Real contractions before childbirth are involuntary contractions of the muscular layer of the uterus. During contractions, not only the baby is pushed out, but also the birth canal is prepared. At this time, the cervix smoothes out and gradually expands to a diameter of 10-12 cm. There are real contractions before childbirth and false, or training ones. The latter occur in the second half of pregnancy and represent contractions of the uterus, during which it prepares for labor. In this article you will learn how contractions begin before childbirth, what contractions look like, and how to distinguish real contractions from false ones.

How to recognize contractions before childbirth?

Mostly during the first birth, pregnant women wonder how to recognize contractions before childbirth. Quite often, even before contractions begin, women intuitively feel that labor will soon begin. During contractions, pain does not appear immediately; it usually begins with a feeling of discomfort in the abdomen or lower back; some women experience pain similar to menstrual pain. Gradually, these sensations become stronger, spreading to the entire abdomen and lower back, pain appears, which can vary from quite strong pressure to twitching sensations.

The pain during contractions is paroxysmal, its occurrence, intensification, reaching a peak and gradual decrease are clearly felt, then a period without pain begins. At first, contractions before childbirth occur with an interval of 15-30 minutes and last 5-10 seconds. The first few hours they bring minor discomfort rather than pain. Gradually, the duration and strength of contractions increase, and the intervals decrease.

Even before contractions begin, the baby begins to move less. If he moves very actively during contractions, this indicates fetal hypoxia. You need to tell your doctor about this.

Before childbirth, bloody discharge appears - this is how the mucus plug comes off. It should not be bright red with a lot of blood. The plug may come off before contractions begin. Sometimes the water breaks before the contractions begin.

Just before the birth of the child, contractions become so frequent that they turn into one another almost without intervals. Then they are joined by pushing - contractions of the muscles of the uterus, abdominal wall and perineum. At this time, the child presses his head on the small pelvis, and the woman in labor has a desire to push, and the pain moves to the perineum. When the cervix is ​​fully dilated, labor begins.

How do contractions occur?

Contractions before childbirth develop gradually, so three stages can be distinguished:

• The first stage is the initial stage, lasting 7-8 hours. At this time, contractions occur with an interval of approximately 5 minutes, and their duration is 30-45 seconds.
• The second phase is active. Its duration is about 5 hours, uterine contractions become more frequent and last longer - with an interval of 2-4 minutes, the duration of contractions reaches 60 seconds.
• The last, transitional phase is from half an hour to 1.5 hours long. Contractions become even more frequent and last longer. They can occur at intervals of a minute and last from 70 to 90 seconds.

If the birth is not the first, the process goes faster.

How to distinguish real contractions from false ones?

False or training contractions, also called Braxton-Hicks contractions, are contractions of the uterus, as a result of which the cervix does not open. They occur long before birth and, unlike real ones, are irregular.

Not every woman feels false contractions; everything is individual - both their presence and absence is a variant of the norm. They are painless, but bring discomfort.

Training contractions are called because during them the uterus prepares for contractions during childbirth. Also, during false contractions, blood rushes to the placenta, which is good for the fetus. False contractions are normal for pregnancy and do not pose any danger. False contractions begin around the 20th week.

Women who are expecting a baby for the first time are often afraid of confusing false contractions with the real beginning of labor. What is the difference between training and real contractions?

1. False contractions can occur from several times a day to six times an hour. At the same time, they are non-rhythmic, and the intensity gradually decreases. Real contractions before childbirth are regular and repeat at smaller intervals and with greater intensity, and their duration also increases gradually.
2. The length of actual contractions may vary, but the intervals between them are almost always equal.
3. False contractions are painless; they cause a feeling of compression in some part of the abdomen or groin. With real pain, sensations spread to the entire abdomen and hip joints.
4. During real contractions before childbirth, other symptoms are observed: breaking of water, mucus plug, pain in the lower back, diarrhea.

What to do when contractions start?

The start time of contractions, their duration and the size of the intervals between them should be recorded. This information will be useful to obstetricians; in addition, taking notes will help you calm down and take your mind off pain.

You can safely get ready for the maternity hospital. If contractions repeat after 15-20 minutes, the birth of the baby will not happen soon. If there are no pathologies, the pregnancy is not multiple, it is better to spend this period at home: a familiar environment will help you relax better. You can do pleasant things: listen to music, watch a movie. If you don't have a caesarean section, you can have something light to eat.

During contractions before childbirth, it is useful to move. This reduces pain, allows the baby to take a comfortable position in the uterus, and prevents fetal hypoxia. It is useful not only to walk, but also to make swaying movements with your hips. Thus, blood circulation improves, muscles relax, and pain decreases.

When uterine contractions become more frequent and intensified, the first thing a woman needs to do is take a comfortable position and relax. Then the pain will be less. Real contractions before childbirth become increasingly longer, and the intervals between them become shorter. The pain spreads from the abdomen to the lower back and does not subside when changing body position.

Signs of pathology during contractions

Sometimes, for various reasons, labor can be slowed down. The first contractions will not necessarily be followed by labor - uterine contractions may become regular only after a few days. This happens more often in primiparous women. In such cases, the maternity hospital resorts to stimulation of labor.

When is it time to go to the maternity hospital?

If real contractions begin before childbirth, it means that labor is approaching. Don't worry, you have time to calmly collect yourself while contractions occur at intervals of 20-30 minutes. Of course, it is advisable that the bag with things is already collected in advance.

The birth of a child is divided into three stages. During the first contraction, the aim is to fully dilate the cervix. The second stage is the passage of the baby from the uterus down the birth canal to the outside world. The third stage is separation of the placenta.

Although every woman's birth experience is unique, all women in labor go through these three stages. The whole process as a whole lasts on average about 14 hours for the first child and about 8 hours for subsequent ones. Some contractions, however, progress more slowly in the first stage and then speed up at the beginning of the second stage. There are many reasons why contractions may slow down.

♦ The child is in the wrong position Most babies are in the best position for birth with their head flexed and pointing down, looking sideways as they pass through the pelvis, and looking down their back as they emerge from the pelvis. If your child is not yet in this position, you can help him to do so. Changing your position and standing up straight can help your baby get into the best position for birth.

♦ Needs more adjustment and stretching The baby's head requires adjustment, and the pelvic tissues need stretching as the baby moves through the birth canal. It may take time to adjust and stretch. ♦ Weak contractions The reductions may not be enough, especially if this is your first child. Your doctor can make the contractions stronger with medication given through an IV.

FIRST STAGE

Contractions at the first stage are often divided into three phases: first or latent, active and transitional or hard. For many women

these phases are definite and distinguishable. Other women do not see clear boundaries between them.

