The question of how to understand when the contractions will begin is relevant mainly for primiparous women who do not have the slightest idea about how this period of labor proceeds. Contractions are expected with trepidation and excitement, with apprehension, and therefore pregnant women with special attention "listen" to their bodies in the last trimester of pregnancy. In this article we will talk about how contractions begin and whether they can be confused with something else.
What it is?
The name itself contains the physiological essence of what is happening. A contraction is the moment when the muscles of the uterus contract. They used to say "grabs", "grabs". This popular definition migrated to textbooks on medicine, and the word became the official medical definition.
Before giving birth, large-scale changes begin in the body of a pregnant woman. The cells of the uterine tissue - myocytes, by themselves do not have a great ability to contract, compress or stretch. In order for the contractions to begin, a sufficient amount of a special protein, actomyosin, must accumulate in them. It is he who is actively produced a few days before childbirth, more often 48 hours. Simultaneously with this process, the placenta and pituitary gland begin to produce a special hormone - oxytocin, which makes the muscles of the uterus more alert and provokes contractions.
With the first labor pains, the important process of cervical dilatation begins. A contraction, appearing from one part of the uterus, spreads to the entire genital organ. The round muscle, which is the neck, begins to open gradually. This is necessary so that the fetus, when the time comes, can leave the mother's womb. The baby's head is larger than the cervix, and therefore the latter needs to open up to 10-12 centimeters for the entire period of contractions, then the baby will be able to get out of the cozy space, which has become too small for him.
Uterine contractions "squeeze" and the fetal bladder. Therefore, at a certain stage of childbirth, the amniotic membranes do not withstand, they burst, and amniotic fluid is poured out. Natural childbirth is impossible without full-fledged contractions.
If cervical dilatation does not occur or it occurs very slowly, labor is stimulated or a cesarean section is performed.
False and true - differences
The purpose of true labor pains is clear and obvious. But with false contractions, women often have reasonable questions. Today, doctors and scientists do not understand the true purpose of false contractions (Braxton Hicks contractions). But it is known quite definitely that short-term tension of the uterus in pregnant women at any time from week 20 can in no way affect the date of birth.
They do not lead to the opening of the cervix, do not put pressure on the fetal bladder. False contractions are not accompanied by the production of oxytocin and actomyosin protein. There is a version that with the help of short-term contractions, the uterus prepares for childbirth, as if “rehearsing”. Training contractions are not observed in all women, they are practically painless and completely safe.
Contractions such as irregular episodes of increased uterine tone are felt.
Unpleasant sensations are quite possible, but they will not be painful. Rather, they can be described as stretching or aching in the very lower abdomen on the left and right. The sensation arises from the tension and tension of the ligaments that hold the uterus. The abdomen turns to stone and after a few seconds or minutes “lets go”. The next fight can be repeated in five minutes, and in five hours, or in a few days. The training fights do not have any regularity, cyclicality, ordering.
This is the main sign that will allow you to recognize false contractions from true ones, which always have a certain frequency, duration and sequence. In other words, contractions during the onset of labor will be repeated at regular intervals, last a certain number of seconds, and grow as it develops.
Painful sensations during a real fight are localized in the back, lower back, over the entire area of the abdomen. The pain begins from the back and lower back and gradually "girdles" the abdomen below and above. When changing the position of the body, taking a pill "No-Shpy" or papaverine, when taking a shower, false contractions usually recede. Real ones cannot be slowed down, delayed or stopped.
It won't be hard to tell the difference, obstetricians say. Real labor pains feel completely different. The nature of sensations, the place of pain, cyclicality and regularity - these are the main signs that will help a woman navigate in time what is happening.
Today, women have access to special applications for smartphones, the so-called counter programs, which will notify their owner that her contractions are real, they will also indicate when it is time to go to the maternity hospital.
Harbingers
Almost always, labor pains are preceded by the so-called symptoms - harbingers. They can appear during pregnancy both a few days before the birth of a baby, and just a few hours before delivery. As already mentioned, before childbirth, serious hormonal, biochemical and physiological changes occur in a woman's body. And these changes can be manifested by the following signs.
- Abdominal prolapse. A harbinger is considered only conditionally, since in some, the stomach sinks long before childbirth.
- Weight loss. A week before giving birth, on average, a woman can lose 1-3 kilograms due to a decrease in the amount of water, due to hormonal changes and a decrease in progesterone levels.
- Diarrhea. Loose stools are found in every second pregnant woman. It is believed that this is how a woman's body is "cleansed" before giving birth.
- Mood swings, depression, anxiety, insomnia - usually worse 3-4 days before delivery.
- Discharge of the mucous plug. It is a yellowish, transparent, pinkish mucus lump with or without blood streaks. After the cork is gone, labor can begin in a few hours or a few days.
- Increase the frequency of training contractions.
- Increased vaginal discharge.
It is not necessary that all these "harbingers" are felt in the complex. But even 1-2 signs from the list may well serve as a signal for readiness. When the precursors appear, do not immediately grab a bag with things and documents and run to the maternity hospital. It can be quite long before the birth. It all depends on how a particular female body will perceive hormonal changes, at what speed the preparation of the uterus and the ripening of the cervix will proceed. It should soften, and it is this process in the precursor stage that can lead to the discharge of the mucous plug from the cervical canal.
The cork may not come out, you don't need to be afraid. More precisely, she will definitely come out, but a woman may not notice this, since this can happen during urination. Often, the plug leaves its place in the cervical canal along with the waters or at the first stage of labor pains.
