How dangerous is the birth process without contractions? What labor contractions are like.

Having heard about rapid labor in an ambulance and even at home, many girls worry about how not to miss the onset of contractions and arrive at the maternity hospital on time. For this, there are certain guidelines, knowing which it is very difficult to miss “hour X”. You need to pay attention to your well-being, the frequency of contractions, vaginal discharge and the baby’s movements. How do contractions begin before childbirth in primiparous and multiparous women, how to distinguish true from false?

Within a few days and sometimes even weeks, the pregnant woman’s body begins to intensively prepare for childbirth. Everything changes, from the nature of a woman’s breathing and well-being to the size of her stomach and vaginal discharge. Careful self-observation will help you understand to the expectant mother how soon she will give birth.

Signs that contractions are starting before childbirth

Already a few weeks before giving birth, you can notice changes that indicate that the body is beginning to prepare. In primiparous women, these processes occur more slowly, so they are somewhat easier to notice. With repeated upcoming births, many changes can occur simultaneously, quickly, so detecting them is a little more difficult. The main points are as follows.

The belly gets smaller. Gradually the baby descends deeper into the pelvis. At the same time, the fundus of the uterus also shifts behind it, so it seems that the stomach has become a little smaller.
It becomes easier to breathe. Due to the fact that the fundus of the uterus and fetus shift downward, space is freed up for the lungs, which until this moment are in compressed conditions. Therefore, the woman will note a decrease in shortness of breath and the appearance of ease when breathing.
Heartburn is reduced. Due to the decrease in pressure on the stomach, the speed and volume of reflux of its contents into the esophagus is reduced, which causes a decrease in the symptoms of burning and pain in the chest.
Pain appears in the lower abdomen. Periodic pulling painful sensations in the lower back, sacrum and lower abdomen - a sign of the imminent start of “training contractions”.
Pressing sensation on the perineum. The presenting part of the fetus, which descends into the pelvis, compresses nerve endings and tissue, causing a bursting sensation in the lower abdomen, on the perineum.
The mucus plug comes off. Throughout pregnancy in cervical canal Women have special mucus that protects against the penetration of microbes to the fetus. On the eve of childbirth, as the cervix dilates, it begins to come out. Women often notice it as thick, clear or slightly grayish mucus in their vaginal discharge.
Diarrhea appears. Nature has long made sure that a woman’s body is prepared for childbirth. Natural loosening of stool occurs no more than a day before contractions.
Body weight decreases. Usually, on the eve of childbirth, a woman loses 1-2 kg instead of gaining. This is due to a decrease in appetite and a decrease in fluid in the body.

If a woman notices all of these symptoms, or at least some of them, it will be easier for her to recognize contractions before childbirth.

What are “false” abbreviations?

“Training contractions” or Bragston-Higgs are contractions of the uterus that are necessary to prepare the birth canal for the entrance of the baby. Women often confuse them with the onset of labor, especially during their first pregnancy.

Normal

False contractions are no different in nature from normal contractions, but they are less intense, short, and irregular. As a result of false contractions, the cervix opens, and the baby descends even further into the pelvic cavity.

The period from the beginning of training contractions to regular labor activity called preliminary. It can occur in physiological and pathological forms. Normally, a woman may feel the following:

contractions begin suddenly, often in the evening or early morning;
do not cause general anxiety to a woman;
despite them future mom may fall asleep;
decrease after taking antispasmodics;
irregular - there may be one contraction in two minutes, and then one after a 10-20 minute break;
contractions end as suddenly as they began.

Usually, after such training sessions, real contractions begin. The transition can be smooth, but often takes a couple of hours or even days. Also, false contractions can occur in several approaches, for example, over two days in the evenings. How training contractions go before childbirth depends on many factors, for example, psychological mood and the presence of diseases.

Pathological

Pathological preliminary period characterized by the following features:

contractions are painful and it seems that they are not going away at all;
a woman feels pain in the lower abdomen, lower back;
discomfort disrupt the psycho-emotional state;
impossible to sleep or rest;
pain is not relieved by antispasmodics.

The pathological preliminary period does not lead to structural changes in the cervix, but exhausts the woman and is accompanied by fetal suffering. Therefore, it is important to identify it in time and treat it. Often the pathological preliminary period becomes the reason for carrying out caesarean section or puncturing the bladder without contractions to stimulate labor.

How to distinguish

An important question is how to identify contractions before childbirth and when to go to the maternity hospital after that.

The intensity of true contractions does not decrease - they only become stronger and more frequent. They can start once every 20 minutes, but then become a multiplicity of ten, five, and then every three to five minutes. At this time, there is often a need for special breathing, which will help a woman endure not entirely pleasant and even painful sensations. At the peak of the contraction - “like a dog” (frequent shallow breathing), as the intensity decreases - deeper and calmer. The following table will help you distinguish between true and false contractions.

Table - True and false contractions before childbirth

Options	False contractions	True contractions
Duration	- 10-15 seconds	- First, 5-10 seconds; - gradually increase to 30-40 seconds
Intensity	- Average	- At first not strong; - then the intensity increases
Periodicity	- Irregular; - at different intervals - from 15 seconds to an hour or more	- Every 15; - then 10 and 5 minutes
Is there fatigue?	- Lightweight	- Moderate
Is it possible to sleep	- Yes, especially after taking antispasmodics	- No
Vaginal discharge	- Mucous (often a “plug”)	- Mucus plug; - water may appear

The main difference between real contractions and training ones is that the latter come and go again. If labor has really begun, then uterine contractions only become stronger and more frequent.

Many women wonder how to count contractions. It is customary to determine its duration, and then the number of minutes until the next one. But modern gadgets allow you to use a simple program. By recording the time, it supposedly reveals whether contractions are false or true.

When to go to the hospital

Women always have a question about when to go to the maternity hospital if contractions begin - immediately with the first symptoms or wait a while.

If contractions begin, but the water has not yet broken and nothing else bothers the pregnant woman, as soon as the uterus contracts every three to five minutes, it is necessary to go to the maternity hospital, if it is no more than 30 minutes away. You should go to the hospital immediately in the following cases:

if water flows– they are usually milky in color, with pathology – yellowish or greenish;
if there is bloody vaginal discharge– one of the signs of placental abruption;
if there are pushings during contractions– a feeling of strong pressure on the perineum when you want to expel the fetus;
if there is a sudden change in movements– either became excessively violent or stopped altogether;
if there is a suspicion of pathological “false contractions” - in this case than faster woman will apply for medical care, the higher the probability of a favorable outcome;
if the pressure has increased - or when other signs of gestosis progression appear (flickering “flies” before the eyes, severe headache).