First or hidden contractions

This is usually the longest part of the contraction and is generally the easiest. During this time, the cervix continues to thin and gradually dilates to 3-4 cm. At this stage, you may feel contractions, but they are usually manageable and you may even be able to sleep during them.

Contractions are usually short, lasting 20-60 seconds. Initially, the breaks between them can be up to 20 minutes, then they gradually intensify and become more frequent after about 6-8 hours. This may be the point at which the mucus plug is removed or the membranes rupture. If there are no medical indications for going to the hospital, it is much more convenient to stay at home during early contractions.

If you first notice contractions at night, continue to rest as much as possible. If you can't rest, find something distracting but not burdensome to do. Don't forget about snacks during this first step. Women are often advised not to eat at all during a contraction. Many hospitals have a policy of active labor management for primiparas. This means that your contractions will be last for a certain period period of time, and the doctor will help complete them if they drag on. Once it is determined that contractions have begun (by regular painful contractions, dilatation of the cervix and sometimes rupture of the membranes), the woman is expected to give birth within 12 hours. Frequent vaginal examinations are performed to check that the uterus is dilating at a rate of 0.5-1.0 cm per hour. If contractions appear to be slowing down, the membranes will be ruptured artificially and medication will be administered. Hospitals that practice active contraction management tend to shorten the duration of first contractions and reduce the number of caesarean sections.

kah in case of general anesthesia, when it is believed that they may suffocate. However, research suggests that there is little risk of this happening, while snacking during contractions may actually improve their development; contractions are hard work and your body will need energy to cope with it.

Symptoms in the early stages of labor may be similar to pre-labor symptoms - spasms, back pain, frequent urination, increased vaginal discharge, pressure on the pelvis, cramps in the legs and hips. Many women experience a surge of energy, but try to save that energy for the future.

Active contractions

This stage occurs when the cervix begins to dilate rapidly. For first-time mothers, at this stage it opens at a minimum speed of 1 cm per hour. Contractions become more noticeable and intense, and if in

At this point, check, then most likely the dilation will be 3 cm. Contractions last 45-60 seconds, intensify, the intervals between them are reduced from 5-7 minutes to 2-3.

As the contractions become stronger and longer, you may need to work harder to relax during and between them. Try walking around and changing your body position to relieve muscle tension. Physically, contractions can result in rapid breathing, increased heart rate, sweating, and

even vomiting. It is important to drink plenty of cold fluids to prevent dehydration. Then the contractions will be felt much stronger, and body pain and fatigue may increase. The amniotic membranes may rupture if this has not happened before. You may feel disconnected from life because you become focused on yourself. Women at this stage of labor sometimes believe that it will never end. Try to remember that this phase is usually short and that the cervix will soon dilate. You may also be concerned about how well things are going, so ask your doctor any questions you have. If you feel embarrassed for any reason, ask your birth partner to do this on your behalf.

Transitional contractions

The transition between contractions, which lasts from an hour to two hours, is the most difficult and requires strength; at this time, the cervix dilates from 8 to 10 cm. Contractions become very strong, last from 60 to 90 seconds and occur every two to three

Small meals can help with contractions

During contractions, the digestive system slows down, so it will not be able to cope with a full stomach, but “fractional meals” (frequently eating small portions) will support the body. Choose foods that are high in energy and easy to digest, such as toast and jam, bananas, soup. Avoid hard-to-digest foods such as meat, dairy products and fats.

minutes. If during the active phase you felt the rapid development of events, then during the transition phase everything will seem slow to you. However, believe - the end will come.

Due to the intensity of this phase, profound physical and mental changes accompany it. As soon as the baby passes into the pelvis, you will begin to experience a lot of pressure in your lower back and/or perineum. You may have frequent urges to go to the toilet, and your legs will become weak and shaky. Severe tension is not unusual and can be accompanied by excessive sweating, hyperventilation, trembling, nausea, vomiting and may lead to exhaustion. During this phase, without realizing it, women may reject the help of their birth partners, as well as not allow themselves to be touched or receive any help regarding contractions.

Many women abandon all inhibitions and express physical pain through atypical behavior, screaming and swearing. Try to see the goal. The pushing phase will soon begin and the discomfort will become much more manageable. Remember that the stronger the contractions, the sooner this phase will end. Don't be afraid to express yourself, find out what works and what doesn't. Try to relax as well, this is the key to maintaining strength and the best way to help the contractions reach their goal.

PAIN DURING CONTRACTS

Contractions is a word that defines the meaning, that is, it is hard work. This work is performed by a very powerful muscular organ. Since the muscles of the uterus are smooth, like the heart, most of the sensations of its activity come from the muscles and nerves surrounding the uterus. The nearby abdominal and pelvic muscles need to relax so that the uterus can effectively do its job of pushing the baby through said muscles and into the outside world. All this can be accompanied by feelings ranging from severe discomfort to terrible pain.

Being squeezed in the birth canal is very stressful for the baby, although it is natural, so the doctor observing you will want to determine the baby's condition. One way to do this is to determine the baby's heart rate using a portable ultrasound machine. Measurements should be taken at regular intervals of 15-30 minutes during contractions and then every five minutes during labor.

An alternative method is to use an external fetal monitor, which uses two sensors attached to the abdomen. One sensor records the baby's heart rate, and the other records uterine contractions. This type of control can be applied periodically,

so you can walk during contractions.

If the child is believed to be unwell, That its development may have to be controlled internally. Once the membranes have ruptured, a small sensor is inserted through the vagina and attached to the baby's head to record his heart rate.

If doctors feel they need more data, they can test the acidity of the fetus. A small tube inserted through the vagina collects a few drops of blood from the baby's head. The blood is tested for acidity, which shows whether the fetus is receiving enough oxygen. The results will help doctors plan further actions.

Purpose of pain

Hard work requires adequate amounts of oxygen and nutrients to keep your muscles pain-free. Muscles forced to work without oxygen or nutrition release And accumulate lactic acid, causing pain. The presence of pain may indicate that your body needs additional oxygen or nutrition. When you exercise, pain causes you to change the way you move, so during contractions it can be a signal to change your breathing rhythm, relax your muscles, or not have enough nutrients to help your uterus work.

If you have not prepared for the birth of a child, the main problem may be fear of the unknown, as it leads to a stress reaction, which leads to pain. Understanding what to expect during labor and birth can help V reduce said fear to a significant extent. If fear runs deep or if you have seen

or have heard horror stories about childbirth, it can be helpful to discuss your concerns with your care provider.

