- emotional instability. Pregnant women can hardly be called absolutely calm people, but shortly before the birth, the situation of the very first weeks is repeated. The mood changes without intermediate states - either laughter or tears. There is a tendency to solitude;
- decreased appetite. The desire to eat even your favorite dishes practically disappears;
- prolapse of the uterus. In the last weeks of pregnancy, the abdomen noticeably drops, decreasing in size. This is the uterus with the fetus inside moving closer to the birth canal;
- frequent urge to urinate and changes in stool. The mass of the pregnant uterus, which has moved to the pelvic area, presses on the bladder and prevents the normal amount of urine from collecting in it. Therefore, you have to empty it more often. The feces in the intestines soften to get out more easily and not interfere with the birth process by compressing the pelvic organs;
- weight loss of the expectant mother. Weight gain with normal appetite slows down as a result of bowel cleansing and the removal of excess fluid from edema that torments many women;
- passage of a plug of mucus. During pregnancy, the mucous plug in the uterine cervix saves from getting infections in the placenta and amniotic fluid. Shortly before childbirth, she gradually begins to come out through the vaginal opening. From the flow of amniotic fluid, the process of cork discharge can be distinguished using special tests. But keep in mind, if the amniotic fluid flows out, then constantly, and the mucus is either in parts at different intervals, or all at once before childbirth;
- nesting instinct. By analogy with birds equipping their nests before hatching, the desire of women to create comfort in their homes is called the nesting instinct. He manifests himself with a desire to put things in order in the house - perhaps the beginning of repairs - and the purchase of necessary and not very things for the crumbs;
- baby wiggling. By 36 weeks, babies become quite large and it is not enough for them to swim in their mother's womb. From that moment on, the fetus reminds of its presence less often and with jerks of the arms and legs, very noticeable to the mother;
- training or false contractions. They are designed to prepare the body for real uterine contractions. They occur most often in the evenings and in the morning up to 6 times a day for 45–60 seconds. The intervals between false contractions are at least half an hour, pain is usually absent, only uncomfortable pulling sensations.
Video: obstetrician-gynecologist about the harbingers of childbirth
Signs of the onset of labor
It is necessary to clearly separate the precursors and signs that labor activity has already begun. Harbingers, especially in primiparas, begin a few weeks before birth.
Table: features of the harbingers of childbirth in primiparous and multiparous
| Precursor | First birth | Repeated births |
| Prolapse of the abdomen | 2-3 weeks before delivery | Due to the weakened abdominal muscles from the previous pregnancy, the stomach looks somewhat lowered from the very beginning, so the movement of the uterus into the pelvic region may not be noticed. Although this happens a week, or even less, before the birth. |
| Emotional instability | For 2-4 weeks | For 1-3 weeks |
| Weight loss | 3-4 weeks before | For 1-2 weeks |
| nesting instinct | For 2-4 weeks | in 1-3 weeks |
| Increased urination, diarrhea or constipation, nausea, vomiting | For 2-3 weeks | 7-10 days before |
| Removal of the mucous plug | For 2-3 weeks, but it is possible to withdraw after the start of contractions | In multiparous, the cork departs in the interval from several hours to two weeks before childbirth. |
| Fetal movements | For 2-4 weeks | For 1-2 weeks. In some children, the inability to swim as before due to tightness and a decrease in the amount of amniotic fluid provokes active movements of the limbs. The baby often and noticeably “knocks” from the inside. |
| false contractions | Preparation of the body for childbirth begins about a month before them. | During the second and subsequent pregnancies, false contractions may be absent or begin 2-3 days before real ones. |
The cervix softens closer to childbirth, which causes a plug of mucus to come out and preventive contractions begin. From this moment on, women feel an increase in uterine tone, the stomach seems to turn to stone at the peak of muscle tension.
Do not put off collecting bags for childbirth for yourself and your baby at the last moment, it is better to put the necessary things and documents at least a month before the due date
The gradual opening of the uterus for the passage of the child is accompanied by painful contractions of the uterus, called real contractions. In multiparous, the period of contractions lasts about 2 times less than during the first birth. This process cannot be controlled like training contractions, and the interval between contractions is getting shorter every hour.
