The expectant mother has been waiting for nine months to meet her baby. What will it be like? Who does he look like? Will he be calm or moody?

Many questions begin to swirl in a pregnant woman's head as she approaches 38 weeks.

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

Norms and numbers for pregnant women

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

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

But why exactly 38 weeks?

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

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

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

The first swallows are the harbingers of childbirth

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

Confidence in an early delivery can be given by the personal feelings of the expectant mother.

They are called harbingers of childbirth. This:

• Dropping of the abdomen;
• Expansion of the pelvic bones;
• Braxton Hicks contractions (more on that below);
• Removal of the mucus plug;
• Discharge of amniotic fluid;
• Lower back pain;
• Change in appetite.

Precursors may not necessarily all appear, and some of them may well occur even 2 weeks before the onset of labor.

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

What are contractions?

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

A woman feels something similar during her period.

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

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

At first, pauses between contractions range from 15-20 minutes. Then they become shorter and shorter (3-5 minutes), and contractions become more intense. During contractions, the cervix dilates. Obstetricians monitor the correctness and stability of the process of its opening.

How do you know when contractions are starting?

Typical story: a woman arrives at the maternity hospital, screams that she is having contractions, and after some time calmly goes home. It underlies more than one comedy about childbirth and the life of pregnant women.

What makes an expectant mother rush to the maternity hospital with insistent demands for an immediate birth?

These are false contractions or Braxton Hicks contractions.

To avoid unnecessary worries, not to frighten relatives and not to rouse doctors for no reason, you need to be able to distinguish false contractions from real ones:

1. False contractions are not periodic.
2. False contractions do not intensify over time.
3. The pain from false contractions goes away when you change body position, take a bath, etc.
4. With false contractions, the cervix does not dilate. Even if it is slightly dilated, false contractions do not provoke its further expansion.
5. To understand that real contractions are beginning, you need to time the intervals between them. At first they can be 15-20 minutes, then reduced to 5 minutes, later to 3 (at this time the woman should already be in the maternity hospital).

   Also, real contractions may be accompanied by bloody discharge - this is the mucus plug coming off.

Pain during contractions

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

Pain during contractions increases gradually.

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

However, no matter how strong the pain is, nature organizes everything in such a way that a woman can easily rest in the short time when the contraction subsides.

If you look objectively at the nature of pain during contractions, it becomes noticeable that only 30% of painful sensations have a real basis.

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

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

So one of the most important things before giving birth is correct emotional state.

Help during contractions

Every woman dreams of painless childbirth. How nice it would be if a good doctor gave an injection at the beginning of labor, and the child was born without pain and suffering!

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

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

• Breathing techniques.
• Special positions practiced during active labor.
• Massage.

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

Pregnant women can become familiar with these techniques in classes at maternity schools, which are often held at antenatal clinics, or in specialized centers for effective parenting.

When to go to the maternity hospital

So, it’s time to answer one of the main questions: when is it time to go to the maternity hospital.

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

Firstly, scary stories from roommates are not good for a pregnant woman about to give birth.

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

Third, it is quite possible that doctors will begin to stimulate labor with the help of medications.

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

1. When regular contractions occur.

   From this moment on, a pregnant woman can already be called a woman in labor. As soon as the intervals between contractions have reached 10-15 minutes, you can get ready for the maternity hospital.
   

We talked about contractions in detail above.


When bleeding occurs.

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

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


2. When amniotic fluid breaks.

   In this case, you should not wait until contractions begin, as any delay can be dangerous for the child’s life.

   The discharge of amniotic fluid should occur when the cervix is ​​dilated by 4-5 cm. However, in 15% of pregnancies it occurs even before contractions begin.

You should remember the time when your water broke and immediately go to the maternity hospital. A long period without water is dangerous for the baby due to the development of infections.

In fact, it is very difficult to be “late” for the maternity hospital - rather, this is the lot of third-rate Hollywood comedies. Your body itself will give a clear signal to your mind!

Mommies, remember that childbirth is a normal physiological process. With proper theoretical, physical and emotional preparation, childbirth will take place without problems.