Medical pain control

There are many ways to cope with the discomfort of contractions (see Chapter 10 for more details). It's best to discuss your options with your doctor before your contractions, so the risks and benefits of each treatment are clear. Knowing the general principles of contractions will help you understand your own condition during them if you think you need medical intervention. Some methods may not be very suitable if you are close to giving birth, as many medications pass into the placenta, affecting the baby's ability to independently adapt to life in the outside world. Besides, knowing that you will give birth in an hour or two During contractions, as in most other situations, if you experience strong sensations without understanding them, it can lead to fear, stress and pain. Understanding what's happening with body, and realizing that these feelings are completely normal will help you explain contractions as “work” rather than “pain.”

Another way when the mind can help the body function, is to concentrate on the goal - in this case, the birth of a child. You may also find that distraction can help you cope. with a feeling of physical pain in the body. Exist Various mental distraction techniques you can use: from breathing, massage, meditation to hypnosis.

Using psychological strategies to cope with pain, the body should not be completely ignored. For example, you may feel discomfort because your child is walking out in the wrong position, but if you change position your body, you can turn the baby around. Or if your bladder is full, emptying it will help the baby come out. Nausea or weakness may indicate for low blood sugar or dehydration. Realize that contractions are an amazing moment and process for which the body is very well prepared"instrumentally". Work together with your body and deal with what is happening in an appropriate and positive way.

Goy, this may be enough to actively help the child move.

Natural contraction management

Try not to rely solely on medical remedies to cope with contractions. Over the centuries, women have created various methods and techniques to make labor more comfortable and medical intervention less likely. Some tried and tested techniques are given below. Ways of assistance that a birth partner can provide are given on p. 182.♦ Position during contractions Take different positions to find the most comfortable one. Try leaning against a wall or your birth partner; sit on a chair facing the back; kneel on a pile of pillows; get on all fours (good for back pain). There will be times when you feel like lying down, then cover yourself with pillows, placing them under your head, stomach, tailbone and between your thighs. ♦ Breath A good supply of oxygen is important during any strenuous activity, and childbirth is no exception. Muscles lacking oxygen produce lactic acid, the accumulation of which causes pain. A lack of oxygen reaching the uterus and placenta can cause the baby to become unwell. Thus, proper breathing is an important element of successful contractions. Breathing exercises, also called systemic breathing, are often taught in prenatal classes because they help to distract women in labor from the other sensations of contractions, ensuring adequate oxygen supply to mother and baby.

Systemic breathing doesn't work for everyone, and it's bad if you don't practice it beforehand. If you want to know more about this method and how it works, ask the instructor at the course.

At the onset of contractions, breathing slowly can help guide relaxation. Taking deep, relaxing breaths at the beginning and end of contractions ensures oxygen flows. When breathing, try not to panic and breathe too quickly, and do not hold your breath for a long time.

At the end of contractions, if the baby's movement stimulates the need for him to come out before the cervix is ​​fully dilated, the doctor may recommend labored or deep panting, as if trying to hold a feather in the air. This type of breathing is also helpful if you need to slow your baby's exit as his head emerges. Exhalation prevents the lungs from expanding and putting pressure on the uterus when it is not needed.

♦ Massage Rubbing and stroking muscles can relieve muscle tension and promote relaxation. Relaxation, in turn, will increase blood flow to the muscles and provide them with an adequate amount of oxygen. Massage carried out between contractions creates pleasant tactile sensations that help improve mood; Massage during contractions helps take your mind off the pain.

If you suffer from lower back pain, ask your birth partner to lightly rub the area, especially around the sacrum (where the spine connects to the pelvis). The massage therapist should first make a series of large circles with the knuckles, and then smaller circles with the thumbs.

♦ Relaxation methods Relaxation will help the body automatically respond to stress. This is a natural “blow-to-blow” reaction that has protected humans from the moment life began. However, the stress reaction is not always useful during contractions, since it causes tension in the muscles in preparation for action, wasting energy in significant quantities; it also leads to the outflow of blood from vital organs - the heart and brain, as well as the uterus.

The mental effort required to slow your breathing and relax your muscles can serve as a distraction from painful contractions. Relaxed muscles make it much easier

Provisions For childbirth

When it comes time to give birth, the best position is upright, as gravity helps push the fetus out. You can use just one position or try several; do whatever makes you feel comfortable. There are many positions you can give birth in, and during contractions, choose one or more to ease pain or help your baby move.

Knees-chest position If you have a large baby, this position can help relieve back pain and turn your baby's back-facing position. It can be useful to slow your child down if he or she is walking too fast. Kneel and place your hands on a pile of pillows or a large round pillow filled with polystyrene or foam rubber. If your back hurts, try rocking your hips from side to side.

Squatting The most common position, it helps the baby move quickly and allows the pelvis to expand up to two centimeters. You don't need to exert much force to push, but it is difficult to stay in this position for a long time. A birth partner holding you up from behind or a birthing chair may help.

Lying on your back This position is traditionally preferred by obstetricians because it makes medical intervention easier. It will also be the safest for a mother who is under deep anesthesia. However, in this position gravity is not used, but pressure

Placing a child on the back may increase the risk of perineal pain and injury.

Lying on your side Used if you are tired, promotes more efficient contractions and slows your baby down if he is going too fast.

Lie on your side on the floor, supported by a large round pillow filled with polystyrene or foam rubber, or regular pillows. If your upper leg is tired, ask your birth partner to support it.

Sitting A good position if you are tired, it is also used for continuous electronic monitoring of the baby's condition if necessary. Sit as straight as possible with pillows under your back and legs apart.

Kneeling with support

If your baby is in a posterior occipital position (facing his back), this position may help him roll over. Kneel on the bed between your birth partner and the provider. Place your arms around their shoulders for support as you push.

the work of the uterus, stretching as the baby passes through the pelvis.

It is important to learn relaxation techniques before giving birth. Understanding what happens during contractions will also help. Knowing that your feelings are normal can help your mind relax and your body relieve stress. ♦ Water Immersion in water can provide significant pain relief during contractions and even help them progress. Many hospitals that use water to relieve pain during contractions keep the water at or below body temperature, as the temperature may be harmful to the baby. Sometimes even a short immersion in water can stimulate contractions so quickly that

that you will give birth right in the water. Water birth is not a problem. Most doctors recommend holding the baby above water for its first breath as soon as it arrives, since the placenta can separate within seconds of birth and the baby needs oxygen quickly. Babies are born with an intact “dive reflex,” which allows them to hold their breath underwater; The baby will not take its first breath until it comes into contact with the colder air on the surface of the water.

SECOND PHASE

Entering transition means it's time to push the baby out. The second stage usually lasts an hour, but it can take less than ten minutes and last up to three hours.

You have reached the second stage of contractions and the moment of labor is approaching.

The baby's head presses on the pelvic floor. The doctor can feel the movement of head 1 with each contraction.

The baby's head is “erupting.”

The widest part of the head is visible at vaginal opening 2. As the head appears, you will be asked to relax and breathe quickly and shallowly rather than push.