Start
Pregnant women are very suspicious, and therefore any changes in their well-being before childbirth can be perceived as a sign that contractions are beginning. On this topic, experienced obstetricians like to say that you cannot miss a contraction, and if in doubt, it means that labor has not yet begun.
You can understand that they have begun by the regularity of the contractions. Already from the very first there will be a noticeable definite pattern. The longest latency period always starts first. In primiparas it can last up to 10-12 hours, in women who have given birth earlier - up to 8 hours. During this period, the uterus should open up to 3 centimeters. The opening is slow, the uterus contracts and relaxes. The fight begins involuntarily, without the participation of the woman's will, and ends after a certain period of time with relaxation.
In the latent stage, contractions will build up gradually. At first, they can happen every 30-40 minutes. The duration of the contraction itself is small - no more than 20 seconds. The sensations during real contractions leave no doubt about what is happening - the woman feels a painful compression of the uterus in the back, in the lower back, and along the entire abdominal wall. This means that the earliest contractions will be relatively rare. Between them, the woman will have about half an hour to rest.
Since the stage is long, there is still time to check all the things that were collected at the hospital, the presence of all the necessary documents, you can not rush to go to the medical facility. You can walk, take a shower, change clothes, some even sing to distract. You need to try to relax as much as possible and tune in to a positive and easy delivery. With all this, a woman must monitor the frequency of contractions and the duration of breaks between them, either using a stopwatch or a watch with a second hand, or using a special program on a smartphone.
You need to go to the hospital when the contractions are repeated every 10-15 minutes.
At the end of the latent period, the period of active contractions begins. It lasts about 4-5 hours, during this time the cervix will open a little more and the opening will be up to 7 centimeters. Contractions intensify, repeat on average every 3-4 minutes, and last up to 60 seconds. This period will require concentration, attention and certain knowledge of the rules of behavior in childbirth from a woman - breathing, postures that facilitate the strength of contractions.
The active period ends with a slowdown period. The strongest contractions for all births are manifested - transitional. They lead to a full dilation of the cervix up to 10-12 centimeters. This period lasts from half an hour to one and a half hours. In primiparas - longer than in multiparous. After that, there is a feeling of pressure downward, as if the woman suddenly wanted to empty the intestines. This is the beginning of pushing and the end of the first stage of labor.
Premature birth is often accompanied by early or prenatal effusion. If the waters have receded, and the contractions have not come, the woman does not need to wait for them to appear. You should immediately go to the maternity hospital, since a long anhydrous period is extremely dangerous for both the child and his mother. And after a spontaneous rupture of the fetal bladder and after its opening (amniotomy), the woman should be under the supervision of doctors.
Contractions can begin at any time of the day - day, night, morning or evening. But in most cases, women say that they felt the first contractions in the afternoon. They are felt more strongly when lying down.
In 10% of cases, childbirth begins with the discharge of amniotic fluid. In only 5% of cases, labor begins on the day indicated as the intended day of birth (PDD). In the rest, the onset of contractions can be expected from 37-38 weeks of pregnancy and later. Childbirth before 37 weeks is considered premature.
How to proceed?
If a woman feels that contractions have come and determines that they are real, true, there is no need to panic. There is plenty of time to calmly drink tea, take a shower and come without haste to the hospital with things. You need to tune in correctly, remember everything that was taught in the courses for expectant mothers.
Already from the first latent stage of contractions, a woman can take control of her condition into her own hands. Correct breathing will help her. You need to inhale deeply and slowly and exhale slowly. As the pain intensifies, the contraction can be “breathed in” by applying shallow short breathing based on deep inhalation and partial exhalation, as well as dog-like breathing.
It's important to breathe this way and not scream, because as the blood is saturated with oxygen, the woman's body begins to produce endorphins, which are not only "hormones of happiness" and improve mood, but also have a pronounced analgesic effect. There are even whole methods of labor pain relief only on the basis of breathing, aromatherapy, warm and cold compresses, massage (Lamaze method).
Women receive a description of the different methods in the classroom at the antenatal clinic, where they are taught breathing, correct postures, in which it will be more comfortable to survive the active phase of contractions.
Try not to eat or drink a lot of fluids early in your labor. Do not take any medication. Move to speed up the dilatation of the cervix, do not lie or sit in one place.
So, with correct breathing and Spartan calmness (in panicking women, those who are very afraid, the contractions are usually always longer and painful), you need to check the documents and call an ambulance or ask your relatives to take you to the maternity hospital. The “ambulance” option is preferable. If something goes wrong, the woman in the ambulance will always be able to get timely help.
Do not wait for a certain frequency of contractions, but immediately go to the hospital if there is bloody discharge from the genitals, water has left.
You especially need to hurry up if the released water is green or any other dark color. This is always a sign of the child's trouble, hypoxia, so you need to get to the doctors as soon as possible, who will decide how to help the baby.
Anesthesia
To relieve pain in the active and transitional stages of labor in modern maternity hospitals, the method of epidural anesthesia is often used, in which the anesthetic is injected directly into the spinal canal. To agree to such anesthesia or not, every woman is free to decide for herself. Feedback from women who have gone through pain relief labor has not always worked as expected. The injection does not relieve pain at all.
Much more positive feedback on the natural pain relief of contractions by the Lamaze method and "Kobas-breathing". Women who tried to approach each stage of childbirth from the first contraction to the last push from the standpoint of natural behavior, correct breathing, obedience in childbirth, argue that childbirth was easy enough, quickly and the sensations were quite tolerable.
For information on how to understand that labor has begun and identify contractions, see the next video.
