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

Having heard about the rapid delivery in the ambulance and even at home, many girls worry about how not to miss the start of labor and arrive on time at the hospital. To do this, there are certain guidelines, knowing which it is very difficult to miss “hour X”. Attention must be paid to your well-being, the frequency of contractions, vaginal discharge and baby movements. How do contractions begin before childbirth in primiparous and multiparous, how to distinguish true from false?

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

Signs that contractions are starting before childbirth

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

The stomach is decreasing. Gradually, the baby descends deep into the small pelvis. At the same time, the bottom 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 bottom of the uterus and the fetus are shifted down, space is freed up for the lungs, which until this moment are in compressed conditions. Therefore, the woman will notice 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 the reflux of its contents into the esophagus decreases, this causes a decrease in the symptoms of burning and pain behind the sternum.
There is pain in the lower abdomen. Periodic pulling pain in the lower back, sacrum and lower abdomen is a sign of the imminent start of “training contractions”.
Pressing sensation in the perineum. The presenting part of the fetus, which descends into the small pelvis, compresses the nerve endings and tissues, causing bursting sensations in the lower abdomen, on the perineum.
Mucus plug comes off. Throughout pregnancy, a special mucus is in the woman's cervical canal, which protects against the penetration of microbes to the fetus. On the eve of childbirth, as the cervix opens, it begins to come out. Often women notice it as a thick, clear or slightly grayish mucus in the vaginal discharge.
Diarrhea appears. Nature has long made sure that a woman's body comes prepared for childbirth. There is a natural loosening of the stool no more than a day before contractions.
Decreased body weight. Usually, on the eve of childbirth, a woman loses 1-2 kg instead of an increase. This is due to a decrease in appetite, 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 Bregston-Higs - uterine contractions that are necessary to prepare the birth canal for the baby to enter. Often women confuse them with the onset of labor, especially during the first pregnancy.

Normal

False contractions by their nature do not differ from ordinary ones, but they are less intense, short, irregular. As a result of false contractions, the cervix opens, and the baby descends even more into the pelvic cavity.

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

contractions begin suddenly, more often in the evening or in the morning;
do not bring general concern to a woman;
in spite of them future mom can fall asleep;
decrease after taking antispasmodics;
irregular - there may be one fight in two minutes, and then one after a 10-20 minute break;
contractions end as abruptly as they started.

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

Pathological

The pathological preliminary period is characterized by the following features:

the contractions are painful and it seems that they do not go away at all;
a woman feels pain in the lower abdomen, lower back;
unpleasant sensations violate the psycho-emotional state;
unable 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 caesarean section or bladder puncture without contractions to induce labor.

How to distinguish

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

The intensity of true contractions does not decrease - they only become stronger and more frequent. They can start every 20 minutes, but then they 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 quite pleasant and even painful sensations. At the peak of the contraction - “like a dog” (frequent shallow breathing), with a decrease in intensity - deeper and calmer. The following table will help 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 up to 30-40 seconds
Intensity	- Medium	- First weak; - then the intensity increases
Periodicity	- Irregular; - with 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	- Not
Vaginal discharge	- Mucous membranes (often a "cork")	- Mucus plug; - water may appear

The main difference between true fights and training fights is that the latter come and go again. If the birth has really begun, then the contractions of the uterus become only stronger and more frequent.

Many women wonder how to count contractions. It is customary to determine its duration, and then the number of minutes before a new one. But modern gadgets allow you to use a simple program. Having fixed the time, she presumably gives out whether these are false or true contractions.

When to go to the hospital

Women always have the question of when to go to the hospital if contractions have begun - immediately with the first symptoms or wait some more time.

If the contractions begin, but the water has not yet broken and nothing else worries the pregnant woman, as soon as the contractions of the uterus are 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 immediately go to the hospital in the following cases:

if water flows- they are usually milky in color, with pathology - yellowish or greenish;
if vaginal discharge with blood- one of the signs of placental abruption;
if during contractions there are attempts- a feeling of strong pressure on the perineum, when you want to expel the fetus;
if the movements have changed dramatically- either became excessively stormy, or stopped altogether;
if there is a suspicion of pathological "false contractions" - in this case, the sooner a woman seeks medical help, the higher the likelihood of a favorable outcome;
if the pressure rises or when other signs of progression of preeclampsia appear (flashing of "flies" before the eyes, severe headache).

What to do when in doubt

Often pregnant women doubt whether they are having contractions or just training. Especially often such situations occur in primiparas. However, you should not be worried or ashamed to seek medical help. When contacting any maternity hospital, the doctor will confirm or deny the onset of labor. It is especially necessary to be vigilant in multiparous women, because often the contractions last for some time inconspicuously, and it is difficult to determine how long the gap is between them. As a result, such mothers barely have time to come to the hospital.

