When can contractions begin in the first birth? How to distinguish false contractions from true (birth) contractions during pregnancy

Pregnancy is coming to an end, and childbirth, no matter how scary it sounds for the expectant mother, is inevitable. However, the main frightening factor for women is not the birth itself, but the contractions during childbirth. The stories of grandmothers, mothers and girlfriends, about how difficult it was to cope with pain during labor, only exacerbate the situation.

In such cases, there is only one advice: to listen to others less, because each organism is individual, therefore any processes in it proceed differently. Some easily cope with the pain, others faint with a light injection. Therefore, in order to cope with fears, one should study the birth process and learn how to breathe correctly during childbirth.

Childbirth and their periods

Childbirth is a complex physiological process that completes pregnancy. Depending on the period of gestation the birth took place, preterm labor (up to 36 weeks), urgent labor that occurred on time (38-41 weeks), and delayed labor (42 weeks) are distinguished. The process of childbirth itself is divided into three periods:

the period of contractions or the period of the opening of the pharynx of the uterus;

the period of expulsion - the withdrawal of the fetus (birth of a child);

the subsequent period - the removal of the birthplace.

The longest is the period of cervical dilatation. At this time, contractions and accompanying pain are present. Most women consider the period of expulsion of the fetus to be childbirth, but normally this process lasts 5-10 minutes and is distinguished by attempts that follow from contractions. Thus, the fetus is pushed out of the uterus. The birth of the placenta is also a short-lived stage and takes about 5-15 minutes, with a maximum of 30 minutes. From the above it follows that childbirth is not only the process of expulsion of the fetus, but also the period of contractions with the discharge of amniotic fluid and the birth of a child's place (placenta).

Contractions

Contractions are involuntary uterine contractions, which are carried out thanks to the muscular layer of the organ. They occur regularly and are required to move the fetus out of the uterus. Contractions are classified as true and false.

A pregnant woman begins to experience contractions before childbirth (false contractions) a few weeks before the very process of giving birth. For the first time, such uterine contractions are recorded after 24 weeks. They differ in their short duration (from a few seconds to a minute), irregularity, the interval between shocks is from 10-15 minutes to 2 hours. False contractions that occur at the final stage of gestation indicate the imminent approach of childbirth. Such contractions of the uterus are also called training, because thanks to them, the woman's body is prepared for the upcoming work of the uterus during childbirth.

True contractions are the starting point of the birth act. It is impossible to let them go or not notice, such an opinion and fear is inherent in women who give birth for the first time. Firstly, the onset of labor is evidenced by the precursors of the process, of particular importance is the discharge of the mucous plug (usually 3-7 days before the onset of labor). Secondly, amniotic fluid may drain. Thirdly, contractions have characteristic parameters, knowing about which, it is difficult to doubt the beginning of labor, even if they are the first for a woman.

Contractions are required in order for the opening of the uterine pharynx to occur, since the baby's head will first pass through it, and then the torso with limbs. The uterine pharynx is the internal and external os of the cervical canal. During the normal course of labor, the uterine pharynx is in a closed state and can pass the maximum of the fingertip. During childbirth, to facilitate the passage of the baby, it opens up to 10-12 centimeters. This disclosure is called complete.

In addition, in the process of the birth act, contractions ensure the movement of the fetus along the planes in the small pelvis. When the cervix is \u200b\u200bfully dilated, and the head of the fetus passes the bony ring of the pelvis and reaches the pelvic floor (vagina), attempts occur, which indicate the beginning of the next stage of the labor process. Contractions and attempts are fruit-driving forces, without which the process of childbirth is impossible.

How to recognize contractions

As mentioned earlier, contractions cannot be missed, even if the woman is giving birth for the first time. However, one should not trust films, where such situations are quite common: a woman is in the last stages of pregnancy and suddenly, without the slightest prerequisites, labor activity occurs, which ends after a couple of hours, and she is already a happy mother. Yes, such situations cannot be completely ruled out, but they refer to rapid childbirth, lasting no more than 4 hours in primiparous women. If the birth is the second - two or less hours pass from the moment the uterine contractions begin until the baby is born.

True contractions begin (with a normal course) gradually and gradually increase, and the interval between contractions decreases. In order to understand that contractions have begun, you need to listen to yourself. Feelings can be very diverse. Some people compare the contractions of the uterus with pain during menstruation, for others it is a stretching or pulling pain in the abdomen that spreads to the lumbar region, which eventually becomes shingles. True labor is the beginning of labor. In order to recognize labor pains, you need to know their characteristics:

pain sensations increase systematically (gradually);

contractions are always regular, with breaks at regular intervals;

the duration of contractions of the uterus gradually increases, while the interval between contractions is reduced.

Another sensation that most expectant mothers describe during labor is the "uterine petrification" (especially if the pain does not bother much). This condition is easily identified by palpation. With the onset of labor, the uterus contracts and hardens, and by the end of the labor process, it gradually relaxes.

Duration of contractions

At the initial stage of labor, each contraction of the uterus lasts 10-15 seconds, while moving to the second stage of labor, the duration of the contractions is 60-90 seconds. The breaks between contractions are initially 10-15 minutes, as the process progresses, the intervals are reduced. In the tugging period, the break is 90-120 seconds, and in some cases even 60 seconds.

Phases of the period of contractions

Given that the cervical dilatation is uneven and the fetus moves along the bone ring at different speeds, the period of contractions is usually divided into three separate phases:

The first, or latent phase.

The beginning of the phase coincides in time with the establishment of regular uterine contractions, and the end of the phase is reflected in the smoothing of the neck and its opening to a diameter of 3-4 centimeters. The duration of uterine contractions in this phase is 20-45 seconds, and the intervals between contractions last about 15 minutes, the duration of the phase itself is about 6 hours. This phase is usually called latent (latent), since at this stage the pain is either mild or absent at all, respectively, drug pain relief is not required.

Second, or active phase.