What to do if in doubt

Often pregnant women doubt whether they are having contractions or just training. Such situations arise especially often in first-time mothers. However, you should not worry or hesitate to seek medical help. When visiting any maternity hospital, the doctor will confirm or deny the onset of labor. Multiparous women need to be especially vigilant, because contractions often last for some time and are hardly noticeable, and it is difficult to determine how long the interval is between them. As a result, such mothers barely have time to arrive at the maternity hospital.

How to relieve pain

Many women are confused and don’t know what to do during contractions. In fact, there is nothing special, but the basic rules on how to make childbirth and labor easier for yourself are as follows:

learn to breathe correctly in each stage of labor;
you can be in a warm shower, directing a stream of water to the sacrum and lower abdomen;
drink warm tea or water;
For many, pain at the stage of cervical dilatation decreases when walking;
you can massage the sacrum - with your hand, with tennis balls;
Exercises in which you need to sit on a gymnastic ball help.

If contractions look more like false ones, you can take antispasmodic drug(for example, “No-shpa” is safe), after this the pain should become less. You should not take other painkillers on your own.

Contractions, like pregnancy itself, occur differently for every woman. After all, there are no identical organisms. Then the question arises, how do you understand that contractions are starting? You should listen to your body, noticing even the slightest changes. With this approach important point it will be difficult to miss, and the woman’s reviews confirm this.

When a woman enters last weeks pregnancy, along with preparing the children's dowry and packing things for the maternity hospital, she involuntarily thinks about how everything will really be.

The main question is how will labor begin? With the breaking of the waters or with the appearance of characteristic labor pains? In this article we will try to answer this difficult question.

How does this happen?

And it happens in different ways. Children are not alike, pregnancies cannot be identical, and any obstetrician-gynecologist will confirm this. Carrying a child is a purely individual process, with its own difficulties and nuances. Childbirth also begins differently for everyone. The most preferable, from the point of view of doctors, is the sequence in which regular true contractions begin first.

They should not be confused with training ones. Unlike false contractions, true contractions cannot be relieved by changing body position or taking the No-shpy tablet, a warm shower will not help, and there will be no benefit from horizontal position bodies. True contractions, if they have begun, occur with simultaneous smoothing and opening of the cervix, which has been tightly closed throughout pregnancy.

This process is not controlled by the woman’s will and cannot be reversible, and therefore true contractions constantly grow, intensify, become longer, and the intervals between them become shorter.

As soon as the contraction repeats every 10-15 minutes, you need to go to the maternity hospital. There is no point in waiting for your water to break.

If labor proceeds correctly, according to the classical pattern described in all obstetrics textbooks, then the waters break without medical intervention when contractions become sufficiently frequent and strong. Pressure from the walls of the uterus at the moment of tension (at the peak of contraction) provokes a violation of the integrity amniotic sac, as a result of which the water pours out, the baby begins to move forward along birth canal. The attempts begin.

IN general outline, perfect birth have the following sequence:

the cervix becomes smoother, it becomes comparable to the body of the uterus, dilatation begins;
fibers smooth muscle become shorter with each subsequent contraction;
the walls of the uterus become denser;
the external pharynx opens, the opening increases with each contraction;
pressure on the bladder increases;
under pressure from the fetal head and the amniotic sac itself, the internal pharynx opens;
water is poured out and attempts begin - the uterus “pushes” the baby out.

The pushing ends with the birth of the baby, then the placenta comes out within 20-45 minutes. With this, the correct textbook childbirth ends, to the great joy of all participants in this process.

Like everything ideal, classic childbirth is a rarity.

There are quite a lot of variants of the norm, and therefore the sequence may be different. We answered the question of whether contractions can begin without the water breaking, but not completely. Very rarely, the water breaks at the very last moment, and the baby is born in the amniotic sac, in which it passes through the birth canal.

In this case, they say that the baby was “born in a shirt.” Popular rumors and signs attribute to such people incredible luck and great luck throughout their lives.

The waters have broken, but there are no contractions

This type of birth is considered unfavorable. But everything will depend on how ready the woman’s body was for upcoming birth and how quickly it will start contractile activity uterus.

If contractions begin to develop immediately after the water breaks, they are strong enough, and the cervix dilates at an optimal pace, then the prognosis is more favorable. If labor is weak, painful, the cervix dilates slowly or does not dilate, then the optimal solution is an urgent emergency C-section.

A long stay of a baby in a waterless environment (more than 8-12 hours) can lead to acute hypoxia, the death of the child, and irreversible consequences for his health, resulting from post-hypoxic disorders in the functioning of the brain. The 48-hour water-free period is considered critical (deadly), although even here everything is ambiguous, and miracles happen.

Situations where the water breaks first do not tolerate even a minute's delay.

The woman needs to be taken to a maternity hospital as soon as possible, where doctors will be able to assess the child’s condition, record his cardiac activity, motor activity, assess the degree of cervical ripening and take a quick and correct solution- stimulate labor or deliver the patient surgically.

The main danger of the waterless period lies in the possibility of infection of the fetus. The fact is that the waters are sterile. If they move away, the baby is deprived of protection. Without amniotic fluid and the mucous plug, bacteria and viruses can penetrate directly to the baby, and he is clearly not ready to meet them yet.

The rupture of water before contractions is usually caused by inflammatory or viral diseases suffered by a woman during pregnancy, the presence of isthmic-cervical insufficiency, polyhydramnios, pregnancy with twins or triplets, thin membranes (according to idiopathic reasons, which is not possible to establish). Also, early rupture of water before contractions can lead to falls on the stomach, butt, or back. later pregnancy.

Simultaneous process

Sometimes contractions begin almost simultaneously with the release of amniotic fluid. In this case, hospitalization should also be urgent. Staying at home and waiting for contractions to reach the required frequency and frequency, which was discussed so much in courses for expectant mothers, is dangerous.

The risks are the same as in the case of premature rupture of water. First, the baby may experience acute hypoxia; intrauterine infection often occurs, especially if some infections remain untreated in the woman herself.

