All expectant mothers experience anxiety before giving birth. Primiparas of the fairer 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 exactly 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 contractions during childbirth feel (frequency, duration and intensity of the process), you need to define this concept. Contractions are involuntary contractions of the reproductive organ - the uterus. A woman is not able to independently manage this process or somehow control it.

The substance actomyosin, a contractile protein, triggers contractions. It is produced by the placenta, as well as the pituitary gland of the embryo under the influence of certain hormones. The process of contractions is very complex, and it is quite difficult for someone inexperienced in this area to understand. When actomyosin synthesis is disrupted or its spatial distribution is incorrect, various complications arise during childbirth. These include weak, unproductive contractions, and decreased strength of the woman in labor.

Early contractions: a threat

Contractions before childbirth are not always timely. 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 stage of pregnancy.

The threat of miscarriage may arise in the first trimester. This happens most often. In this case, women experience the following: nagging pain in the lower abdomen, stool liquefaction. Often at these times it is associated with insufficient progesterone secretion. With appropriate therapy, signs of pathology, as well as the problem itself, can be eliminated.

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

or harbingers

From about the middle of pregnancy, expectant mothers may notice new sensations. False contractions before childbirth, the frequency of which varies greatly, most often do not pose any danger. At the moment of contraction of the uterus, the woman feels tension in the abdomen, which does not cause her pain. This state lasts from several seconds to a minute. A false contraction may recur after a few hours or days.

Precursor contractions of the reproductive organ become more frequent as the period increases. Before giving birth, a woman experiences Braxton-Hicks contractions every day. Such spasms help prepare the cervix for childbirth: they soften and shorten it. If you feel false contractions, be sure to tell your doctor. It is necessary to ensure their real safety.

Signs

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

• increased frequency and dilution of stools;
• rupture of amniotic fluid;
• girdle aching pain;
• lumbago in the back;
• pressure on the pelvis;
• nausea and vomiting;
• feeling of tension, petrification in the stomach;
• decreased fetal motor activity.

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

latent phase

How do contractions feel before childbirth? The frequency of uterine contractions always decreases steadily. At the very beginning, a woman may notice a weak 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. Provided the amniotic sac is intact, the woman in labor does not experience severe discomfort. However, you shouldn't stay at home. Go to the medical facility of your choice.

Contractions before childbirth: frequency of the active phase

Such uterine contractions last at least 20-30 seconds (up to a minute). They are repeated regularly, the interval gradually shortens and ranges from 2 to 5 minutes. Painful sensations become more pronounced during this period. It is already difficult for the expectant mother to move. Often it is at this stage of labor that the membranes rupture and water is released. If this happened, then now the process will go much faster.

The duration of the active phase may vary. On average it ranges from 2 to 5 hours. If the integrity of the membranes is preserved, then the painful sensations are significantly dulled, and the process proceeds more slowly.

Attempts

There is an interesting feature that contractions before childbirth have. The frequency of uterine contractions decreases by the time the cervix dilates. In other words, as soon as the birth canal is ready for the passage of the baby, 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. Increasing the period will allow the woman in labor to push out the fetus using each contraction.

During pushing, 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 start having contractions before giving birth (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 sensations. Tell us about 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 just harbingers.

Doctors remind patients that the second and subsequent births always progress faster than the first. Therefore, if you are preparing to become a mother again, do not delay your visit to the maternity hospital. Surely you already know about them and what their frequency is. In case of rupture of the membranes and leakage of amniotic fluid, you need to go to the maternity hospital even in the absence of contractions. Have an easy birth and good health!

The last weeks of waiting are over. Contractions begin. The climax of the entire pregnancy is coming - a few more hours and you will see your baby. Of course, you will worry and worry about the outcome of labor, but if you are well prepared and understand what to expect, what happens at each stage of labor, then your courage will also return. Give life to a child! After all, this is such happiness! Prepare yourself, master techniques and methods of relaxation and breathing control in advance - they will help you maintain composure and cope with pain. And don’t be alarmed if during contractions something doesn’t turn out quite as you expected.