Immediately after the opening of the cervix up to 4 centimeters, the active phase takes effect. This phase is characterized by rapid dilatation of the cervix and intense labor. It lasts about 3-4 hours, while the duration of the contractions increases to 60 seconds, and the intervals are shortened, to 2-4 minutes. If the cervix has expanded to a diameter of 8 centimeters, and the fetal bladder remains intact, then a timely amniotomy (opening the fetal bladder) should be performed.

Third phase (deceleration phase).

It takes effect upon reaching the opening of the uterine pharynx up to 8 centimeters in diameter, and ends with its maximum opening. If contractions are present during the first birth, the duration of the third phase is from 40 minutes to 2 hours. If the woman is in the second childbirth, then the deceleration phase may be absent altogether. Uterine contractions last 60-90 seconds, and the interval between repetitions is 1 minute.

Based on the information above, it is easy to calculate the total duration of contractions, as well as labor in general. Thus, the duration of the first stage of labor for primiparous women generally ranges from 10 to 12 hours. If childbirth is repeated, then the distance of the first period is reduced to 6-8 hours. If the duration of the first stage of labor is exceeded relative to the specified time, one should talk about prolonged labor.

When to go to the hospital

Many are interested in the question: "When, after the start of labor, to go to the hospital?" Quite often, especially if the first birth is planned, women arrive at the hospital too early (which causes the mother to be overly nervous), or, conversely, are late. In order to avoid such situations, you should determine when to call an ambulance.

It is quite easy to understand that the contractions have begun, especially during the first birth. Contractions of the uterus become regular, and the interval between contractions reaches 10 minutes, gradually it begins to decrease, first to 7 minutes, then to 5 and further. When the woman herself determines that the period between contractions is within 5-7 minutes, you should call an ambulance. With repeated births, the regularity of contractions is established almost immediately, and the intervals between contractions are rapidly reduced. Accordingly, a doctor should be called immediately in order to exclude a rush to admission to the hospital, when, when the cervix is \u200b\u200bfully dilated, just having arrived, you already need to be on the delivery table. In such cases, the likelihood of road birth also increases (this problem is especially relevant for large cities with difficult traffic ("traffic jams")).

In addition, you need to immediately contact an ambulance in such cases:

discharge of amniotic fluid (very often this happens in a dream, and a woman, waking up, thinks that she has wet herself);

suspicion of an outpouring of amniotic fluid (light liquid begins to leak, or odorless, light enough liquid discharge appears);

bloody discharge with clots, scarlet or dark in color appeared (probably placental abruption).

The onset of labor with regular contractions makes not only the woman, but also her family members to be nervous and fidgety. Thus, the bag necessary for admission to the hospital must be collected in advance, according to the existing list, so as not to miss something important in a hurry. Before the arrival of the ambulance team, relatives should support the expectant mother psychologically and set her up for a positive outcome of the event (quite often, upon the arrival of the ambulance, the doctor does not know who to help first, a woman in labor or her semi-faint relatives).

Relief of labor pain

This is not to say that the pain during childbirth is so unbearable that it would be easier to die than to survive. We repeat once again, to believe the stories of loved ones about how unbearable and painful it was for them during childbirth, that almost every second of them gave birth to one or more children. So it wasn't that hard. Every woman in her life must go through this natural process, because this is the only way to become a happy mother.

Undoubtedly, soreness, and sometimes intense pain will accompany the process of contractions and expulsion of the fetus. Yes, it is possible to stop painful sensations with the help of medications, but is it necessary for the unborn child. In addition, there are a number of techniques and recommendations, with the help of which pain during contractions will significantly decrease or disappear altogether.

How to relieve labor pain?

Psychoprophylactic training.

This preparation begins in the second half of pregnancy. In the classroom at the antenatal clinic (the so-called "school of mothers"), midwives and a doctor explain in detail the entire process of childbirth and answer questions of interest to expectant mothers. The algorithm of behavior at each stage of labor is explained, the technique of correct breathing to ease contractions and relieve pain. The main fears of women come from ignorance of the process itself and the lack of information about how to behave correctly in a given situation. Competent psycho-preventive training not only eliminates gaps in the understanding of childbirth, but also sets up a pregnant woman for a positive outcome and meeting her unborn child.

Abstracting from fears.

You do not need to constantly scroll through the upcoming labor process in your head and worry about possible pain, or think about how to survive possible complications. If this is not stopped, a vicious circle is formed in which the more a woman experiences and fears, the more likely complications will arise, against the background of nervous tension. Childbirth should be expected not with fear, but with joyful feelings, after such a long bearing of the baby under your heart, it becomes possible to see him and press him to the breast.

Warm water.

If contractions have appeared at home and time permits, then doctors recommend taking a warm, but in no case hot bath (only on condition that the amniotic fluid has not departed). A warm water bath maximizes relaxation and relieves tension in the uterine muscles, resulting in smoother contractions and faster cervical dilatation. If the waters are gone, you can take a warm shower. In the maternity hospital, the newly arrived mother is also sent to the shower, where you can relax under streams of warm water.

Maximum relaxation.

If contractions occur at home, the long breaks between contractions should be carried out in a state of maximum comfort and relaxation. You can turn on your favorite music, drink tea in peace (only if you do not have a caesarean section), watch your favorite show. The first stage of labor is very long (especially in primiparous women), so it should be used in order to gain energy and strength for the upcoming active labor.

Active behavior.

Active behavior during the period of uterine contractions is the adoption of comfortable postures and walking during contractions. More recently, in obstetric practice, there were recommendations according to which a woman in the first period should be exclusively in a horizontal position, but today it has been proven that an upright position only accelerates the favorable dilation of the cervix and greatly facilitates the process of contractions. You can also make circular movements with your hips or swing your pelvis, dance.

Massage.

The first stage of labor is most suitable for massage. You can perform self-massage, but it is better to involve your husband in this process. Light circular movements (clockwise) can stroke the abdomen. It is also allowed to massage the sacrum and lower back, pressure with fists on the sides of the spine and thumbs in the area of \u200b\u200bthe anterior upper spines of the pelvic girdle (they are easily identified, since the bones protrude here most of all).