The head appeared. After one or two contractions it will come out completely. The doctor will hold it gently until the whole body appears.

The body appears. After one or two contractions of the uterus, the rest of the body will appear. The child may be like during the initial stage of contractions, anesthesia can significantly increase its duration.

Even after long, exhausting contractions, many women in the second stage feel a surge of energy, since the cervix has already fully dilated and childbirth is about to occur. Now you can be much more active and mentally abstract, which will give you the most positive attitude.

The second stage has another significant advantage: when you push during contractions, the discomfort seems to disappear. Since the second stage has some duration, it allows the perineum to gradually stretch, although moments of pressure will be felt, but not painful. Often strong pressure from a closely walking child and subsequent squeezing

the nerve endings itself results in some form of anesthesia. For many women, this pinching of nerves blocks perception of perineal tears, medical incisions, and suturing.

Contractions in the second stage still last 60-90 seconds, but can come every 2-4 minutes. Your position may affect the pattern of contractions; standing can intensify them, while lying on your back and knees-to-chest position can slow them down.

You'll be tempted to push the baby out, but it's important to wait until your doctor says it's time. You will experience intense pressure on your rectum and a burning sensation as the baby's head emerges from your vagina. At this point, your feelings may change - from complete exhaustion and covered in vernix, and there may be blood stains on his skin 4.

The newborn is handed over to you.

Once the baby has been checked and the umbilical cord has been cut, he will be wrapped and handed to you 5. Place him on his stomach so that he can feel comfortable with the mother's familiar heartbeat and breathing pattern.

CUTTING THE UMBILICAL CORD

The doctor can clamp and cut one cord immediately or wait until it stops pulsating. Sometimes the doctor gently pulls on the umbilical cord to help the placenta, which is pushed out by uterine contractions, come out.

dansiness to enthusiastic excitement at the thought of the long-awaited meeting with the child.

Time to push the baby out

Once you've been cleared by your doctor to push your baby out, pushing during tense moments will give you relief from pent-up feelings. Even before the doctor’s decision, the body itself tells many women that the uterus has fully dilated and it’s time to push the baby out. As the baby presses on the pelvic floor muscles, the receptors signal to “push.” Often the urge to push is mistaken due to bowel urges, since the baby's pressure on the rectum irritates the same receptors.

Typically, the urge to push the baby out will occur 2-4 times during the period of uterine contractions, or you will experience one long continuous urge. Take a deep breath, relax your pelvic muscles and push your abdominal muscles. The duration of the effort is not as important as the timing of the uterine contractions. Short efforts (about 5-6 seconds) are usually sufficient and allow sufficient oxygen to enter the blood.

Sometimes the anterior lip of the cervix may not open fully when the first urge to push out occurs. This may happen because the baby is moving too quickly or is positioned poorly. Pushing the baby through an undilated uterus can cause swelling and delay labor. To reduce the cervical or, as it is also called, the anterior lip, try to lie on your left side or stand on all fours for several contractions. Sometimes blowing out breathing can help avoid pressure on the lip: this is the kind of breathing when you blow out a candle. The knees-to-chest position can also relieve pressure on the cervix and pelvic muscles, reducing the urge to push.

The birth of a child

The first sign that the baby is ready to be born is stretching of the anus and perineum. With each contraction, the baby's head becomes more visible in the vaginal opening. As soon as it stops moving back, it will remain at the entrance to the vagina. This position is called “cutting through.”

In a short period of time, the perineum thins from about five centimeters to one. This is completely normal and the stretched tissue will return to its normal state within minutes of delivery. You may feel this stretch as a lot of pressure, perhaps with some sharp pain, as the baby's head (or buttocks, if breech) stretches the vaginal opening. It is at this point that you may be offered an episiotomy if it is suspected that you will tear the tissue severely.

By the time your baby is born, it is best to continue with slow, controlled pushing movements, which will allow the perineum to gradually stretch and prevent tearing. The doctor may even advise you not to push so that the uterus itself completes the final moment with less effort.

Cutting the umbilical cord

After the baby is born, the umbilical cord is usually clamped in two places and cut between them. It is not necessary to clamp and cut the umbilical cord right away, but this allows the doctor to check the baby's condition if necessary. Having the umbilical cord cut also gives you more freedom to move with your baby. Some doctors prefer to wait until the umbilical cord stops pulsing. If the baby and mother are doing well, this is a reasonable option.

THIRD STAGE

The third stage of labor represents the complete completion of pregnancy with the removal of the placenta. In most cases this happens automatically and requires little effort. As soon as the baby leaves the uterus, the latter continues to contract, which leads to a significant decrease in its volume and usually tears the less flexible placenta from its walls. Subsequent contractions push the placenta out.

Many hospitals recommend active management of the third stage of labor to prevent severe postpartum hemorrhage. Immediately after the baby is born, an injection will be given in the upper leg, which will ensure further contractions of the uterus. This will allow the nurse to remove the placenta by gently pulling on the umbilical cord. If you are lying down, they may massage your uterus or ask you to push and push the placenta out.

Early breastfeeding helps prevent problems related to the placenta because nipple stimulation releases the hormone oxytocin, which contracts the uterus. If you have excessive bleeding, your doctor may prescribe an IV to help your uterus contract and reduce postpartum bleeding. Once the placenta comes out, they will check to see if there are any parts of it left in the uterus. Rupture of the placenta occurs very rarely when parts of it remain behind the uterus. To remove them, the obstetrician must reach inside the uterus and manually remove the remains. This surgery is usually performed in an operating room under general anesthesia to relieve pain.

IMMEDIATELY AFTER THE BIRTH OF A CHILD

The baby is finally born, and you are experiencing a storm of strong feelings - relief, jubilation, excitement and even disbelief that you have become a mother. You may feel chills, shivers, and be hungry and thirsty after all that hard work.

You will receive stitches before you leave the delivery room if you had an episiotomy or tears. Most women hardly notice that this has happened, they are so busy with their children; If necessary, local anesthesia is used. Don't be alarmed if you notice heavy bleeding. This is completely normal and the discharge, called lochia, will continue for the next few weeks. Mother pads should be used during this time.

After your child has spent some time with you, he will be taken for a bath and undergo a pediatric examination and necessary procedures. You may then be transferred to the maternity ward. The baby will be brought to you and a crib may be placed next to your bed.

Breech presentation

Breech babies are positioned so that their legs or buttocks are closest. This position of the baby can make labor difficult because the head is the largest part of the body and can become trapped if the body passes through a partially dilated cervix. With a breech presentation, vaginal delivery is possible, but these babies sometimes require a caesarean section to avoid injury to the baby or mother.