How to relieve pain

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

learn to breathe correctly in each period of childbirth;
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 the contractions are more like false, you can take an antispasmodic drug (for example, No-shpa is safe), after which the pain should become less. Other painkillers should not be taken on their own.

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

When a woman enters the last weeks of pregnancy, along with the preparation of the baby dowry and the collection of things for the maternity hospital, she involuntarily thinks about how everything will actually be.

The main question - how will the birth begin? From the breaking of the waters or from the appearance of characteristic labor pains? In this article, we will try to answer this difficult question.

How does it happen?

And it happens in different ways. Children are not alike, pregnancies cannot be identical, and any obstetrician-gynecologist will confirm this. Bearing a child is a purely individual process, with its own complexities 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. Unlike false ones, true contractions cannot be removed by changing the position of the body or taking the No-shpy pill, a warm shower will not help, and there will be no sense in the horizontal position of the body. True contractions, if they have begun, proceed with simultaneous smoothing and opening of the cervix, which was tightly closed throughout the pregnancy.

This process is not controlled by the will of the woman, cannot be reversed, and therefore true contractions are constantly growing, intensifying, becoming longer, and the intervals between them are shorter.

As soon as the contraction repeats every 10-15 minutes, you need to go to the hospital. Don't wait for the water to break.

If the birth proceeds correctly, according to the classical pattern described in all obstetrics textbooks, then the waters break without medical intervention when the contractions become quite frequent and strong. The pressure of the walls of the uterus at the moment of tension (at the peak of the contraction) provokes a violation of the integrity of the fetal bladder, as a result of which water is poured out, the baby begins to move forward along the birth canal. Pushing starts.

In general terms, ideal childbirth has the following sequence:

the cervix becomes smoother, it is compared with the body of the uterus, disclosure begins;
smooth muscle fibers become shorter with each subsequent contraction;
the walls of the uterus become more dense;
the external pharynx opens, the opening increases with each contraction;
pressure on the bubble increases;
under the pressure of the fetal head and the amniotic sac itself, the internal os opens;
there is an outpouring of water and attempts begin - the uterus "pushes" the baby out.

Attempts end with the birth of a child, then the placenta comes out within 20-45 minutes. On this, the correct textbook births are completed to the great joy of all participants in this process.

Like everything perfect, classic childbirth is a rarity.

There are quite a few variants of the norm, and therefore the sequence may be different. To the question of whether contractions can begin without water breaking, we answered, but not completely. Very rarely, the waters break at the very last moment, and the child is born in the amniotic membrane, in which he passed through the birth canal.

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

The waters broke, but there are no contractions

This variant of childbirth is considered unfavorable. But everything will depend on how ready the woman's body was for the upcoming birth and how quickly the contractile activity of the uterus begins.

If the contractions begin to develop immediately after the water breaks, they are strong enough, the neck opens at an optimal pace, then the forecasts are more favorable. If labor activity is weak, painful, the cervix opens slowly or does not open, then an urgent emergency caesarean section is considered the best solution.

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

Situations when the waters break first do not tolerate even a moment's delay.

The woman needs to be taken to the hospital of the obstetric institution as soon as possible, where doctors will be able to assess the condition of the child, record his cardiac activity, physical activity, assess the degree of maturation of the cervix and make a quick and correct decision - to stimulate labor activity or deliver the patient surgically.

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

Usually, inflammatory or viral diseases that a woman suffered during pregnancy, the presence of isthmic-cervical insufficiency, polyhydramnios, pregnancy with twins or triplets, thin fetal membranes (for idiopathic reasons that are not possible to establish) usually lead to the outflow of water before contractions. Also, early outflow of water before contractions is fraught with falling on the stomach, on the buttocks, on the back in late pregnancy.

Simultaneous process

Sometimes contractions begin almost simultaneously with the discharge of amniotic fluid. In this case, hospitalization should also be urgent. Staying at home and waiting for contractions to pick up the necessary frequency and frequency, which was talked about so much in courses for expectant mothers, is dangerous.

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

The situation in which contractions began almost simultaneously with the break of the water is dangerous for the development of rapid, rapid labor, which, in turn, is dangerous for birth injuries, premature placental abruption, massive bleeding and other serious complications for the child and mother.

There are contractions, there is no outpouring

In some situations, when the fetal membranes in which the baby is located are too dense, the intervention of doctors is required. When there is no time to wait and attempts are on the way, the cervix is fully opened, the whole fetal sac is pierced, the so-called amniotomy is performed.