The outflow of amniotic fluid occurs both after the onset of contractions, and 1–2 hours before the start of uterine contractions. Amniotic fluid comes out gradually or all at once.
An easy way to determine if water or normal discharge comes from the vagina is available at home and does not require commercial tests. It is necessary to roll up a sterile gauze cut (bandage) in 3-4 layers and put it in underpants. After 10 minutes, take it out and examine it carefully. The water will soak the gauze through and through, and the mucus will remain on the surface.
You need to call an ambulance or go to the hospital on your own as soon as the waters break or contractions begin. Both of these signs are signals that childbirth has begun, it is not necessary to wait for the second to appear, and sometimes it is dangerous for the woman in labor and the baby.
In what cases, besides childbirth, an urgent visit to the maternity hospital is necessary
Reasons for seeking medical help may appear throughout all three trimesters of pregnancy. Call the obstetrician team or go to the maternity hospital by private transport or taxi in the following cases:
- the appearance of bloody vaginal discharge, especially a bright scarlet color. This may indicate spontaneous abortion, ectopic pregnancy, or placental abruption;
- deterioration in general well-being, accompanied by chills, headache, blurred vision and flies before the eyes. These symptoms may be signs of anemia, heart problems, intoxication of the body due to a stop in the development of pregnancy or the onset of proeclampsia;
- heat. From scratch, this symptom does not appear, which indicates the penetration of infection into the body and internal inflammation. Both are dangerous, especially during pregnancy;
- severe vomiting that does not allow eating and drinking. With this sign of acute toxicosis, there is a risk of dehydration of the mother's body, which negatively affects the child. Also, vomiting more than 5 times a day suggests kidney failure or internal infection;
- allergy attack. If a negative reaction to any irritant other than redness of the skin is accompanied by breathing problems, severe itching and other signs, medical help is needed immediately. Otherwise, the development of suffocation and laryngeal edema is possible, and this already leads at least to oxygen starvation and cannot be treated without medical help;
- sudden onset of severe pain in the abdomen. One of the main signs of a threat to the safe bearing of a child;
- an increase in blood pressure above 140/90. Such a life-threatening pathology for the mother and child, like eclampsia, develops very quickly, the first sign of it is an increase in blood pressure, then convulsions follow;
- strong swelling. If the limbs have become like columns of a large theater, we are talking about preeclampsia - late toxicosis of pregnant women, threatening the development of preeclampsia. Also, edema can be a symptom of a serious disorder in the functioning of the kidneys;
- absence of tremors or fetal movements for more than 6 hours in a row. Even in the last weeks, children in the tightness of the mother's womb periodically show signs of life with jerks. If the child does not send any signals for more than 6 hours, then he has problems. Possible intrauterine death of the fetus;
- outpouring of amniotic fluid or the onset of regular contractions long before due date. Most likely, premature birth began.
I did not have any forerunners, because my son abruptly decided to be born a month ahead of schedule. The contractions were real. On June 9, 2018, my sister went for an ultrasound, because the day before the doctor called and said that the tests were not very good. At the clinic, she underwent dopplerography, which showed a complete absence of blood flow in the placenta. The ambulance team was immediately called and 3 hours later, by caesarean section, my nephew was born at 36 weeks. We did. Due to pre-eclampsia - Anya had high blood pressure in recent days - there was almost no amniotic fluid, they were not produced. There were also no fights. Therefore, if the doctor recommends an additional examination or retake of tests, do not ignore at any time.