Two or more children

The prospect of having two or more children can be daunting, to say the least. But many women give birth to twins vaginally without any problems, and labor tends to go faster than with one baby. However, with multiple births, extra care must be taken and an anesthetist will always be on hand in case of a caesarean section. The first baby may be delivered vaginally without difficulty, but the second may be positioned incorrectly, in which case assistance will be required. The second child is born 10-20 minutes after the first. If progress is slow, you may be given medicine or forceps to speed up labor. The placenta or placentas may come out soon, or you may be given an injection to speed up its release. If you are expecting triplets or more, there is a high chance of a caesarean section.

Posterior view of occipital presentation

A baby moving through the birth canal with his head down and his back to

mother's spine (posterior view of the occipital presentation), it will be difficult to be born. These babies have a slightly larger head circumference to accommodate the narrow birth canal, and contractions may last longer and be accompanied by severe back pain.

PURE breech presentation

POSTERIOR VIEW OF OCCIPITAL PRESENTATION

However, it is not uncommon for the baby to turn in the middle of contractions or during the pushing stage. If the baby does not turn spontaneously, the doctor may encourage the baby to turn by increasing uterine contractions with medication.

PELVIC PRECTION WITH FEET FORWARD

In the last trimester of pregnancy, a woman increasingly feels special cramps in the abdominal area, which are called training or “false” contractions. These are irregular contractions of the uterine walls that do not initiate 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 to miss the onset of labor outside the hospital due to training contractions if they are unable to recognize the onset of true contractions. This fear is especially typical for those women who are carrying their first child. Doctors rush 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 can you determine that they have begun and what sensations will there be, is the pain severe, can it be alleviated?

Harbingers of childbirth

Childbirth does not occur suddenly, without any preliminary “bells”; the body makes full preparations for a difficult and prolonged labor, forming harbingers of an early birth. These include an increase in the frequency of training contractions and their intensification, although also without any regularity of occurrence, as well as shortening of the cervix, which causes the fetal head to descend into the small pelvis with a lowering of the abdomen. It becomes easier for a woman to breathe and eat. In addition, it is typical for the mucous plug to drain from the vagina either over several days or all at once in the form of a lump of pinkish mucus.

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

If such manifestations appear, childbirth is expected in the coming days, so you need to be prepared for it by collecting all the necessary things and bags with documents. Labor can begin with (gradual or immediate outpouring of a large volume) or with contractions, at first rare and not intense, then more and more strong and frequent.

It is contractions that mark the beginning of labor, or rather its first period, during which, due to contractions, a smooth and gradual opening of the cervix will occur. They begin as quite noticeable and painful, but short-term sensations in the lumbar and lower abdomen, forming at certain intervals. Gradually, uterine contractions become more frequent and longer, and the periods of relaxation between them become shorter and shorter, which indicates that the cervix is ​​almost open and there will soon be attempts.

What are contractions called?

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

As the contractions intensify and become more frequent, the cervix opens and smoothes out; by the time of pushing, the opening of the cervix reaches 10 cm. Against the background of contractions, the baby gradually moves along the birth canal.

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During the period of dilatation of the cervix, one of the contractions may open the amniotic sac, which leads to the rupture of water, or at a certain period the doctor will open it to stimulate labor.

Muscle contractions during childbirth are regular and intensifying; during contractions, the muscles spasm in the lower abdomen, causing it to become very tense and stiff. A woman experiences pain in the lower back, inside the abdomen and in the perineum, radiating to the tailbone.

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

The sensations of pain have a wave-like character, initially it is light and barely noticeable, 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 during a cramp, but with a gradual increase in pain. During contractions, through special techniques and practices, pain can be significantly reduced; for this, medications and pain relief are used, as well as relaxation methods, massage, etc.

Emotional components of contractions, sensitivity to pain

Each woman perceives childbirth differently, so everyone’s feelings during contractions are different. Some people talk about severe pain, but for others it is quite tolerable and is relieved by simple techniques. This largely depends on the pain threshold and sensitivity, and 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 may intensify; if she is collected and prepared, the contractions are easier to bear.

Recognizing contractions before childbirth

Sometimes, before giving birth, false contractions become strong and quite unpleasant subjectively, which is why they can mislead the expectant mother about the onset of labor.

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

True contractions have equal intervals between contractions, are not eliminated by a bath and rest, and increase in intensity of sensations and duration. It is worth distinguishing them from aching or abdominal pain due to the position of the fetus in the uterus and stress on the lower back, sprained ligaments and divergence of the pelvic bones in the area of ​​the pubic symphysis. There may be weak aching pain in the lumbar region, pelvis and abdomen, girdling in nature. In this case, there is no tension in the muscles of the uterus, the abdomen is quite soft.

Phases of the labor process, 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 shorten, and, based on this, three phases are distinguished in the first stage of labor:

• Latent (initial) can be hidden or slightly expressed in sensations
• Active
• Transitional.

For initial stage a typical time period 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 are gradually reduced to 10-5 minutes. At this time, the cervix dilates 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 dilates from 3 to 7-8 cm.

Transition phase in the first period the shortest, it lasts up to an hour and a half and 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 dilatation of the cervix up to 10 cm, when it can already allow the fetal head to pass through.

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.

What a woman should do when contractions begin

If contractions start, you shouldn’t immediately panic and shout “I’m giving birth,” you need to calm down, notice the intervals between them and get ready for the maternity hospital. You should arrive at the maternity hospital when the interval between contractions is about 10 minutes.. You should not focus on contractions; during them you need to breathe measuredly and calmly, and be distracted. If it gets cold for 20-30 minutes between contractions, you can slowly collect all your things, take a shower and go to the maternity hospital.

You should urgently go to the maternity hospital when your water breaks, blood appears, or other alarming symptoms appear, if your water has a green or pink tint.

What to do to ease contractions?

During labor, for some women, the 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 cannot be given (allergies to drugs, back skin problems, spinal deformities, threats from the fetus).

To improve the condition and relieve pain during contractions, there is relaxation and proper breathing techniques. They are taught during childbirth preparation courses, as well as in the maternity hospital upon admission; midwives usually help set up proper breathing.

The expectant mother is warned that the baby will soon be born by the first signs of contractions before childbirth. For some women, they appear within a few hours or days, while for others, symptoms are felt long before the birth of the child. Precursors in the 2nd and early 3rd trimesters are always false and help the body tune in to the upcoming process. Real contractions are a signal that the baby has begun his journey into this world.

The uterine muscles tense constantly, but only in the last months before giving birth will a pregnant woman be able to feel the first signs of the onset of contractions. They are painful, but short-lived (last no more than 1 minute). These manifestations do not have a certain periodicity and dynamics, but when they appear, they cause discomfort to the woman.

When a pregnant woman feels pain, her stomach also becomes hard. It is recommended to change the position of the body or switch to something else, the uterus returns to tone, and the spasms go away. Some women, if they lead an active lifestyle, do not even pay attention to the primary symptoms of contractions during pregnancy.