HOW TO DETERMINE THE BEGINNING OF CONTRACTIONS

YOUR ANXIETY that you will miss the onset of contractions is absolutely groundless. Although false contractions that occur in the last weeks of pregnancy can sometimes be mistaken for the beginning of labor, you will not confuse real contractions with anything.

SIGNS OF CONTRACTS

Appearance
By opening slightly, the cervix pushes out the blood-stained mucus plug that clogged it during pregnancy.
What to do This can happen a couple of days before contractions start, so wait until the abdominal or back pain becomes constant or the amniotic fluid has broken before calling your midwife or hospital.

Leakage of amniotic fluid
Rupture of the amniotic sac is possible at any moment. The water may flow out in a stream, but more often it oozes out little by little - it is retained by the child’s head.
What to do Call a midwife or ambulance immediately. Hospitalization is safer, even if there are no contractions yet, since infection is possible. In the meantime, place a waffle towel to absorb moisture.

Uterine contractions
At first they make themselves felt as dull pain in the back or hips. After some time, contractions will begin, similar to the sensations during painful menstruation.
What to do When contractions become regular, fix the intervals between them. If you think contractions have started, call your midwife. As long as they are not very frequent (up to 5 minutes) or painful, there is no point in rushing to the maternity hospital. The first birth usually lasts quite a long time, 12-14 hours, and part of this time is best spent at home. Walk slowly, stopping to rest. If your water has not yet broken, you can take a warm shower or have a light meal. The maternity hospital may advise you not to arrive before the contractions intensify and begin to repeat every 5 minutes.

HARNESSES OF CONTRACTS
Weak uterine contractions occur throughout pregnancy. In the last few weeks, they become more frequent and more intense, so sometimes they can be mistaken for the beginning of contractions. When you feel such contractions, get up, walk around and listen to see if they continue and if the pauses between them become shorter. Precursors of contractions are usually irregular.

FREQUENCY OF CONTRACTS
Monitor the dynamics of contractions over the course of an hour: beginning and end, intensification, increase in frequency. When contractions stabilize, their duration should be at least 40 seconds.

FIRST PERIOD

AT THIS STAGE, the muscles of the uterus contract to open the cervix and allow the fetus to pass through. During the first birth, contractions last on average 10-12 hours. It is possible that at some point you will be overcome by panic. No matter how well prepared you are, the feeling that something is happening to your body beyond your conscious control can be frightening. Stay calm and try not to disturb your body, do what it tells you. It is now that you will truly appreciate the presence of your husband or girlfriend nearby, especially if they know what contractions are.

BREATHING IN THE FIRST PERIOD OF LABOR
At the beginning and end of the contraction, breathe deeply and evenly, inhaling through your nose and exhaling through your mouth. When the contraction reaches its peak, resort to shallow breathing, but now inhale and exhale through the mouth. Don't breathe like this for too long - you may get dizzy.

ARRIVAL AT THE MATERNITY HOSPITAL

At the reception department you will be met by a nurse-midwife who will carry out all the formalities and preparatory procedures. Your husband may be next to you at this time. If you are giving birth at home, you will be prepared for the birth in the same way.

Midwife Questions
The midwife will check the registration records and your exchange card, and will also check to see if your water has broken and if there has been any release of mucus plug. In addition, he will ask a series of questions about the contractions: when did they start? how often do they happen? How do you feel? what is the duration of the attacks?

Survey
Once you have changed, your blood pressure, temperature and pulse will be taken. Your doctor will do an internal examination to determine how dilated your cervix is.

Fetal examination
The midwife will feel your stomach to determine the baby's position and use a special stethoscope to listen to the baby's heart. It is possible that she will record the fetal heartbeat through a microphone for about 20 minutes - this recording will help determine whether the child receives enough oxygen during uterine contractions.