Correct posture.

At the moments of the fight, the expectant mother should take the most comfortable position for herself. You can lean forward and lean against the headboard or wall, while spreading your legs shoulder-width apart. You can squat down or get on all fours, and in some cases, raising one leg helps, as an option, you can put it on a chair and lean against the wall. Many maternity hospitals are equipped with special huge balls, on which it is convenient to lie or jump during the uterine contraction. The main thing when taking a comfortable position is not to forget about the correct breathing technique.

We breathe correctly.

As mentioned above, proper breathing not only helps to reduce pain during labor, but also saturates the fetus with oxygen as much as possible. It is not advisable to scream during contractions, because, firstly, during the cry, breathing is held, respectively, the fetus does not receive oxygen. Secondly, screaming requires a lot of energy, which will come in handy during pushing. Thirdly, the child is simply frightened, because if the mother screams, then something is wrong.

We are distracted.

A variety of distractions can help you forget about or relieve pain. You can sing songs or recite poetry, perform arithmetic calculations aloud, or repeat the multiplication table.

Confidence in the doctor.

An important point for influencing the intensity of painful sensations is the trust in the attending physician. If the doctor for any reason makes the mother worried, you should ask the obstetrician to replace the doctor. However, the best option is to arrange in advance with the doctor whom the woman in labor wants to see in the role of the delivery person.

Correct breathing

Correct breathing during labor and childbirth not only eases painful sensations, but also relaxes the body as much as possible, saturates the fetus and the expectant mother with oxygen, and promotes the rapid opening of the uterine pharynx. To our great regret, a significant number of expectant mothers are skeptical about learning the technique of correct breathing, not believing in the “miraculous” possibilities, such a simple thing as breathing, and, as practice shows, then complain about their skepticism in this matter. Correct breathing techniques are taught in "mothers' schools" (usually with antenatal clinics) for a period of 30-32 weeks. It is necessary to master this technique in order for the execution of movements to become automatic and in the future to facilitate the course of childbirth.

Breathing technique

Correct breathing primarily depends on the phase and strength of the contraction. It is very important to follow the rule: the more intense and longer the contractions, the more often you need to breathe. Correct breathing techniques:

We breathe slowly and deeply.

This breathing technique is recommended for use in the latent phase of contractions, namely during the period when they bring only discomfort and do not cause pain. The inhalation is carried out quickly and shortly, and the exhalation is done as long and slowly as possible. Inhale should be through the nose and exhale through the mouth, with the lips folded into a tube. Doctors recommend breathing in a count - when you inhale, count to three, and exhale, counting to five.

Candle technique.

With a set of contractions of power and duration of contractions, it is necessary to start breathing quickly and shallowly. Inhalation is done through the nose, and exhale - through the mouth, with the lips "tube". Breathing should be quick and shallow, as if trying to put out a candle. At the end of the bout, we return to slow deep breathing. The occurrence of light dizziness after breathing according to the "suppository" technique can be explained by hyperventilation of the lungs. In addition, shallow breathing promotes the release of endorphins into the bloodstream, which relieve pain.

The Big Candle Technique.

This technique is applied at the end of the first period of labor. The inhalation is carried out with effort (as with a stuffy nose), and the exhalation is carried out through almost closed lips.

Breathing on early attempts.

When the cervix is \u200b\u200bnot fully open yet, and the head begins to descend, early attempts appear, which are contraindicated, since they can cause a rupture of the cervix. In such cases, it is necessary to change the position of the body (squat down or stand up), at the beginning of the contraction you need to breathe in the candle technique, then inhale briefly and repeat the “candle” again. You should breathe at this rate until the end of the bout. It is recommended to breathe freely between contractions.

The doggy technique.

Breathing is shallow and frequent, but the mouth should be open (exhale and inhale through the mouth).

Breathing when pushing.

Initially, when pushing, we inhale as deeply as possible, and then we push into the perineum, making efforts to push the child out. You cannot translate the pushing into the face, as there will be a headache and rupture of blood vessels on the retina. During the period of the contraction, you need to push three times. After the appearance of the child's head, you should stop pushing and switch to breathing according to the "doggy" method. At the command of the doctor, attempts are resumed, at this stage a child is born.

Postpartum contractions are postpartum contractions. The fact is that after the baby is born, you still need to give birth to the baby's place (placenta, afterbirth). After the separation of the placenta from the uterine walls, pain recurs, however, its intensity is much lower than in the first period. In such cases, there is no need for strong attempts; small efforts are enough to leave the placenta.

The pregnant woman is waiting for the appearance of contractions and at the same time experiences an animal fear in front of them. Popular rumor attributes the strongest pain sensations to this stage of childbirth. If experienced mothers go for a second or third birth and already have a good idea of \u200b\u200bwhat awaits them, then women who are impatiently awaiting the appearance of their first child are at a loss. We will talk about the features and sensations, the timing and duration of contractions in women giving birth for the first time in this article.

How does it start?

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

Labor can begin in different ways. From the discharge of water, from the exit of the mucous plug, from the beginning of the rhythmic contractions of the uterus - contractions. The latter option is considered the most preferable, since premature outpouring of water always complicates childbirth, even if it happens right 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 to give birth from the discharge of water.

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

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

The purpose of labor contractions in childbirth is obvious - at the first stage, they are needed so that the cervix opens and clears the passage for the child who is to 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. Rhythmic contractions of the uterus slightly "push" the baby out. His time has come, there is no need to remain in the mother's womb any longer.

How to understand that childbirth has begun?