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

The appearance of the first child in a family is an unforgettable event for all its members, especially for the mother of the baby, who has experienced all sorts of worries, pain and inconvenience. Over time, labor and other pain is replaced by tender feelings for the baby, and at some point, first a timid, and then, perhaps, persistent thought about a second child arises.

Every mother knows that the most exciting and most important moment of the entire pregnancy period is childbirth. Perhaps, calling this period a “moment” would not be entirely correct, because it has its own duration, individual for each woman. But the beginning of this process cannot be missed. Especially if this is the second birth. How do you find out when and how the second birth begins?

At the final stage of pregnancy, it is quite understandable for a pregnant woman to want to predict how this will happen a second time. It is always useful to analyze previous births. If they were accompanied by any surprises or complications, then your conclusions will help avoid their repetition. And if everything went well, then you should do the same. The participation of a doctor in developing a “strategy” is quite appropriate - together we can create a more reliable plan of action.

How will it be and what to expect?

The course of the second pregnancy and the second birth have their own characteristics, because the mother’s body has already experienced the very peak of the moment, so it is familiar with all the changes throughout the entire process.

Note! New births will be different from the first.

In a pregnant woman's body, preparation for childbirth is under the control of female sex hormones. As we know, the main hormone of the entire 9-month period is progesterone. It creates normal tone of the uterus, promotes the production of cervical mucus, ensures the successful development and growth of the baby, the necessary content of oxygen and nutrients in the blood, as well as the delivery of this valuable material to the baby, depends on it. But about two weeks before giving birth, a change in the woman’s hormonal background is observed: progesterone gives up its leadership to another hormone - estrogen, which must fulfill a completely different mission. It's time to prepare the way for the baby to come into the world. And the hormone copes with this successfully and in a very timely manner:

1. The very beginning of labor is labor pains, which make themselves felt as a result of nerve impulses. A nerve impulse occurs when the concentration of the hormone estrogen reaches the desired concentration.
2. In the first stage of labor, estrogen ensures the elasticity and patency of the birth canal. After all, it depends on them how actively the cervix will open in the first stage of labor.
3. In the second stage of labor, the duration of the pushing period largely depends on the elasticity of the vaginal walls and their ability to stretch.

Childbirth is a reflexive, complex, dependent and regulated process by the nervous system and hormonal levels. A contraction, which is a contraction of the uterus, is nothing more than a reaction of the uterus to irritation of the nerve endings in its walls. At this moment, the nerve segments release active substances that promote the next, new contraction of the uterus. And this circular chain continues until the end of childbirth, until your intrauterine treasure “comes out” and announces this with its exclamation.

Predecessors of childbirth

In order to know in advance how the second birth begins, it is important to familiarize yourself with the main “signals” of its approach. These signals are recognized starting from the 32nd week and become unbearable immediately before delivery itself. Let's look at them.

My stomach dropped. The belly usually drops starting at 36 weeks. But we are giving birth for the second time! In this case, the child is in no hurry to descend, and sometimes does this immediately before birth, finally allowing the mother to breathe a little more freely - the diaphragm no longer experiences the same pressure from the child’s body as before. For the same reason, it also becomes easier for the stomach - heartburn makes itself felt less often. At the bottom of the uterus, the baby reduces his vigorous activity - he feels cramped, his head is fixed, he can only move his arms and legs. But with a breech presentation, there is no prolapse of the abdomen.

The pelvic bones move apart. Aching pain in the lower back clearly demonstrates this. There is a stretching of the sacroiliac joint, which occurs because the heavier baby sinks lower and lower. Lower back pain can be reduced by swimming and special exercises.

Swelling and cramps appeared. The reason is the same - the baby has dropped down the abdomen. Its head presses on the blood vessels of the pelvis, and the vessels respond with cramps and swelling of the legs.

"False" contractions. Starting from the 30th week, the pregnant woman’s body may experience Braxton-Higgs contractions, which are also called “false” contractions. Their clear manifestation usually occurs 2-3 weeks before birth. Multiparous women are more likely to experience Braxton-Higgs contractions, whereas during their first birth they may have gone completely unnoticed. Therefore, it is hardly possible to call them a sure sign of the onset of second labor.