A situation in which contractions began almost simultaneously with the water breaking is dangerous due to the development of rapid, quick birth, which, in turn, are dangerous due to receiving birth injuries, premature detachment placenta, massive bleeding and other severe complications for the child and mother.

There are contractions, but there is no effusion

In some situations, when the membranes in which the baby is located are too dense, doctor intervention is required. When there is no longer time to wait and an attempt is approaching, the cervix is fully dilated, the whole fetal sac is punctured, and a so-called amniotomy is performed.

Towards the end of pregnancy, a woman begins to be tormented by fears. She alternates between being afraid of childbirth, fearing that the process is taking too long to begin, and worrying that something will suddenly go wrong. At 36-37 weeks, at 38 weeks, discomfort in the abdominal area increasingly appears: it seems to harden, and some pain occurs.

The expectant mother is trying to determine whether real contractions have begun or whether this is simply the preparation of the uterus for difficult work - childbirth. During the second birth or third pregnancy, it is a little easier for a woman: she already imagines what true contractions are and will not confuse them with real ones. But it’s difficult for first-time mothers. What are the types of contractions, what are they like, and how do their symptoms differ during pregnancy? Let's try to understand how training ones differ from real ones. What are the differences?

What is the difference between false contractions and real ones?
Symptoms
How real contractions begin
True or false contractions: how the sensations differ
When do false contractions begin?
True contractions after training: is it possible?
Self-help measures

How to understand that contractions have begun for real

The first sign of real contractions is regularity. Contractions of the uterus, starting with not very pronounced discomfort, gradually become more frequent, and the intervals between them become shorter. If you feel a growing wave of pain 8 times in 2 hours or more often, this is a sign that it is time to prepare for a trip to the maternity hospital. If pain bothers you once an hour, are contractions felt or not? Most likely, this is just training for now.

Real contractions usually appear around 40 weeks (if everything is going well) - sometimes earlier, sometimes a little later. How to determine that the baby is about to be born? This can be understood by the following signs:

the intervals between waves of pain become shorter and shorter, the stomach tenses more than 5 times per hour, and then more and more often;
contractions are rhythmic - you can calculate the frequency by seconds;
the process is very painful, it can begin in the evening and last all night;
the plug comes off;
appear bloody issues from the genital tract;
water pours out (they can leak little by little).

Does the baby move during true contractions? Nature wisely arranged everything: she provided the baby with unconditioned reflex, which helps the mother to quickly “push” him out of the womb. During each real contraction, the baby rests his legs against the fundus of the uterus and pushes away from it. This reflex persists for some time after birth: if you put your hand on the heel of a newborn, he will try to push off from this support.

Due to the pain, the mother does not feel these movements. Just before the start of labor, on the contrary, it seems to her that the baby is somehow too quiet: he begins to move much less often than before.

How to distinguish training contractions from real ones

The main difference between Braxton-Hicks contractions and true contractions is that they occur at different frequencies. The difference between false contractions and real ones is also manifested in the fact that they are much less painful. Normally, there should be no pain at all - the pregnant woman only feels that her stomach is very tense (as if it is turning to stone).

Such contractions do not last all day or night. Usually they stop within an hour and then can start again - after a break.

A woman can influence such a contraction - for example, by taking no-shpu or papaverine. The medicine has a relaxing effect on the muscles of the uterus, and the contraction stops. There is no discharge from the genital tract.

During the examination, the doctor will note that the cervix is still closed. There are no harbingers of labor. This is a sign that the woman’s body does not yet “plan” to begin labor.

False contractions during pregnancy: symptoms

If you know the symptoms of false contractions, then you don’t have to worry: you can distinguish them from labor pains even without the help of an obstetrician.

So, false contractions have symptoms:

A gradually increasing feeling of compression of the uterus in the fundus, on the right or left, in the lower abdomen or groin area.
The most memorable symptom is irregularity. Therefore, when contractions occur, you need to arm yourself with a watch with a minute hand or a phone with a timer. Within an hour, false contractions occur no more than 6 times.
Their appearance is characterized by suddenness and unpredictability.
They are painless, the characteristic characteristic for them is discomfort in a certain area of the uterus.
They decrease gradually and then completely disappear.

How to recognize real contractions

At 38-39 weeks, a woman notices that the feeling that her stomach is getting hard begins to appear more and more often. She may be overcome with anxiety: what if it’s time to pack her bag for the maternity hospital? They can be distinguished by the severity of sensations: while training ones are almost always tolerated quite easily, then true ones literally exhaust a woman. Each time she has less and less opportunity to rest before the next attack. Contractions are frequent.

Contractions: how to understand that they are real? The pain quickly increases, and many women compare the nature of their sensations to a wave; it grows, becomes unbearable and then recedes.

You can determine this by the following signs: no matter what you do expectant mother to alleviate your condition, the pain does not decrease. She can try to do what she did previously during Bragston-Higgs contractions and which helped her stop the process completely:

change position - stand up if lying down, walk around if sitting;
move around, do household chores;
accept warm shower;
take a no-shpa tablet or put a suppository with papaverine.

In case of true contractions, this will not have any effect. A little relief can only come from a massage of the lumbosacral area and correct breathing, which the pregnant woman had to learn at the school for expectant mothers. But the relief will be insignificant.

A real contraction usually begins in the back and gradually moves to the stomach. Sometimes women feel as if their whole body hurts, that they are literally being torn apart from the inside. Someone who usually has very painful periods draws a parallel between contractions and this pain.

Does the stomach turn to stone during real contractions?

When a pregnant woman, closer to her due date, becomes increasingly stiff in her stomach and pulls in her lower back, she can ask the doctor: “If the stomach becomes stiff, are these painful false contractions or are they already real?”

Usually, with true pain, the pain is so intense that all other sensations - including the feeling that the stomach has become hard - lose significance and become secondary.

What happens during a fight? The uterus tenses under the influence of special hormones, “pushing” the fetus to exit. The cervix opens more and more over and over again, reaching such a width that it becomes able to let the baby’s head through. While the cervix is closed, this - that is, the onset of labor - cannot be allowed. The most painful and difficult thing is the process of disclosure. During false contractions, dilatation does not occur.

How long do false contractions last? Average duration they do not exceed a couple of hours. The most important thing is that their intensity does not increase, but, on the contrary, weakens.