Toward the end of pregnancy, a woman begins to be tormented by fears. She alternately: either she is afraid of childbirth, then she fears that the process does not start for too long, then she worries that suddenly something will go wrong. At a period of 36-37 weeks, at 38 weeks, unpleasant sensations in the abdomen appear more and more often: it seems to harden, there is some soreness.

The expectant mother is trying to determine whether she has real contractions or is it just preparing the uterus for difficult work - childbirth. During the second birth or in the third pregnancy, a woman is a little easier: she already imagines what true contractions are and does not confuse them with real ones. But it is difficult for first-timers. What are the contractions, what do they look like, how do their symptoms differ during pregnancy? Let's try to understand how the training ones differ from the real ones. What are the differences?

What is the difference between false contractions and real contractions?
Symptoms
How real fights start
True or false contractions: what is the difference between sensations
When do contractions start?
True contractions after training: is it possible
Self-help measures

How do you know if contractions are real?

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

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

the intervals between the waves of pain are getting 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, can begin in the evening and go all night;
cork comes off;
bloody discharge from the genital tract appears;
water pours out (they can leak a little).

Does the baby move during true contractions? Nature wisely arranged everything: she provided the baby with an unconditioned reflex, which helps the mother to “push” him out of the womb as soon as possible. During each real contraction, the child rests his legs against the bottom of the uterus and pushes away from him. 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.

Because of the pain, the mother does not feel these movements. Just before the onset of childbirth, 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 practice contractions from real ones

The main difference between Braxton-Hicks contractions and true contractions is that they occur at different intervals. The difference between false contractions and real ones is also manifested in the fact that they are much less painful. Normally, pain as such should not be at all - the pregnant woman only feels that her stomach is very tense (as if stoned).

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

A woman can influence such a fight - 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.

On examination, the doctor will note that the cervix is still closed. There are no signs of childbirth. This is a sign that the woman’s body is not yet “planning” to start labor.

False contractions during pregnancy: symptoms

If you know the symptoms of false contractions, then you don’t have to worry: it will be possible to distinguish from generic ones even without the help of an obstetrician.

So, false contractions have symptoms:

Gradually increasing feeling of contraction of the uterus in the fundus, on the right or left, in the lower abdomen or inguinal region.
The most memorable symptom is irregularity. Therefore, when contractions appear, 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 is suitable for them - discomfort in a certain area of \u200b\u200bthe uterus.
Decrease gradually, and then completely disappear.

How to recognize real contractions

At 38-39 weeks, a woman notices that more and more sensations began to appear, as if her stomach were hardening. She may be overwhelmed by anxiety: what if it’s time to pack a bag for the hospital? You can distinguish them by the sharpness of sensations: if the training ones are almost always tolerated quite easily, then the true ones literally exhaust the woman. Less and less every time she has the opportunity to rest before the next attack. Contractions are frequent.

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

You can also determine such signs: no matter what the expectant mother does to alleviate her condition, the pain does not decrease. She may try to do what she did earlier with Bregston-Higs contractions and which helped her completely stop the process:

change your posture - stand up if you were lying down, walk around if you were sitting;
move around, do household chores;
take a warm shower;
drink a pill no-shpy or put a candle with papaverine.

With true contractions, this will not give any effect. Only a massage of the lumbosacral zone and proper breathing, which the pregnant woman had to learn at the school of expectant mothers, can bring a little relief. But the relief will be insignificant.

A real fight usually starts from the back and gradually moves to the stomach. Sometimes it seems to women that their whole body hurts, that they are literally 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 the term of birth, increasingly stiffens her stomach and pulls her lower back, she can ask the doctor a question: “If the stomach stiffens, 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 their meaning and become secondary.

What happens in a fight? The uterus tenses under the influence of special hormones, "pushing" the fetus to the exit. The cervix opens more and more over and over again, reaching such a width that it becomes able to skip the baby's head. While the cervix is closed, this - that is, the beginning of labor - cannot be allowed. The most painful and difficult is just the process of disclosure. With false contractions, disclosure does not occur.

How long do false contractions last? Their average duration does not exceed a couple of hours. Most importantly, their intensity is not growing, but, on the contrary, is weakening.

False contractions: how many days before childbirth?

How long before birth do contractions start? The first signs of Bregston-Higs 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 the birth, they can intensify. However, in some women, on the contrary, there is a “calm” before childbirth.

Appearing at a period of 20 weeks or at 21 weeks - long before the birth, Bregson-Higs contractions become more pronounced by 38 weeks. The process is somewhat different in multiparous and primiparous: in the second case, they begin later. Although each case is individual, it is impossible to determine in advance when training bouts will appear and how long they can last. After how much childbirth will begin, if false contractions are in full swing, it is also unknown: after all, this is just a preparatory process. The uterus is straining, training for difficult work - the time is not far when childbirth begins.

