Start of labor pains. Contractions: Necessary Pain

Many expectant mothers, especially those pregnant with their first child, think about childbirth with anxiety. Frightens the unknown, thoughts of painful contractions or a negative experience of first birth. In a series of articles on optimal behavior during various stages of labor, we will describe in detail all stages of the birth process and give clear recommendations for each of them. Knowledge is power!
By reading this information, you will know what to do at different stages of labor. You will feel confident and calm, because childbirth is a wonderful, natural and healthy process!

Harbingers of childbirth and false contractions

Water broke - what to do?

The first stage of labor - the period of disclosure

Early phase of the first stage of labor

When to go to the hospital?

What to pay attention to in the first stage of childbirth?

Active phase of the first stage of labor

The last trimester of pregnancy is the most exciting time in a woman's life. The closer the time of birth comes, the more questions a woman begins to have. The most relevant of them relate to how contractions occur before the birth process, what general sensations occur at this time, whether the pain is strong.

It is this process that is most often frightened by representatives of the weaker sex, in whom pregnancy occurs for the first time. In fact, everything is not so scary, so you do not need to worry much about this. With negative emotions, the pain can greatly increase. The less you think about it and be afraid of the development of contractions, the easier the birth itself will be.

There are also special techniques that help reduce the manifestation of pain during childbirth.

A woman who is carrying a baby can get confused with the development of false (training) contractions. They can occur from the 20th week of gestation. False symptoms before childbirth add some discomfort and discomfort, but are considered an irregular ailment, short in time, and most often almost painless. Uterine tension and discomfort can be relieved by walking or a warm bath.

real contractions - this is the main sign of the imminent onset of labor. How are the contractions before childbirth, and what do they look like more? For every woman, they manifest themselves in completely different ways. This will largely depend on the physiological characteristics of the woman and on the position of the child in the abdomen. For example, some women may feel mild general pain in the lumbar region, which after some time passes to the abdomen and pelvis, encircling the woman.

Others report that the sensations during labor can be compared to the discomfort that occurs during menstruation. The pain only gets worse with time. In preterm labor, the uterus may appear to be hardening and hardening. This can be quickly determined by placing a hand on the stomach.

Process symptoms

All of the symptoms described can also apply to false uterine contractions by Braxton Higgs. Then How can you tell real contractions from fake ones? There are general signs of this natural process, by which any woman in position will be able to understand that she will soon begin labor processes:

At first, a woman may feel contractions after a short period of time. Pain at this time is weak. Over time, the intervals between contractions before childbirth begin to decrease, and the pain during such a process only increases.

Based on general symptoms, There are three phases to this process:

1. Initial pain (hidden or latent form);
2. active;
3. transitional.

initial stage on average lasts up to 7 or 8 hours. The time can be 30-45 seconds, the time interval between them is about five seconds. During this time, the cervix has time to open up to 0-3 cm.

At the onset of the active phase, which lasts from 3 to 5 hours, contractions can last up to one minute. Intervals before childbirth are 2-4 minutes. The cervix during this process opens by 3-7 cm.

transitional phase(the phase begins to noticeably slow down) is considered the shortest. A woman can continue to be in it for 0.5-1.5 hours. Contractions begin to take on a longer form. From this time they begin to last from 70 to 90 seconds. The time between contractions also becomes shorter compared to the rest of the phases. After 0.5-1 minutes, the woman will feel contractions in the uterus. The cervix begins to open by 7-10 cm.

The contractions during the second labor can also be divided into three phases, but the total time of each phase will be shorter than during the first labor.

What to do when contractions start

At the start of the fight a pregnant woman should calm down, since extra commotion and nervousness are not at all helpers in this situation. It is best to take a comfortable position in a chair, on a chair or on a bed and start fixing the intervals between contractions and their duration. All data received must be recorded. No need to think about what will be more painful to endure - contractions or childbirth. Because of fear, the pain will become much stronger.

If the contractions last a short period of time, and the intervals between them are large (from 20 to 30 minutes), then the child is still too early to be born. At the same time, the woman still has time to collect all the necessary things, as well as call an ambulance for a trip to the hospital. During this period of time, with the support of loved ones, you can take a shower. During contractions, the duration between which will vary from 5-7 minutes, you already need to go to the hospital.