False contractions: how many days before birth?

How long before birth do false contractions begin? The first signs of Bragston-Higgs contractions may appear as early as 20 weeks. But in the second trimester they usually do not bother the expectant mother too much.

A few days before giving birth, they may intensify. However, some women, on the contrary, experience a “lull” before childbirth.

Appearing at 20 weeks or 21 weeks - long before birth, Bregson-Higgs contractions become more pronounced by 38 weeks. The process is somewhat different for multiparous and primiparous women: in the second case, they begin later. Although each case is individual, it is impossible to determine in advance when training contractions will appear and how long they may last. How long it will take for labor to begin, if false contractions are in full swing, is also unknown: after all, it’s simple preparatory process. The uterus tenses, exercising in front of difficult work– the time is not far when labor will begin.

Can false contractions turn into real ones?

We have already found out that the answer to the question of whether real contractions can be irregular is, in this case, negative. But it is known that false contractions can precede true ones. It is impossible to say exactly when real contractions begin after training contractions: you need to watch for the appearance of other signs. Increasing pain, the direction of the “wave” from the back, and most importantly - the established frequency - will tell the expectant mother that “hour X” is already close.

It happens that labor begins prematurely: at 31, 32 weeks contractions began and became true. It is necessary to get to the maternity hospital as quickly as possible. The child can be saved!

At the beginning of the labor process, the doctor asks the woman about the frequency of contractions, clarifies what kind of pain she has, and asks whether the plug has come out, whether there has been an outpouring of water. He looks at the dilation of the cervix - this is how he determines the mother’s readiness for childbirth. To understand whether the child is ready, the woman undergoes a CTG. How to use CTG to determine whether everything is okay with the baby, whether it is necessary emergency help? Doctors focus on the fetal heartbeat - if it is from 110 to 150 beats per minute, everything is fine. If the number rises sharply to 160 and begins to fall, the child does not have enough oxygen. The doctor chooses the method of delivery. A caesarean section may be suggested.

What to do in case of false contractions

So, your term is 36-39 weeks, the doctor examined you, made sure that there was no dilation, reassured you, saying that these were Bragston-Higgs contractions, and sent you home to “finish your walk.” How to help yourself if contractions become noticeable and even painful, feel like strong tension and interfere with night's rest? First, you need to tune in to the fact that everything is going normally: both false and true contractions shorten the cervix and soften it, gradually preparing it for childbirth. Secondly, a number of measures can be taken:

take a shower – not hot, but warm;
walk around the apartment;
drink an antispasmodic.

For some, simply turning over to the other side helps. Light massage The lower back can also smooth out unpleasant sensations. Can training contractions last 3 hours? How many hours do they last? Normally, tension bothers a woman for several minutes, after which there is a break. Uterine contractions are spontaneous, and they can also be repeated during the day and night, but they never have a clear periodicity and do not look very painful.

Now that you know what false contractions are like and what the symptoms of real ones are, you will feel more confident. You shouldn’t panic during training contractions, but you need to tell your gynecologist about them. The doctor will assess the situation and develop a further pregnancy management strategy.

Have an easy pregnancy and a painless birth!

Current video

False contractions during pregnancy

It is believed that the process of contractions is irreversible. If they started during childbirth, then it is not possible to stop or weaken them.

If we talk about external influences, then contractions are really almost impossible to control. But for a variety of reasons they can stop and weaken. In this article we will talk about why labor weakness develops and what to do if this happens.

Causes

At normal birth contractions increase in time and duration, in strength and intensity. This is necessary to open the cervix so that the baby can leave the mother's womb. A situation in which contractions are not strong enough or were regular and then stopped is considered a complication of the birth process. If contractions slow down, they speak of primary labor weakness. If the attempts stop, they speak of secondary weakness of the labor forces.

Cessation of uterine contractions during childbirth is not normal. And the reason for this is hypotension of the smooth muscles of the uterus. Reduced uterine tone can result from:

uterine hypoplasia;
myoma;
endometritis;
uterine anomalies – saddle-shaped or bicornuate uterus;
failure of the uterine tissue due to previous abortions or diagnostic curettages;
scars on the cervix nulliparous women arising due to the treatment of erosion;
high level of progesterone in a woman’s body, reduced level of oxytocin;
hypothyroidism, obesity;
the age of the woman giving birth is under 20 years or over 36 years;
gestosis.

Most often, this complication occurs in women who give birth to their first child; during the second or subsequent births, the likelihood of developing weakness of labor forces is minimal, although not completely excluded.

According to statistics, up to 7% of all primiparous women experience weakening contractions or pushing; among multiparous women this occurs in 1.5% of cases. Most often, contractions stop suddenly when premature birth or during post-term pregnancy. At risk for sudden weakness of labor forces are women who are carrying a large baby or several babies at the same time, since the walls of the uterus in this case are overstretched.

Stopping labor threatens both women with polyhydramnios and those whose pelvic size does not correspond to the size of the fetal head. Too early release of amniotic fluid is also the cause of weak contractions. In addition, factors such as placenta previa, fetal hypoxia, and malformations of the baby may also affect the condition.

Quite often doctors cannot determine the reasons sudden stop contractions or slowing them down. At good analyzes and in an ideal state of health, a woman’s labor may slow down for psychogenic reasons.

If the child is unwanted, if there is strong fear before childbirth, if a woman was very nervous in the last days before giving birth, was in the midst of family conflicts, did not get enough sleep, did not eat well, the development of so-called idiopathic weakness of labor is possible.

Sometimes the reason is too much a large number of painkillers that the woman took on her own initiative, fearing pain during contractions, or administered in the maternity hospital, but the latter is the least likely.

Consequences

If you do nothing and stick to wait-and-see tactics, the likelihood negative consequences will grow every hour.

The baby can become infected, because the uterus is already partially open. A long period without water is dangerous due to hypoxia and the death of the child. If weakness occurs in the second half of labor, severe bleeding in the mother may begin, and asphyxia and injuries to the baby are possible.

What to do?

The woman herself just needs to monitor the duration and frequency of contractions in order to notice the lag in time. With pathological weak contractions, the rest intervals between uterine spasms are approximately 2 times longer than normal, and the contraction lags behind the norm in duration.

