Contractions: how to understand that they have begun. False contractions and sure signs

• Pain as during intestinal upset
• Lower back pain
• Pain in unexpected places
• Contractions without pain

How to recognize contractions?

​

KEANA: The beds in the pregnancy pathology department were so hard that every morning I thought that contractions had started (I definitely had back pain like during menstruation), but when real contractions began, I realized that they couldn’t be confused with anything, that’s for sure!

mama_Levika: About two weeks before giving birth, a slight tingling sensation begins in the lower abdomen, it seems like contractions, but, girls! You can’t confuse contractions with anything, don’t rush to call an ambulance...

What are contractions

So, there comes a time when your baby is ready to be born. Labor begins, which many expectant mothers recognize by painful contractions. But what is a “confrontation” and what happens at this moment?

” A contraction is an involuntary contraction of the smooth muscles of the uterus of a wave-like nature. They allow the cervix to open - the only “way out” for the child.

To imagine how the muscles of the uterus move, think of a crawling snail: a wave passes along its sole from the tail to the head, and tense muscles push it forward. The same thing happens with the uterus: not all of it tenses at the same time.

The upper part of the uterus is more “muscular”. It is she who compresses the amniotic sac. As you remember from your school physics course, a liquid easily changes shape, but practically does not change volume. So the fertilized egg begins to put all its might on the lower part of the uterus - there are fewer muscle fibers here, so it does not shrink, but, on the contrary, stretches. The main pressure falls on the cervix - the “weak link” of the muscle sac. The amniotic sac literally wedges there: the anterior fluid (amniotic fluid located in front of the baby) presses the amniotic sac into the birth canal and pushes it apart.

” It is believed that in the uterus there is a dominant focus of excitation, most often localized in the right corner of it (“pacemaker”), from here the wave of contractions spreads to the entire musculature and goes in a downward direction.

A woman cannot control contractions, unlike pushing, which involves the muscles of the perineum, the muscles of the abdominal wall, and the diaphragm. That is why, in the last stage of labor, the midwife asks the woman to push or, on the contrary, hold back for a few seconds. Indeed, we can all tense our abdominal muscles, but it is absolutely impossible to strain, for example, the muscles of the stomach through willpower.

When the uterus is tense and stretched, the blood flow to its muscles is blocked (if you clench your fist with all your might, you will see certain areas of the skin turn white), and the nerve endings leading to the uterus are also compressed. This is what determines the sensations that arise: the pain is dull, periodic (“it will grab you, then it will let go”), and most importantly, it is perceived differently by all women (depending on the location of the child, the uterus, and also on where the nerve endings are most compressed ). But the pain during pushing, which is caused by the movement of the child along the birth canal, is perceived by all mothers in the same way: the unpleasant sensations are concentrated in the vagina, rectum, perineum, and the pain is quite acute.

This is why the sensations during contractions raise so many questions - are these really contractions or, for example, osteochondrosis? Let's look at the most typical examples of pain!

Pain “like menstruation”

Unpleasant sensations are localized in the lower abdomen and resemble pain during the onset of menstruation.

Lyalechka: The pain is like menstruation, only worse.

SV1980: The contractions were similar to menstruation at the beginning.

As a rule, women in labor who perceive contractions as “pain during menstruation” also feel the occurrence of - “petrification” of the abdomen.

Pain as during intestinal upset

Abdominal pain during contractions reminds many expectant mothers of the discomfort of an intestinal disorder, cramping attacks that accompany diarrhea.

ANelli: at the beginning it didn’t hurt, it was just a feeling that you really needed to go to the toilet, but when you go to the toilet early in the morning with an interval of 20-30 minutes, but there is no result, you understand that the intestines have nothing to do with it!

Zuleyka: I thought I had been poisoned by something the day before, my stomach was churning...

By the way, immediately before childbirth, intestinal function actually becomes more active, and bowel movements may occur more than once.

Lower back pain

Quite often, the source of pain is the lumbar region: “pulls”, “grabs”.

vedetta: I had such pain - it seized my lower back and the pain rose from bottom to top along my back and stomach. And then she also went down and passed through. To be honest, it doesn’t look much like menstruation...

Tanyusha_I'll be a mother: suddenly my lower back began to hurt every 15 minutes and then decrease a little bit... I didn’t wait right away and went to the maternity hospital.

The phenomenon of back pain has two explanations: the pain can radiate to the lower back, or it can be felt lower, in the tailbone area - most likely it is caused by the divergence of the pelvic bones.