The sensations of B-X contractions are very similar to ordinary (true) contractions, with the only difference being that the frequency of real contractions is constant: every 20 minutes, evenly intensifying and lengthening in duration. Braxton-Higgs contractions occur with constant dynamics (without intensification or lengthening in time) and are repeated after different periods of time: sometimes 10 minutes, sometimes 30, sometimes 15, sometimes 20 minutes. They usually last for 2-3 hours, and can also recur every day (in this case, consult a doctor). But the main difference between Braxton-Higgs contractions is that their activity does not lead to dilatation of the cervix.

Note! It also happens that B-X contractions gradually transform into real contractions with their inherent regularity and characteristic dynamics, smoothly transitioning into normal labor.

“False” contractions suggest “training” of the muscle tissue of the uterus. Why shouldn't she try her hand at responsible work in the last week before giving birth?

The mucus plug has come away. The phenomenon is very insidious and individual: it can happen either immediately before birth or 2 weeks before it, but more often - 4-5 days before birth and last a couple of days. It is a detachment of mucus (can be in the form of a clot with different shades - from red to whitish) and often indicates that labor can begin at any time.

The amniotic fluid has leaked. This suggests that the onset of labor may occur in the next 24 hours. The bubble usually contains 800 ml of clear water with white inclusions, but in some cases their volume can reach 2-3 liters. A greenish tint of the water indicates the presence of hypoxia (oxygen deficiency) of the fetus.

According to what was intended by nature (and maybe by the Almighty, because the birth of a person is a mystery beyond the control of man), the amniotic sac with amniotic fluid is opened starting from the middle of the 1st stage of labor. The cervix was already half dilated, and the amniotic sac helped her with this. But if the bladder is opened, which can happen on its own, then amniotic fluid spontaneously flows out of the vagina. This may not be preceded by any sensations (contractions, straining, the urge to urinate).

Note! For a baby left in a fluid-free space during the rupture of amniotic fluid, a sudden change in environment is stressful. In addition, the membranes have always protected the fetus and uterus from infection, therefore, with the release of amniotic fluid, the risk of infection increases.

Therefore, the loss of water or its partial leakage should be a signal for urgent contact with doctors. The results of the test for leakage of amniotic fluid will be given after just 15 minutes. But the main thing is that you will be under the supervision of doctors!

Well, and the most important thing. Regular contractions. Of course, contractions are a classic of labor. Second-bearing women do not need to explain what real contractions are, thanks to which the following occurs:

• in the first stage of labor: dilation of the cervix to allow the baby to emerge from it;
• in the second stage of labor: the movement of the baby along the birth canal and its actual birth;
• in the third stage of labor: the birth of the placenta - the placenta separates from the wall of the uterus, which is born along with the remains of the umbilical cord and amniotic sac.

The duration of true contractions at the beginning of labor is 10-15 seconds, at the end - about 1 minute, pain intensifies as labor progresses. The interval between true contractions is gradually reduced - from 15 minutes or more to 2-3 minutes.

So, repeated births occur faster than the first. But it is worth knowing that only if the second child is born no later than 5 years later, and also if the cervix has not undergone radical surgery between births. After all, any interference can prevent her from behaving as expected.

Contractions will not be so scary for a woman in labor if you learn more about them. It is a woman’s fear and uncertainty that sometimes makes labor so painful and difficult.

In this article we will tell you what stages you will go through during childbirth, how long contractions will last, and how uterine contractions feel at different stages.

What it is?

Contractions of the uterine muscles, which occur periodically and constantly dynamically increase, are called “contractions” due to the nature of the pain. She “grabs” the back, lower back and stomach of the woman in labor, and then smoothly “releases”. Normal childbirth always begins with the appearance of such sensations. Of course, there may be several options. For some, the water breaks initially, for some, the amniotic fluid leaks and contractions occur simultaneously. But these options are considered complications and have nothing to do with the norm. The mechanism of contractions is very complex. So, they can begin only if a number of important conditions are met:

• the pregnant woman’s body produces enough relaxin and oxytocin, and the level of progesterone, which helped maintain pregnancy, has decreased;
• a sufficient amount of protein has accumulated in the cells of the uterine tissue - actomyosin, which provides contractility at the cellular level;
• the cervix is ​​quite “mature”, softened and elastic.