Everything else should be decided by doctors. First of all, they must understand how far behind the norm the dilation of the cervix during primary contractions is. A decision will then be made on further actions. So, sometimes it is enough to insert a catheter into bladder women in labor or perform a puncture of the amniotic sac during polyhydramnios, and labor resumes and then proceeds normally.

Puncture of amniotic sac amniotomy

Medication-induced sleep during childbirth

If a woman is very tired, she is exhausted, and the baby has no signs of trouble or hypoxia, then the woman in labor can be given sleeping pills so that she gets some sleep, after which labor can resume on its own.

If these measures do not help, the woman can be induced to give birth by injecting oxytocin intravenously, which increases contractility uterus. If stimulation turns out to be useless, then the woman undergoes a caesarean section.

Initially, without stimulation of labor, signs such as fetal hypoxia, a long anhydrous period, and the appearance of blood discharge from the genital tract, indicating possible early placental abruption, will speak in favor of an emergency cesarean section.

How to prevent it?

There is no way to prevent weakness of the labor force. But doctors can do everything that is necessary if a woman turns to the maternity hospital for help in time.

You can learn more about primary and secondary weakness of labor in the following video.

The last weeks of waiting are over. Contractions begin. The climax of the entire pregnancy is coming - a few more hours and you will see your baby. Of course, you will worry and worry about the outcome of labor, but if you are well prepared and understand what to expect, what happens at each stage of labor, then your courage will also return. Give life to a child! After all, this is such happiness! Prepare yourself, master techniques and methods of relaxation and breathing control in advance - they will help you maintain composure and cope with pain. And don’t be alarmed if during contractions something doesn’t turn out quite as you expected.

HOW TO DETERMINE THE BEGINNING OF CONTRACTIONS

YOUR ANXIETY that you will miss the onset of contractions is absolutely groundless. Although false abbreviations, which happen in the last weeks of pregnancy, can sometimes really be mistaken for the beginning of labor; you will not confuse real contractions with anything.

SIGNS OF CONTRACTS

Appearance
By opening slightly, the cervix pushes out the blood-stained mucus plug that clogged it during pregnancy.
What to do This can happen a couple of days before contractions start, so wait until your stomach or back pain becomes constant or goes away before calling your midwife or hospital. amniotic fluid.

Leakage of amniotic fluid
Rupture of the amniotic sac is possible at any moment. The water may flow out in a stream, but more often it oozes out little by little - it is retained by the child’s head.
What to do Call your midwife immediately or ambulance. Hospitalization is safer, even if there are no contractions yet, since infection is possible. In the meantime, place a waffle towel to absorb moisture.

Uterine contractions
First they make themselves known as dull pain in the back or hips. After some time, contractions will begin, similar to the sensations during painful menstruation.
What to do When contractions become regular, fix the intervals between them. If you think contractions have started, call your midwife. As long as they are not very frequent (up to 5 minutes) or painful, there is no point in rushing to the maternity hospital. The first birth usually lasts quite a long time, 12-14 hours, and part of this time is best spent at home. Walk slowly, stopping to rest. If your water has not yet broken, you can take a warm shower or have a light meal. The maternity hospital may advise you not to arrive before the contractions intensify and begin to repeat every 5 minutes.

HARNESSES OF CONTRACTS
Weak uterine contractions occur throughout pregnancy. In the last few weeks, they become more frequent and more intense, so sometimes they can be mistaken for the beginning of contractions. When you feel such contractions, get up, walk around and listen to see if they continue and if the pauses between them become shorter. Precursors of contractions are usually irregular.

FREQUENCY OF CONTRACTS
Monitor the dynamics of contractions over the course of an hour: beginning and end, intensification, increase in frequency. When contractions stabilize, their duration should be at least 40 seconds.

FIRST PERIOD

AT THIS STAGE, the muscles of the uterus contract to open the cervix and allow the fetus to pass through. During the first birth, contractions last on average 10-12 hours. It is possible that at some point you will be overcome by panic. No matter how well prepared you are, the feeling that something is happening to your body beyond your conscious control can be frightening. Stay calm and try not to disturb your body, do what it tells you. It is now that you will truly appreciate the presence of your husband or girlfriend nearby, especially if they know what contractions are.

BREATHING IN THE FIRST PERIOD OF LABOR
At the beginning and end of the contraction, breathe deeply and evenly, inhaling through your nose and exhaling through your mouth. When the contraction reaches its peak, resort to shallow breathing, but now both inhalations and exhalations are through the mouth. Don't breathe like this for too long - you may get dizzy.

ARRIVAL AT THE MATERNITY HOSPITAL

At the reception department you will be met by a nurse-midwife who will carry out all the formalities and preparatory procedures. Your husband may be next to you at this time. If you are giving birth at home, you will be prepared for the birth in the same way.

Midwife Questions
The midwife will check the registration records and your exchange card, and will also check whether your water has broken and whether there has been any release of mucus plug. In addition, he will ask a series of questions about the contractions: when did they start? how often do they happen? How do you feel? what is the duration of the attacks?

Survey
They will measure you when you change clothes. blood pressure, temperature and pulse. Your doctor will do an internal examination to determine how dilated your cervix is.

Fetal examination
The midwife will feel your stomach to determine the baby's position and use a special stethoscope to listen to the baby's heart. It is possible that she will record the fetal heartbeat through a microphone for about 20 minutes - this recording will help determine whether the child receives enough oxygen during uterine contractions.

Other procedures
You will be asked to provide urine to be tested for sugar and protein. If your water hasn't broken yet, you can take a shower. You will be directed to the prenatal ward.

INTERNAL INVESTIGATIONS
The doctor will, if necessary, conduct internal examinations, monitoring the position of the fetus and the degree of dilatation of the cervix. Ask him questions - you should also know what is happening. Usually disclosure the uterus is coming unevenly, as it were. in jerks. The examination is carried out in the intervals between contractions, therefore, if you feel the next contraction approaching, you will have to inform the doctor about it. You will most likely be asked to lie on your back, supported by pillows, but if this position is uncomfortable, you can lie on your side. Try to relax as much as possible.

CONTRACTS
The cervix is a ring of muscles that are normally closed around the uterine os. The longitudinal muscles that form the walls of the uterus extend from it. During contractions, they contract, pulling the cervix inward and then stretching it enough to allow the baby's head to pass through the uterine os.
1. The cervix relaxes under the influence of hormones.
2. Weak contractions smoothly smooth the cervix.
3. Strong contractions cause the cervix to dilate.