Pain in unexpected places

Sometimes pain can radiate to the most unexpected places, so that a woman in labor complains that, for example, her hips or ribs hurt.

Alma: contractions started - it hurts in my side and radiates to my kidney and leg!

Most often, women identify radiating pain as “kidney pain,” especially if they have experienced it before. Pain in the hips, knees, numbness in the legs can be a result of compression of large blood vessels in the lower abdomen.

Contractions without pain

This also happens, especially at the very beginning of labor. The sensations, however, are quite unpleasant. Expectant mothers usually feel how the uterus becomes toned for a few seconds - the stomach “turns to stone”, then relaxes again. Similar sensations arise if during contractions you do .

Ksyusha_SD: I kept walking and thinking, how will I understand that this has begun? I felt good and there were no changes in my appetite either. I really understood only when the contractions started - the tone of the tummy just began periodically.

Of course, not everyone is so lucky, but it happens that a woman is not very susceptible to pain. So at the beginning of labor, while the pressure on the cervix is ​​low (or, for example, she has a flat membrane in which ), the sensations may be unpleasant, but not painful.

As you can see, descriptions of contractions vary greatly. How to recognize them?

Periodicity. Contractions, no matter how they feel, occur at regular intervals. This is how labor contractions differ from “training” ones - .

Increasing frequency. During childbirth, contractions occur more and more frequently.

Gain. The intensity of pain increases.

Lack of response to your actions. The unpleasant sensations do not disappear if you change your body position, walk, lie down, or take a shower.

Displacement of painful sensations. Gradually, the pain shifts to the perineal area, on which the baby’s head begins to press.

Did everything coincide? It's definitely time for you to go to the maternity hospital!

However, sometimes the safety of mother and baby can only be ensured with the help of medical intervention.

Changes may occur in your body indicating that a crucial moment is approaching. Women feel them several weeks before giving birth - with varying degrees of intensity - or do not feel them at all.

The duration of the difficult process of bringing a baby into the world can vary greatly. For the first birth, it averages 13 hours, for repeated births - about eight. Doctors consider the beginning of labor to be the dilatation of the cervix with regularly recurring contractions.

Over the past 50 years, the average duration of this process has been halved, asin severe cases they are now done in a timely manner C-section. Spontaneous contractions often begin at night when the body relaxes. Many children prefer to look at this world for the first time in the dark. According to statistics, most births occur at night.

What exactly causes labor pains is a question to which the answer is not yet known. What is clear is that the child himself plays an important role in this process. But exactly what mechanisms provide the decisive impetus remains a mystery.

Recent studies suggest that contractions begin under the influence of a protein substance produced by the child, the so-called SP-A protein, which is also responsible for the maturation of the lungs.

Consultation with a gynecologist. Braxton Hicks contractions are usually difficult to distinguish from real labor contractions. During the third trimester, false labor contractions become more intense and frequent if you are active or dehydrated. If you feel them, sit in a cool place, elevate your feet, drink something and rest. If the intervals between contractions increase and their intensity decreases, then they are false. If they become more frequent or severe (especially if they occur every 5 minutes), call your doctor. I always tell patients that no one has ever described their sensations as “spastic” while giving birth to a child. As a rule, the intensity of labor contractions, during which the child passes through the birth canal, is described as follows: “I can’t walk or talk.”

You've seen it in countless movies. Sudden realization: the woman in labor needs to be taken to the hospital URGENTLY! The woman becomes a real fury, spewing curses (“You did this to me!”). Doubled over in terrible pain, she stops moaning only to unleash another round of curses at her poor, panic-stricken husband, who suddenly forgets everything he learned in the Lamaze course, loses his bag prepared for the trip to the maternity hospital, and inevitably sends car straight into a traffic jam, where he ends up having to deliver the baby himself.

The truth is that most couples have plenty of time to realize that labor has actually begun. No one knows exactly what triggers this mechanism, but they are approaching quite quickly. Here are some signs that will tell you it's time to grab your bag and the baby in labor - and get in the car.

Labor begins - signs of labor

Most women give birth to their children earlier or later than the estimated date indicated on the exchange card.

Moreover, most often the deviation in both directions does not exceed ten days. Ultimately, the expected date of birth only plays the role of a guideline. Only 3% to 5% of children are born exactly on this day. If the doctor said that your baby will be born on December 31st, you can be sure: New Year's Eve you won't give birth.