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

And the primiparous woman thinks that at any moment she can miss something important and be late in the 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. He 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 starts, during which women are anxiously trying to find some "harbingers" about which she read on women's forums, and which can make it clear that childbirth is not far off. Harbingers include anxiety, mild depression, mood swings, sleep disturbances, insomnia, and more active training bouts. They appear like this: the stomach turns to stone, slightly "sips" in the sides and lower abdomen (due to the tension of the ligaments), and then they pass and can be repeated 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 simply by taking a shower, drinking a glass of milk or a No-Shpy pill, or even changing her body position. With a training bout, a pregnant woman can go to bed and doze off quite successfully.

Is it possible to miss the moment of the onset of real fights? Obviously not. After all, true contractions are rhythmic from the very beginning, they are repeated at regular intervals, the pain is no longer pulling, but a slight encircling character, the region of the back, lower back is drawn into it, the pain increases with each contraction. You will not be able to fall asleep, the No-Shpy tablet or shower will not take effect. If labor pains have begun, it is unlikely that it will be possible to stop or weaken them. The duration of the bout 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 tensions of the uterus become regular and obey a certain rhythm, we can say that the first stage of labor is already underway. It is called latent (hidden).

If there is no bloody discharge, the water has not receded, there is no need to rush to call an ambulance and rush to the hospital with special signals. The latency 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 a lot of time to put your nerves and feelings in order, psychologically tune in to a positive outcome of events and check things and documents collected in the 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 correct breathing during childbirth. The latency period is the time to start applying theoretical knowledge in practice - to breathe correctly, taking deep breaths and exhales to relax as much as possible. You can walk, sing, communicate. You shouldn't lie in one position horizontally.

The sensations are wavy and growing. The contraction usually "originates" in the back, covers the lower back and moves first to the bottom, and then up 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 earliest 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 are repeated, first every half an hour, then every 20 minutes.

By the end of the latent stage of labor, contractions last 25 seconds and are repeated every 10-15 minutes. It is on this optimistic note that you should arrive at the hospital. By this time, the cervix reaches 3 centimeters. The next phase of contractions is active, it should take place in the family home. It will be safer for everyone.

Active phase

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

If you breathe correctly, maintain calmness, massage the sacral zone, the second stage of contractions can be experienced easier.

Contractions at this stage look like a prolonged spasm, the peak of the contraction becomes prolonged. Typically at this stage, during a normal delivery, water flows.

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 antenatal ward.

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

Transition period

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

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

In the transition period, a woman begins to feel a pronounced pressure on the bottom, as it usually feels if you really want to empty the intestines.

But you can't push for now. The obstetrician will give the corresponding command already in the second phase of labor - in attempts.

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?

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

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

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

Once the baby is born, the woman can relax. There is still the birth of the placenta ahead, but it will not be so painful and unpleasant, especially since the baby is applied to the breast and the mother can already see the baby, hug, therefore, for many, the birth of the placenta proceeds relatively easily. This period takes 20 to 40 minutes.

This completes the birth. The woman is sent to the postpartum ward for rest, the baby is sent to the children's department in order to be treated, washed, 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. Lack of generic experience makes it difficult for a woman to choose a comfortable position during labor, from time to time she forgets what she was taught in the preparatory courses in the antenatal clinic. At such moments, some begin to panic. From the point of view of psychological readiness, women who have given birth earlier behave more disciplined in subsequent births.

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

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

Complications are less dependent on the physiology of the firstborn, to a greater extent - this is a consequence of erroneous actions of the woman in labor, disobedience to the commands of the midwife or doctor leading the delivery.

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

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

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

Learning the technique of correct breathing during contractions and attempts. It is necessary to practice breathing exercises during pregnancy carefully, half-heartedly, but it is recommended to devote at least 10-15 minutes a day to this. Then 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. Respiratory techniques help to feel less painful during the period of contractions, 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. From the latency period to the very attempts to relieve tension and pain, massage of the sacral zone, acupressure of the hand and face will help. Experienced obstetricians will show and tell all the techniques during the training.
Psychological consultations. They will help form the correct 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 tell you about some techniques that allow a woman to be more confident in her strengths and abilities.
Learning postures to make it easier to survive contractions. In real childbirth, before the period of attempts, a woman will be able to change her body position, adjusting to her own feelings.

Legal and household assistance. During the course, the expectant mother will be told about what benefits and payments she can count on after the birth of the baby, how to arrange maternity leave, and also tell what things need to be collected at the hospital, when to do it, what documents will need to be provided upon hospitalization to the obstetric institution.

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

In the last trimester of pregnancy, a woman is increasingly experiencing special cramps in the abdomen, which are called training or "false" contractions. These are irregular contractions of the uterine walls, which do not form the start of the labor process and do not lead to the opening of the cervix, but prepare the uterine walls for an early birth. Many pregnant women are afraid because of the training contractions to miss the onset of labor outside the hospital, if they cannot recognize the true contractions that have begun. This fear is especially typical for those women who are carrying their first child. Doctors are in a hurry to reassure expectant mothers, saying that they will not confuse true contractions at the beginning of labor with training contractions and will immediately understand that labor has begun. What sensations do true contractions bring, how to determine that they have begun and what sensations will be there, is the pain strong, can it be alleviated?

Harbingers of childbirth

Childbirth does not occur suddenly, without any preliminary "bells", the body conducts full preparation for a difficult and prolonged labor act, forming the harbingers of imminent birth. These include an increase in the frequency of training contractions and their intensification, although also without any regularity of occurrence, as well as a shortening of the cervix, due to which the fetal head sinks into the small pelvis with a lowering of the abdomen. It becomes easier for a woman to breathe and eat. In addition, the discharge of the mucous plug from the vagina is typical both for several days and at the same time in the form of a lump of pinkish mucus.

The beginning of labor: how to understand that contractions have begun?

When such manifestations appear, childbirth is expected in the coming days, so you need to be ready for them by collecting all the necessary things and bags with documents. Labor activity can begin with (their gradual or pouring out at once in a large volume) or with contractions, at first rare and not intense, then more and more strong and frequent.