Other procedures
You will be asked to provide urine to be tested for sugar and protein. If your water hasn't broken yet, you can take a shower. You will be directed to the prenatal ward.

INTERNAL INVESTIGATIONS
The doctor will, if necessary, conduct internal examinations, monitoring the position of the fetus and the degree of dilatation of the cervix. Ask him questions - you should also know what is happening. Usually the uterus dilates unevenly, as it were. in jerks. The examination is carried out in the intervals between contractions, therefore, if you feel the next contraction approaching, you will have to inform the doctor about it. You will most likely be asked to lie on your back, supported by pillows, but if this position is uncomfortable, you can lie on your side. Try to relax as much as possible.

CONTRACTS
The cervix is ​​a ring of muscles normally closed around the uterine os. The longitudinal muscles that form the walls of the uterus extend from it. During contractions, they contract, pulling the cervix inward and then stretching it enough to allow the baby's head to pass through the uterine os.
1. The cervix relaxes under the influence of hormones.
2. Weak contractions smoothly smooth the cervix.
3. Strong contractions cause the cervix to dilate.

PROVISIONS FOR THE FIRST STAGE OF LABOR
During the first period, try to try different body positions, finding the most comfortable one for each stage. These positions must be mastered in advance so that at the right moment you can quickly take the appropriate pose. You may suddenly feel like it would be better to lie down. Lie not on your back, but on your side. The head and thigh should rest on pillows.

Vertical position
At the initial stage of contractions, use some kind of support - a wall, a chair or a hospital bed. You can kneel if you wish.

Sitting position
Sit facing the back of a chair, supported by a pillow. The head is lowered on the hands, the knees are spread apart. Another pillow can be placed on the seat.

Leaning on my husband
During the first stage of labor, which you will probably endure on your feet, during contractions it is convenient to place your hands on your husband’s shoulders and lean on him. Your husband can help you relax by massaging your back or stroking your shoulders.

Kneeling position
Get on your knees, spread your legs and, relaxing all your muscles, lower your upper body onto the pillows. Keep your back as straight as possible. In the intervals between contractions, sit on your thigh.

Four point support
Kneel down, leaning on your hands. This is convenient to do on a mattress. Move your pelvis forward and backward. Don't hunch your back. Between contractions, relax by lowering yourself forward and resting your head on your hands.

LABOR PAIN IN THE BACK
In cephalic presentation, the baby's head pushes against your spine, causing back pain. To make it easier:
during contractions, lean forward, placing your weight on your hands, and make forward movements with your pelvis; walk at intervals
In the intervals between contractions, let your husband massage your back.

Lumbar massage
This treatment will relieve back pain and also calm and reassure you. Let your husband massage the base of your spine, pressing on it with the heel of his palm in a circular motion. Use talcum powder.

HOW TO HELP YOURSELF

Move more, walk between contractions - this will help cope with pain. During attacks, choose a comfortable body position.
Stay as straight as possible: the baby's head will rest against the cervix, contractions will become stronger and more effective.
Focus on your breathing to calm yourself and take your attention away from your contractions.
Relax during breaks to save energy for when you need it most.
Sing, even scream, to relieve pain.
Look at one point or object to distract yourself.
React only to this fight, don’t think about the next ones. Imagine each attack as a wave, “riding” which you will “bear” the child.
Urinate more often - the bladder should not interfere with the advancement of the fetus.

HOW CAN A HUSBAND HELP

Praise and encourage your wife in every possible way. Don't be put off if she gets annoyed - your presence is still important.
Remind her of the relaxation and breathing techniques she learned in the courses.
Wipe her face, hold her hand, massage her back, offer to change her position. You need to know in advance what kind of touches and massage she likes.
Be a mediator between your wife and the medical staff. Stay on her side in everything: for example, if she asks for a painkiller.