Loose stools

This is due to hormonal changes caused by prostaglandins.

And this makes sense: your body begins to cleanse the intestines to free up more space inside the body for the baby.

Estimated date of birth (EDD)

This is the day on which your baby is statistically likely to be born. Most give birth somewhere between 37 and 42 weeks. Although many women don't give birth exactly on their expected date, you should definitely know it so you can be prepared. The closer it is, the more attention you need to pay to your bodily sensations and possible signals of the onset of labor. When you turn over the calendar and see the month in which the birth is due, you will feel excitement (and mild panic). Soon!

Contractions - first signs of approaching labor

In 70-80% of cases, the onset of labor announces itself with the appearance of real labor pains. They cannot be immediately distinguished from training ones, which you may have noticed for the first time a few weeks ago. At these moments, the stomach hardens and the uterus contracts for 30-45 seconds.

The pain caused by contractions is well tolerated at first: you can even walk a little if you want. As soon as a certain regularity is established in the contractions, you will, without any prompting, put everything aside and listen to what is happening inside you.

As contractions gradually intensify, it is recommended to perform the breathing exercises that you were taught in childbirth preparation courses. Try to breathe as deeply as possible, inhale from your stomach. Your baby also has to do hard work during birth. And oxygen will be very useful to him for this.

Braxton Hicks contractions (preparatory). These contractions of the uterine muscles begin at early stages, although you may not notice them. You will feel tension in the uterus. Such contractions are brief and painless. Sometimes there are several of them, they follow each other, but usually they stop quickly. Closer to labor, Braxton Hicks contractions help prepare the cervix for the process.

Go to the clinic immediately!

Regardless of the onset of contractions, if the baby stops moving, the membranes are ruptured, or there is vaginal bleeding, you should immediately go to the clinic.

Braxton Hicks contractions are a “warm-up” before the real contractions begin. They can start and stop several times and often stop when you are active (for example, while walking). Early labor contractions will be uneven in intensity and frequency: some will be so strong that you will lose your breath, others will simply resemble spasms. The intervals between them will be either 3-5 or 10-15 minutes. If you talked to your doctor for 15 minutes discussing whether labor had started or not, and never stopped, it was most likely a false alarm.

Learn to recognize contractions

During the early stages of labor, contractions lasting about 30 seconds may occur every 20 minutes.

• The first contractions are similar to spasmodic menstrual pain (radiating pain). The muscles of the uterus begin to contract so that the cervix opens to the full 10 cm.
  
• Late contractions feel like severe menstrual pain or reach an intensity you never imagined.
  
• When contractions become very strong and the rhythm of contractions becomes regular, it means it has begun for real!
  

There are no mandatory standards for when you can come to the maternity hospital. But if contractions occur every 5 minutes for an hour and make you freeze in pain, no one will prevent you from appearing in the maternity ward. Make an action plan with your doctor, taking into account the time it takes to travel.

• If you live near a maternity hospital, wait until the contraction rhythm is 1 every 5 minutes for an hour, and then call and tell your doctor that you are going.
  
• If the maternity hospital is 45 minutes away from you, then most likely you should leave when the contractions are less frequent.
  

Discuss this with your doctor in advance so you don't panic during labor. Remember that with the onset of the active stage, the cervix in most women dilates by 1-2 cm per hour. So do the math: 6-8 hours before you start pushing. (But if at your last doctor’s appointment you were told that your dilation was 4 cm, it is better to come to the maternity hospital early.)

Consultation with a gynecologist. I caution expectant parents, especially if this is their first pregnancy, that there may be a few “false alarms.” My wife is an OB/GYN and she made me take her to the hospital 3-4 times while pregnant with each of our three children! If she couldn't tell for sure, who could? I always tell patients: it is better for them to come and be checked (if it is premature, they will simply be sent home) than to give birth on the side of the road.

Timing is everything

How to calculate the time and rhythm of contractions? There are two ways. Just pick one and stick with it and watch things unfold.

Method 1

1. Note the moment when one contraction begins and its duration (for example, from 30 seconds to 1 minute).
   
2. Then note when the next contraction begins. If it is not felt within 9 minutes, then the regularity of contractions is 10 minutes.
   
3. It can become confusing if contractions occur more frequently. Always note the time from the start of one contraction to the start of the next.
   