It is the contractions that mark the beginning of labor, or rather their first period, during which due to contractions, a smooth and gradual opening of the cervix will occur. They begin as quite tangible and painful, but short-term sensations in the lumbar region and lower abdomen, which form at regular intervals. Gradually, the contractions of the uterus become more frequent and longer, and the intervals of relaxation between them are getting shorter, which suggests that the cervix is \u200b\u200balmost open and there will soon be attempts.

What is called contractions

In obstetrics, contractions are called intermittent contractions of muscle fibers in the uterine wall. During each of the contractions, the processes of stretching and contraction of the muscles occur inside the uterus, while stretching of the fibers in the region of the cervix (circular) is formed, against the background of the tension of the longitudinal fiber.

As the contractions intensify and become more frequent, the cervix opens and smoothes, by the time of attempts, the opening of the cervix reaches 10 cm. The baby, against the background of contractions, gradually moves along the birth canal.

note

During the period of cervical dilatation in one of the contractions, the fetal bladder may open, which leads to the outpouring of water, or at a certain period to stimulate labor, the doctor opens it.

Muscle contractions during childbirth are regular and intensifying, during the period of contraction, the muscles spasm in the lower abdomen, which is why it is very tense and stiff. A woman experiences pain in the lower back, inside the abdomen and in the perineal region, radiating to the tailbone.

note

Sometimes the sensations are described as painful periods, only intensifying in duration.

The sensations of pain have a wavy character, initially it is light and barely perceptible, gradually increases in intensity, reaches a maximum for a few seconds and recedes until the next contraction... You can compare it with spasms in the calf muscle with a convulsion, but with a gradual increase in pain. During contractions, due to special techniques and practices, pain can be significantly reduced; for this, both medications and anesthesia are used, as well as methods of relaxation, massage, etc.

Emotional constituents of contractions, sensitivity to pain

Each woman perceives childbirth in her own way, therefore, the sensations during labor are different for everyone. Someone speaks of severe pain, but for someone it is quite bearable, it is alleviated by simple techniques. This largely depends on the pain threshold and sensitivity, the degree of preparation of the woman for childbirth. Emotions, attitude to what is happening and fear, fatigue and nervous tension have a strong influence. If a woman is afraid of childbirth, due to fear and panic, the pain can increase, if she is collected and prepared, the contractions are more easily tolerated.

Recognizing contractions before childbirth

Sometimes before childbirth, false contractions become strong and subjectively unpleasant enough, because of which they can mislead the expectant mother about the beginning of labor.

The first single training contractions are formed after 20 weeks, but by the end of the term they occur frequently and can be quite strong. Their distinctive feature is their irregular nature, a short period of contractions and painlessness (they do not lead to the opening of the neck). Taking a warm bath or sleep, resting in a supine position and calming down, taking antispasmodics or a suppository with papaverine rectally helps to relieve such tension in false contractions.

True contractions have equal intervals between contractions, are not eliminated by bath and rest, and increase in intensity of sensations and duration. It is worth distinguishing them from aching or abdomen due to the position of the fetus in the uterus and loads on the lower back, sprains and divergence of the pelvic bones in the pubic articulation. There may be aching weak pains in the lumbar region, pelvis and abdomen, girdling in nature. At the same time, there is no tension as such to the muscles of the uterus, the abdomen is quite soft.

Phases of the birth process, the nature of contractions

The interval between the first contractions can be 30-20 minutes, they are short and not very painful. This is the very beginning of labor. Then the intervals are reduced, and, based on this, in the first stage of labor, three phases are distinguished:

Latent (initial) can be latent or mild in sensation
Active
Transient.

For initial stage a typical time interval is about 8 hours, at this time the contraction does not exceed 30-45 seconds in duration, the intervals with it start from 30 minutes and gradually decrease to 10-5 minutes. At this time, the opening of the cervix occurs from 0 to 3 cm. At this time the woman needs to get to the maternity hospital.

Active phase lasts up to five hours, during this period the length of contractions reaches a minute, they occur at intervals of 2-4 minutes, the cervix opens from 3 to 7-8 cm.

Transition phase in the first period, the shortest, it lasts up to one and a half hours and the contractions last up to 90 seconds. They are strong and painful, compared to previous periods, gradually the relaxation period is reduced to one minute, contractions follow one after another, which leads to the opening of the cervix up to 10 cm, when it can already miss the head of the fetus.

In the second and subsequent births, the intervals are divided in the same way, but their duration is shorter, and the contractions themselves are stronger and more productive.

Woman's actions at the start of labor

If contractions have begun, do not immediately panic and shout "I am giving birth", you need to calm down, note the intervals between them and get ready for the hospital. It is worth arriving at the hospital when the interval between contractions is about 10 minutes... You should not get hung up on fights, during them you need to breathe calmly and calmly, be distracted. If it gets cold for 20-30 minutes between contractions, you can take your time to collect all your things, take a shower and go to the hospital.

An urgent need to go to the hospital when the waters drain, when blood appears or other disturbing symptoms, if the outgoing water has a green or pink tint.

What to do to make contractions easier?

During labor pains for some women, pain is excruciating and unpleasant. To relieve pain and relieve stress, doctors may offer labor pain relief (, injections), but if there are contraindications, pain relief should not be done (allergy to drugs, back skin problems, spinal deformities, fetal threats).

To improve the condition and relieve pain during labor, there is relaxation techniques and proper breathing... They are taught even in preparatory courses for childbirth, as well as in the maternity hospital upon admission, midwives usually help to adjust the correct breathing.

Update: October 2018

The due date is approaching and more and more questions arise from the expectant mother. Among the many exciting topics for pregnant women, the following sounds: what are false contractions during pregnancy? Unfortunately, not every obstetrician considers it necessary to explain the essence of false contractions, how they differ from real ones and whether this is normal. Most pregnant women experience false contractions and, as a rule, shortly before childbirth. In addition to such fights, a number of other precursors testify to the approaching birth, which are difficult to miss.