TRANSITION PHASE

THE HARDEST time of labor is the end of the first period. Contractions become strong and long, and the intervals are reduced to a minute. This phase is called transition. Exhausted, you will probably be either depressed or overly agitated and tearful at this stage. You may even lose track of time and fall asleep between contractions. This may be accompanied by nausea, vomiting and chills. In the end, you will have a great desire to strain and push the fetus out. But if you do this ahead of time, swelling of the cervix is ​​possible. So ask your midwife to check that your cervix is ​​fully dilated.

BREATHING IN THE TRANSITION PHASE
If premature pushing begins, take two short breaths and one long exhale: “oof, oof, fu-u-u-u.” When the urge to push stops, exhale slowly and evenly.

How to stop pushing
If the cervix has not yet opened, in this position, take a double breath and exhale long: “oof, oof, fu-u-u-u” (see above right). You may need pain relief. Kneel down and, leaning forward, put your head in your hands; the pelvic floor should seem to hang in the air. This will weaken the urge to push and make it more difficult to push the fetus out.

HOW CAN A HUSBAND HELP

Try to calm your wife down, encourage her, wipe away the sweat; If she doesn't want it, don't insist.
Breathe with her during contractions.
Put some socks on her if she starts getting chills.
If you start pushing, call your midwife immediately.

WHAT HAPPENS TO THE CERVIX
The cervix, palpable at a depth of 7 cm, is already sufficiently stretched around the fetal head.
If the cervix can no longer be palpated, it means that its dilation has completed.

SECOND PERIOD AS soon as the cervix is ​​dilated and you are ready to push, the second stage of labor begins - the period of expulsion of the fetus. Now you add your own efforts to the involuntary contractions of the uterus, helping to push the fetus out. The contractions have become stronger, but they are less painful. Pushing is hard work, but your midwife will help you find the most comfortable position and guide you on when to push. Don't rush things, try to do everything right. During the first birth, the second stage usually lasts more than an hour.

BREATHING IN THE SECOND STAGE OF LABOR
When you feel the urge to push, take a deep breath and, leaning forward, hold your breath. Take deep, calming breaths between pushes. Relax slowly as the contraction subsides.

POSITIONS FOR EXPELATION OF THE FETUS
When pushing, try to stay straighter - then gravity will work for you.

Squatting
This is the ideal position: the lumen of the pelvis opens, and the fetus comes out under the influence of gravity. But if you haven't prepared yourself for this pose in advance, you will soon feel tired. Use a lighter option: if your husband sits on the edge of a chair with his knees spread, you can sit between them, resting your hands on his thighs.

On my knees
This position is less tiring and also makes pushing easier. Having support from both sides will give your body greater stability. You can just lean on your hands; your back should be straight.

Sitting
You can give birth sitting on the bed, surrounded by pillows. As soon as you start pushing, lower your chin and clasp your legs with your arms. In the intervals between attempts, rest by leaning back.

HOW TO HELP YOURSELF
At the moment of contraction, strain gradually, smoothly.
Try to relax your pelvic floor so much that you feel it sinking.
Relax your facial muscles.
Don't try to control your bowels or bladder.
Rest between contractions, save your strength for pushing.

HOW CAN A HUSBAND HELP
Try to somehow distract your wife between attempts, continue to calm and encourage her.
Tell her what you see, such as the appearance of a head, but don't be surprised if she doesn't pay attention to you.

CHILDREN

THE PEAK OF BIRTH has arrived. The baby is about to be born. You will be able to touch your baby's head, and soon you will be able to hold him in your arms. At first, you will probably be overcome by a feeling of great relief, but it will be followed by surprise, and tears of joy, and, of course, a feeling of immense tenderness for the child.

1. The fetal head approaches the vaginal opening, pressing on the pelvic floor. The top of the head will soon appear: with each push it will either move forward, or perhaps roll back somewhat as the contractions weaken. Don't worry, this is completely normal.

2. As soon as the top of the head appears, you will be asked not to push any further - if the head comes out too quickly, perineal tears are possible. Relax, catch your breath a little. If there is a risk of serious ruptures or any abnormalities in the child, you may have an episiotomy. As the head expands the vaginal opening, a burning sensation occurs, but it does not last long, giving way to numbness, which is caused by strong stretching of the tissue.