4. If a contraction lasts a whole minute, and the next one begins 3 minutes after the end of the previous one, then contractions occur once every 4 minutes. When their frequency increases, it is difficult to concentrate on counting. Ask someone close to you to count the contractions for you.
   

Method 2

Almost the same, but here you start counting the time from the end of one contraction to the end of the next.

Opening and effacement of the cervix

Imagine your cervix as a big, plump donut. Before childbirth, it begins to thin and stretch. Expansion (opening) and thinning (flattening) can occur over a period of weeks, a day, or a few hours. There is no standard for the time frame and nature of the process. As the due date approaches, your doctor will make conclusions about the condition of the cervix as follows: “Dilatation 2 cm, shortening 1 cm.”

Abdominal prolapse

This happens when the fetus descends to the entrance to the pelvis and, as it were, “gets stuck” there, i.e. no longer moves inside. During Braxton Hicks contractions, it moves even further into the lower pelvic region. Imagine the child moving into the “start” position. This process begins for all women at different times, for some - only before childbirth. For many, the news of fetal descent is both good and bad news. It becomes easier to breathe and eat now, but the pressure is on bladder and the pelvic ligaments make you run to the toilet more and more often. Some expectant mothers even begin to think that the baby might simply fall out, because it is now so low. During the exam, your doctor will determine how low in the pelvis your baby is, or what his “position” is.

Abdominal prolapse occurs when the child seems to “fall” and descends towards the entrance to the pelvis. Head first, the baby moves into the pelvis, thereby preparing to travel through the birth canal. However, for women who experience abdominal prolapse a few days or weeks before giving birth, this symptom is a “false clue”, and for some it does not happen at all until the start of active labor. Braxton Hicks contractions become stronger, the baby gradually moves lower into the pelvis, the pressure on the cervix increases, and it softens and thins.

Rupture of membranes

In 10-15% of cases, the onset of labor is heralded by premature rupture of the membranes, which occurs before the first contractions appear.

If the baby's head is firmly established in the pelvis, then the loss of amniotic fluid will not be so large-scale.

You will know that the amniotic sac has ruptured by copious discharge of clear, warm fluid from the vagina.

Rupture of the amniotic sac does not cause any pain, since there are no nerve fibers in its membrane. Sometimes the amniotic fluid may be green in color: this means that the baby has already passed his first stool. Record the time of rupture of the membranes and the color of the discharged fluid, and inform the midwife or the maternity ward of the clinic. Here you will receive instructions on your next steps.

It is very rare that the amniotic sac ruptures in its upper part, with amniotic fluid draining out only drop by drop. Then they can easily be mistaken for urine or vaginal discharge, especially if the bladder is slightly weak. If you suspect that amniotic fluid is breaking, call your doctor immediately or go to the maternity hospital. A short inspection will clarify the situation.

As a rule, rupture of the membranes does not lead to dramatic consequences. Usually, contractions occur spontaneously within the next 12-18 hours and labor occurs. naturally. In the absence of contractions, they are artificially stimulated with appropriate medications to reduce the risk of infection for mother and child.

Water breaking

Sometimes the amniotic sac is referred to by the strange, biblical-sounding term “fetal sac.” When it bursts (either naturally or by a doctor), it means that labor will occur within 24-48 hours. As a rule, the doctor decides not to take risks and not wait more than 24 hours after opening the bladder, especially if the baby is born at term, because there is a danger of infection.

If your water breaks

When the amniotic sac bursts, it's like a small flood, and it's impossible to predict exactly when or where it will happen. In the third trimester, the amniotic sac, a soft and comfortable “place of stay” for the baby, already contains about a liter of amniotic fluid. (Pour a liter of water on the floor - this is what it might look like.) But remember:

• For some women, the “leakage” is very small.
• Fluid will continue to leak from the sac even after your water breaks because your body will continue to produce it.
• Some women's water does not break spontaneously, and to stimulate labor, the doctor performs an amniotomy by piercing the sac with a long plastic hook.
• The liquid should be colorless. If it is dark (greenish, brownish, yellowish), this may mean that the baby has defecated directly in the uterus (this type of stool is called meconium). This could be a sign severe stress in the fetus. Call your doctor immediately.

Consultation with a gynecologist. Heavy vaginal discharge in late dates Pregnancies are completely normal. V 10-20% of women at this stage are so significant that they have to wear pads all the time. Blood flow to the vagina and cervix increases in the third trimester, so vaginal secretion also increases. You may not immediately understand whether this is discharge or your water has broken. If you feel “wet,” dry yourself and walk around a little. If fluid continues to leak, call your doctor.