Harbingers of childbirth

The period of bearing a fetus in women lasts on average 280 days or 40 obstetric weeks. By the end of this period, in about 2 weeks, the harbingers of childbirth appear, which inform about their imminent onset. Thanks to the harbingers, the woman understands that the long-awaited meeting with the baby will soon come. These signs appear in all women, in some they are well pronounced, while others do not notice them at all. But childbirth rarely begins suddenly, "without warning", and the period of harbingers is laid down by nature for that, so that a woman has time to prepare and tune in to childbirth. The appearance of all precursors of childbirth is considered not at all necessary; the occurrence of one or two should already alert a woman.

False contractions

The concept of false contractions was introduced by the English physician Braxton Hicks at the end of the 19th century, therefore their other name is Braxton Hicks contractions or training. False contractions are called periodic, spontaneously occurring muscle contractions of the uterus. Their appearance is recorded already from 6 weeks of gestation, but in most pregnant women they are felt only after 20 weeks. By the end of pregnancy, at about 38 weeks, false or training contractions are felt by expectant mothers in 70% of cases. Such contractions are called false, since they do not lead to the start of labor and stop on their own.

Abdominal prolapse

The belly sinks in expectant mothers a couple of weeks before giving birth in primiparous and several hours in multiparous. This is due to the fact that the presenting part of the baby, as a rule, the head, is pressed against the entrance to the small pelvis, pulling the uterus along. At the same time, its upper part (bottom) also descends, which relieves the pressure of the uterus on the chest and abdominal cavities. From the moment the woman notes relief of breathing, shortness of breath disappears with little physical exertion, but is in a sitting position or it becomes more difficult to walk. Since the uterus no longer lifts the stomach, heartburn and belching disappear. But moving the uterus down increases the pressure on the bladder, which is manifested by increased urination.

With the prolapse of the uterus, a feeling of heaviness in the lower abdomen and discomfort in the region of the inguinal ligaments may appear. Also, tingling in the legs and lower back is possible. These symptoms are associated with irritation of the nerve endings located in the small pelvis when the head is inserted into its entrance.

The mucous plug comes off

This feature is considered the most characteristic, it is difficult not to notice it. From the early stages of pregnancy, the cervical glands begin to produce a thick secretion that fills the cervical canal and prevents the penetration of pathogenic microorganisms into the uterine cavity, thereby protecting the fetus and amniotic fluid from infection. On the eve of childbirth, the production of estrogens in the woman's body increases, due to which the cervix begins to soften and open slightly, which contributes to the discharge of the mucous plug. The characteristic signs of its discharge are jelly-like mucous clots that are visible on the linen. The color of the mucous plug is different: from white or transparent to yellowish or pinkish. Often, streaks of blood are visible in the cork, which is considered the norm and indicates the imminent onset of labor (within a day). A mucous plug is allocated either entirely and immediately, or in parts throughout the day. Removal of the cork is painless, but sipping pains in the lower abdomen may appear. The time taken for the cork to pass is different. It can leave both 2 weeks before the onset of labor, and immediately with the onset of contractions.

Weight loss

One to two weeks before the start of the contractions, the weight of the pregnant woman is reduced (by about 500 grams - 2 kg). The effect of progesterone, which retained fluid in the body, decreases, and estrogens are included in the work. As a result, excess fluid is removed from the body, edema decreases, it is much easier to put on shoes and pull on gloves with rings.

Urination and bowel movements change

Most pregnant women note the appearance of constipation before childbirth, which is associated with compression of the rectum by the presenting part of the child. But the opposite situation is also possible - the occurrence of diarrhea. Also, urination becomes more frequent, as the fetal head presses on the bladder, provoking a frequent urge to urinate. Urinary incontinence is possible, especially with physical exertion.

Change in fetal movement

By the end of pregnancy, the expectant mother notes a decrease in the child's motor activity. This is due to the rapid growth and increase in fetal weight. The child becomes cramped in the uterus, which is reflected in his movements, there are fewer of them.

Frequent mood swings

On the eve of childbirth, a pregnant woman is characterized by frequent mood swings. Activity and efficiency are suddenly replaced by tears, which is due to neuroendocrine processes and woman's fatigue. Often, expectant mothers fall into apathy, sleepy and seek solitude. All these signs indicate the accumulation of energy before the upcoming birth act.

Causes and characteristics of false contractions

What are false contractions for? First of all, they keep the uterus in good shape, "train" it before childbirth and create conditions for the "ripening" of the cervix. Secondly, thanks to the training folds, blood flow to the child is increased, which contributes to his better oxygenation and nutrient saturation. It becomes clear that false contractions are absolutely normal manifestations, which should not be feared. There are a number of factors that can push the occurrence of false contractions.

Provoking factors

Training contractions occur under the following conditions:

excessive physical exertion (housework, playing sports, prolonged standing on their feet, etc.);
taking a hot shower / bath;
increased motor activity of the fetus;
use and strong often (excite the nervous system and increase the tone of the uterus);
emotional stress, stress;
active sex and orgasm (release of oxytocin, which promotes uterine contractions);
smoking and drinking alcohol;
fatigue, sleep disturbance;
full bladder (pressing on the uterus, forcing it to contract);
(the volume of circulating blood decreases, the blood supply to the uterus worsens, which provokes its contractions);
improper or insufficient nutrition;
multiple pregnancy or large fetus (too tight space for the child / children, any movement of them irritates the uterine walls);
overeating or feeling hungry, consumption of "soda" (makes the stomach contract, the irritation of which is transmitted to the uterus);
touching the belly with a stranger.

Characteristics of false contractions

As indicated, false contractions occur in the second half of gestation, but usually on the eve of childbirth (at 38 - 39 weeks of gestation). As a rule, training contractions appear in the evening when the woman is resting. These contractions do not cause pain, occur irregularly and infrequently. In addition, false contractions only prepare the cervix for disclosure, but do not cause it. Some expectant mothers may not feel false contractions, but this does not indicate deviations.

