearing pain during contractions, or administered in the hospital, but the latter is the least likely.

Consequences

If you do nothing and adhere to a wait-and-see approach, the likelihood of negative consequences will increase every hour.

The baby can become infected, because the uterus is already partially open. A long period without water is dangerous due to hypoxia and the death of the child. If weakness occurs in the second half of labor, severe bleeding in the mother may begin, and asphyxia and injuries to the baby are possible.

What to do?

The woman herself just needs to monitor the duration and frequency of contractions in order to notice the lag in time. With pathological weak contractions, the rest intervals between uterine spasms are approximately 2 times longer than normal, and the contraction lags behind the norm in duration.

Everything else should be decided by doctors. First of all, they must understand how far behind the norm the dilation of the cervix during primary contractions is. A decision will then be made on further action. So, sometimes it is enough to insert a catheter into the bladder of a woman in labor or puncture the amniotic sac during polyhydramnios, and labor resumes and then proceeds normally.

If a woman is very tired, she is exhausted, and the baby has no signs of trouble or hypoxia, then the woman in labor can be given sleeping pills so that she gets some sleep, after which labor can resume on its own.

If these measures do not help, the woman can be induced to give birth by injecting oxytocin intravenously, which increases uterine contractility. If stimulation turns out to be useless, then the woman undergoes a caesarean section.

Initially, without stimulation of labor, signs such as fetal hypoxia, a long anhydrous period, and the appearance of blood discharge from the genital tract, indicating possible early placental abruption, will speak in favor of an emergency cesarean section.

How to prevent it?

There is no way to prevent weakness of the labor force. But doctors can do everything that is necessary if a woman turns to the maternity hospital for help in time.

You can learn more about contractions in the following video.

What sensations indicate that labor is approaching?

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 you overcome fear and act consciously during childbirth.

In modern obstetric practice, labor 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 maternity hospital on time.

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

Training, warning or prenatal contractions

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

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

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

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

Just like training ones, they do not open the cervix of the uterus and do not threaten pregnancy, although the intensity of the sensations is more vivid and may well instill anxiety in first-time women. Premonitory 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 ease these contractions.

It is impossible to stop real or labor contractions by resting or changing positions. Contractions occur involuntarily, under the influence of complex hormonal processes in the body, and are not subject to any control on the part of the woman in labor. Their frequency and intensity are increasing. In the initial phase of labor, contractions are short, lasting about 20 seconds and repeating every 15-20 minutes. By the time the cervix is ​​fully opened, the interval is reduced to 2-3 minutes, and the duration of contractions increases to 60 seconds.

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

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 during real contractions the interval becomes stable, and the length of contractions increases.

Description and functions of contractions

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

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

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

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

Afterwards, pushing occurs - active contraction of the abdominal muscles and diaphragm (duration 10-15 sec.). Occurring reflexively, pushing helps move the baby along the birth canal.

Phases and duration of contractions before childbirth

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

Characteristic	Latent phase	Active phase	Deceleration phase
Phase duration	7-8 hours	3-5 hours	0.5-1.5 hours
Frequency	15-20 minutes	Up to 2-4 minutes	2-3 minutes
Duration of contraction	20 seconds	Up to 40 seconds	60 seconds
Degree of opening	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. The actual time of contractions greatly depends on whether the woman is giving birth for the first time or is having a repeat birth, her physical and psychological readiness, the anatomical characteristics of the body and other factors.

Contractions before the first and subsequent births

However, a common factor that influences the duration of contractions is the experience of previous births. This refers to a kind of “memory” of the body that determines differences during certain processes. During the second and subsequent births, the birth canal opens on average 4 hours faster than during the first. This occurs because in women giving birth to their second or third child, the internal and external os open at the same time. During the first birth, dilation occurs sequentially - from the inside to the outside, which increases the time of contractions.

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

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

In articles devoted to the topics of motherhood and pregnancy, there is information that contractions before the second birth often occur not before, but after the waters have 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 births and the nature of their onset.

It is necessary to understand that the described scenarios are only options, and in no case an axiom. Each birth is very individual, and its course is a multifactorial process.

Feelings during contractions

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

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

However, in the vast majority of cases, women experience the peak of spasm as a contraction, a strong contraction, or “grasping,” as follows from the very name of the contraction.

Is it possible to miss contractions?

Not all women in labor experience tension in the uterine muscles that causes unbearable pain. How a woman tolerates it depends on the threshold of sensitivity, emotional maturity and special preparation for childbirth. Some people endure the contractions, but for others they are too painful to hold back a scream. But it’s impossible not to feel contractions. If they are not there, then there is no labor activity, which is an essential condition for physiological childbirth.

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

Spontaneous release of water is called premature. This situation requires immediate medical intervention; waiting for contractions at home is unacceptable.

Mechanism of action at the onset of contractions

It is important to understand what to do at home if contractions begin and labor is approaching. A few recommendations:

• The first thing is not to panic. Lack of composure and unconstructive emotions interfere with concentration and lead to unreasonable actions.
• Having felt 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 note 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. The warning signs usually subside completely within two hours.
• If the spasms have become regular, the pause time between them is clearly defined, you can start getting ready for the maternity hospital. You should plan your departure so that you can be examined by a doctor by the time the frequency of contractions reaches once every 10 minutes. In the normal course of labor, this will happen approximately no earlier than after 7 hours. Therefore, if contractions begin at night, you should try to get at least a little rest.
• You can take a shower and do hygiene procedures.
• For repeated births, you should go to the hospital immediately after contractions become regular, without waiting for their interval to shorten.