Signal bleeding is a symptom of the onset of labor

Usually, throughout pregnancy, the uterine os remains closed with viscous mucus, which protects the fetal bladder from inflammation. When the cervix shortens and the uterine pharynx opens, the so-called mucus plug comes out. This is also a sign of impending labor. However, labor pains do not necessarily occur on the same day. Sometimes it takes several more days or even weeks before real contractions appear.

Closer to childbirth, mucus may lose its viscosity and come out as a clear liquid. In most cases, this is accompanied by a small, so-called signal, bleeding. It is much weaker than menstrual and completely harmless. However, to be sure, you should talk to your doctor or midwife about this - you should make sure that the bleeding is not caused by other reasons that could threaten you and your baby. Very often, a woman does not notice the separation of the mucus plug at all.

Light spotting or spotting

They may appear due to changes occurring in the cervix as it prepares to open. Contractions soften the cervix and the capillaries begin to bleed. Contractions intensify and spotting occurs. Any pressure on the cervix may cause slight bleeding (due to exercise, sex, straining during bowel movements, or straining the bladder muscles). If you are unsure whether this bleeding is normal, call your doctor.

Removal of the mucus plug

The cervix softens and begins to open, releasing a mucus plug. Sometimes the mucus flows out slowly or the plug may come out in the form of a knotty thick flagellum. Until this moment, mucus acts as a protective barrier in the cervix and is constantly produced by the body, especially a lot closer to childbirth. It's not a sign of impending labor—some women produce mucus for weeks beforehand—but it's definitely a sign that something is starting to change.

Backache

Pain may occur if the baby is positioned facing forward rather than toward your back. If the baby does not turn to his back, they may get worse. Pain may also occur due to the pressure of his head on your spine when contractions begin.

Cozy nest: not only for birds

Pregnant women often have a strong desire to build a cozy nest even before the onset of labor. The surge of “nesting” energy, which contrasts so strongly with the debilitating fatigue of the last trimester, forces expectant mothers to arrange their habitat, turning it into a nice and clean “incubator”. Another sign that you have begun the “nesting” period is the speed with which you try to get everything done, and how demanding you make requests to your family. "Nesting" is usually expressed as:

• painting, cleaning, arranging furniture in the nursery;
  
• throwing away trash;
  
• organizing things of the same type (food in the buffet, books and photographs on the shelves, tools in the garage);
  
• deep cleaning the home or completing “renovation projects”;
  
• purchasing and organizing children's clothing;
  
• baking, preparing food and stuffing it around the refrigerator;
  
• packing a bag for a trip to the hospital.
  

An important caveat: for some pregnant women, “nesting” never occurs, and if such impulses appear, then future mom feels too lethargic to do anything.

Symptoms of labor

False contractions are a nagging pain in the lower abdomen, similar to pain during menstruation. If such contractions are not strong and not regular, there is no need to do anything special: this is only preparing the uterus for childbirth. The uterus seems to be testing its strength before the important work ahead, gathering itself and relaxing its muscles. At the same time, you can feel the tone of the uterus - sometimes it seems to gather in a lump and become harder. The uterus can become toned without pain, since the closer the birth gets, the more sensitive and irritable it becomes. This is fine.

The third important harbinger of labor may be the release of the mucus plug. This is a mucous content that “lives” in the cervix, as if clogging the baby’s “house”. The mucus plug may come off in the form of a thick and sticky discharge of a transparent pinkish color.

A woman may not feel the warning signs of labor, although most often the expectant mother still feels preparatory contractions.

A normal first labor lasts approximately 10-15 hours. Subsequent births usually proceed somewhat faster than the first, but this does not always happen. I am an example of this exception, as my second labor lasted 12 hours longer (20 hours) than my first (8 hours).

If a woman’s amniotic fluid has broken, she must go to the clinic immediately. Amniotic fluid protects the baby, and he should not be left without it for a long time. Therefore, if you feel lukewarm, clear water leaking out, call your doctor and get ready to go to the maternity hospital.

Usually, after your water breaks, contractions begin (or they suddenly intensify if you have been in labor before). If contractions have not started, most likely in the maternity hospital they will try to induce labor (with the cervix ready) so as not to leave the baby unprotected for a long time.

