How to understand that labor has begun: important signs

The last days of pregnancy are usually very anxious and hectic. Regardless of what kind of child a woman is expecting, she is worried about how the birth will begin. The fact is that each childbirth in a row can begin in a different way, and therefore the experience does not guarantee that the scenario of the previous birth will be repeated to within a fight. The primiparous are more experienced than others, they have no birth experience at all. In this article we will tell you how to understand that labor is approaching, and how to determine that it has already begun.

How to determine the approximation?

The date of birth is a big secret of nature. Despite the fact that obstetricians indicate the PDD (estimated day of birth) in the exchange card, no one will say the exact date when the baby decides to be born. Only 5% of babies are born exactly in the DA. All the rest choose for themselves other dates - before or even after the designated period.

That is why expectant mothers are so afraid not to notice, miss, confuse the beginning of labor with other sensations for which the most difficult third trimester is so rich.

The best assistant and prompter for a pregnant woman is her own organism. Usually he starts giving "clues" in advance that labor is approaching.

The prenatal phase officially begins at 38 full obstetric weeks. It is from this period that you need to listen as carefully and anxiously as possible to changes in your own state. The child is already mature enough, he is ready to be born any day.

Usually, even in those women who did not have training contractions during the gestation period, they start at 38 weeks. They appear as short spontaneous tensions of the muscles of the uterus, which recede rather quickly, do not have a fixed interval between themselves. This means that after one training bout, another can occur in half an hour, and in three hours, and only the next day. Labor pains are cyclical and are always repeated in time with a certain interval characteristic of a certain period of labor.

After 38 weeks, on average, the harbingers of childbirth appear. This is where the expectant mother should be extremely careful - some preliminary signs can be very similar to pregnancy complications. For example, due to an increase in the amount of vaginal discharge, it is easy to miss the leakage of amniotic fluid, and a vaginal infection with yellowish gelatinous discharge can be confused with the beginning of the separation of the mucous plug.

A distinctive feature of the generic process from various preparatory "activities" is irreversibility. If labor begins, it cannot be stopped, slowed down or weakened, since it is an exclusively reflex act. A woman can influence the harbingers and change their character with medicines and other methods.

When do they start?

Childbirth is the logical conclusion of complex and multi-stage processes that take place in the female body on the eve of the birth of a child. Each of these processes is closely related to the others. When asked when labor will begin, there is only one answer - when all internal processes will reach their maximum development.

The uterus becomes large. The female reproductive organ gains weight and reaches a solid size. The neuromuscular apparatus of the uterus a few weeks before childbirth begins to prepare for the upcoming labor pains. In the cells of the myometrium (structural tissue of the uterus), a substance begins to be produced that will help the tissues to contract - actomyosin. At 38 weeks and a little later, the uterine tissue gets rid of excess nerve fibers. This is a natural physiological mechanism of pain relief.

The placenta should be fully ripe for delivery. A week before the onset of labor, she begins to produce oxytocin. The pituitary gland helps her in this. The proper concentration of this hormone in the female body leads to the onset of contractions. The hormonal factor is critical - for labor to begin, progesterone levels need to drop. This hormone was responsible for all nine months for maintaining pregnancy, for creating optimal conditions for the development of the fetus. By childbirth, it is no longer necessary, and progesterone decreases in proportion to the growth of estrogen and oxytocin.

Before giving birth, a woman's body begins to accumulate glycogen, ATP, phosphorus compounds and electrolytes. They make the uterus more resilient to the upcoming contractions and, in general, increase the energy potential of the expectant mother.

One of the important factors that has a direct effect on the timing of the onset of labor is the state of the nervous system. In case of failures in it, the preparation of the uterus for childbirth slows down, the hormonal balance changes, which can cause both premature birth and prolonged pregnancy.

Harbingers - myths and reality

The fact that childbirth is close, a woman can be prompted by the so-called "harbingers" - the first signs, the totality of which suggests the approach of imminent birth. For all women there is no single list of symptoms, “harbingers” depend on the individual characteristics of the female body. The most common signs are as follows.