3. When the head appears, the baby's face is turned down. The midwife checks to make sure the umbilical cord is not wrapped around the neck. If this happens, it can be removed when the entire body is released. The infant then turns his head to the side, turning around before fully releasing. The midwife will wipe his eyes, nose, mouth and, if necessary, remove mucus from the upper respiratory tract.

4. The last contractions of the uterus, and the baby's body is released completely. Usually the baby is placed on the mother's stomach, since the umbilical cord is still holding it in place. Perhaps at first the baby will seem bluish to you. His body is covered with vernix, and there are traces of blood on his skin. If he is breathing normally, you can pick him up and press him to your chest. If breathing is difficult, the patient's airway will be cleared and, if necessary, an oxygen mask will be given.

THIRD STAGE OF LABOR
At the end of the second stage of labor, you will probably be given an intravenous injection of a drug that increases uterine contractions - then the placenta will come out almost instantly. If you wait for it to peel off naturally, you may lose a lot of blood. Discuss this point with your doctor in advance. To remove the placenta, the doctor places one hand on your stomach and gently pulls the umbilical cord with the other. After this, he must check that the placenta has come out completely.

APGAR SCALE
After delivering the baby, the midwife evaluates his breathing, heart rate, skin color, muscle tone and reflexes, calculating a score on the 10-point Hangar scale. Usually in newborns this indicator ranges from 7 to 10. After 5 minutes, a second count is carried out: the initial score, as a rule, increases.

AFTER CHILDREN
You will be cleaned and, if necessary, stitches will be placed. The neonatologist will examine the newborn, the midwife will weigh and measure him. To prevent the baby from developing a rare disease associated with insufficient blood clotting, he may be given vitamin K. The umbilical cord is cut immediately after birth.

QUESTION and ANSWER "I'm afraid of injury during childbirth. Is there such a danger?"
Don't be afraid, there is no such danger - the vaginal walls are elastic, their folds can stretch and allow the fetus to pass through. “Should I breastfeed my baby immediately after birth?” You can give breastfeeding, but if the baby doesn’t take it, don’t insist. In general, the sucking reflex in newborns is strong, and when they suck, they are in a good mood.

ANESTHESIA

CHILDREN RARELY painless, but pain also has a special meaning: after all, every contraction is a step towards the birth of a baby. You may need painkillers, depending on how your contractions are progressing and your ability to cope with the pain. You may be able to overcome it using self-help techniques, but if the worsening pain becomes unbearable, ask your doctor for pain medication.

EPIDURAL ANESTHESIA
This anesthesia relieves pain by blocking the nerves of the lower body. It is effective when contractions cause back pain. However, not every hospital will offer you an epidural. The time of its use should be calculated so that the effect of the anesthetic ceases by the 2nd stage of labor, otherwise labor may be slowed down and the risk of episiotomy and forceps may increase.

How it happens
Epidural anesthesia requires approx. 20 minutes. You will be asked to curl up with your knees touching your chin. An anesthetic will be injected into the lower back with a syringe. The needle is not removed, which allows you to administer an additional dose if necessary. The effect of the anesthetic wears off after 2 hours. It may be accompanied by some difficulty in movement and trembling in the hands. These phenomena will soon pass.

Action
on you The pain will pass, clarity of consciousness will remain. Some women experience weakness and headache, as well as heaviness in the legs, which sometimes lasts for several hours.
Per child None.

NITRIC OXIDE WITH OXYGEN
This gas mixture significantly reduces pain without completely eliminating it and causes euphoria. Used at the end of the 1st stage of labor.

How it happens
The gas mixture enters through a mask connected by a hose to the apparatus. The effect of the gas appears after half a minute, so at the beginning of the contraction you need to take several deep breaths.

Action
on you The gas dulls the pain, but does not relieve it completely. When you inhale, you will feel dizzy or nauseous.
Per child None.