Labor usually begins with contractions. Typically, women often begin to feel pain in the lower abdomen and aches in the lower back about a couple of weeks before giving birth. But how then do you understand what it is: preparatory contractions of Braxton-Hicks or the beginning labor activity?! Such questions and concerns almost always arise among women who are faced, theoretically or practically, with the precursors of childbirth.

It is not at all difficult to distinguish preparatory contractions from the onset of labor! When your stomach starts to swell, be a little more attentive to yourself: is it the same pain as usual, perhaps the painful sensations have lingered a little, or does something else intuitively seem unusual to you?

If you feel that these painful sensations are regular (appear and disappear with little frequency), it makes sense to start timing, counting contractions and writing them down.

Let's say that at about 5 o'clock in the morning you decide that your stomach hurts a little in a special way or for quite a long time. Get yourself a stopwatch (you have it in your phone) and start counting.

At 5 o'clock in the morning pain appeared, a contraction began, it lasted 50 seconds, then there was no pain for 30 minutes.

At 5:30 the stomach begins to pull again, the pain lasts 30 seconds, then nothing bothers you for 10 minutes, etc.

When you see that the pain regularly repeats, intensifies, the duration of contractions increases, and the interval between them decreases - congratulations, you have begun labor.

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

How does it all begin?

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

Labor can begin in different ways. From the breaking of water, from the release of the mucus plug, from the beginning of rhythmic contractions of the uterus - contractions. The latter option is considered the most preferable, since premature rupture of water always complicates childbirth, even if it occurs exactly on time. It is from contractions that the process of childbirth manifests itself in the vast majority of expectant mothers. Only 10% of women begin labor when their waters break.

Contractions are contractions of the muscles of the uterus. Labor contractions occur simultaneously with the opening of the cervix. This muscular tight ring was tightly closed throughout pregnancy, and the cervical canal inside it was closed with a mucus plug. The beginning of the opening of the cervix is ​​accompanied by contractions, which increase and become stronger as they expand.

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

The purpose of contractions during childbirth is obvious - at the first stage they are needed so that the cervix opens and clears the passage for the child, who will pass through the birth canal and be born. They compress the space inside the uterus, leading to rupture of the membranes; in the stage of active contractions, the waters recede and this is considered quite timely. The rhythmic contractions of the uterus slightly “push” the baby to come out. Its time has come, no longer stay in mother's womb not necessary.

How to understand that labor has begun?

The first birth always brings many questions, the main one of which is how to recognize whether labor has begun and whether it is time to go to the maternity hospital. Experienced obstetricians have an old joke on this topic, which says that if a woman has doubts whether she is giving birth, then she will not give birth, since it is impossible to confuse childbirth and training contractions of the uterus. But mostly women who are pregnant for the second or third time agree with obstetricians on this; they know for sure that doctors are not lying.

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

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

Precursor contractions are not regular, they come on their own and disappear in the same way. A woman can easily relieve discomfort by simply taking a shower, drinking a glass of milk or a No-Shpa tablet, or even changing her body position. After a training contraction, a pregnant woman can go to bed and quite successfully doze off.

Is it possible to miss the moment of the onset of real contractions? Obviously not. After all, true contractions are rhythmic from the very beginning, they are repeated at regular intervals, the pain is no longer nagging, but a slight encircling nature, the back and lumbar region are drawn into it, the pain increases with each contraction. You won’t be able to fall asleep, the No-Shpa tablet or a shower will have no effect. Once labor contractions have begun, it is unlikely that they will be stopped or weakened. The duration of the contraction will be the same each time. And this is the main difference between “harbingers” and real fights.

Latent stage - sensations

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

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

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

The sensations are of a wave-like, increasing nature. The contraction usually “originates” in the back, covers the lower back and moves first to the bottom and then to the top of the abdomen. Then the tension subsides, the woman gets the opportunity to rest a little before the next contraction.

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

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

Active phase

After the cervix opens by 3 centimeters, contractions become quite painful and begin to occur more frequently over time. The duration of the contraction is 25-60 seconds, between contractions there are within 3 minutes.

If you breathe correctly, remain calm, massage the sacral area, the second stage of contractions will be easier to survive.

Contractions at this stage look like a prolonged spasm, the peak of the contraction becomes prolonged. Usually at this stage during normal labor your waters break.

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

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

Transition period

This period is the final one. After this, pushing begins - the shortest period of labor. Transitional contractions are also called the deceleration phase. The spasms themselves reach their maximum value during the entire period of labor. Each contraction lasts at least a minute and spasms are repeated every 2-3 minutes.