Video: what threatens preeclampsia in pregnant women
What is the danger of untimely hospitalization of pregnant women
Every fifth expectant mother is at risk for various indicators and these women cannot avoid hospitalization. And there are previously healthy pregnant women who do not want to call an ambulance once again or go to the hospital after relief, although the symptoms are serious. In addition to the planned ones, there are emergency reasons to go to the hospital; in no case should you refuse to stay in hospital. Risks for untimely hospitalization of pregnant women:
- spontaneous abortion;
- premature birth;
- inability to provide qualified assistance in the "field conditions";
- intrauterine fetal death;
- poisoning of the body during the decomposition of a frozen embryo;
- rupture of internal organs in which an ectopic pregnancy develops;
- death of mother and child with a critical form of preeclampsia - eclampsia;
- delayed fetal development as a result of hypoxia;
- angioedema;
- placental abruption, which is dangerous for maintaining pregnancy.
Timely hospitalization increases the chance of carrying a pregnancy and gives the mother and child the opportunity to receive the help of doctors and equipment if necessary. In addition to the above dangers, there is an individual development of events. Depression is not ruled out due to an incorrect decision to refuse hospitalization. The rapid delivery of women who naively believe that they have a lot of time left takes both the woman in labor and the doctors by surprise.
I personally know a woman who lives three minutes walk from our city maternity hospital, but who gave birth in an ambulance. Even in difficult years, the "ambulance" to the women in labor came to us as soon as possible, and they did not take them to the delivery room. Everything ended happily, but what nerves did it cost all the heroes of the story.
It is believed that repeated pregnancy proceeds somewhat differently. Therefore, even experienced mothers do not know when to go to the hospital for the second birth, so as not to miss the right moment. It is necessary to understand the main features of repeated delivery.
Harbingers and symptoms
For timely treatment to the hospital, you need to familiarize yourself with the main aspects of the period of contractions. As a rule, a woman manages to get to the maternity hospital before the birth act begins.
How to understand that the second birth begins? The expectant mother will feel the harbingers of the imminent birth of a child, such as the passage of a mucous plug, lowering of the abdomen and rupture of the fetal bladder. Contractions are noticeable with short breaks, which gradually increase.
Heralds of the second birth are different from the first. We are talking about the time of the appearance of the baby into the world. This means that the cork comes out an hour before the birth of the baby, just like the stomach, it falls right in the delivery room.
Training contractions are not a reason to go to the hospital during the second pregnancy. They are noticeable even a couple of weeks before the birth process. If regularity is visible in uterine contractions and intensity increases, this indicates that labor cramps are real. In such a situation, the main thing is to remain calm and not panic.
If a partner birth is expected, it is important to place the older child in advance with relatives in case of hospitalization. It is required to tune in to positive emotions and wait for an interval between uterine contractions of 7-8 minutes.
When to meet in the hospital for the second birth? In multiparous, the stages of labor are shortened, so it is better to go to the maternity hospital early, when the interval between uterine spasms is 10 minutes.
Mandatory hospitalization is required when the amniotic fluid is discharged. This applies to any pregnancy, the gestation period does not matter.
The expectant mother needs a trip to the hospital in case of an emergency (bleeding, green or red water, fetal inactivity) or regular uterine cramps every 7-8 minutes.
True and false contractions
If this is the second pregnancy, training uterine contractions are noticeable from as early as 20 weeks. Over time, their intensity increases, but still Braxton-Hicks contractions can really be distinguished from real ones.
Training spasms are irregular, there is no pattern in their duration. The intensity of fake contractions depends on the physical activity of the future mother (they are noticeable during the day, and everything is calm at night), the tone is removed with the help of a warm shower.
True labor contractions of the uterus cannot be stopped or affected by their strength. Real contractions become more intense and longer over time, the lower abdomen is pulled, the lower back aches and the sacrum is felt. The woman is surrounded by pain, which gradually increases.
Labor activity during the second birth proceeds quickly. On average, with repeated delivery, the procedure takes no more than 8 hours. For this reason, you should try to start recording contractions on time so as not to miss the right moment to travel to the maternity ward.
You can count the intervals and duration of uterine contractions using a notepad, pen and watch or a special smartphone application. Both methods are correct, but the virtual contraction rhyme is more practical to use. It is enough to press the button at the beginning of the spasm and at its end. The program will automatically calculate the duration and interval.