A trip to a medical facility does not need to be postponed until a later moment, even though the initial phase can last several hours in a row. Amniotic fluid may depart ahead of schedule, and at this time it will already be necessary to be under the supervision of a gynecologist. When water breaks, it is forbidden to take a hot or warm bath, since for this reason the possibility of developing infectious complications, embolism, bleeding, and placental abruption may increase.

How to induce contractions and labor

Many women go into labor already at 37-40 weeks. But there are cases when childbirth occurs at 41, 42 and even at 43 weeks. The representatives of the fair sex in this case begin to get very worried, nervous, because at this time there is already a strong desire to see the child, but he still cannot be born. There have also been cases when the baby died at such a time in the mother's stomach, but contractions did not occur.

The death of the baby may occur due to the fact that the placenta itself begins to age. The child lacks oxygen and nutrients. How to induce contractions and labor processes is a common question that worries many mothers who carry a baby longer than the date of the expected birth.

There are also folk methods to stimulate childbirth and contractions, but you do not need to experience them for yourself. For example, some teas and herbal decoctions can adversely affect the health of both the woman and the developing fetus, as some of them are contraindicated during pregnancy due to the possible activation of a miscarriage.

How to help a woman in labor

Doctors can help a woman in position and reduce pain during childbirth with the help of special tools. But do not place high hopes on anesthesia. There is a possibility that the drug will have a bad effect on the child and on the mother.

The main method that will help reduce overall pain is what is the correct breathing during childbirth. When it is carried out, the woman quickly relaxes and ceases to worry. When contractions come on, you need to focus your attention on the exhalation. At this time, you need to imagine that together with the air, all the pain comes out of the body. A pregnant woman may scream during contractions and during the birth of a child. Sighs, screams and groans help to alleviate the general condition. Proper breathing must be learned in advance and exercised regularly, since childbirth is always stressful, due to which all memorized information can be quickly forgotten.

A woman can relax with a massage and simple gentle touches from her husband. Contractions are considered a signal of the onset of labor. It is at their onset that you need to do a slow massaging of the lower back. At the same time, a woman can stand or sit on a chair, leaning her hands on some surface.

Lumbar massage during childbirth very good for a woman. This is because the sacral nerve runs to the spinal cord from the uterus and through the lower back. If you carefully massage such an area, then the pain will be significantly reduced. It is good if the spouse will be at the birth itself and help the woman at this difficult and important moment for her.

The mental attitude is also important. Positive emotions, thoughts that soon it will be possible to look at your child for the first time, will help reduce pain. In order to properly respond to what is happening around and not panic too much, a woman must understand exactly how childbirth occurs and what can be felt at this time.

In the intervals between long contractions, you do not need to wait for the next contraction. This time should be spent on rest. With a tense expectation of subsequent processes, you can get tired in a short period of time.

It should also be noted that contractions are completely normal.. Absolutely all women in position pass through it. The question of how contractions begin worries most mothers. It is simply impossible to accurately describe all the symptoms and sensations, since in each case they will be different. Someone compares them with pain during menstruation, and someone with an upset bowel. In any case, there is no need to be afraid of the pain that occurs with them. All discomfort will quickly disappear after the birth of the long-awaited baby.

What can alleviate the condition

There are simple but effective ways which will help to significantly alleviate the condition of the mother before the birth of the baby

Attention, only TODAY!

In order to help everyone who wants to prepare for childbirth, we have created a School for Future Parents on the pages of our magazine.

regular contractions

The classic onset of labor activity is the occurrence of contractions that are insignificant in duration and sensations. The first contractions are usually not associated with pain or significant discomfort. Describing their feelings at this moment, women in labor say that the stomach seems to “harden” for 5-10 seconds, and then completely relaxes until the next contraction. The only subjective sensation in this variant of the onset of labor may be a slight "sipping" in the lower abdomen and in the lumbar region. Most women experience similar sensations during the premenstrual period. A very important sign of true labor activity is regularity, that is, intervals between contractions of equal duration. For example: the fight started at 6:00 and lasted 7 seconds, the next fight started at 6:20 and also lasted 7 seconds, the next fight started at 6:40, etc.

