Childbirth is a natural process, which in many cases could successfully occur without the participation of a doctor or midwife.
However, sometimes the safety of the mother and baby can be ensured only with the help of medical intervention.
Changes may occur in your body, indicating that the crucial moment is approaching. Women feel them several weeks before giving birth — with varying degrees of intensity — or they do not feel at all.
The duration of the difficult process of the birth of a baby into the world can be very different. For the first birth, it averages 13 hours, for repetitive - about eight. The beginning of labor in physicians is considered to be the opening of the cervix with regularly repeated contractions.
Over the past 50 years, the average duration of this process has been halved, as in severe cases, a Cesarean section is now done in a timely manner. Often spontaneous contractions begin at night when the body relaxes. Many kids prefer for the first time to look at this world in the dark. According to statistics, most births occur at night.
What exactly causes birth pains is a question, the answer to which is not yet known. What is clear is that the child itself plays an important role in this process. But which mechanisms give a decisive impetus, remains a mystery.
Recent studies suggest that contractions begin under the influence of the protein substance produced by the child, the so-called SP-A protein, which is also responsible for the maturation of the lungs.
Consultation gynecologist. Usually, Braxton-Hicks contractions are difficult to distinguish from true generic ones. In the third trimester, false labor pains become more intense and frequent if you live an active life or you have dehydration. If you feel them, sit in a cool place, raise your legs, drink something and rest. If the intervals between contractions increase, and their intensity decreases, then they are false. If they become more frequent and stronger (especially if they occur every 5 minutes), call your doctor. I always tell patients that no one else, giving birth to a child, described his feelings as “spastic”. As a rule, the intensity of labor contractions, in which the child passes through the birth canal, is described as: "I can not walk and talk."
You have seen it in countless films. Sudden awareness: the woman in labor must be URGENTLY taken to the hospital! A woman becomes a real fury, belching curses (“You did this to me!”). Bent over in half from the terrible pain, she stops moaning only in order to give out another portion of curses to her unhappy, panic-stricken husband, who suddenly forgets everything he learned in Lamaz courses, loses his bag, prepared for the trip to the hospital, and inevitably sends car right in traffic, where he eventually had to take delivery himself.
The truth is that most couples have plenty of time to understand that the birth has really begun. No one knows exactly what triggers this mechanism, but they are approaching fairly quickly. Here are some signs that tell you that it's time to grab the bag and the woman in labor - and get in the car.
Most women give birth to their children earlier or later than the billing period specified in the exchange card.
And most often the deviation in the one and in the other direction does not exceed ten days. Ultimately, the estimated date of birth plays only the role of a certain guideline. Only 3% to 5% of children are born exactly on this day. If the doctor said that your baby will be born on December 31st, you can be sure that you will not give birth on New Year's Eve.
All because of hormonal changes caused by prostaglandins.
And this makes sense: your body begins cleansing the intestines to free up more space inside the body for the baby.
This is the day your child will be born with a statistical probability. Most give birth between 37 and 42 weeks. Although many women do not give birth exactly on the estimated date, you must know her in order to be ready. The closer it is, the more attention should be paid to their bodily sensations and possible signals of the onset of labor. Turning the calendar sheet and seeing the month in which the birth should take place, you will feel anxiety (and a slight panic). Soon!
In 70-80% of cases, the onset of labor declares itself by the appearance of real labor contractions. They can not immediately be distinguished from the training, which you may have noticed the first time a few weeks ago. At these moments, the abdomen hardens and the uterus contracts within 30-45 seconds.
The pains caused by contractions are initially well tolerated: you can even walk a little if you want. As soon as a certain regularity is established in abbreviations, you will postpone all affairs without any prompting and will listen to what is happening inside you.
With the gradual intensification of contractions, it is recommended to perform breathing exercises that you were taught during the preparation for childbirth courses. Try to breathe as deeply as possible, breathe in with your belly. Your baby also has to do the hard work during the birth. And oxygen will be very useful for this.
Braxton-Hicks contractions (preparatory). These contractions of the muscles of the uterus begin early, although you may not notice them. You will feel tension in the uterus. Such contractions are brief and painless. Sometimes there are several, they go one after the other, but usually they stop quickly. Closer to the childbirth Braxton-Hicks contractions help prepare the cervix for the process.
Immediately to the clinic!
Regardless of the occurrence of contractions at the termination of the movements of the child, the opening of the fetal bladder or vaginal bleeding, you should immediately go to the clinic.
Fights Braxton-Hicks - "warming up" before the start of these fights. They can begin and end several times and often stop when you are active (for example, when you walk). Early labor pains will be uneven in intensity and frequency: some will be so strong that you will catch your breath, others will just remind you of cramps. The intervals between them will be 3-5, then 10-15 minutes. If you talked with your doctor for 15 minutes, discussing whether your childbirth began or not, and never stopped, it is most likely a false alarm.