PROVISIONS FOR THE FIRST STAGE OF LABOR
During the first period, try to try different body positions, finding the most comfortable one for each stage. These positions must be mastered in advance so that at the right time you can quickly take suitable posture. You may suddenly feel like it would be better to lie down. Lie not on your back, but on your side. The head and thigh should rest on pillows.

Vertical position
On initial stage during contractions, use some kind of support - a wall, a chair or a hospital bed. You can kneel if you wish.

Sitting position
Sit facing the back of a chair, supported by a pillow. The head is lowered on the hands, the knees are spread apart. Another pillow can be placed on the seat.

Leaning on my husband
During the first stage of labor, which you will probably endure on your feet, during contractions it is convenient to place your hands on your husband’s shoulders and lean on him. Your husband can help you relax by massaging your back or stroking your shoulders.

Kneeling position
Get on your knees, spread your legs and, relaxing all your muscles, lower yourself top part bodies on pillows. Keep your back as straight as possible. In the intervals between contractions, sit on your thigh.

Four point support
Kneel down, leaning on your hands. This is convenient to do on a mattress. Move your pelvis forward and backward. Don't hunch your back. Between contractions, relax by lowering yourself forward and resting your head on your hands.

LABOR PAIN IN THE BACK
In cephalic presentation, the baby's head pushes against your spine, causing back pain. To make it easier:
during contractions, lean forward, placing your weight on your hands, and make forward movements with your pelvis; walk at intervals
In the intervals between contractions, let your husband massage your back.

Lumbar massage
This treatment will relieve back pain and also calm and reassure you. Let your husband massage the base of your spine, pressing on it with the heel of his palm in a circular motion. Use talcum powder.

HOW TO HELP YOURSELF

Move more, walk between contractions - this will help cope with pain. During attacks, choose comfortable position bodies.
Stay as straight as possible: the baby's head will rest against the cervix, contractions will become stronger and more effective.
Focus on your breathing to calm yourself and take your attention away from your contractions.
Relax during breaks to save energy for when you need it most.
Sing, even scream, to relieve pain.
Look at one point or object to distract yourself.
React only to this fight, don’t think about the next ones. Imagine each attack as a wave, “riding” which you will “bear” the child.
Urinate more often - the bladder should not interfere with the advancement of the fetus.

HOW CAN A HUSBAND HELP

Praise and encourage your wife in every possible way. Don't be put off if she gets annoyed - your presence is still important.
Remind her of the relaxation and breathing techniques she learned in the courses.
Wipe her face, hold her hand, massage her back, offer to change her position. You need to know in advance what kind of touches and massage she likes.
Be a mediator between your wife and medical personnel. Stay on her side in everything: for example, if she asks for a painkiller.

TRANSITION PHASE

THE HARDEST time of labor is the end of the first period. Contractions become strong and long, and the intervals are reduced to a minute. This phase is called transition. Exhausted, you will probably be either depressed or overly agitated and tearful at this stage. You may even lose track of time and fall asleep between contractions. This may be accompanied by nausea, vomiting and chills. In the end, you will have a great desire to strain and push the fetus out. But if you do this ahead of time, swelling of the cervix is possible. So ask your midwife to check that your cervix is fully dilated.

BREATHING IN THE TRANSITION PHASE
If premature pushing begins, take two short breaths and one long exhale: "Ugh, uh, uh-uh." When the urge to push stops, exhale slowly and evenly.

How to stop pushing
If the cervix has not yet opened, in this position, take a double breath and exhale long: “oof, oof, fu-u-u-u” (see above right). You may need pain relief. Kneel down and, leaning forward, put your head in your hands; pelvic floor it should seem to hang in the air. This will weaken the urge to push and make it more difficult to push the fetus out.

HOW CAN A HUSBAND HELP

Try to calm your wife down, encourage her, wipe away the sweat; If she doesn't want it, don't insist.
Breathe with her during contractions.
Put some socks on her if she starts getting chills.
If you start pushing, call your midwife immediately.

WHAT HAPPENS TO THE CERVIX
The cervix, palpable at a depth of 7 cm, is already sufficiently stretched around the fetal head.
If the cervix can no longer be palpated, it means that its dilation has completed.

SECOND PERIOD AS soon as the cervix is dilated and you are ready to push, the second stage of labor begins - the period of expulsion of the fetus. Now you add your own efforts to the involuntary contractions of the uterus, helping to push the fetus out. The contractions have become stronger, but they are less painful. Attempts are hard labour, but your midwife will help you find the most comfortable position and guide you on when to push. Don't rush things, try to do everything right. During the first birth, the second stage usually lasts more than an hour.

BREATHING IN THE SECOND STAGE OF LABOR
When you feel the urge to push, take a deep breath and, leaning forward, hold your breath. Take deep, calming breaths between pushes. Relax slowly as the contraction subsides.

POSITIONS FOR EXPELATION OF THE FETUS
When pushing, try to stay straighter - then gravity will work for you.

Squatting
This ideal position: The lumen of the pelvis opens and the fetus comes out under the influence of gravity. But if you haven't prepared yourself for this pose in advance, you will soon feel tired. Use a lighter option: if your husband sits on the edge of the chair with his knees apart, you can sit between them, resting your hands on his thighs.

On the knees
This position is less tiring and also makes pushing easier. Having support from both sides will give your body more stability. You can just lean on your hands; your back should be straight.

Sitting
You can give birth sitting on the bed, surrounded by pillows. As soon as you start pushing, lower your chin and clasp your legs with your arms. In the intervals between attempts, rest by leaning back.

HOW TO HELP YOURSELF
At the moment of contraction, strain gradually, smoothly.
Try to relax your pelvic floor so much that you feel it sinking.
Relax your facial muscles.
Don't try to control your bowels or bladder.
Rest between contractions, save your strength for pushing.

HOW CAN A HUSBAND HELP
Try to somehow distract your wife between attempts, continue to calm and encourage her.
Tell her what you see, such as the appearance of a head, but don't be surprised if she doesn't pay attention to you.

CHILDREN

THE PEAK OF BIRTH has arrived. The baby is about to be born. You will be able to touch your baby's head, and soon you will be able to hold him in your arms. At first, you will probably be overcome by a feeling of great relief, but it will be followed by surprise, and tears of joy, and, of course, a feeling of immense tenderness for the child.