Symptoms and sensations

Since each organism is individual, the symptoms of false contractions may vary. Someone feels them well due to the significant intensity and severity of unpleasant sensations, while for someone they pass almost imperceptibly. The characteristic features of training fights include:

contractions are irregular, it is impossible to catch the rhythm of their occurrence (they can occur every 5 - 6 hours (but less often than 6 times an hour) and after 1 - 2 days;
the duration of false contractions is short, a few seconds, no more than a minute;
tension (compression) of the uterus;
vivid sensations during contractions, do not cause pain, but bring discomfort;
usually occur in the evening or at night when a woman is resting (during the day, expectant mothers often do not focus on them);
the intensity of contractions quickly decreases with a change in body position.

What are the sensations with false contractions? In many cases, training contractions are painless, and expectant mothers tolerate them quite easily. But in the case of a low threshold of pain sensitivity, false contractions are very unpleasant and even require assistance. Feelings with false contractions resemble menstrual pain: pulling in nature and occur in the lower abdomen. Also, a woman can herself feel the hardening of the uterus by placing her hand on her stomach.

Differences between real and false contractions

How to distinguish false contractions from real ones? The signs of training and true fights are shown in the table:

Sign	training	true
Significant pain sensations that intensify over time	—	+
The duration of the contraction increases	—	+
Discharge of amniotic fluid	—	+
There is no clear rhythm of uterine contractions, irregular contractions	+	—
The intensity of the contraction increases, the uterine contractions last a minute or longer	—	+
The disappearance of contractions when changing body position or physical activity	+	—
The neck gradually opens and smoothes	—	+
There is pressure in either the vagina or the pelvis	—	+
Lasts less than 2 hours, and less than 4 uterine contractions occur in an hour	+	—

How to deal with false contractions

To eliminate the discomfort caused by training contractions, following some recommendations will help:

stroll

A leisurely walk in a park or square will help not only eliminate discomfort, but also enrich the mother's blood with oxygen, which is useful for the baby.

Change body position

Sometimes it is enough to change the position of the body, to take the most comfortable position. If the pregnant woman is lying, you can get up and take a few steps, or sit down while standing for a long time.

Get distracted

Watching your favorite movie, listening to calm music or reading a book can help you distract and relax.

Warm water

Taking a warm shower or scented oil bath can help ease Braxton Hicks contractions.

Correct breathing

The occurrence of false contractions is an excellent moment for training correct breathing in labor, which was taught in the classroom at school for mothers. Take deep breaths through your nose, trying to exhale slowly and smoothly through your mouth, and curl your lips together. You can try dog-like breathing - intermittent and frequent, but not get carried away, otherwise your head will spin.

Drink water or a snack

If false contractions are due to dehydration, drinking a glass of plain water is enough to relieve them. In case of hunger, even a lung that provoked uterine contractions, you should have a snack, but easily digestible and nutritious (for example, a banana).

When to call an ambulance

Sometimes situations arise when you need to urgently call an ambulance or contact your doctor:

the gestational age at which uterine contractions appeared is less than 36 weeks (the threat of premature birth is not excluded);
the occurrence of moderate or profuse bleeding (suspected placental abruption);
the appearance of watery discharge (possible rupture of amniotic fluid);
discharge of the mucous plug before 36 weeks;
pressing pain in the sacral and lumbar regions;
feeling of pressure in the perineum;
excessive physical activity of the child or its sharp decrease;
the frequency of contractions is 3 or more in 10 minutes (the beginning of the labor act).

Preliminary period - what does this mean? The preparatory period is called the period of time during which the woman's body is prepared for childbirth. That is, the preliminary period can be called the preparatory period, during which the precursors of childbirth appear. The normal preliminary period is recorded in 30 - 33% of women at the end of gestation (38 - 40 weeks). The physiological preliminary period is characterized by:

contractions that occur with different frequency, duration and intensity, but last no more than 6 - 8 hours;
perhaps the spontaneous disappearance of contractions and their reappearance after 24 hours;
sleep and general well-being of the pregnant woman is satisfactory;
complete readiness of the expectant mother for childbirth is noted ("mature" cervix, mammary and oxytocin tests are positive, etc.);
the uterus is in normotonus, the fetus does not suffer in utero;
in 70%, the normal preliminary period develops into an adequate labor activity.

Pathological preliminary period

The pathological preliminary period is said to be when the preparatory period is prolonged, characterized by irregular but painful contractions that do not contribute to structural changes in the neck. It is diagnosed in 10 - 17% of pregnant women and, as a rule, turns into anomalies of labor (weakness of contractions or discoordination of contractions). In foreign literature, such a pathology is called "fake birth".

Causes

The pathological nature of the preliminary period can be provoked by:

emotional lability and neuroses;
endocrine pathology (obesity or underweight, menstrual irregularities, genital infantilism, and more);
somatic pathology (heart defects, arrhythmias, hypertension, kidney and liver diseases);
chronic inflammatory processes of the uterus and cervix;
large fruit;
(dystrophic processes);
fear of childbirth, unwanted pregnancy;
first birth in women under 17 and over 30;
little and;
incorrect position of the fetus and placenta;
and others.

How does it manifest

The clinical picture of the pathological preliminary period is characterized by painful contractions that occur not only at night, but also during the day. Contractions are irregular and do not turn into true ones for a long time. The pathological preliminary period can last from one to ten days, which disrupts the sleep of the pregnant woman and contributes to her fatigue.

The cervix does not undergo structural changes, that is, it does not "mature". It is long, located anteriorly or posteriorly, dense, and the outer and inner pharynx are closed. Also, the lower segment of the uterus does not unfold, and the uterus itself is easily excitable and has an increased tone.

The presenting part of the child does not press against the entrance to the small pelvis for a long time, despite the absence of any discrepancy between the size of the baby and the mother's pelvis. The presence of hypertonicity of the uterus makes it difficult to palpate the head and small parts of the child.

Uterine contractions are monotonous for a long time, the intervals between them are not shortened and the intensity of contractions does not increase. The psycho-emotional status of the expectant mother also suffers. She is irritable and whiny, aggressive and afraid of childbirth, doubts their successful completion.