Another sign of true generic activity is the ability to develop dynamically. From the moment of the onset of labor, contractions should gradually increase in sensation and lengthen in time; the intervals between contractions, on the contrary, will become shorter and shorter. If at the beginning of labor the contractions last about 5-7 seconds, and the interval is 20 minutes, then by the time the cervix is ​​fully opened, when the baby is already beginning to descend through the birth canal, the duration of the contraction can increase to 40-50 (!) seconds, and the interval will decrease to 1-2 minutes. With this option for the onset of labor, you should go to the maternity hospital as soon as the interval between contractions is reduced to 10 minutes no later, and only if the road to the maternity hospital is guaranteed not to take more than an hour. Until this moment, the expectant mother can be at home under the supervision of relatives. However, this is possible only if the woman in labor is in good health. If a woman's amniotic fluid begins to drain, blood pressure rises, bloody discharge from the genital tract occurs - immediately go to the hospital!

Training bouts

Now consider another option for the onset of labor - irregular, or training, contractions. They feel similar to the real ones, but the intervals between them may differ significantly from each other. For example, "real" first contractions will occur clearly every 20 minutes. And with a “false alarm”, the interval between adjacent contractions will be uneven. Let's say: 20 minutes - 15 minutes - 30 minutes - 10 minutes - 45 minutes, etc. Not typical for training bouts and the dynamics of the process: they will neither intensify nor lengthen, and the intervals between them will remain uneven. Training bouts can have two different outcomes. In the first case, they will stop by themselves. It should be noted that this scenario is the most common for a woman who is preparing to become a mother for the first time. After all, the uterus is a muscular organ and has the right to train before a decisive event. Normally, such training can be repeated several times during the last week before childbirth; they usually last no more than 2-3 hours and do not cause much discomfort (with the exception, of course, of the unrest of the expectant mother and her relatives).

Much less often, such a “rehearsal” may turn out to be a general one. Then the initially irregular intervals between contractions will gradually become regular, and the training contractions will turn into regular labor activity. If it becomes obvious that the contractions that have arisen are irregular (and in order to understand this, it is enough to compare a couple of intervals between adjacent contractions), the best thing to do ... go to bed! Before childbirth, it is especially important to save energy - because they will be so useful to you!

Remember: even if the training contractions turn into regular labor, it is impossible to oversleep the birth! In the first case, you will get enough sleep and will calmly wait for the real start of childbirth. In the second - also get enough sleep and wake up with a good regular labor activity. Harbinger contractions never precede rapid labor, so you will not be late for the hospital. But in the case when false contractions are repeated every day, cause significant discomfort and deprive the pregnant woman of sleep, it is necessary to consult a doctor, she will be hospitalized in the maternity hospital.

Premature rupture of amniotic fluid

Now let's talk about the outflow of amniotic fluid. Normally, the fetal bladder, in which the water is located, should open no earlier than the middle of the first stage of labor, when the cervix is ​​already half open. Up to this point, the fetal bladder is actively involved in the process of opening the cervix, so its "early" rupture can cause a weakening of labor activity. In addition, with a violation of the integrity of the membranes, the risk of infection of the uterus and fetus increases significantly. Therefore, at the slightest suspicion of amniotic fluid leakage, it is necessary to immediately go to the hospital - regardless of the presence of contractions, the size of the intervals between them and the amount of fluid released from the genital tract!

In obstetrics, a central and lateral rupture of the membranes is distinguished. The rupture of the bladder at the level of the cervix is ​​called central. With this arrangement of the gap, the amniotic fluid will “gush in a stream”, as if somewhere inside the woman in labor had opened a faucet. The liquid will flow down the legs, all clothes below the waist will instantly become wet. As you can see, it is simply impossible to miss such an event!

Water leaves in a completely different way if the rupture occurs high and the “hole” in the fetal bladder is covered by the wall of the uterus. Such a gap is called a high lateral gap. In this case, water will constantly leak in a small amount, wetting the sanitary napkin and the woman's underwear. The rupture of the fetal bladder can be independent, not accompanied by any subjective sensations. That is, there will be no pain, no spasm, no urge to urinate, there may not even be contractions - just at one “wonderful” moment you will feel that liquid is being released from the vagina in addition to your desire.