Abdominal prolapse

The tummy of the pregnant woman shifts down, its shape visually changes. This is due to the establishment of the fetal head to the internal pharynx - the exit from the uterine cavity. A woman can notice that her stomach has dropped on her own. It becomes much easier to breathe, since the bottom of the uterus no longer presses on the diaphragm, heartburn, which is exhausting a woman, decreases - the uterus ceases to support the stomach. But the pressure on the bladder and intestines increases, due to which the woman's urge to urinate increases and becomes more frequent, uncontrolled urine leakage can occur when coughing or laughing, and constipation also increases.

Abdominal prolapse in primiparous usually occurs 3-4 weeks before delivery. In multiparous, the symptom appears 1-4 days before the onset of labor, and sometimes already in the process of the first labor pains or just a few hours before them.

Change in gait, pelvic pain

After the baby takes a "prelaunch position" in the uterus, an increased load falls on both the bones and muscles of the pelvis. Therefore, the gait becomes clumsy, the woman "waddles" more and more when walking. There are pulling and breaking weak pains in the bones of the pelvis, in the ligaments. If symphysitis has already begun, then the pain in the area of the pubic articulation increases.

Most often, a woman may experience discomfort while having to stand for a long time, when getting out of bed from a prone position, when climbing stairs.

Allocations

Vaginal discharge changes both quantitatively and qualitatively. They become more abundant, thinner, as the concentration of progesterone decreases every day. The discharge should be monitored especially closely - if jelly-like impurities appear in them, this may mean the beginning of the discharge of the mucous plug. During pregnancy, the plug closes the cervical canal located in the cervix so that bacteria and viruses do not penetrate into the uterine cavity, so that the environment in the uterus remains sterile.

The cork can come off in parts or come out entirely. In primiparas, this can happen two weeks before childbirth, in multiparous, the cork leaves a few days before the onset of labor pains, already in their process or when water is poured out.

Weight loss

The woman begins to lose weight before giving birth. This sign was noticed long ago. Such an unexpected "weight loss" by a couple of kilograms is associated with a decrease in the amount of intercellular fluid. This process also begins with a decrease in progesterone levels. In addition, a woman's body begins to cleanse itself, so diarrhea often begins a few days before childbirth.

Baby behavior

The crumbs in the overwhelming majority of cases, before giving birth, subside within 4-5 days, stop actively moving. The child also stores up energy, because the birth process will require great efforts from him. In addition, the baby has already grown so much that it is difficult for him to move in the uterus - it becomes too tight for him.

It is important at this stage to continue to record the episodes of decreased activity. If there is no movement at all for 12 hours, you should definitely consult a doctor.

"Nesting"

The nesting syndrome is a manifestation of the animal instinct for arranging a “nest” - a dwelling before the appearance of offspring in it. Many birds and animals do this. This is manifested by the fact that a woman is drawn to do the cleaning, put everything in order, once again rearrange the children's things in the prepared children's room. It is believed that the instinct has a beneficial effect on the psyche of the pregnant woman, helping to cope with fears of childbirth and dark thoughts. It does not appear in everyone and is not a mandatory sign.

Ripening of the neck

This is an objective sign, which is regarded by doctors as practically the only reliable one. The cervix is normally tightly closed during pregnancy. By childbirth, it begins to become shorter, the round muscle softens - it is important that the neck opens up and releases the baby with the onset of the labor process. Assessing the condition of the cervix can begin as early as 38 weeks of pregnancy. This can only be done by an obstetrician-gynecologist at a scheduled appointment; a woman cannot independently examine the cervix.

The cervix is sensitive to hormonal effects, and therefore, if the balance of hormones is disturbed, with a number of other factors, a woman may hear from the doctor the verdict that her cervix is immature. In this case, after 39 weeks, drug maturation will be carried out - they will affect the woman's body with hormonal and other drugs that will help the neck become shorter and softer. Normally, before childbirth, the cervix is shortened to 1-1.5 centimeters. In this case, they say that the cervix is mature and childbirth is on the way.

Other signs and symptoms

Other signs include a large group of symptoms that have long been noticed by pregnant women as precursors - insomnia, and increased sleepiness, and appetite disorders - excessive or lack of it, and nausea, and even vomiting a few days before childbirth, a state of increased anxiety, irritability , touchiness, tearfulness.