The long course of the pathological preliminary period is often complicated by the premature outpouring of water and. Due to the expenditure of energy, this pathology often turns into a weakness of the birth forces.

Often there are autonomic disorders (neurocirculatory dystonia, increased sweating), a woman complains of pain in the lumbar and sacral regions, palpitations and shortness of breath, painful movement of the baby.

Question answer

Question:
I have my first birth and I am afraid that I will not be able to distinguish false contractions from true ones. What do i do?

Many primiparous women are afraid to miss real contractions, mistaking them for false ones. Doctors recommend: in case of any doubt about false contractions, especially if they are painful and last a minute or more, you should go to the hospital. The obstetrician will conduct an internal vaginal examination and assess maturity and. If the alarm is false, the woman will be allowed to go home with a recommendation to come to the antenatal clinic in 2 to 3 days.

Question:
When I gave birth for the first time, the doctors told me about some wrong preparatory contractions and after a while they opened the fetal bladder, after which I gave birth myself. What was it and is there a high probability of a repetition of this situation in the second birth?

In the first birth, you had a pathological preliminary period. The likelihood of developing it in the second childbirth depends on many reasons, but primarily on the mood for the successful completion of childbirth. Attend mothers' school, engage in self-hypnosis and breathing exercises, try to get rid of the fear of childbirth and follow the doctor's recommendations. Competent psycho-preventive preparation for childbirth will significantly reduce the chances of a pathological course of the preparatory period.

Question:
I have 41 - 42 weeks (counted in the antenatal clinic), but there are no false contractions and other harbingers of childbirth. What to do?

You may be overweight. Use natural methods to stimulate labor (long walks, sex, certain meals, etc.).

Question:
How is the pathological preliminary period treated?

The tactics of managing a woman depends on the duration of the pathological preparatory period, the state of the neck, the intensity of pain, the state of the mother and child. With a "mature" neck and the duration of this pathology less than 6 hours, the fetal bladder is opened to stimulate contractions. If the cervix is \u200b\u200b"immature", but this period lasts 6 or less hours, sedatives (Relanium) are prescribed and the cervix is \u200b\u200bprepared (intracervical prepidil-gel). In the case of a protracted course (more than 10 hours) of the pathological preparatory period, a drug-induced sleep-rest is prescribed, after which the pregnant woman wakes up in the active phase of contractions.

It is already a few days left before the finale of the most beautiful period in a woman's life called "pregnancy". Everyone lives in anticipation of the appearance of the baby: the crib is already assembled, the diapers and undershirts are ironed, the package in the maternity hospital is in the most prominent place and is waiting in the wings. The excitement is simply overwhelming, because contractions can begin at any time, without even waiting for the expected date of birth. How to determine the onset of contractions in order to call an ambulance on time and transfer yourself into the hands of experienced obstetricians?

What are contractions?
Contractions are considered regular and involuntary contractions of the muscles of the uterus, which, together with attempts, help to expel the fetus. Labor begins with the appearance of regular contractions, which promote the opening of the cervix to the desired size. Doctors recommend writing down the time of the beginning of the first contractions on paper and monitoring their frequency. The first contractions are similar to the cramps a woman experiences during her period. The interval between them is on average half an hour, and the contractions themselves last 5-10 seconds. As labor increases, the period between contractions decreases, their duration increases, and the contractions themselves become very painful. When the frequency of contractions is maximum (once every 1-2 minutes), they will turn into attempts.

How to distinguish false contractions from real ones?
False or training contractions, they are also called Braxton-Hicks contractions, are not the beginning of labor and are distinguished by their irregularity and almost painlessness. For example, the second contraction came 5 minutes after the first, and the third one 20 minutes after the second, and the fourth only an hour later.

Such contractions will go away on their own if you lie down on your side and relax. If false contractions bring obvious discomfort, then you can drink two no-shpa tablets. If contractions remain irregular and painful, it is best to call an ambulance.

Training contractions can last for quite a long time and sometimes develop into real contractions, turning into regular contractions with a certain pain and frequency.

How to determine the onset of contractions?
Many women who have given birth have noticed that if they constantly walk in anticipation of contractions, then, as luck would have it, they do not appear. But if you forget about them for a moment, they are right there! Women's unrest is justified, but it is not difficult to determine the onset of contractions, since this period cannot be confused with anything:

In a few days or hours, the mucous plug leaves the pregnant woman. From this moment you can wait for the onset of labor.
There are situations when the amniotic fluid leaves before the contractions begin. But this is considered the beginning of labor.
A surefire way to determine the onset of contractions is to calculate the duration and time interval between painful sensations.
Pain during contractions is special, rolling. It builds up gradually, reaches a peak and also gradually releases.
As the interval decreases, contractions become more painful. The pain can cause slight chills and nausea.
Other hallmarks of real contractions are sacral contractions and lower back pain.

Women do not need to worry about how to determine the onset of contractions. When they start, the woman will understand it herself. And useful tips will help a woman to survive the time of the beginning contractions before leaving for the maternity hospital:

you need to go to the hospital when the interval between contractions is 10-15 minutes (depending on how far away the hospital is);
if anxiety and anxiety prevail, then you can leave earlier;
it is better to get to the hospital during the daytime by ambulance because of possible traffic jams, and at night you can also take your own car;
if the maternity hospital is very close, then you can walk (provided that the pregnancy was proceeding well and there are no contraindications to excessive activity);
during contractions, you need to breathe correctly;
excessive excitement or panic will only increase the pain;
during the long interval between contractions, you can cook food for your husband for a couple of days and collect the bag in the hospital;
eating is not recommended after the onset of contractions, as violent contractions can cause a gag reflex.

It is not worth worrying in vain; to determine the beginning of contractions, a woman will be helped by her new sensations, which will be the beginning of labor and bring the woman closer to the most long-awaited moment - the appearance of a baby.