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

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

But you can’t push yet. The obstetrician will give the appropriate command already in the second phase of labor - in pushing.

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

What will happen next?

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

If you push on command, don’t scream, don’t clench your legs, don’t squeeze your perineum, breathe deeply, holding your breath at the moment of pushing and making a long, smooth exhalation at the end of the pushing, then the baby can be born in the very near future.

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

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

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

Features of the first birth

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

The birth canal of a primigravida woman is narrower and less elastic. They are more difficult to stretch, and therefore even pushing feels different and lasts longer. The cervix also takes longer to open, and nothing can be done about this physiological aspect.

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

Complications depend to a lesser extent on the physiology of the firstborn; to a greater extent, they are a consequence of erroneous actions of the woman in labor, disobedience to the commands of the midwife or doctor leading the birth.

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

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

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

• Teaching proper breathing techniques during contractions and pushing. You need to practice breathing exercises during pregnancy carefully, half-heartedly, but it is recommended to spend at least 10-15 minutes a day on this. Then correct breathing will be natural and when labor begins, the woman will not have to remember how and when to inhale and exhale in order to relieve pain and help herself and the baby. Breathing techniques help to feel the period of contractions less painfully, because due to the saturation of the body with oxygen, there is an increased production of endorphins, which have an analgesic effect.

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

• Legal and domestic assistance. During the courses, the expectant mother will be told about what benefits and payments she can count on after the birth of her baby, and how to apply for maternity leave, and will also tell you what things need to be packed for the maternity hospital, when to do it, what documents will be required to be provided upon admission to the maternity hospital.

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

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 they already know that the real ones 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 back side palms 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.

Pregnant women are most afraid of contractions, especially those who have not given birth before and only know about contractions from the stories of “experienced” women. And what do women in labor usually tell about this phenomenon (or, most likely, what do all pregnant women willingly and undeniably believe in)? Firstly, contractions are the beginning of labor - and this is a correct statement (although not completely, since there are so-called “false contractions”). Secondly, almost all women in labor remember the incredible pain during labor (although in fact few people remember this pain, since it is forgotten and it is impossible to compare it with anything) and most importantly, all pregnant women are in the last trimester of pregnancy ( or even much earlier!”) expect painful contractions. And try to tell them that your contractions were almost painless and that in fact not everything is so scary - they will never believe it. Moreover, already at the beginning of pregnancy they will agree with the doctor about labor pain relief.

Fortunately, there are few such pessimists, and most expectant mothers still expect “tolerable” pain, although they fear the contractions before childbirth. Ignorance is always scary, and, as a rule, contractions certainly do not come of our own free will (unless, of course, we resort to inducing labor). So how do these contractions begin? How not to lose sight of them? And what actually lies in this “terrible word”?

What does it feel like when contractions start?

Contractions are called contractions because they cause a feeling of grasping, sharp compression. When it comes to the upcoming birth, cramping sensations naturally occur in the hip joints.

In fact, contractions are a very complex “biochemical process”, since they involve the baby’s pituitary gland and the placenta itself, which begin to produce special substances, which in turn contribute to the opening of the cervix, which is accompanied by contractions.

During contractions, the uterus contracts, its muscle fibers thicken and shorten, which helps open the cervix to the extent that the baby's head can squeeze through it. Full dilatation is recorded when the cervix is ​​dilated by 12 cm, and the intrauterine pressure also increases, as a result of which the amniotic sac ruptures and the amniotic fluid drains.

How to know if contractions have started

When can a pregnant woman expect contractions? We have all heard about the threat of premature birth, which also begins with contractions, but along with these signs of impending labor, the woman also experiences other symptoms. In any case, cramping pain requires the expectant mother to special attention. Practice shows that the contractions themselves and the sensations during them are different for all women. Even false contractions, which doctors love to talk about, are not noticed by all pregnant women. Moreover, the expectant mother can only find out about real labor pains when she has a desire to push. We have also heard about rapid labor, when contractions can no longer be confused with anything.

Ideally, everything happens something like this: starting from the 20th week of pregnancy, the body begins to “rehearse” the upcoming birth by contracting the muscles of the uterus. The woman feels that something is wrong with the uterus: it turns to stone and relaxes with chaotic frequency. So, a woman can “grab” for a whole minute, then the pain subsides and disappears without a trace, and soon resumes, but the regularity of such contractions cannot be noted. We are talking about false contractions - harbingers of the upcoming birth. But not all women experience this condition, and their labor begins on time with real contractions.