Learn to recognize contractions
At the initial stage of labor, contractions lasting about 30 seconds can occur every 20 minutes.
There are no mandatory rules when you can come to the hospital. But if the contractions occur every 5 minutes for an hour and make you freeze in pain, no one will hinder your appearance in the delivery room. Make a plan with your doctor taking into account the time it takes to travel.
Discuss this in advance with your doctor so as not to panic during childbirth. Remember that with the onset of the active stage, the cervix in most women opens up to 1-2 cm per hour. So count: 6-8 hours before the start of the effort. (But if at the last doctor's appointment you were told that the disclosure is 4 cm, it is better to come to the hospital early.)
Consultation gynecologist. I warn future parents, especially if this is the first pregnancy, that there may be several “false alarms”. My wife is an obstetrician-gynecologist, and she forced me to bring her to the hospital 3-4 times, being pregnant with each of our three children! If she could not recognize for sure, then who can? I always tell patients: it is better to let them come and check them (if it is premature, they will just be allowed to go home) than to give birth on the side of the road.
Time is everything
How to count the time and rhythm of labor? There are two ways. Just pick one and stick to it as you watch.
Almost the same, but here you begin to count the time from the end of one fight to the end of the next.
Imagine your cervix in the form of a large plump bagel. Before giving birth, it begins to thin and stretch. Expansion (opening) and thinning (smoothing) can occur within a few weeks, one day, or several hours. There is no standard time frame or nature of the process. As the date of birth approaches, your doctor will make a statement about the condition of the cervix in this way: “Exposing 2 cm, shortening 1 cm.”
This happens when the fetus descends to the entrance to the small pelvis and “sticks” there, i.e. no longer moves inside. With Braxton-Hicks contractions, it shifts even more to the lower pelvic region. Imagine that a child goes into a “starting” position. This process begins in all women at different times, in some - just before the birth. For many, the message of lowering the fetus is both good and bad news. Breathing and eating are now easier, but pressure on the bladder and pelvic ligaments makes it necessary to run to the toilet more and more often. Some expectant mothers even begin to think that the child can just fall out - because he is now so low. During the examination, your doctor will determine how low the baby is in the pelvis or what its “position” is.
Abdominal prolapse occurs when the child “falls”, as it were, falling to the entrance to the small pelvis. Head forward, the baby moves to the pelvis, thereby preparing for the journey through the birth canal. However, for women whose abdominal prolapse occurs a few days or weeks before giving birth, this symptom is “false evidence”, and for some this does not happen at all before the onset of the active stage of labor. Braxton-Hicks contractions are getting stronger, the child gradually moves lower into the pelvis, the pressure on the cervix increases, and it softens and softens.
In 10-15% of cases, the beginning of childbirth heralds a premature rupture of the membranes, which occurs before the first contractions appear.
If the head of the child is firmly established in the pelvis, the loss of amniotic fluid will not be so large.
You will learn about the rupture of the fetal bladder by copious discharge of clear, warm fluid from the vagina.
The rupture of the membranes does not cause any pain, since there are no nerve fibers in its membrane. Sometimes the amniotic fluid may have a green color: this means that the baby has already allocated its first chair in them. Record the time of rupture of the fetal bladder and the color of the waste liquid; report this to the midwife or to the clinic's maternity ward. Here you will receive instructions regarding your further actions.
Very rarely, a rupture of the membranes of the fetus occurs in its upper part, while the amniotic fluid flows only drop by drop. Then they are easy to take for urine or vaginal discharge, especially with a small bladder weakness. If you suspect that the amniotic fluid is moving away, call your doctor right away or go to the hospital. A short inspection will clarify the situation.
As a rule, rupture of the membranes does not lead to dramatic consequences. Usually in the next 12-18 hours, contractions spontaneously occur, and childbirth occurs naturally. In the absence of contractions, they are artificially stimulated with appropriate medications in order to reduce the risk of infection for the mother and child.
Sometimes the fetal bladder is called the strange, biblically-sounding term "baby bag." When it bursts (in a natural way or a doctor pierces it), it means: childbirth will occur within 24-48 hours. As a rule, the doctor decides not to risk and not wait more than 24 hours after opening the bladder, especially if the child is born on time, because there is a danger of infection.
If the waters are gone
When the fetal bladder bursts, something like a small flood happens, and it is impossible to predict when and where it will happen. In the third trimester in the fetal bladder, the soft and comfortable “seat” of the baby, there is already about a liter of amniotic fluid. (Pour a liter of water on the floor — something like this might look like.) But remember:
Consultation gynecologist. Abundant vaginal discharge in late pregnancy is absolutely normal. V 10-20% of women at this stage are so significant that they have to wear pads all the time. Blood flow to the vagina and cervix increases in the third trimester, and therefore vaginal secretion increases. Immediately you can not understand, it is a selection or water has withdrawn. If you feel "in a wet place," wipe yourself and walk around a bit. If fluid continues to flow, call a physician.