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 fights begin after training fights: you need to observe the appearance of other signs. Increased pain, the direction of the "wave" from the back, and most importantly - the established periodicity - will tell the expectant mother that the "X hour" is already close.

It happens that childbirth begins prematurely: at 31, 32 weeks, contractions began and turned into true ones. You need to get to the hospital as soon as possible. The child can be saved!

At the beginning of the birth process, the doctor asks the woman about the frequency of contractions, clarifies what pain she has, wonders if the cork has come off, if there was an outpouring of water. He looks at the opening of the cervix - this is how he determines the readiness of the mother for childbirth. To understand whether the child is ready, a woman undergoes CTG. How to determine on CTG if everything is in order with the baby, is emergency help needed? Doctors are guided by the fetal heartbeat - if it is from 110 to 150 beats per minute, everything is in order. If the figure rose sharply to 160 and began to fall, the child does not have enough oxygen. The doctor chooses the method of delivery. A caesarean section may be offered.

What to do with false contractions

So, your period is 36-39 weeks, the doctor performed an examination, made sure that there was no dilatation, reassured you, saying that these were Bregston-Higs contractions, and sent you home to “walk”. How to help yourself if the contractions become noticeable and even painful, feel like a strong tension and interfere with a night's rest? First, you need to tune in to the fact that everything is going fine: like false, like true, contractions shorten the cervix and soften it, gradually preparing for childbirth. Secondly, there are a number of steps you can take:

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

For some, it even helps to simply roll over to the other side. A light massage of the lower back can also smooth out the discomfort. Can training bouts last 3 hours? How many hours do they last? Normally, tension worries a woman for several minutes, after which there is a break. Uterine contractions are spontaneous, and during the day and night they can also be repeated, but they never have a clear periodicity and do not look like very painful.

Now, knowing what false contractions look like and what are the symptoms of real ones, you will feel more confident. You should not panic during training fights - but you need to tell the gynecologist about them. The doctor will assess the situation and develop a further strategy for managing the pregnancy.

Have an easy pregnancy and painless delivery!

Actual video

False contractions during pregnancy

It is believed that the process of contractions is irreversible. If they began in 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 generic weakness develops and what to do if this happens.

The reasons

In normal childbirth, 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 the contractions are not strong enough or were regular, and then ended, is considered a complication of the birth process. If the contractions are slowed down, they talk about primary generic weakness. If the attempts stopped, they speak of a secondary weakness of the tribal forces.

The 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 lead to:

hypoplasia of the uterus;
myoma;
endometritis;
uterine anomalies - saddle or bicornuate uterus;
failure of the uterine tissue due to previous abortions or diagnostic curettage;
scars on the cervix in nulliparous women due to erosion treatment;
a high level of progesterone in a woman's body, a reduced level of oxytocin;
hypothyroidism, obesity;
the age of the woman in labor is up to 20 years or older than 36 years;
gestosis.

Most often, such a complication occurs in women who give birth to their first child, with a second or subsequent birth, the likelihood of developing weakness of the tribal forces is minimal, although not completely excluded.

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

Stopping labor activity threatens both women with polyhydramnios and those whose pelvic dimensions do not correspond to the size of the fetal head. Too early outflow of amniotic fluid is also the cause of the development of weakness of contractions. In addition, factors such as placenta previa, fetal hypoxia, and malformations of the baby can also affect.

Quite often, doctors cannot establish the reasons for the sudden stop of contractions or their slowdown. With good analyzes and an ideal state of health, a woman may slow down labor activity for psychogenic reasons.

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

Sometimes the cause is too much pain medication, which the woman took on her own initiative, fearing pain in labor or introduced in the hospital, but the latter is the least likely.

Effects

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

The baby can become infected, because the uterus is already partially open. A long waterless period is dangerous with hypoxia, the death of a child. If weakness arose in the second half of childbirth, then heavy bleeding in the mother may begin, asphyxia and injuries in the baby are not excluded.

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.

The rest is for the doctors to decide. First of all, they must understand how far behind the norm the opening of the cervix during primary contractions. Then a decision on further actions will be made. So, sometimes it is enough to insert a catheter into the bladder of a woman in labor or to puncture the fetal bladder with polyhydramnios, and labor activity resumes and then proceeds normally.

Amniotomy

Medical sleep during childbirth

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

If these measures do not help, a woman can be stimulated into labor, for which oxytocin is administered intravenously, which increases the contractility of the uterus. If the stimulation is useless, then the woman is given a caesarean section.