PROMEDOL
This medicine is used in the 1st stage of labor, when the woman in labor is excited and finds it difficult to relax.

How it happens
An injection of promedol is administered into the buttock or thigh. The onset of action is after 20 minutes, duration is 2-3 hours.

Action
on you Promedol manifests itself in different ways. For some, it has a calming effect, relaxing, causing drowsiness, although the consciousness of what is happening is completely preserved. There are also complaints about loss of self-control and intoxication. You may feel nauseous and shaky.
Per child Promedol can cause respiratory depression and drowsiness in a child. After childbirth, breathing can be easily stimulated, and drowsiness will disappear on its own.

ELECTRO-STIMULATION
The electrical stimulation device reduces pain and stimulates the internal pain coping mechanism. It works on weak electrical impulses that affect the back area through the skin. A month before giving birth, find out if there is such a device in the maternity hospital and learn how to use it.

How it happens
Four electrodes are placed on the back where the nerves leading to the uterus are concentrated. The electrodes are connected by wires to the manual control panel. With its help you can regulate the current strength.

Action
on you The device reduces pain at the initial stage of labor. If contractions are very painful, the device is ineffective.
Per child None.

MONITORING THE CONDITION OF THE FETAL

DURING the entire period of labor, doctors constantly record the fetal heart rate. This is done with a regular obstetric stethoscope or using an electronic monitor.

OBSTETRIC STETHOSCOPE
While you are in the delivery room, the midwife regularly listens to the fetal heartbeat through the abdominal wall.

ELECTRONIC FETAL MONITORING
This method requires sophisticated electronic equipment. In some hospitals, such monitoring (control) is used throughout labor, in others - occasionally or in the following cases:
if labor is induced artificially
if you have had an epidural
if you have complications that could threaten the fetus
if abnormalities are detected in the fetus.
Electronic monitoring is absolutely harmless and painless, but it significantly limits freedom of movement - thus you cannot control contractions. If your doctor or midwife has suggested continuous monitoring, find out if this is really necessary.

How it happens
You will be asked to sit or lie down on a couch. The body will be supported with pillows. Adhesive tapes with sensors will be attached to the abdomen to detect the fetal heartbeat and record uterine contractions. The instrument readings are printed on paper tape. After the amniotic fluid has broken, the baby's heart rate can be measured by placing an electronic sensor near the baby's head. This monitoring method is the most accurate, but not very convenient. Some maternity hospitals use radio wave monitoring systems with remote control (telemetric monitoring). Their advantage is that you are not tied to bulky equipment and can move freely during contractions.

SPECIAL DELIVERY METHODS
EPISIOTOMY
This is a dissection of the vaginal opening to prevent rupture or to shorten the second stage of labor if the health of the fetus is threatened. To avoid an episiotomy:
learn to relax your pelvic floor muscles
When expelling the fetus, stay straighter.

Indications
An episiotomy will be needed if:
the fetus has a breech presentation, a large head, other abnormalities
you are in premature labor
use forceps or vacuum
you don't control your attempts
the skin around the vaginal opening does not stretch enough.

How it happens
At the climax of the contraction, an incision is made into the vagina - downwards and, usually, slightly to the side. Sometimes there is no time for an anesthetic injection, but you still won’t feel pain, since partial numbness of the tissues also occurs due to the fact that they are stretched. Suturing after an episiotomy or rupture may be quite lengthy and painful - a complex procedure that requires special care. Therefore, insist that you have a good local anesthetic. The suture material dissolves on its own after some time and does not need to be removed.

Consequences
It's normal to feel discomfort and inflammation after an episiotomy, but the pain can be severe, especially if it becomes infected. The incision heals in 10-14 days, but if something bothers you then, consult a doctor.

FRUIT EXTRACTION
Sometimes forceps or vacuum extraction are used to help the baby come into the world. The use of forceps is possible only when the cervix is ​​fully dilated and the fetal head has entered it. Vacuum extraction is also permissible in case of incomplete dilatation - in the case of protracted labor.