Usually throughout pregnancy, the uterine pharynx remains closed with viscous mucus, which protects the fetal bladder from inflammation. With the shortening of the cervix and the opening of the uterine throat, the so-called mucus plug comes out. This is also a sign of imminent labor. However, labor pains do not necessarily occur on the same day. Sometimes it takes several days or even weeks before the onset of real contractions.
Closer to childbirth mucus can lose its viscosity and flow away as a clear liquid. In most cases, this is accompanied by a small, so-called signaling bleeding. It is much weaker than the menstrual and completely harmless. And yet, for loyalty, you should talk to a doctor or midwife about this — you should make sure that the bleeding is not caused by other reasons that could threaten you and your baby. Very often, a woman does not even notice the separation of the mucous membrane.
It may appear due to changes occurring in the cervix - it is preparing for disclosure. The cuts soften the cervix, the capillaries begin to bleed. The contractions intensify, and bloody discharge occurs. Any pressure on the cervix can cause slight bleeding (due to exercise, sex, straining during bowel movements or straining of the muscles of the bladder). If you are unsure whether this bleeding is normal, call your doctor.
The cervix softens and begins to open, with a mucus plug released. Sometimes mucus flows out slowly or the stopper can come out in the form of a knotty thick flagellum. Up to this point, mucus plays the role of a protective barrier in the cervix and is constantly produced by the body, especially a lot closer to childbirth. It is not a sign of approaching labor, - for some women, mucus is released a few weeks before, - but it is definitely a sign that something is starting to change.
Pain may occur if the child is facing forward, and not in the direction towards your back. If the baby does not turn to the back, they may increase. The pain may also occur due to the pressure of its head on your spine at the start of contractions.
Pregnant women even before the onset of labor often have a strong desire to make a cozy nest. The burst of “nesting” energy, which contrasts so strongly with the debilitating fatigue of the last trimester, forces future moms to develop their habitat, turning it into a cute and clean “incubator”. Another sign that you have started a period of "nesting" —that the speed with which you try to do everything, the exacting demands you make to your household. "Nesting" is usually expressed in:
An important caveat: for some pregnant women, “nesting” never happens, and if such impulses appear, the expectant mother feels too sluggish to do something.
False contractions are a pulling pain in the lower abdomen, similar to the pain of menstruation. If such contractions are not strong and not regular, there is no need to do anything on purpose: for now, this is only the preparation of the uterus for childbirth. The uterus seems to be trying its strength before the upcoming important work, gathering and relaxing its muscles. At the same time you can feel the tone of the uterus - sometimes it is as if going into a ball, it becomes more solid. The uterus can come in tone without pain, since the closer the delivery, the more sensitive and irritable it becomes. This is normal.
The third important harbinger of childbirth may be the discharge of mucus plug. This mucous contents, which "live" in the cervix, as if clogging the "house" of the baby. The mucus plug can come off in the form of thick and sticky secretions of a transparent pinkish color.
A woman may not feel the harbingers of childbirth, although more often the future mother still feels the preparatory labor.
Normal first births last about 10-15 hours. Subsequent delivery usually proceeds somewhat faster than the first, but this is not always the case. I am an example of such an exception, since my second birth lasted 12 hours longer (20 hours) than the first (8 hours).
If a woman's amniotic fluid has moved away, then you should immediately go to the clinic. Amniotic fluid protects the baby, and it should not be for a long time without them. Therefore, if you feel warm tepid water flow out, call a doctor and get ready for a maternity hospital.
Usually, after the water has departed, contractions begin (or they intensify dramatically if you have been in labor before). If the contractions do not start, most likely in the maternity hospital you will try to trigger labor activity (with the finished cervix), so as not to leave the baby for a long time without protection.
Usually childbirth begins with contractions. Usually, lower abdominal pain and aches in the back are often felt by women about a couple of weeks before giving birth. But how then to understand what it is: Braxton-Hicks preparatory bouts or the beginning of labor activity ?! Such a question and fears almost always arise in women who are confronted theoretically or practically with harbingers of childbirth.
It is not at all difficult to distinguish preparatory contractions from the onset of labor! When you begin to sip your stomach, be a little more attentive to yourself: is it such a pain, as usual, perhaps the painful sensations have lasted a bit, or something else intuitively seems unusual to you?
If you feel that these painful sensations are regular (appear and disappear with a small periodicity), it makes sense to start noting time, counting contractions and recording them.
Suppose, at about 5 o'clock in the morning, you decided that your stomach hurts a little bit in a special way or for quite a long time. Stock up on a stopwatch (he is on the phone) and start counting.
At 5 o'clock in the morning there was pain, the fight began, it lasted 50 seconds, then there was no pain for 30 minutes.
At 5:30, she starts to pull her belly again, the pain lasts 30 seconds, then for 10 minutes nothing bothers you, etc.
When you see that the pain regularly recurs, increases, the duration of contractions increases, and the gap between them is reduced - congratulations, you have started labor activity.