You can visually see how your stomach tenses for a few seconds and then relaxes. This phenomenon is often observed when the expectant mother takes a bath in the eighth or ninth month of pregnancy.

The purpose of false contractions is to correct the position of the fetus in the mother's womb, making it more convenient for the baby to move through the birth canal. Thanks to prenatal contractions, the cervix and the uterus itself prepare for the upcoming process so that it takes place without tissue injury. Such irregular “exercises” make the muscles more elastic and pliable for opening the neck.

Every week the painful symptoms of the first contractions become stronger, but these are not yet signs of labor. During training spasms, there is no pain in the lower back, concentrating only in the lower abdomen. This indicates that there is still a long way to go before the baby arrives.

The baby begins to gradually descend into the cervix, putting more and more pressure on the bottom of the uterus. If a woman is giving birth repeatedly, then this moment will begin later than for firstborns. In 10% of mothers, signs of the first contractions during pregnancy appear immediately before birth.

To understand that contractions are false, it is worth observing them. Without noticing an increase in duration and intensity, you can calm down - these contractions are training. Even if the plug has come off at this stage, it is too early to talk about the onset of labor.

This happens with false contractions, but the mucus in this case has a brown tint, not pinkish. Only the combination of a number of signs is confirmation that the process has entered the true stage.

Symptoms of real contractions

Moving purposefully towards the birth canal, the child sinks lower and lower. As soon as the fetus settles in the pelvis, the uterus contracts more actively, and these spasms become more frequent.

What are the symptoms of contractions in pregnant women:

1. spasms are regular, predictable;
2. the dynamics of growth can be traced;
3. the pain is not localized in one place;
4. Changing the position of the posture does not relieve pain symptoms.

Prenatal contractions become frequent and appear at regular intervals. With each subsequent contraction, the pain becomes stronger; it is felt not only in the lower abdomen, but also spreads to the lower back, which is not observed with false spasms.

Real contractions begin smoothly, reach a painful climax, and then subside. Signs appear because the circular muscles of the neck are being developed. Muscles, contracting, stretch downward, to the sides.

As soon as the spasm subsides, the muscles return to their original position. Subsequent contractions become more intense, allowing the cervix to open further. At the same time, during true contractions the uterus tends to push the baby out.

No matter how the pregnant woman tries to change her body position, she cannot get rid of the pain. It’s not possible to switch to some kind of activity, but exercises designed for such moments will allow you to endure the pain. To alleviate symptoms, it is recommended to resort to special breathing exercises that are taught to pregnant women.

Count of contractions

The entire process of labor takes several hours, or even days. It is divided into 3 main stages, based on the degree of advancement of the fetus along the birth canal. Contractions are the first signal before birth, making it clear that movement has already begun. Real contractions, unlike false ones, have their own dynamics that need to be controlled.

At what interval do the first contractions begin? At first, the contractions are barely noticeable, last no more than 10 seconds, and appear after 30-40 minutes. The intensity of the process gradually reduces the interval between contractions to 5 minutes, lasting about 15 seconds. This is a clear sign that the cervix has dilated by 4 cm, then the last stage of labor begins.

Monitoring the dynamics of uterine contractions is mandatory. If at least 5 contractions occur in an hour, it’s time to go to the hospital. The duration of painful spasms of 50 seconds with breaks of 3 minutes indicates that the uterus is fully dilated and the baby is about to be born.

In order to get to the delivery room on time, the pregnant woman begins to count her contractions. To do this, you need to have a watch with a second hand and a pen and notepad on hand. As soon as a woman feels the first painful contractions, she immediately records the time on paper and monitors the condition. Each time, the length of the contraction and the time until the next spasm begins are calculated.

If the pain makes it difficult to control yourself, you can entrust this procedure to one of your relatives. There are online programs on the Internet that allow you to calculate the intensity of contractions. They not only track the dynamics, but also tell you when false signs turn into true ones. By downloading the program application to a smartphone, a pregnant woman will be able to control the frequency online, even while in the maternity hospital.

Changing the degree of contractions

There are situations when contractions unexpectedly pass and labor activity subsides. If a woman is nursing, then labor stimulation is necessary. For their part, doctors will administer appropriate medications. A pregnant woman can also take part in speeding up the process.

How to speed up contractions:

• move more, sit less;
• stimulate the breasts;
• resort to manual techniques;
• change the situation.

To help the baby take the correct position, the mother is recommended to be active and lie or sit less. The movements will make it possible to shift the center of gravity downward, which will increase the pressure on the neck. Being active doesn't just mean doing housework or walking in the park. It is recommended to do gymnastics for pregnant women or dancing.

Massaging the nipples provokes the production of oxytocin, which stimulates labor. Manipulations are carried out manually or using a special pump. A woman can perform stimulation while lying in bed, sitting in a chair, or while in the shower.

A general massage is useful, which will not only reduce pain, but also speed up labor. Knowing the location of the desired acupuncture points, pressing on them can easily provoke the production of oxytocin.

Sometimes a boring environment has a negative impact on labor. It is important to change the surroundings here - go to another room, go outside or visit a friend. When you are in a hospital, it is enough to take a trip along the corridor or look into the ward where there is already a newborn baby.

When prenatal cramps are too intense and start prematurely, they can be slowed down. Breathing exercises and poses, massage, and a warm bath will help reduce pain. It is recommended to take a sedative, such as valerian.

Signs of labor

Mood and well-being. Pregnant women have premonitions on a subconscious level before contractions. Some women begin to experience increased fatigue, while others suddenly experience a burst of energy. The pregnant woman is under emotional stress, causing her mood to change several times a day.

Each of the features suggests that there is not long left before the birth. In addition to the signs of labor pains, there are other symptoms that a woman should not ignore.

Pelvic organs. The uterus carries out its preparation, periodically becoming toned in order to reject the fetus. Fabrics become more elastic. The cervix softens to such an extent that it easily opens and allows the baby to pass through. Pain in the lower back becomes more noticeable and spreads to the lower abdomen, groin, perineum, and the stomach drops.

Fetal activity. The child slows down his activity and purposefully moves towards the exit. The belly drops lower, which relieves pressure from the diaphragm, and the pregnant woman can breathe easier. But discomfort appears in the intestines and bladder, leading to problems with bowel movements and frequent trips to the toilet.

Chills and appetite. Symptoms include fever, accompanied by trembling and chills. For most people, stomach upset is accompanied by nausea and vomiting. Other mothers, on the contrary, have a strong appetite - the body is trying to restore the energy spent fighting contractions.