After the first true contractions, it is important to dress in a spacious and comfortable sundress or dressing gown that can be easily removed. In winter, wear a dress or a warm nightgown.
Road to the hospital
As soon as the expectant mother understands that it is time to go to the maternity hospital for the second birth, she should decide on what and how soon she needs to go there. A woman in labor should make a choice based on the current situation. With the normal course of the period of contractions, without pathologies and bleeding, it is quite possible to go to give birth on your own (by car or taxi). If the expectant mother saw green, brown, scarlet water or spotting, you need to immediately call an ambulance.
When it is not possible to go to the hospital by car, it is better to go there before the second birth has begun. This is the only way to really get to the right hospital. An ambulance will take you to a nearby or on duty.
Bag collection. It is important to properly pack before going to the hospital for the second birth. Usually, expectant mothers are given a list in the antenatal clinic, according to which, you need to put things down for a stay in the maternity ward. These are personal hygiene products, clothes for a newborn, diapers and diapers. As a rule, multiparous people already filter everything that is written in mandatory positions, according to personal experience.
With a delayed second pregnancy, you should contact the maternity hospital as early as possible (no later than 40 weeks). Then the woman is stimulated with drugs. But because of the peculiarities of the second birth, namely the shortened stages of labor, it is necessary to know the secrets to prevent breaks and cracks.
How not to tear during the second birth:
- train the vaginal muscles;
- lubricate the perineum with vegetable oil (olive, almond);
- try to avoid drug stimulation
If you follow the recommendations of a gynecologist, the chance of injury to the genital organs during childbirth decreases. The cause of cracks and ruptures may be the age of the woman in labor or her physiological characteristics (lack of tissue elasticity). In such a situation, the advice of obstetricians will not help prevent complications.
Recognizing the second birth is not difficult, since the woman already has an idea of \u200b\u200bwhat lies ahead for her. The main rule is to get to the maternity hospital on time so as not to give birth to a child on the road. With the outflow of amniotic fluid at any time, you should immediately go to the hospital, because the baby should appear no later than 12 hours after the rupture of the fetal bladder. It is necessary to fix contractions and their duration correctly. Then you can count on a positive outcome of the birth process and the appearance of a healthy baby.
There are a number of symptoms that occur in the last weeks of pregnancy that indicate the imminent onset of childbirth - the harbingers of childbirth. In most women, this manifests itself in the form of irregular false contractions, sometimes very painful, prolapse of the abdomen, increased uterine excitability, decreased appetite and weight gain, and finally, discharge of the mucous plug. This happens as a result of a kind of hormonal preparation for the birth of your body and indicates readiness No. 1 for the baby. Going to the hospital with the appearance of harbingers is unreasonable. This will only interfere with the normal course of the birth process and will become a reason for unnecessary medical interventions.
The appearance of regular contractions
During pregnancy, many women experience irregular, sometimes painful, but short-lived contractions (especially in the evenings) of two to four hour periods of regular contractions (five to ten minute intervals) that gradually subside.
Contractions, announcing the approach of childbirth and the opening of the cervix, are of a fundamentally different nature: they become regular, longer and stronger. Contractions happen spontaneously, regardless of your will.
In this situation, the main thing is not to fuss. Sit comfortably, find a position in which you will be most comfortable: riding a chair, sitting on the floor, kneeling, lying down, etc. Just breathe calmly, without restricting your breath, and make the most of the short break between contractions. The more successful your relaxation is, the less intense the pain will be during the contraction. Strange as it may seem, but I don’t feel like eating or drinking at this time. And even less you want someone to talk to you.
But if at this time you want to walk, do something, in short, be active, and even eat something tasty, then it is possible that your birth has not yet begun. Take a warm shower to relieve stress. It may seem to you that after a shower, the contractions have stopped. But this is only proof that the birth has not yet begun. Take advantage of this brief lull to unwind.
The process of dilating the cervix is not so fast: 1 cm per hour at the first birth, and dilatation is considered complete at 10 cm.