1. The fetal head approaches the vaginal opening, pressing on the pelvic floor. The top of the head will soon appear: with each push it will either move forward, or perhaps roll back somewhat as the contractions weaken. Don't worry, this is completely normal.

2. As soon as the top of the head appears, you will be asked not to push any further - if the head comes out too quickly, perineal tears are possible. Relax, catch your breath a little. In case of threat serious breaks or any abnormalities in the child, you may have an episiotomy. As the head expands the vaginal opening, a burning sensation occurs, but it does not last long, giving way to numbness, which is caused by strong stretching of the tissue.

3. When the head appears, the baby's face is turned down. The midwife checks to make sure the umbilical cord is not wrapped around the neck. If this happens, it can be removed when the entire body is released. The infant then turns his head to the side, turning around before fully releasing. The midwife will wipe his eyes, nose, mouth and, if necessary, remove mucus from the upper respiratory tract.

4. The last contractions of the uterus, and the baby's body is released completely. Usually the baby is placed on the mother's stomach, since the umbilical cord is still holding it in place. Perhaps at first the baby will seem bluish to you. His body is covered with vernix, and there are traces of blood on his skin. If he is breathing normally, you can pick him up and press him to your chest. If breathing is difficult, he will be relieved Airways, and if necessary, they will give you an oxygen mask.

THIRD STAGE OF LABOR
At the end of the second stage of labor, you will probably have intravenous injection a drug that increases uterine contractions - then the placenta will come out almost instantly. If you wait for it to peel off naturally, you may lose a lot of blood. Discuss this point with your doctor in advance. To remove the placenta, the doctor places one hand on your stomach and gently pulls the umbilical cord with the other. After this, he must check that the placenta has come out completely.

APGAR SCALE
Having received the baby, the midwife evaluates his breathing, heart rate, skin color, muscle tone and reflexes, calculating a score on a 10-point Hangar scale. Usually in newborns this indicator ranges from 7 to 10. After 5 minutes, a second count is carried out: the initial score, as a rule, increases.

AFTER CHILDBIRTH
You will be cleaned and, if necessary, stitches will be placed. The neonatologist will examine the newborn, the midwife will weigh and measure him. To prevent the baby from developing rare disease, associated with insufficient blood clotting, he may be given vitamin K. The umbilical cord is cut immediately after birth.

Question and answer "I'm afraid of injury during childbirth. Is there such a danger?"
Don’t be afraid, there is no such danger - the vaginal walls are elastic, their folds can stretch and allow the fetus to pass through. “Should I breastfeed my baby immediately after birth?” You can give breastfeeding, but if the baby doesn’t take it, don’t insist. In general, the sucking reflex in newborns is strong, and when they suck, they are in a good mood.

ANESTHESIA

CHILDREN RARELY painless, but pain also has a special meaning: after all, every contraction is a step towards the birth of a baby. You may need painkillers, depending on how your contractions are progressing and your ability to cope with the pain. You may be able to overcome it using self-help techniques, but if the worsening pain becomes unbearable, ask your doctor for pain medication.

EPIDURAL ANESTHESIA
This anesthesia relieves pain by blocking the nerves of the lower body. It is effective when contractions cause back pain. However, not every hospital will offer you an epidural. The time of its use should be calculated so that the effect of the anesthetic ceases by the 2nd stage of labor, otherwise labor may be slowed down and the risk of episiotomy and forceps may increase.

How does this happen
Epidural anesthesia requires approx. 20 minutes. You will be asked to curl up with your knees touching your chin. Anesthetic will be injected with a syringe into the lower back. The needle is not removed, which allows you to administer an additional dose if necessary. The effect of the anesthetic wears off after 2 hours. It may be accompanied by some difficulty in movement and trembling in the hands. These phenomena will soon pass.

Action
On you The pain will pass, clarity of consciousness will remain. Some women feel weak and headache, as well as heaviness in the legs, which sometimes lasts for several hours.
Per child None.

NITRIC OXIDE WITH OXYGEN
This gas mixture significantly reduces pain without completely eliminating it and causes euphoria. Used at the end of the 1st stage of labor.

How does this happen
The gas mixture enters through a mask connected by a hose to the apparatus. The effect of the gas appears after half a minute, so at the beginning of the contraction you need to take several deep breaths.

Action
On you The gas dulls the pain, but does not relieve it completely. When you inhale, you will feel dizzy or nauseous.
Per child None.

PROMEDOL
This medicine is used in the 1st stage of labor, when the woman in labor is excited and finds it difficult to relax.

How does this happen
An injection of promedol is administered into the buttock or thigh. The onset of action is after 20 minutes, duration is 2-3 hours.

Action
On you Promedol manifests itself in different ways. For some, it has a calming effect, relaxing, causing drowsiness, although the consciousness of what is happening is completely preserved. There are also complaints about loss of self-control and intoxication. You may feel nauseous and shaky.
Per child Promedol can cause respiratory depression and drowsiness in a child. After childbirth, breathing can be easily stimulated, and drowsiness will disappear on its own.

ELECTRO-STIMULATION
The electrostimulation device reduces painful sensations and stimulates the internal pain coping mechanism. It works on weak electrical impulses that affect the back area through the skin. A month before giving birth, find out if there is such a device in the maternity hospital and learn how to use it.

How does this happen
Four electrodes are placed on the back where the nerves leading to the uterus are concentrated. The electrodes are connected by wires to the manual control panel. With its help you can regulate the current strength.

Action
On you The device reduces pain at the initial stage of labor. If contractions are very painful, the device is ineffective.
Per child None.

MONITORING THE CONDITION OF THE FETAL

DURING the entire period of labor, doctors constantly record the fetal heart rate. This is done with a regular obstetric stethoscope or using an electronic monitor.

OBSTETRIC STETHOSCOPE
While you are in the delivery room, the midwife will regularly listen through abdominal wall fetal heartbeat.

ELECTRONIC FETAL MONITORING
This method requires sophisticated electronic equipment. In some hospitals, such monitoring (control) is used throughout labor, in others - occasionally or in the following cases:
if labor is induced artificially
if you have had an epidural
if you have complications that could threaten the fetus
if abnormalities are detected in the fetus.
Electronic monitoring is absolutely harmless and painless, but it significantly limits freedom of movement - thus you cannot control contractions. If your doctor or midwife has suggested continuous monitoring, find out if this is really necessary.