Cork. The consequence of abdominal prolapse is the release of the mucous plug that closes the entrance to the uterus. It looks like drops of pinkish jelly. If the plug comes out, it means that the cervix has begun to open, and it is time for the pregnant woman to prepare for childbirth. Although they can begin in a few days.

Water. The more the baby's body moves into the birth canal, the higher the likelihood of rupture of the membranes. Sometimes it does not open completely, and liquid gradually seeps out. The bubble may not burst, so you need to take into account the frequency of contractions.

Sometimes amniotic fluid is discharged even in the absence of uterine contractions. In this situation, you should go to the maternity hospital immediately, since without an amniotic sac there is a risk of the child contracting an infection. In such a situation, the umbilical cord may fall out, thereby cutting off oxygen supply to the fetus.

Weight. Another sign of impending childbirth is a loss of body weight by 1.5-2 kg in the last weeks. If you have scales at hand, you should monitor this parameter daily. This sign will allow you to tune in to the imminent manifestation of contractions.

Nesting syndrome. Even by her behavior, the expectant mother will be able to understand that an important event in life is just around the corner. The so-called nesting instinct is activated in the subconscious. The woman begins to actively tidy up the apartment, washing everything, ironing it, preparing children's things.

To understand that you are having contractions, you need to constantly listen to your body. Spasmodic pain that appears immediately before the birth of a baby differs from false contractions. Knowing the symptoms of these and other manifestations, it will not be difficult to distinguish true contractions from training ones. The dynamics of the phenomenon and accompanying signs will help the pregnant woman arrive at the maternity ward in a timely manner in order to give birth to the baby without complications.

Before we begin to study what contractions are and how they differ from each other, we need to define the very concept of “fight.” After all, expectant mothers expecting their first child have never experienced such a feeling before and are most worried that they will not notice it, miss it, or confuse it with something else. So, what is a fight, or more precisely, what do all, without exception, types of fights that will be discussed in this article have in common?

Contractions are the sensations associated with a short-term increase in the tone of the uterus during pregnancy and childbirth. At its core, a contraction is a single contraction of the muscular wall of the uterus. Typically this contraction lasts a few seconds. At the moment of contraction, the expectant mother feels a gradually increasing and then gradually decreasing tension in the abdominal area. If at this moment you place your palm on your stomach, you will notice that it becomes very hard - “like a stone”, but after the contraction it completely relaxes and becomes soft again. Apart from involuntary tension of the uterus, other changes in the well-being of the expectant mother during false contractions are usually not noted.

Braxton Hicks contractions

These contractions got their name from John Braxton Hicks, an English doctor who lived at the end of the nineteenth century and first described them in 1872. The contractions that Hicks mentioned are short, mild and completely painless contractions of the uterine muscles lasting no more than a minute. They can appear most often after the 20th week of pregnancy. Braxton-Hicks contractions are distinguished from other types of contractions by the complete lack of periodicity: these are simply short single contractions of the myometrium (uterine muscles), which normally appear during the day and are separated by significant time intervals: for example, a couple of times in the morning, one in the middle of the day, three at dinner and one more before bed.

At first, of course, new sensations can excite the expectant mother, but pretty soon most women get used to these contractions, fortunately, they appear rarely and irregularly, and stop noticing them altogether. As the period increases, the number of such training contractions that occur during the day usually increases, but even then they still remain short and completely painless. The need for Braxton-Hicks contractions for the expectant mother’s body is explained simply: the uterus is a muscular organ that at least occasionally needs to work, strain, contract—in a word, train in order to prepare for childbirth. Many pregnant women note that such contractions more often appear in a certain uncomfortable situation, for example, when walking quickly, bending over, or staying in an uncomfortable position for a long time. If the sensations are associated with physical activity, you can try to take a more comfortable position: sit down or lie on your side. If contractions occur due to an uncomfortable position, it is better to move a little: stand up, stretch, walk, or even take a short walk. These contractions are also called training contractions, and this is no coincidence: after all, they gradually prepare the mother’s body and nervous system for the new sensations that she will encounter during childbirth.

Training contractions

Harbingers of childbirth are usually called external manifestations of those changes in the body that are actually noticeable for the expectant mother, which become direct preparation for the onset of labor.

Precursor, training or false contractions are those that occur shortly before childbirth and are not labor itself, since they do not lead to dilatation of the cervix. These are the same contractions that future parents, due to inexperience, so often mistake for the beginning of real labor. In fact, distinguishing training contractions from real ones is quite simple: you need to find three differences.

Large intervals. False contractions are repeated at significant intervals; There may be intervals of 20, 30, 40 minutes or even an hour between adjacent sensations.

Irregularity of contractions. “Imaginary” contractions feel similar to real ones, but the intervals between them can differ significantly from each other. For example, the first labor contractions will occur clearly every 20 minutes. And a “false alarm” is characterized by an uneven rhythm of contractions and intervals: 20 minutes - 15 minutes - 30 minutes - 10 minutes - 45 minutes, etc.

Lack of dynamics. Training contractions, unlike real labor contractions, will neither intensify nor lengthen, and the intervals between them will remain uneven. Even if the “training sessions” happen quite often and alternate at equal intervals, they do not develop into something more: the interval and the sensations from the contraction itself remain the same after an hour, or two, or three.

Training contractions can have two different outcomes. In the first case, they will stop on their own. It should be noted that this scenario is the most common for a woman preparing to become a mother for the first time. After all, the uterus is a muscular organ and has the right to exercise before a decisive event. Much less often, such a “rehearsal” can turn out to be a dress rehearsal. Then the initially irregular intervals between contractions will gradually become regularized, and training contractions will gradually turn into regular labor. In any case, if it has become obvious that the contractions that have arisen are irregular (and in order to understand this, it is enough to compare a couple of intervals between adjacent contractions), the best thing to do is... go to bed. After all, before giving birth, it is especially important to save energy - after all, it will be so useful for this, the most important event in life! Even if events develop according to the second scenario, and the harbingers turn out to be a “dress rehearsal”, it is impossible to sleep through the birth! In the first case, the expectant mother will simply get some sleep and calmly wait for the real start of labor. In the second, she will also get enough sleep and wake up with good regular labor.

When is it time to go to the maternity hospital?
, as soon as the interval between contractions is reduced to 10 minutes, but no later! Until this moment, the expectant mother can stay at home. However, this is only possible if she is in good health. If a woman’s amniotic fluid begins to leak, her blood pressure rises, or bleeding from the genital tract occurs, go to the maternity hospital immediately!