For most primiparas, going to the hospital should be under the following conditions:
- 12-15 contractions occur per hour;
- contractions are constant, the break between them is less than 5 minutes;
- contractions last at least a minute;
- the contractions are strong enough that you can no longer ignore them, you have to use various tricks to cope with them.
There is one good rule, using which you can get to the hospital exactly when you need it. The 4-1-1 rule means contractions come in 4 minutes, last one minute, and don't subside for an hour or more.
Labor and prenatal contractions
| Birth pains | Prenatal (false) contractions |
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Rupture of the fetal bladder
With the approach of childbirth at the height of the contraction, amniotic fluid may be discharged as a result of rupture of the fetal bladder. If the rupture is not accompanied by complications, then a warm, sticky, whitish liquid (about 20 ml) resembling water is released. After that, the water continues to leak, right up to the birth itself, and most of it will flow out at the same time as the baby comes out.
It happens that the fetal bladder remains safe and sound until childbirth. Sometimes the rupture of the fetal bladder precedes painful contractions.
As soon as your water breaks, change clothes, put on a sanitary pad and, without delay, go to the hospital, preferably in a lying or half-sitting position.
But the symptoms that indicate that you need to hurry with the fees to the hospital:
- you find that you suddenly rushed blood (more than during menstruation);
- sudden pain in the uterus, different from contractions;
- constant dizziness;
- your inner voice is constantly telling you that something is wrong.
Women are looking forward to when that happy moment comes and they can take their child in their arms. But before that happens, you still have to go through the contractions. Yes, and to the hospital in time to be in time. Many do not even understand what contractions are. And this is a signal that you will soon meet with your baby. Contractions are expressed as regular contractions of the uterus, which are accompanied by pulling pains in the lower back and lower abdomen.
Start of contractions
When the contractions are just starting, they are still very weak and last only a few seconds, while repeating every 10-12 minutes. But there are such cases that everything starts from stronger and more frequent contractions of the uterus, which gradually increase. Also, do not forget that this is just the beginning, as you feel only a slight discomfort due to a feeling of heaviness in the lower abdomen.Such sensations can arise and cease, but labor activity does not begin at the same time. But when the contractions become more regular, but the interval between them is 25-30 minutes, this also does not mean the onset of labor. In most cases, a woman does not even pay attention to such contractions. And you should not go to the hospital until the time interval between them begins to gradually decrease with each subsequent contraction and, accordingly, the level of pain increases. this reduction in time will continue to 3-4 minutes.
It is also worth noting that pain in most cases occurs in the abdomen, and in the interval and between contractions it does not exist at all. The lower back begins to hurt, then the sides, and lastly, the entire focus of pain is placed in the abdomen. The very first few contractions are very similar to a slight tingling, and when the duration of the contraction itself increases to 10-15 seconds, the pain becomes more intense. In women who give birth for the first time, contractions can usually last almost 12 hours. For those who have not given birth for the first time, this figure can be reduced by almost half.
Let's go to the maternity hospital
Whether it is necessary to go to the hospital is very easy to determine by contractions. If the repetition time of contractions is less than ten minutes, then you can already get ready. You can also determine by the fact that the amniotic fluid has departed. Although they can leak a little bit, which will be almost imperceptible. Or pour out in several portions. In this case, you should immediately go to the maternity ward and in no case expect the onset of contractions. You can’t wait because if the period of waterlessness is very long, then this threatens to cause complications during the birth itself, and even infection in the uterus is possible. Although usually during the first birth, the waters depart relatively slowly, and only during the second can all of them leave at once.Already right in the hospital!
Also, you can not pull with a visit to the hospital in the event that spotting has appeared. In most cases, a few days before giving birth, a cork closes the cervix in women. It looks like a small lump of mucus, often with blood impurities. It is quite safe, but it is still better to go to the hospital as labor can begin at any time. Therefore, it is necessary that there is someone nearby. Or a future dad or, of course, a better specialist.It is also desirable that during the contractions, one of her relatives should be next to the woman in labor, because it is during this period that she needs support as much as possible. But not only moral, but also physical in the form of stroking the abdomen or a light massage of the lower back.