Contractions begin in one part of the muscle tissue of the uterus and gradually spread to neighboring areas until the entire body of the uterus, as well as the cervix, is involved in the contraction.

This tight and round muscle is very strong, and therefore its opening takes a long time. The fibers of the cervix become shorter and shorter with each contraction, and the cervix itself opens up. When dilatation is complete, the baby's exit from the mother's womb will be possible.

Periods and stages

A woman cannot control contractions. They begin and develop independently of her will.

The first uterine contractions are called latent (hidden). They can be distinguished from false ones by the frequency of repetition. The false contractions that were present during the “precursor” period were repeated infrequently and, by and large, were not very painful. And if they caused inconvenience, it was more psychological.

Real contractions occur at regular intervals from the very beginning. The first contractions can be quite short and infrequent. One contraction usually repeats every 30-40 minutes and lasts no more than 20 seconds. If this happens, there can be no doubt - labor has begun.

But you shouldn’t panic and run around the apartment looking for a phone to call an ambulance at this stage either. The latent period of contractions is the longest; a woman has at least 4-6 hours to calmly get ready and no less calmly go to the maternity hospital, not forgetting documents and things important for hospitalization.

A woman needs to come to the maternity hospital when contractions repeat once every 10 minutes, and during the second or third birth a little earlier, since each stage of labor proceeds faster in a repeat pregnancy.

Continuation - the active phase of contractions. It usually already goes under the supervision of doctors. It is believed that it begins after the cervix dilates three centimeters. Contractions intensify, each lasting at least 40-50 seconds, they are repeated every 4-5 minutes. After this period, the stage of the most severe contractions begins.

Uterine contractions in the transition period before pushing are repeated every 1-2 minutes and last a maximum of 60-70 seconds. The cervix is ​​completely open, dilation is 10-12 centimeters.

Then attempts begin, during which the baby is “pushed” into the birth canal and passes through it. A woman can already partially influence this process by making certain efforts to end childbirth more quickly. You need to push only at the command of your obstetrician. Childbirth will end not with the birth of a child, but with the birth of a placenta. Typically, the subsequent stage of labor occurs with less pain.

Duration

The main question is how long contractions last. It is quite difficult to answer this question unequivocally, because much depends on the individual characteristics of the female body, on the number of births, on possible complications, which are quite difficult to predict. On average (these are very average values), contractions last as long as:

A woman cannot regulate the duration. Medical workers cannot influence the duration of uterine contractions over time.

In some cases, it is necessary to stimulate and speed up contractions if they are too sluggish and the dilatation of the cervix is ​​slow. In this case, bladder catheterization or amniotomy (mechanical opening of the fetal sac) is performed. After the bladder is punctured, sometimes the contractions “diverge”, and the subsequent period is somewhat shortened.

Contractions will continue until the fetus is delivered. After this, uterine contractions are activated only at the moment of expulsion of the placenta. This stage takes on average from 20 to 40 minutes; in primiparous women, the placenta usually separates faster than during repeated births.

Feel

A woman can feel the change of stages, focusing not only on the time frame. The initial contractions at first resemble pain during menstruation, and then they have a clear encircling character. According to women, the pain begins somewhere in the middle of the back, quickly moves to the lower back and sacrum, to the very bottom of the abdomen and rises up the abdominal wall.

After some time, the pain subsides. In the active phase of labor, uterine contractions are more painful, frequent, and intense. The transition from contractions to pushing is characterized by sudden sensations of sharp pressure below, the woman in labor has a desire to push and empty her bowels.

How to make it easier?

The knowledge and skills that a pregnant woman can acquire in courses for expectant mothers held in every antenatal clinic will help relieve pain.