How to recognize them? Again, ideally, the first contractions go unnoticed by the woman, except that very little discomfort is felt in the abdomen or lower back, and a strong premonition that childbirth is about to take place (it’s difficult for women’s intuition to find an explanation, but almost every woman subconsciously knows : it's time!).

Gradually, the second, active, phase of contractions begins, when they occur at a precise interval, which is shortened all the time: cramping attacks are repeated more and more often, last longer, not only the frequency and duration increases, but also the degree of pain. This goes on until one contraction lasts more than two minutes, and the second occurs after 60 seconds. At this time, you should already be in the maternity hospital, because in 30-40 minutes the birth itself will begin. The last stage of contractions is the most painful, as the woman has an overwhelming feeling of going big. But if the uterus is not open, she will have to hold back her efforts so as not to harm herself and the baby.

What to do if contractions start

When the first contractions begin, you should stop any activities and try to rest. Many people find it helpful to walk around the room; others sit down and stand up. As soon as the contractions intensify and begin to repeat more often, immediately go to the maternity hospital. Particularly suspicious people may go to the hospital earlier.

Don't worry about anything: the doctor delivering the baby knows exactly what to do and when. If it’s too early to push, he will certainly notify you about it.

The main thing now is to relax as much as possible. No matter how paradoxical it may sound, try to let go of all worries and fears. Panic will not lead to anything good, and, strictly speaking, there is nothing to be afraid of. The birth you've been waiting for so long begins. There are only a few hours left before meeting the baby. Whether you can help him overcome the difficult path into this world now depends on you. Breathe evenly and deeply, trying to relax and “let go” of the pain. Excessive tension in the muscles will increase pain, and therefore it is important to relax them as much as possible now.

Listen to your body, remember breathing techniques during labor - use them as you go. different periods birth process. Shallow “dog” breathing will help restore strength and not harm the child between attempts. At the doctor’s command, smoothly take a full breath of air so that in the next minute you can push productively.

Think about the baby, you just have to calm down, tune in to a productive birth and listen carefully to the instructions of the medical staff.

Is the pain during contractions terrible?

So we ourselves scared you by describing the “most painful” last stage of labor. I myself was waiting for it and was afraid of it more than the birth itself, but I was never able to understand why women in labor were crying and screaming so much, because it turned out that the pain was tolerable, moreover, even pleasant. You may not believe it, but the pain during contractions was quenched by the thought that this is how one is born little man, my little blood.

It turns out that my feelings were scientifically confirmed. In fact, labor pain is not hidden in the uterus, since its contraction is a natural process, which means that pain receptors (and there are very few of them in the muscles of the uterus) do not give a signal to the brain about any violations (the meaning of any pain is precisely consists in “notifying” the body of “problems”). But the real feeling of pain arises in the muscles that surround the uterus, and in order to overcome it, it is only important to learn to control their relaxation, since muscle tension interferes with the normal physiological course of labor. Moreover, fear, anxiety and worry aggravate muscle tension. Hence the simple conclusion: a pregnant woman who is afraid of childbirth experiences great pain from the first contractions. But many women do not even know what labor pain and pain during contractions are, so learn to properly tune yourself to the inevitable process - childbirth, namely, know how to relax; do not waste your energy, as you will need it during the period of expulsion of the fetus; talk to your baby; don’t try to overcome the pain, but simply take it for granted.

I think that if you consciously prepare for the process of childbirth, then you will not need information about epidurals, nitrous oxide with oxygen, promedol and other ways to relieve pain from contractions and childbirth.

If contractions don't come

As always, there is a flip side to the coin: the woman waits for contractions, waits, but they never come, even after the pregnancy has expired. We have to stimulate them. Contractions will be artificially induced if they do not appear at 41-42 weeks of pregnancy, and the fetus is found to have any abnormalities that threaten its life. The most common methods of inducing labor are: injection of Cerviprost (a hormonal drug that softens the cervix) into the cervical canal; intravenous administration of a hormonal drug (also promotes uterine contraction); opening of the amniotic sac (after which contractions begin).

Do not rush to “try on” the worst of yourself. Believe that everything will happen naturally for you, without pain, without complications, and most importantly, without fear. A woman ready for childbirth will immediately understand: here they are, contractions! Just a little more - and the most desired treasure will appear!

Especially for Tanya Kivezhdiy