It should be noted that the harbingers of childbirth are shrouded in a mass of myths that are far from medicine. Therefore, any change in well-being and condition is advisable not to be attributed to the signs described by someone on the forums, but to discuss with your doctor. Only he can distinguish a precursor from a pathology in time.

Symptoms of the onset of labor

Despite all the signs that may accompany the last couple of weeks before childbirth, there are only two reliable signs by which one judges the onset of labor - this is the beginning of labor pains and the passage of water. According to them, both the woman and the doctor will be able to accurately determine that labor has begun. All other symptoms and putative precursors of diagnostic value are essentially of no value. So, it's time to talk in more detail about two reliable signs that symbolize the onset of labor.

Contractions

As all the prerequisites - nervous, hormonal, humoral, physiological - develop, true labor pains begin. These are rhythmic contractions of the fibers of the uterus, they have a clear pattern, frequency, contractions do not develop back. It is this feature that will help to distinguish real contractions from false ones, which can be repeated as a training activity of the female body in the last weeks before the upcoming birth.

If the contractions do not subside after the No-Shpy pill, a warm shower, if they do not change intensity after a change in body position, then we can say with a high degree of probability that labor has begun.

The first contractions are not painful. It is only in films that women are shown who, with a groan, unexpectedly "fold" in half when labor begins. The first uterine contractions are quite painless and feel like pain during menstruation.

Most often, the first contractions are repeated every 30-40 minutes. Each contraction lasts a few seconds - usually no more than 20. After it, the woman has enough time to rest, which should be used as much as possible for relaxation, relaxation, so that muscle clamps do not occur. With such contractions, there is no need to go to the hospital, the woman can be at home until the time when the contractions begin to recur more often. With an interval of 5-10 minutes between contractions, you need to call an ambulance and go to the hospital. The first contractions are called latent, they can last 8-10 hours, the opening of the cervix by the end of the period will be only 3 centimeters.

The second period of contractions is called active. Contractions are stronger, more frequent - by the end of this stage they are repeated every 2-3 minutes, the duration of each contraction is up to 50 seconds. The neck opening is up to 7 centimeters. It is advisable to spend this period under the supervision of doctors, since the birth of a baby is already inevitably approaching. Active contractions are usually observed within 3-5 hours.

The third period of contractions will only last half an hour or an hour or more. These contractions are called transitional, they flow into attempts, which a woman learns about by an acute desire to empty the intestines - the neck is fully open, the head begins to be born. Transient contractions are the strongest and most prolonged. They are repeated every 1-1.5 minutes and last for a minute.

Anyone who doubts whether it will be possible to recognize true labor pains when labor begins, I want to tell you about the old obstetric joke, which says that a woman who doubts whether labor has begun does not actually give birth. When a woman gives birth, she has no doubts. True contractions are really so specific that it is very, very difficult to confuse them with other uterine contractions.

Water

It should be noted that labor starting with contractions is classic, normal and healthy. This is how up to 90% of all births on the planet begin, since physiologically this is the best option. Water with them leaves only in the second stage - with active contractions, when the opening reaches 4-6 centimeters. Under the pressure of the fetal head, the fetal bladder bursts and the amniotic fluid flows out.

But in 10% of cases, childbirth begins with the passage of water. They may well leak in small portions, or they can go away immediately in full. Childbirth in this case is almost always considered complicated. If the contractions do not develop on their own after 6 hours, the woman is given drug induction of labor. If it does not help, an emergency caesarean section is performed.

Special tests, amniosystems, which are sold in pharmacies and are in every antenatal clinic, where a woman can turn with suspicion of leakage, and where she will be given an express assessment of the composition of secretions, can help distinguish water leakage from urine. When leaking, signs such as an increase in vaginal discharge should be alerted, especially when a woman spends several hours in a horizontal position and then sits down or stands up. Wet spots can appear on linen, on the bed.

The momentary outpouring of water requires attention from a woman. It is necessary not to panic, but to immediately assess the approximate volume of amniotic fluid, its color, smell and consistency. In this case, there is no need to wait for the contractions to begin at home. After draining of water or suspicion of beginning leakage, you should immediately go to the obstetric institution. The anhydrous period should be under medical supervision.

If the waters are not clear, but greenish, with blood or others, be sure to inform the doctor about it. This is often a sign of fetal hypoxia and a direct indication for caesarean section without waiting time for contractions and induction of labor.