In favor of an emergency caesarean section, initially, without stimulating labor, signs such as fetal hypoxia, a long anhydrous period, the appearance of bloody discharge from the genital tract, indicating a possible early placental abruption, will speak.

How to prevent?

Prevention of weakness of tribal forces does not exist. But doctors can do whatever is necessary if a woman goes to the maternity hospital in time for help.

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

So the last weeks of waiting are over. Fights begin. The climax of the whole pregnancy is coming - a few more hours, and you will see your baby. Of course, you will worry and worry about the outcome of childbirth, but if you are well prepared and understand what to expect, what happens at each stage of the contractions, then the courage will also return. Give life to a child! After all, this is such happiness! Prepare yourself, master the techniques and techniques of relaxation and breath control in advance - they will help you maintain composure and cope with pain. And do not be alarmed if during the fights something is not quite the way you expected.

HOW TO DETECT THE STARTING OF BRIGHT

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

SIGNS OF STRENGTH

Appearance
As the cervix opens, it pushes out the blood-stained mucous plug that clogged it during pregnancy.
What to do This can happen a couple of days before the onset of labor, so wait until the pain in the abdomen or back becomes constant or the amniotic fluid breaks before calling the midwife or the hospital.

Drainage of amniotic fluid
The rupture of the amniotic sac is possible at any moment. The waters can flow away, but more often they ooze little by little - they are delayed by the head of the child.
What to do Call a midwife or an ambulance right away. Hospitalization is safer even if there are no contractions yet, as infection is possible. In the meantime, lay down a waffle towel to absorb moisture.

Uterine contractions
At first they make themselves felt as dull pains in the back or in the hips. After a while, 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 your contractions are on, 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 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 the water has not yet broken, you can take a warm shower or lightly refresh yourself. The maternity hospital may advise you not to come until the contractions have intensified and begin to recur every 5 minutes.

harbingers of fights
Weak uterine contractions occur throughout pregnancy. In the last few weeks, they have become more frequent and more intense, so sometimes they can be mistaken for the start of contractions. Feeling such contractions, get up, walk around and listen to see if they continue, if the pauses between them become shorter. Harbingers of contractions are usually irregular.

PERIODICITY OF STRENGTHS
Track the dynamics of contractions during the hour: the beginning and end, amplification, increase in frequency. When the contractions stabilize, their duration should be at least 40 seconds.

FIRST PERIOD

AT THIS STAGE, the uterine muscles contract to open the cervix and let the fetus through. At the first birth, contractions last an average of 10-12 hours. It is possible that at some point you will panic. No matter how well prepared you are, the feeling that something beyond your control is happening to your body can be frightening. Stay calm and try not to interfere with your body, do what it tells you. Right now you will truly appreciate the presence of a 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 also inhaling and exhaling through the mouth. Don't breathe like this for too long - you may feel dizzy.

ARRIVAL AT THE Maternity Hospital

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

Midwife Questions
The midwife will check the registration records and your exchange card, as well as clarify if the waters have broken and if there has been a mucus plug. In addition, he will ask a series of questions about contractions: when did they start? how often do they occur? what do you feel about it? what is the duration of the attacks?

Survey
When you change, your blood pressure, temperature and pulse will be taken. The doctor will conduct an internal examination to determine how much the cervix has dilated.

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

Other procedures
You will be asked to provide a urine sample for sugar and protein analysis. If your water hasn't broken yet, you can take a shower. You will be taken to the delivery room.

INTERNAL SURVEYS
The doctor will, if necessary, conduct internal examinations, controlling the position of the fetus and the degree of cervical dilatation. Ask him questions - you should also know about what is happening. Usually, the opening of the uterus is uneven, as it were. jerks. The examination is carried out in the intervals between contractions, therefore, feeling the approach of the next contraction, you will need to inform the doctor about it. Most likely, you will be asked to lie on your back, surrounded by pillows, but if this position is uncomfortable, you can lie on your side. Try to relax as much as possible.

BATTLE
The cervix is a ring of muscles, normally closed around the uterine os. The longitudinal muscles that form the walls of the uterus depart from it. During a contraction, they contract, drawing the neck inward, and then stretching it so that the baby's head passes into the uterine os.
1. The cervix relaxes under the influence of hormones.
2. Weak contractions smoothly smooth the cervix.
3. Strong contractions lead to the opening of the cervix.

PROVISIONS FOR THE FIRST PERIOD OF LABOR
In the first period, try to try different positions of the body, finding the most convenient for each stage. These positions must be mastered in advance so that at the right time you can quickly take the right posture. You may suddenly feel that it is better to lie down. Lie on your back, not on your side. The head and thigh should be supported by pillows.