Going to the hospital, it is necessary to note the time of the outflow of amniotic fluid, the approximate amount and color of the released fluid. In the absence of complications, the amniotic fluid is almost transparent and contains inclusions in the form of particles of cheese-like lubricant, which covers the baby. If the amniotic fluid has different shades of green, this indicates intrauterine fetal hypoxia - a lack of oxygen. In any case, all the information about the nature of the amniotic fluid that will be reported to the doctor will help him take quick and effective measures to help the mother and baby, and the birth will end safely.

So, let's summarize our first lesson:

1. If contractions begin, interspersed with uniform and gradually shortening intervals, the baby's mother feels good, the water has not poured out - we go to the maternity hospital no later than a 10-minute interval between contractions.
2. If the contractions that have begun are irregular, the mother and baby feel good, the water has not poured out - we are resting and waiting for further developments.
3. If any amount of water has poured out or is leaking, or there is at least a suspicion of a discharge of water, we go to the maternity hospital immediately. In doubtful cases, a special analysis will be performed in the emergency room of the maternity hospital - a swab for water. The result will be ready in 15-30 minutes and will allow you to confirm or refute the fact of rupture of the fetal bladder, regardless of its size and location.

Women are waiting for the birth of a baby, not only with trepidation, but also with anxiety. Many are afraid of the pain that they will have to experience, others fear for their health and the health of the child. There are those who are afraid to miss the start of labor. This is especially true for primiparas, who do not know how contractions begin. A number of signs will help a woman not to confuse training uterine contractions with generic ones.

1. Latent, or latent period.
2. active period.
3. Deceleration period.

It is most important for primiparous women to be able to distinguish sensations during labor contractions from sensations during false contractions, the signs of which are in many ways similar to the latent period of contractions.

They are also called training. They occur mainly in nulliparous women from about the 20th week of pregnancy and help the body prepare for childbirth, they also “train” the uterus: they make it more elastic and soft. They last on average up to 2 minutes, the interval between them is changeable, reaches from 30 minutes to an hour.

There are a number of features that distinguish training bouts:

• irregular character;
• contractions do not increase, do not intensify;
• the interval between them is always different;
• there is no disclosure of the uterine pharynx (this will be determined by the gynecologist).

Training uterine contractions sometimes seem strong enough, but they are not cramping, but are more of a aching, pulling character. It is quite possible to cope with them if you take a different position, just lie down, take a warm bath, relax.

real contractions

The more common name is generic. They are difficult to confuse with other conditions, and women who go to childbirth not for the first time will easily recognize them. Signs by which you can determine how contractions begin in primiparas:

1. Labor contractions of the uterus begin, as a rule, with aching pain in the lower abdomen, lower back, hips, which intensifies over time, has a wave-like character: it either subsides, then resumes. Often these pains are compared with menstrual, however, during contractions, they are regular and increasing in nature, and the intervals between them are shrinking every hour. Such contractions do not stop, do not calm down, but only intensify.
2. The uterus tenses, there is a so-called tone, which is easy to feel by placing your hand on your stomach. The uterus becomes stony, becomes hard, there is a feeling that it is compressed, tense. After a while, when the contraction loses its intensity, the uterus relaxes again. Each time the pain and tone intensify. During training contractions, the tone of the uterus is felt to a lesser extent.
3. The duration of uterine contractions increases, and the intervals between them become smaller each time. The cervix opens up.

The first labor contractions in the latent period are short, lasting from 20 to 30 seconds, the interval between them is 20-30 minutes. Gradually, they are felt not as a simple pulling of the abdomen, the pain increases, the contraction itself lasts up to 40-45 seconds, the interval between them decreases to 5-6 minutes. This is the time to go to the hospital.

Important: If the waters break at the initial stage of childbirth, then you need to call an ambulance immediately, since during the anhydrous period there is a high risk of initiating the fetus.

If the contractions last an average of 1 minute, and the break between them is reduced to 1-2 minutes, this is a sign that the cervix is ​​open and attempts will soon begin, that is, the child will be born very soon. At this time, the woman should already be in the delivery room, since only a doctor should control the attempts. Due to improperly organized childbirth, cervical ruptures, fetal injury and other unpleasant consequences often occur at this stage.