Indications
Forced extraction is performed:
if you or the fetus have any abnormalities during childbirth
in case of breech presentation or premature birth.

How it happens

Forceps You will be given pain relief - inhalation or intravenous anesthesia. The doctor applies forceps, wraps them around the child’s head, and gently pulls it out. When applying forceps, pushing is completely eliminated. Then everything happens naturally.
Vacuum extractor This is a small suction cup connected to a vacuum pump. It is brought through the vagina to the fetal head. While you push, the fetus is gently pulled through the birth canal.

Consequences
Forceps may leave dents or bruises on the fetus's head, but they are not dangerous. After a few days these marks disappear.
Vacuum The suction cup will leave a slight swelling and then a bruise on the baby's head. This too will gradually go away.

STIMULATION OF LABOR
Stimulation means that contractions will have to be induced artificially. Sometimes methods are used to speed up contractions if they are going too slowly. Physicians' approaches to stimulation often vary; so try to find out what the practice of inducing labor is in the area where you will be giving birth.

Indications
Contractions are induced artificially:
if, when labor is delayed for more than a week, signs of abnormalities in the fetus or dysfunction of the placenta are detected
if you have high blood pressure or any other complications that are dangerous for the fetus.

How it happens
Artificially induced labor is planned in advance, and you will be asked to go to the maternity hospital in advance. There are 3 methods of stimulating contractions:
1. The hormonal drug cerviprost is injected into the cervical canal, softening the cervix. Contractions can begin in about an hour. This method is not always effective during the first birth.
2. Opening of the amniotic sac. The doctor makes a hole in the amniotic sac. Most women do not experience any pain. Soon uterine contractions begin.
3. A hormonal drug is administered intravenously through a drip that promotes contraction of the uterus. Ask for an IV to be placed on your left arm (or right arm if you are left-handed).

Consequences
The introduction of a hormonal drug is preferable - you can move freely during contractions. When using an IV, contractions will be more intense and the intervals between them will be shorter than during normal labor. Besides, you have to lie down.

BUTICAL PRECTION
In 4 cases out of 100, the baby comes out with the lower body. Childbirth in this position of the fetus is longer and more painful, so it must take place in a hospital. Since the head, the largest part of the baby's body, will be the last to appear during birth, it is measured in advance with an ultrasound scanner to ensure that it will pass through the pelvis. An episiotomy will be required; Caesarean section is often used (in some clinics it is mandatory).

TWINS
Twins must be delivered in a hospital because forceps are often used to remove them. In addition, one of them may have a breech presentation. You will likely be offered an epidural. There will be one first stage of labor. There are two second pushes: first one child comes out, followed by the second. The interval between the birth of twins is 10-30 minutes.

C-SECTION

With a CESAREAN section, the baby is born through an open abdominal wall. You will be informed in advance about the need for surgery, but this measure may be caused by complications during childbirth. If a caesarean section is planned, an epidural will be used, meaning you will be awake and able to see your baby right away. If the need for surgery occurs during contractions, then epidural anesthesia is also possible, although general anesthesia is sometimes required. It is difficult to come to terms with the fact that you cannot give birth normally. But these experiences can be overcome if you prepare yourself psychologically.

HOW IT HAPPENS
Your pubic area will be shaved, an IV will be placed in your arm, and a catheter will be inserted into your bladder. They will give you anesthesia. If you have an epidural, a screen will probably be placed between you and the surgeon. Typically a horizontal incision is made, then the surgeon uses suction to remove the amniotic fluid. The child is sometimes removed using forceps. After the placenta is delivered, you will be able to hold him in your arms. The operation itself lasts about five minutes. Stitching takes another 20 minutes.

Cut
The bikini incision is made horizontally, above the upper pubic line, and once healed it is almost invisible.