Vertical position
At the initial stage of 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, leaning on a padded pillow. Head down on hands, knees apart. Another pillow can be placed on the seat.

Leaning on her husband
At the first stage of labor, which you will probably endure on your feet, during contractions it is convenient to put your hands on your husband’s shoulders and lean on. 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 the muscles, lower your upper body onto the pillows. Keep your back as straight as possible. Sit on your hip between contractions.

Four point support
Get on your knees, leaning on your hands. It is convenient to do this on a mattress. Move your pelvis back and forth. Don't hunch your back. Between contractions, relax by lowering yourself forward and resting your head in your hands.

BIRTH 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, transferring weight to your hands, and make progressive movements with your pelvis; walk in intervals
in the intervals between contractions, have your husband massage your back.

Lumbar massage
This procedure will relieve back pain, as well as calm and invigorate you. Let the husband massage the base of your spine, pressing in a circular motion with the protrusion of the palm of your hand. Use talc.

HOW TO HELP YOURSELF

Move more, walk in the intervals between contractions - this will help to cope with the pain. During attacks, choose a comfortable body position.
Stay as straight as possible: the baby's head will rest against the cervix, the contractions will become stronger and more effective.
Focus on your breath to calm yourself and take your attention away from contractions.
Relax during breaks to save energy until the time when they are most needed.
Sing, even shout, to ease the pain.
Look at one point or at some object to distract yourself.
React only to this fight, do not think about the next. Imagine each attack as a wave, "riding" which you will "carry" the child.
Urinate more often - the bladder should not interfere with the progress of the fetus.

WHAT CAN A HUSBAND HELP

Praise and encourage your wife in every possible way. Do not get lost if she is annoyed - your presence is still important.
Remind them of the relaxation and breathing techniques she learned in the course.
Wipe her face, hold her hand, massage her back, offer to change position. What kind of touches and massage she likes, you need to know in advance.
Be an intermediary between the wife and the medical staff. Keep her side in everything: for example, if she asks for a painkiller.

TRANSITION PHASE

THE MOST DIFFICULT time of childbirth is the end of the first period. The contractions become strong and long, and the intervals are reduced to a minute. This phase is called transitional. Exhausted, you will probably be either depressed at this stage or overly excited and tearful. You may even lose your sense 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, straining, to push the fetus out. But if you do it ahead of time, swelling of the cervix is possible. Therefore, ask the midwife to check if the cervix is fully dilated.

BREATHING IN THE TRANSITION PHASE
If premature attempts begin, take two short breaths and one long exhalation: "uh, uh, fu-u-u-u-u." 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 a long exhalation: "uh, uh, fu-u-u-u" (see top right). You may need pain relief. Get on your knees and, leaning forward, lower your head into your hands; the pelvic floor should seem to hang in the air. This will weaken the urge to push and make it difficult to push the fetus out.

WHAT CAN A HUSBAND HELP

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

WHAT IS HAPPENING TO THE CERVOCUS
The cervix, palpable at a depth of 7 cm, is already sufficiently stretched around the fetal head.
If the cervix is no longer palpable, then its expansion has ended.

SECOND PERIOD AS soon as the cervix has 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 became stronger, but they are already less painful. Pushing is hard work, but your midwife will help you find the most comfortable position and guide you when to push. Do not rush things, try to do everything right. In the first birth, the second period usually lasts more than an hour.

BREATHING IN THE SECOND PERIOD OF LABOR
Feeling the urge to push, inhale deeply and lean forward to hold your breath. Take deep, calming breaths between pushes. Relax slowly as the contraction subsides.

POSES FOR THE EXJUICE OF THE FETUS
When pushing, try to stay straighter - then gravity will also work on you.

Squatting
This is the ideal position: the pelvic lumen opens and the fetus is released by gravity. But if you have not prepared yourself for this pose in advance, you will soon feel tired. Use the easy option: if your husband sits on the edge of a chair with his knees apart, you can sit between them, resting your hands on his hips.

On the knees
This position is less tiring, and it also makes it easier to push. If you are supported from both sides, this will give the body more stability. You can just lean on your hands; the back should be straight.

sitting
You can give birth while sitting on the bed, surrounded by pillows. As soon as the attempts begin, lower your chin down and clasp your legs with your hands. Rest between pushes by leaning back.

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

WHAT CAN A HUSBAND HELP
Try to somehow distract your wife between attempts, continue to calm and cheer her up.
Tell her about what you see, such as the appearance of the head, but do not be surprised if she does not pay attention to you.

BIRTH

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 pick him up. At first, you will probably be overwhelmed 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 a little when the contractions are weakened. 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, take a break. If there is a threat of serious tears or any abnormalities in the child, you may have an episiotomy. As the head expands the vaginal opening, there is a burning sensation, but it does not last long, giving way to numbness, which is caused by a strong stretching of the tissues.