Here it is, the approaching joyful-anxious finish! It seems to have begun! Everything you need in the maternity hospital is collected, and you begin to remember what you were taught in classes for pregnant women when labor began. We remember together and wait for the moment when it is already necessary to go to the maternity hospital.
Briefly about fights
So, the harbingers of childbirth. They are a signal of the beginning process of labor activity, they are regularly repeated uterine contractions and are accompanied by characteristic pulling pains in the lower back and lower abdomen.
How do they start? It is worth knowing that the first contractions are too weak, for a couple of seconds, and they come with an interval of 10-12 minutes. Sometimes contractions immediately become more frequent, repeat after 5-6 minutes and are quite strong. Over time, they become more frequent with increasing pain and duration.
It should be borne in mind that the rhythm of uterine contraction is a feeling of pressure in the lower abdomen. Usually, such contractions do not introduce severe discomfort into the general condition. It is rather a feeling of heaviness and size of the uterus itself, which can spread to the entire abdomen. Sometimes the expectant mother feels such contractions even a couple of weeks before the onset of the birth process itself, but a regular and prolonged rhythm of uterine contractions does not occur, and this does not flow into childbirth. If the contractions are repeated after 25-30 minutes, then they may be non-birth and have a chance to stop soon. Usually, such contractions do not tire a woman at all, and with the above nature of them, there is no need to go to the hospital.
When real, prenatal contractions come, the intervals between them are necessarily reduced. This happens until the contractions repeat every 3-4 minutes. By the way, in the period between the increase in contractions with a relaxed stomach, a pregnant woman does not feel pain.
The first real contractions a woman feels in her stomach and very rarely - in the lumbar region. It seems to her that the pain rolls in the form of a wave, starting from the side of the lower back and passing through the sides, localized in the abdomen. The first contractions resemble mild tingling, then the duration of the contraction itself lasts up to 6-10 seconds at shorter intervals.
As a rule, in nulliparous women, the total duration of contractions is approximately 10-12 hours. In multiparous mothers, this period is shorter - 6-8 hours.
It's time for the nursery!
The frequency of contractions is the main indicator of when you need it. If your contractions began to repeat more often than once every 10 minutes, then the time has come.
The second option is a departure or outpouring. It is also possible to leak them in small portions. In such a situation, you do not need to wait for the increase in contractions, their regularity, but immediately go to the hospital. The fact is that the duration of the anhydrous period directly affects the likelihood of complications during childbirth and even infection through the uterus of the fetus.
It happens that the fetal bladder leaks slowly. But sometimes it breaks suddenly - and the waters can simply rush in a strong stream long before the rhythmic contractions of the uterus begin. This happens more often in the second birth than in the first. It should be noted that the process of rupture of the fetal bladder is not painful. He just can alarm a woman very much. But the main thing here is to pull yourself together and inform the doctor about it as soon as possible. Rhythmic contractions after this can occur only after an hour or two. And it also happens that they may not come even within two or three days. In any case, the rupture of the amniotic sac is an obligatory signal of the imminent onset of childbirth, therefore, without five minutes, the mother should call the doctor and strictly follow his instructions. The doctor will tell you how to proceed.
It's time to go to the hospital!
Without calls and consultations, you need to go to the maternity hospital in the case when bloody discharge from the vagina appears. Usually, a day or two before giving birth, a pregnant woman exudes mucus, sometimes stained with blood, from the birth canal. This is due to the discharge of the mucous plug from the cervical canal and does not pose any danger. If bleeding occurs, you need to go to the hospital immediately! It is very serious.
When a woman starts contractions, it is better if the future dad or one of the relatives is nearby. Indeed, at this time, more than ever, she needs support with words, touches, stroking. Very often, the first weak contractions introduce even an optimistic woman into a panic. Therefore, moral support, bringing it into tone with calm words are very important. And even if the birth will not be a partner, then it is advisable for daddy to accompany the woman to the maternity hospital.
Specially for Elena TOLOCHIK