During the first and repeated pregnancy

Harbingers in primiparous appear in advance, while in multiparous women immediately before childbirth. The time interval in the second case is very small, it can be limited to several days or even hours. And childbirth itself begins in different ways. Multiparous usually perceive everything more calmly, they have a generic experience, and therefore do not show increased emotionality on the eve of childbirth and do not take for signs of approaching labor some symptoms that are not at all. Increased suspiciousness is the lot of women who are going to give birth for the first time.

Therefore, women who are about to give birth for the first time usually notice the onset of labor faster, while multiparous women simply do not attach importance to many signs. The severity of sensations during the first birth is stronger, and the duration of each stage is overall longer.

If the second, third births and subsequent ones are on the way, a woman should consult a doctor for advice if she has three or more "precursors" at the same time, and you must arrive at the hospital earlier - when the contractions will be repeated every 10 minutes. The birth canal of such women in labor is better prepared, the opening of the internal and external pharynx of the uterus proceeds faster, there is a higher likelihood of rapid, rapid labor.

After stimulation

If a decision is made to stimulate labor for medical reasons, then the onset of labor will proceed under the supervision of doctors. Induction of labor involves a large range of medical measures - preparation of the cervix, amniotomy (puncture of the bladder and drainage of amniotic fluid), stimulation of contractions by the administration of doses of oxytocin. Once the bladder is punctured, contractions usually develop within 3-4 hours. If this does not happen, labor is stimulated with medications. If there is no effect, a cesarean section is performed.

Premature

As already mentioned, childbirth does not always occur on time. The fact that premature birth has begun can be prompted to a woman by a variety of symptoms, while there may not be any precursors as such. Premature labor is defined as labor that begins between 28 weeks and 37 weeks of gestation.

In most cases, doctors see the prerequisites for premature birth, inform the expectant mother about this, and be sure to offer hospitalization and constant monitoring. In some situations, such premature birth begins suddenly and is an unpleasant "surprise" for both the woman in labor and the doctor who observed her during pregnancy.

What signs may indicate the likely onset of labor earlier than the due date of obstetricians:

an annoying feeling of heaviness in the lower abdomen;
the stomach drops before 35 weeks of pregnancy;
the uterus often comes in tone and is in tension for a long time;
there are pink, bloody, or bloody discharge from the genitals;
the woman feels strong pressure in the perineum and pelvis;
there are girdle cramping pains.

Premature birth in itself is fraught with many dangers, and therefore, if at least one of the above signs appears, a woman should consult a doctor and not refuse hospitalization if it is offered by specialists. When bloody discharge appears, you must immediately call an ambulance.

Can it be accelerated?

Women who have already brought their baby to 39-40 weeks are almost always interested in whether it is possible to accelerate childbirth, since the body of the expectant mother is overloaded and very tired by the end of pregnancy. Medicine has a very specific opinion on this matter - it is impossible to accelerate childbirth without an urgent need outside the hospital, this can cause serious complications for both the mother and the baby.

There is a widespread belief among the people that walking up the stairs and washing the floors help to bring the onset of labor closer. The same properties are attributed to sexual contacts - semen contains natural prostaglandins, which accelerate the dilatation of the cervix. It is believed that the mother's walks on foot, picking up matches scattered on the floor while squatting, will help the "late" baby.

Various popular councils should be treated with great caution. So, advice to drink castor oil can lead to severe debilitating diarrhea, dehydration, and advice to breathe essential oils can lead to the development of a respiratory allergic reaction.

Despite the woman's fatigue, which is understandable and quite natural to everyone, experts simply recommend that you be patient. It is best for labor to begin without any stimulation, on your own. After all, neither traditional methods nor drug induction of labor guarantee that the contractions that have begun will be sufficient, coordinated, that there will be no primary weakness, which may become the basis for an emergency caesarean section.

If a woman previously had endometritis or a discrepancy of the abdominal muscles, there is a scar on the uterus, there is usually no question of any stimulation at all, since a baby who has been "rushed" can be born quickly, which will increase the risk of injury to both the mother and the fetus. and in the case of a scar, rupture may occur due to excessive muscle contractility.