Video: How to distinguish attempts from contractions

General differences between training uterine contractions and birth contractions

In nulliparous women, contractions begin for the most part in the same way as in multiparous women. Thus, labor contractions during the preparatory period are distinguished by their regularity and at the initial stage do not last more than 40 seconds. The interval between them cannot increase, but always only decreases.

When preparing a pregnant woman for childbirth, doctors advise, when uterine contractions are felt, to write them down: the time when they started and when they ended, how long the next ones appeared and how long they lasted, whether the pain increases each time or, conversely, subsides. It is desirable to make records with an accuracy of up to a second. According to them, the doctor testifies whether these are false contractions or labor. It is possible to clarify this even by phone, if there was an agreement in advance.

Contractions in the latent phase can be schematically represented as follows:

It is worth remembering: During training bouts, the active phase does not occur, that is, the pain does not increase, their duration does not change, the interval between them fluctuates (more often - in the direction of increase).

Training uterine contractions rarely last more than 2-3 hours.

Video: Feelings during contractions. Differences between training contractions and generic contractions

What to look out for

Many not only multiparous, but also primiparous do not feel the preparatory period. The trained uterus of multiparous women does not need to be “prepared”, going straight to active contractions. That is why many women who give birth to a second and subsequent babies undergo so-called rapid labor, lasting only 4-6 hours.

Primiparous, accustomed to training contractions, often do not pay attention to the first “bells”, skip the latent phase and understand that childbirth began only when the pain intensifies, the stomach “hardens”, and the interval between contractions decreases significantly. You should not panic, because this is exactly the period when doctors advise going to the hospital. The second phase of contractions lasts up to 5 hours, so there will be enough time.

Severe pain during contractions, according to many obstetrician-gynecologists, is provoked by the woman herself, panicking, pinching, thereby interfering with the normal birth process. It is necessary to relax as much as possible, using proper breathing and other techniques that are discussed in courses for expectant mothers.

If there are no contractions

Sometimes a primiparous woman does not wait for birth contractions of the uterus. The absence of contractions before the period of 40-42 weeks is considered normal, if at the same time hypoxia is not recorded in the fetus, the placenta is in a normal state and nothing threatens pregnancy in general. As a rule, from the 40th week of pregnancy, a woman is placed in a hospital and already there, under the supervision of doctors, she is waiting for the onset of childbirth.

In the absence of contractions for a period of 42 weeks, labor is stimulated. In conditions that threaten the health of a woman or an unborn child, a decision is made on operative delivery.

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

How to recognize contractions before childbirth?

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

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

Even before contractions begin, the baby begins to move less. If he moves very actively during contractions, this indicates fetal hypoxia. This must be told to the doctor.

Before childbirth, sanious discharge appears - this is how the mucous plug leaves. It should not be bright red with lots of blood. The cork can move away before the start of contractions. Sometimes the discharge of water also occurs before the start of contractions.

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

How do fights happen?

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

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

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

How to distinguish real contractions from false ones?

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

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

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

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

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

What to do when contractions start?

The time of the onset of contractions, their duration and the size of the intervals between them should be recorded. This information will be useful to obstetricians, in addition, keeping records will help to calm down and distract from pain.

You can easily go to the maternity hospital. If the contractions are repeated after 15-20 minutes, the birth of the baby will not happen soon. If there are no pathologies, the pregnancy is not multiple, it is better to spend this period at home: a familiar environment will help you relax better. You can do pleasant things: listen to music, watch a movie. If you are not going to have a caesarean section, you can have a light snack.

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

When uterine contractions become more frequent and intensified, first of all, a woman needs to take a comfortable position and relax. Then the pain will be less. Real contractions before childbirth become longer and longer, and the intervals between them become shorter. The pain spreads from the abdomen to the lower back, does not weaken with a change in body position.

Signs of pathology during contractions

Sometimes, for various reasons, labor activity can be slowed down. It is not necessary for the first contractions to be followed by childbirth - uterine contractions can become regular only after a few days. This is more common in primiparous women. In such cases, in the maternity hospital resort to the stimulation of labor.

When is it time to go to the hospital?

If real contractions began before childbirth, then childbirth is approaching. Don't worry, you have time to calmly collect yourself while the contractions come at intervals of 20-30 minutes. Of course, it is desirable that the bag with things is already assembled in advance.