3. When the head appears, the baby's face is turned down. The midwife checks if the umbilical cord is wrapped around the neck. If this happens, it can be removed when the entire body is released. The infant then turns its head to the side, turning around before full release. 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, because the umbilical cord still holds it. Perhaps at first the baby will seem bluish to you. His body is covered with primordial grease, traces of blood remain on the skin. If he breathes normally, you can take him in your arms, press him to your chest. If breathing is difficult, the airway will be cleared and, if necessary, an oxygen mask will be given.

THIRD PERIOD
At the end of the second stage of labor, you will probably be given an intravenous injection of a drug that increases uterine contractions - then the placenta will move almost instantly. If you wait for it to flake off naturally, you may lose a lot of blood. Discuss this point with your doctor in advance. To remove the placenta, the doctor puts one hand on your stomach and gently pulls on the umbilical cord with the other. After that, he must check that the placenta has passed completely.

APGAR SCALE
After receiving the baby, the midwife evaluates his breathing, heart rate, skin color, muscle tone and reflexes, calculating a score on a 10-point Angar scale. Usually in newborns, this indicator ranges from 7 to 10. After 5 minutes, a re-count is performed: the initial score, as a rule, grows.

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

Question and answer "I'm afraid of injury during childbirth. Is there such a danger?"
Do not be afraid, there is no such danger - the vaginal walls are elastic, their folds can stretch and let the fetus through. "Should I breastfeed my baby immediately after giving birth?" You can give a breast, but if the baby does not take it, do not insist. In fact, the sucking reflex in newborns is strong, and when they suck, they are in a good mood.

ANESTHESIA

BIRTH IS 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 pain medication, depending on the progress of your contractions and your ability to manage the pain. You may be able to overcome it using self-help techniques, but if the escalating pain becomes unbearable, ask your doctor for painkillers.

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 application should be calculated so that the effect of the anesthetic ceases by the 2nd stage of labor, otherwise slowing down labor and increasing the risk of episiotomy and forceps may occur.

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

Action
On you The pain will pass, the clarity of consciousness will remain. Some women experience weakness 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 removing it, and causes euphoria. Apply at the end of the 1st period of childbirth.

How does this happen
The gas mixture enters through a mask connected by a hose to the apparatus. The action of the gas manifests itself in half a minute, so at the beginning of the fight, you need to take a few deep breaths.

Action
On you The gas dulls the pain, but does not remove it completely. When inhaling, 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 it is difficult for her to relax.

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

Action
On you Promedol manifests itself in different ways. It has a calming effect on someone, relaxes, causing drowsiness, although the consciousness of what is happening is completely preserved. There are also complaints about the loss of control over oneself, the state of intoxication. You may feel nauseous and shaky.
per child Promedol can cause respiratory depression and drowsiness in a child. After childbirth, breathing is easy to stimulate, and drowsiness will disappear by itself.

ELECTRO-Stimulation
The electrical stimulation device reduces pain and stimulates the internal mechanism of overcoming pain. It works on weak electrical impulses that affect the back area through the skin. A month before the 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 at the concentration of nerves leading to the uterus. The electrodes are connected by wires to the manual control panel. With it, you can adjust the current strength.

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

OBSERVATION OF THE STATE OF THE FETUS

DURING the entire period of childbirth, doctors constantly record the heart rate of the fetus. This is done with a conventional obstetric stethoscope or with an electronic monitor.

OBstetrical Stethoscope
While you are in the delivery room, the midwife regularly listens to the fetal heartbeat through the abdominal wall.

ELECTRONIC FETUS MONITORING
This method requires sophisticated electronic equipment. In some hospitals, such monitoring (control) is used throughout the birth, in others - occasionally or in the following cases:
if childbirth is artificially induced
if you have had an epidural
if you have complications that could threaten the fetus
if the fetus has abnormalities.
Electronic monitoring is absolutely harmless and painless, however, it significantly limits the freedom of movement - thus you cannot control contractions. If your doctor or midwife has suggested that you have ongoing 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 is fixed with pillows. Adhesive tapes will be attached to the abdomen with sensors that capture the fetal heartbeat and register uterine contractions. Instrument readings are printed on paper tape. After the amniotic fluid breaks, the baby's heart rate can be measured by holding an electronic sensor close to the baby's head. This monitoring method is the most accurate, but not very convenient. Some maternity hospitals use radio wave monitoring systems with remote control (telemetry monitoring). Their advantage is that you are not tied to bulky equipment and can move freely during fights.