How does this happen
You will be asked to sit or lie down on a couch. The body will be supported with pillows. Adhesive tapes with sensors will be placed on the abdomen to detect the fetal heartbeat and record uterine contractions. The instrument readings are printed on paper tape. After the amniotic fluid has broken, the baby's heart rate can be measured by placing an electronic sensor near his head. This monitoring method is the most accurate, but not very convenient. Some maternity hospitals use radio wave monitoring systems with remote control (telemetric monitoring). Their advantage is that you are not tied to bulky equipment and can move freely during contractions.

SPECIAL DELIVERY METHODS
EPISIOTOMY
This is a dissection of the vaginal opening to prevent rupture or to shorten the second stage of labor if the health of the fetus is threatened. To avoid an episiotomy:
learn to relax your muscles pelvic floor
When expelling the fetus, stay straighter.

Indications
An episiotomy will be needed if:
the fetus has a breech presentation, a large head, other abnormalities
you are in premature labor
use forceps or vacuum
you don't control your attempts
the skin around the vaginal opening does not stretch enough.

How does this happen
At the climax of the contraction, an incision is made into the vagina - downwards and, usually, slightly to the side. Sometimes there is no time for a painkiller injection, but you still won’t feel pain because partial numbness tissues also occur due to the fact that they are stretched. Suturing after an episiotomy or rupture may be quite lengthy and painful - a complex procedure that requires special care. Therefore, insist that they do you a good job local anesthesia. Suture material After a while it dissolves on its own; there is no need to remove it.

Consequences
It's normal to feel discomfort and inflammation after an episiotomy, but the pain can be severe, especially if it becomes infected. The incision heals in 10-14 days, but if something bothers you then, consult a doctor.

FRUIT EXTRACTION
Sometimes forceps or vacuum extraction are used to help the baby be born. The use of forceps is only possible when full disclosure cervix when the fetal head has entered it. Vacuum extraction is also permissible in case of incomplete dilatation - in the case of protracted labor.

Indications
Forced extraction is performed:
if you or the fetus have any abnormalities during childbirth
in case of breech presentation or premature birth.

How does this happen

Forceps You will be given pain relief - inhalation or intravenous anesthesia. The doctor applies forceps, wraps them around the child’s head, and gently pulls it out. When applying forceps, pushing is completely eliminated. Then everything happens naturally.
Vacuum extractor This is a small suction cup connected to a vacuum pump. It is brought through the vagina to the fetal head. While you push, the fetus is gently pulled through the birth canal.

Consequences
Forceps may leave dents or bruises on the fetus's head, but they are not dangerous. After a few days these marks disappear.
Vacuum The suction cup will leave a slight swelling and then a bruise on the baby's head. This too will gradually go away.

STIMULATION OF LABOR
Stimulation means that contractions will have to be induced artificially. Sometimes methods are used to speed up contractions if they are going too slowly. Physicians' approaches to stimulation often vary; so try to find out what the practice of inducing labor is in the area where you will be giving birth.

Indications
Contractions are induced artificially:
if, when labor is delayed for more than a week, signs of abnormalities in the fetus or dysfunction of the placenta are detected
if you are tall arterial pressure or any other complications dangerous to the fetus.

How does this happen
Artificially induced labor is planned in advance, and you will be asked to go to the maternity hospital in advance. There are 3 methods of stimulating contractions:
1. The hormonal drug cerviprost is injected into the cervical canal, softening the cervix. Contractions can begin in about an hour. This method is not always effective during the first birth.
2. Opening of the amniotic sac. The doctor pierces a hole in amniotic sac. Most women do not experience any pain. Soon uterine contractions begin.
3. A hormonal drug is administered intravenously through a drip that promotes contraction of the uterus. Ask for an IV to be placed on left hand(or to the right if you are left-handed).

Consequences
Introduction hormonal drug preferably, you can move freely during contractions. When using an IV, contractions will be more intense and the intervals between them will be shorter than with normal birth. Besides, you have to lie down.

BUTICAL PRECTION
In 4 cases out of 100, the baby comes out bottom bodies. Childbirth in this position of the fetus is longer and more painful, so it must take place in a hospital. Since the head, the largest part of the baby's body, will be the last to appear during birth, it is measured in advance with an ultrasound scanner to ensure that it will pass through the pelvis. An episiotomy will be required; Caesarean section is often used (in some clinics it is mandatory).

TWINS
Twins must be delivered in a hospital because forceps are often used to remove them. In addition, one of them may have a breech presentation. You will likely be offered an epidural. There will be one first stage of labor. There are two second pushes: first one child comes out, followed by the second. The interval between the birth of twins is 10-30 minutes.

C-SECTION

With a CESAREAN section, the baby is born through an open abdominal wall. You will be informed in advance about the need for surgery, but this measure may be caused by complications during childbirth. If a caesarean section is planned, an epidural will be used, meaning you will be awake and able to see your baby right away. If the need for surgery arises during contractions, then epidural anesthesia is possible, although sometimes it is required general anesthesia. It is difficult to come to terms with the fact that you cannot give birth normally. But these experiences can be overcome if you prepare yourself psychologically.

HOW DOES THIS HAPPEN
Your pubic area will be shaved, an IV will be placed in your arm, and a catheter will be inserted into your bladder. They will give you anesthesia. If you have an epidural, a screen will probably be placed between you and the surgeon. Typically a horizontal incision is made, then the surgeon uses suction to remove the amniotic fluid. The child is sometimes removed using forceps. After the placenta is delivered, you will be able to hold him in your arms. The operation itself lasts about five minutes. Stitching takes another 20 minutes.

Incision
The bikini incision is made horizontally, above the upper pubic line, and once healed it is almost invisible.

AFTER OPERATION
After giving birth, you will not be allowed to lie down for a long time without getting up. Walking and movement are completely harmless for you. The incision will still be painful for the first few days, so ask for pain relief. Stand straight, supporting the seam with your hands. After two days, start light exercise; in another day or two, when the bandage is removed, you can swim. The stitches are removed on the 5th day. In a week you will feel quite good. Avoid heavy exercise for the first 6 weeks. After 3-6 months the scar will fade.

How to breastfeed
Place the child on pillows so that his weight does not put pressure on the wound.