AFTER THE OPERATION
After giving birth, you will not be allowed to lie down for a long time without getting up. Walking and movement are completely harmless for you. The incision will still be painful for the first few days, so ask for pain relief. Stand straight, supporting the seam with your hands. After two days, start light exercise; in another day or two, when the bandage is removed, you can swim. The stitches are removed on the 5th day. In a week you will feel quite good. Avoid heavy exercise for the first 6 weeks. After 3-6 months the scar will fade.

How to breastfeed
Place the child on pillows so that his weight does not put pressure on the wound.

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 classical 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 signs 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 late 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, rapid 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.

This question worries more women who are expecting their first child. They are afraid of missing the onset of labor, and therefore, at the first “bell”, they rush to the maternity hospital. So can labor begin without contractions? What should a mother know without five minutes about the possible onset of labor?

Unconventional start of labor

As a rule, they begin with contractions that gradually intensify. Then the interval between them decreases.

But sometimes the onset of labor may be atypical. In some cases, the expectant mother first leaks amniotic fluid. They represent the environment in which the fetus develops inside the mother's womb. Amniotic fluid is found in the membranes of the fetus, which, together with the placenta, form a barrier that protects the unborn child. This fluid allows the fetus to develop in sterile conditions throughout pregnancy. Amniotic fluid normally flows out during the first stage of labor, that is, until the cervix is ​​dilated by 4 centimeters. This happens at the height of one of the fights. Their effusion before the onset of labor is called prenatal or premature. More often, early rupture of water occurs in multiparous women. This process is not accompanied by pain, discomfort, or other unpleasant sensations.

If the waters are released prematurely, the amniotic sac may rupture above the cervix. In this case, they flow out slowly. But sometimes it ruptures directly above the opening of the cervix. In this case, the water drains quickly and in large quantities, as they say, like out of a bucket.

When the amniotic sac ruptures high up, it can be difficult to determine whether it is water or the mucus plug is coming off. Both types of discharge are similar. It is difficult for a firstborn woman to distinguish them.

So how can you determine whether it is water or a cork? The latter leaves 1-5 days before the start of delivery. It can be beige or pinkish in color. Sometimes it contains streaks of blood. The plug may come off in parts, sometimes for several days in a row. At the same time, the discharge does not increase when coughing, sneezing, or squatting.

As for amniotic fluid, it is clear and watery. They are yellowish. They flow constantly, and when coughing and sneezing, the discharge increases. After the release of water, the labor process develops within several hours.

It is worth noting that the option of childbirth, which begins with the rupture of water, is more risky and unsafe. After all, in essence, the fetus remains unprotected. Bacteria from the cervix and vagina can penetrate it. Childbirth should occur 12 hours after rupture of the membranes, no later! Then complications and risks for the baby can be avoided.

If labor begins with the rupture of water, then the woman must notice when this happened, quickly call her husband or call an ambulance in order to get to the maternity hospital as soon as possible. No need to wait for contractions!

Also, when the water breaks, you need to pay attention to its color. If they are normal, that is, odorless, transparent, liquid, then you can get to the maternity hospital on your own.

A woman giving birth in a car should lie on her side, not on her back! This position slightly slows down labor and helps prevent compression of the umbilical cord when its loops fall out. This sometimes happens with premature rupture of water and is a complication of the birth process. Also, the position on the side helps to provide the fetus with the amount of oxygen it needs.

What is forbidden to do when water leaks?

Under no circumstances should you stay at home during their departure, as the risk of infection and fetal hypoxia increases. Its head is inserted into the uterine cavity and can sometimes press against the umbilical cord.

It is also prohibited to take hygiene procedures. This increases the risk of infection. You also cannot do an enema or shave. Eating food is also prohibited, because when the waters break, the need for surgical delivery with anesthesia arises more often.

The ban on eating and hygiene procedures is also due to the fact that they take up time. And when the water breaks, the expectant mother should get to the maternity hospital as quickly as possible. She is also forbidden to be nervous and panic. You need to calm down, get ready for hard work and maintain a good mood.

Especially for- Elena Kichak

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.

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.

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.