SPECIAL DELIVERY TECHNIQUES
EPISIOTOMY
This is a dissection of the entrance of the vagina 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
keep upright when expelling the fetus.

Indications
An episiotomy is needed if:
the fetus has a breech presentation, a large head, other deviations
you have a premature birth
use forceps or vacuum
you are not in control
the skin around the entrance to the vagina is not stretched enough.

How does this happen
At the climax of the contraction, an incision is made in the vagina - down and, usually, slightly to the side. Sometimes there is no time for an anesthetic injection, but you still won’t feel pain, since partial numbness of the tissues also occurs due to the fact that they are stretched. Quite long and painful, perhaps, will be suturing after an episiotomy or rupture - a complex procedure that requires special care. So insist that you get a good local anesthetic. The suture material dissolves itself after a while, it is not necessary to remove it.

Effects
Uncomfortable sensations and inflammation after an episiotomy are normal, but pain can be severe, especially when infected. The incision heals in 10-14 days, but if something bothers you later, see a doctor.

FRUIT RECOVERY
Sometimes forceps or vacuum extraction are used to help the baby come into the world. The use of forceps is possible only when the cervix is fully dilated, when the fetal head has entered it. Vacuum extraction is also acceptable with incomplete disclosure - in the case of prolonged labor.

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

How does this happen

Forceps You will be given anesthesia - inhalation or intravenous anesthesia. The doctor applies forceps, wrapping them around the child's head, and carefully pulls it out. When applying forceps, attempts are completely excluded. Then everything happens naturally.
vacuum extractor This is a small suction cup connected to a vacuum pump. Through the vagina, it is brought to the head of the fetus. While you push, the fetus is gently pulled through the birth canal.

Effects
Forceps may leave dents or bruises on the head of the fetus, 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 child's head. This, too, will gradually subside.

STIMULATION OF LABOR
Stimulation means that contractions will have to be artificially induced. Sometimes methods are used to speed up contractions if they go too slowly. Doctors' approaches to stimulation often differ; so try to find out what is the practice of artificial induction of labor where you will give birth.

Indications
Contractions are artificially induced:
if, with a delay in labor for more than a week, signs of abnormalities in the fetus or a disorder in the functions of the placenta are found
if you have high blood pressure or any other complications that are dangerous to the fetus.

How does this happen
Artificially induced labor is planned in advance, and you will be asked to go to the hospital in advance. Use 3 methods of stimulating contractions:
1. Cerviprost is injected into the cervical canal to soften the cervix. Contractions may start in about an hour. This method is not always effective in the first birth.
2. Opening of the amniotic sac. The doctor pierces a hole in the amniotic sac. Most women do not experience any pain. Soon, uterine contractions begin.
3. Through a dropper, a hormonal drug is administered intravenously, which promotes uterine contraction. Ask to have the drip placed on your left hand (or your right hand if you're left-handed).

Effects
The introduction of a hormonal drug is preferable - you can move freely during contractions. When using a dropper, the contractions will be more intense and the intervals between them will be shorter than during normal childbirth. Plus, you have to lie down.

BUTTOCK PRESENTATION
In 4 cases out of 100, the baby comes out with the lower part of the body. Childbirth in this position of the fetus is longer and more painful, so they must take place in a hospital. Because the head, the largest part of the baby's body, will be the last to appear at birth, it is measured beforehand with an ultrasound scanner to make sure it passes 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, as forceps are often used to extract them. In addition, one of them may have a breech presentation. You will probably be offered an epidural. The first stage of childbirth will be one. There are two second ones - pushing - first one child comes out, followed by the second. The interval between the birth of twins is 10-30 minutes.

C-SECTION

With a caesarean section, the baby is born through the opened abdominal wall. You will be advised in advance of the need for surgery, but this measure may be due to 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 general anesthesia is sometimes required. It's hard to come to terms with the fact that you can't give birth normally. But these experiences are surmountable if you prepare psychologically.

HOW DOES THIS HAPPEN
Your pubis will be shaved, a dropper will be placed on your arm, and a catheter will be inserted into your bladder. They will give you anesthesia. In the case of epidural anesthesia, a screen will probably be installed between you and the surgeon. Usually a horizontal incision is made, then the surgeon removes the amniotic fluid with suction. The child is sometimes removed with forceps. After the placenta has been rejected, you will be able to take him in your arms. The operation itself takes five minutes. Another 20 minutes takes suturing.

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

AFTER OPERATION
You will not be allowed to lie down for a long time without getting up after childbirth. Walking and movements are completely harmless for you. The incision will still be painful for the first few days, so ask for pain medication. Stand straight, supporting the seam with your hands. After two days, start light exercises; in a 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 well. Avoid strenuous activities 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 press on the wound.