Birth pains

The classic onset of labor is the occurrence of contractions that are insignificant in duration and sensation. The former are usually not associated with pain or significant discomfort. In fact, they are practically no different from the harbingers. Describing their sensations at this moment, women in labor say that the stomach tenses very strongly, but not painfully, and becomes hard as a stone for a dozen seconds. At the same time, a feeling of pressure is felt inside the abdomen - also completely painless, but rather strange and unusual. Then all the new sensations pass, as unexpectedly as they appeared, and the expectant mother’s stomach completely relaxes until the next contraction. Many women wait and are very afraid of pain at this moment. However, these fears are completely in vain: the first contractions can be called an unusual sensation, perhaps unpleasant, definitely exciting, but certainly not painful. The only subjective sensation with this type of onset of labor may be a slight “straining” in the lower abdomen and lumbar region. Most women experience similar sensations during the premenstrual period (PMS).

They occur periodically, at certain intervals. The intervals between uterine contractions are called intervals. During the pause, the uterus relaxes and the expectant mother rests without experiencing any unusual sensations. Thanks to contractions, the following occurs:

• dilation of the cervix, necessary for the baby to be able to leave the uterus (I stage of labor);
• movement of the fetus along the birth canal and its birth (II stage of labor);
• separation of the placenta from the wall of the uterus and the birth of the placenta - the placenta with the remains of the fetal bladder and umbilical cord (III stage of labor).

Each contraction develops in a certain sequence. At the beginning of the contraction, the contraction of the muscle wall is minimal, then it gradually increases, reaches a peak (the highest degree), and then also subsides evenly and gradually. At the end of the contraction, the uterus relaxes. We can say that the sensations during contractions are wave-like in nature: any contraction, no matter how significant it feels, begins with a barely noticeable feeling of tension in the abdomen, which gradually increases towards the middle of the contraction and also smoothly “fades away” towards its end . At the beginning of physiological (natural) labor, each contraction usually lasts no more than 10–15 seconds. As labor progresses, contractions gradually intensify and lengthen; towards the end of labor, one contraction lasts about a minute. And the intervals between contractions, which are quite long at the beginning of the process (15 or more minutes), gradually shorten and at the end of labor last no more than 2–3 minutes. Contractions at any time during labor occur involuntarily; the expectant mother cannot control them at will.

Pushing contractions

In the second stage of labor, when the cervix is ​​fully dilated, each new contraction pushes the baby forward, and it begins to move along the birth canal. From this moment on, each contraction is accompanied by a false urge to defecate (the desire to empty the intestines). This feeling is so similar to the desire to go to the toilet “big” that many expectant mothers believe that it arose in connection with a poorly done enema. This misconception is explained quite simply: it is caused by the pressure of the fetal head on the rectum, located next to the vagina. At this stage, the expectant mother needs to avoid premature attempts, which often lead to an increase in intracranial pressure of the fetus, and for the woman in labor, they are fraught with ruptures of the tissues of the birth canal. At the beginning of the pushing period, the expectant mother just needs to relax as much as possible, helping the baby descend through the birth canal due to contractions of the uterus. And only at the very end, when the baby’s head has dropped as far as possible, at the command of the staff, the woman in labor will begin to push - hold her breath and strain her abs, pushing the baby out.

Most expectant mothers also associate this stage with the fear of unbearable pain, but even here expectations will not be met. The very moment of the birth of a baby is accompanied by severe physical stress rather than pain for the mother. The fact is that the baby’s head stretches the tissues of the perineum so much that the blood supply to them is temporarily disrupted. Without blood supply, the transmission of a nerve impulse, which is also a pain signal, is impossible. Therefore, there is no pain in the perineum, which expectant mothers are so afraid of, at this moment! There is only a feeling of fullness inside the vagina created by the baby.

Afterpains

After the birth of a newborn, the contractions stop for a while, but after 5-10 minutes the new mother again feels a contraction, which marks the separation of the placenta - the placenta, umbilical cord and membranes. Following this, the placenta is born and the birth is considered complete.

However, even after labor is completed, the woman continues to experience postpartum contractions for several days. The main criterion for the recovery of a young mother’s body after childbirth is the rate at which the uterus returns to its normal size, the state of the muscle and mucous layer, which is typical for it outside of pregnancy. Involution of the uterus occurs due to its periodic contractions, or postpartum contractions. During such contractions, the uterus decreases in size, its cavity is cleared of excess mucous membranes formed during pregnancy, and the healing of the placental site (the wound remaining at the site of attachment of the placenta to the uterus) is accelerated.

These contractions are significantly different from labor contractions: the feeling of tension in them is practically not noticeable, and the pain is more reminiscent of intestinal spasms than menstrual pain. In order for the uterus to quickly return to its “pre-pregnancy” size, and postpartum contractions to stop bothering the young mother, the process of uterine involution can be stimulated as follows:

• Lie more on your stomach - in this position, tension occurs in the abdominal muscles, which is transmitted to the muscles of the uterus (myometrium) and stimulates its contractions.
• Monitor regular urination - a full bladder prevents the uterus from contracting and clearing secretions.
• Apply the baby to the breast on demand, every 1.5–2 hours: during sucking, the mother’s body produces oxytocin, a hormone that stimulates uterine contractions.

What you need to know about the warning signs of labor

1. The appearance of precursor contractions already at 35–37 weeks is normal and does not require an unscheduled visit to the doctor, emergency medical care or hospitalization. The harbingers of childbirth are just manifestations of a planned restructuring in the body of the expectant mother, the “finishing touches” of preparation for the upcoming joyful event!
2. The absence of precursor contractions closer to the expected date of birth is also not a pathology. Not all expectant mothers note on the eve of childbirth those changes in well-being that are commonly called harbingers. This does not mean that someone is not preparing for childbirth. It’s just that the “final preparations” sometimes go completely unnoticed by the pregnant woman. Thus, the subjective (that is, related to the pregnant woman’s feelings) absence of precursors of labor should not cause the expectant mother to worry and contact specialists overtime.
3. The appearance of precursor contractions indicates the likelihood of regular labor developing over the next two hours to two weeks. Consequently, the absence of labor an hour, a day, or even a week after the first noted precursory phenomena is not considered a violation and does not require special consultation with a doctor.

Are contractions real or not?

A very important sign of true labor, or real contractions, is the regularity of sensations, that is, adjacent contractions should be the same in strength, duration and intervals between them. At the same time, equal intervals between contractions are considered the main criterion for their regularity - after all, the contractions themselves are initially so short and insignificant in sensations that it may be difficult for the expectant mother to objectively compare them.

Another property of real labor activity is growth, or the ability to develop dynamically. From the moment labor begins, contractions should gradually intensify in sensation and lengthen in time; in this case, the intervals between contractions, on the contrary, will become increasingly shorter. If at the beginning of labor contractions last about 5–7 seconds, and the interval is 20 minutes, then by the time the cervix is ​​fully opened, when the baby begins to descend along the birth canal, the duration of contractions can increase to 40–50 seconds, and the interval can decrease to 1–2 minutes.