Thus, proper breathing of a woman in labor will not only provide the newborn child with sufficient oxygen levels throughout the entire process, but will also naturally reduce pain. When the body, especially the brain, is saturated with oxygen, the female body produces more endorphins. These hormones not only give a feeling of happiness and mild euphoria, but also have a pronounced analgesic effect.

At the early stage of contractions, you need to practice deep and calm slow breaths and the same exhalations. In this case, the duration of exhalation should be approximately twice as long as the duration of inhalation.

When contractions become frequent and painful, a woman should alternate between calm breathing between contractions and rapid and intense breathing at the peak of pain.

When pushing, you use a deep breath and hold your breath at the moment of pushing, while you don’t need to puff out your cheeks and strain your head to prevent hemorrhages; you push “from the bottom,” and the air-filled chest “pushes” the baby out, facilitating his expulsion from the womb.

Most women await the birth of their first child with fear, apprehension and self-doubt. And when they are expecting a second child, the feeling of waiting is already different. Mothers know what will happen and how it will happen, and are mentally prepared for the difficulties ahead. But at the birth of a second baby, everything does not always happen the same as the first time. So, we will learn about the threshold of the second birth, the characteristics of contractions.

About the harbingers of repeated births

The main difference between them may be that everything happens faster. Precursors of a second birth may be more pronounced. After all, prenatal processes are already familiar to the female body. And if a woman forgets her previous experience a little, then the reproductive system will quickly remind her of this.

The main harbingers of an early birth are prolapse of the abdomen, passage of the mucous plug, training contractions, digestive disorders, an unprecedented surge of strength, and rupture of amniotic fluid.

The removal of the plug before the second birth does not always occur in advance. And while a first-time mother may not notice this or confuse it with vaginal discharge, an experienced woman in labor will immediately identify the mucus plug. Its departure is not evidence that active labor will begin on the same day. It starts after the amniotic fluid is released.

Contractions during the second pregnancy may be more intense and fleeting. Training or false contractions can now be confused with labor contractions, because they are also stronger. The signs of real contractions during a second pregnancy are no different from the first. They are characterized by regularity, increasing strength, and a reduction in the interval between them.

Future babies always give signals to their mother before they are born. But if an inexperienced woman may not hear or recognize them, then a woman with experience will understand that the child is ready to be born. So, a few days before birth, the baby calms down, as if he were in a state of suspended animation. But on the eve of childbirth, he becomes overly active. So the baby declares that it is time for him to be born.

As for stool disorders, firstborns often think that they were poisoned by eating something stale. Pregnant women with their second, third and subsequent children know that in this way the intestines are cleansed in preparation for the birth of the baby.

Sudden breaking of waters during the second birth occurs more often than during the first, when the integrity of the amniotic sac is violated by the doctor or it ruptures during contractions. With repeated pregnancy, rupture often occurs in the absence of other warning signs. And this is a sure sign that contractions will begin within an hour.

Features of the onset of contractions in multiparous women

Many mothers remember how, during their first birth, doctors and midwives fussed around them, trying to speed up the delivery. But during the second birth, the maternity hospital staff can act exactly the opposite, trying to delay the rapid labor process.

Obstetric statistics state that second births occur twice as fast as the first, which last on average 10 hours. This is why contractions during the second birth are more intense, and the interval between them shortens faster. Such a contraction is dangerous for the baby and his mother. It threatens her with rupture of the birth canal. And the baby can fall with the wide part of its head into the mother’s pelvis due to overstretching of the lower part of the uterus. Therefore, when noticing the first signs of labor during a second pregnancy, a woman should not massage her lower back or finish housework. You need to lie on your side, put a pillow between your legs, take the phone and immediately call an ambulance or tell your husband that she urgently needs to be taken to the maternity hospital.

The rapid onset and course of repeated labor is normal. But the second birth and contractions will not always be stronger. If about ten years passed between a woman’s first and second births, then her body could simply “forget” about how to behave and prepare for the birth of a baby. The uterus “does not remember” how to act, the cervix opens slowly. So, with a large gap between births, the second may be even more protracted than the first. Therefore, gynecologists advise having a second baby 5-6 years after the first.