The beginning of childbirth - causes, harbingers, signs. Ways to speed up the onset of labor

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Introduction. How to recognize the onset of labor?

Many pregnant women often wonder about the upcoming date. childbirth, and women who are about to give birth for the first time are especially worried. As a rule, they are very afraid of not recognizing the labor that has begun in time and confusing it with a temporary malaise. In many cases, a close observation of the woman for the changes that occur in her body will help to resolve these unrest.

Already at 38 weeks, the prenatal period begins, when the first harbingers of childbirth and the first, as yet irregular (training) contractions, appear. Such contractions appear irregularly, and they pass after a change in body position or a short rest. In nulliparous women, such training uterine contractions can continue for five, and in some cases even more, days before delivery. When they appear, you do not need to worry and urgently go to the hospital, but the expectant mother should inform her doctor, relatives and friends about such changes in her body.

When the first signs of leakage or outflow of amniotic fluid appear, which may indicate the onset of labor or premature labor, the woman should immediately notify the doctor or independently contact a medical institution to resolve the issue of further hospitalization.

If a woman has learned to recognize training contractions, then she will be able to distinguish them from the onset of labor, or true contractions. These sensations are difficult to confuse with any other symptom, since they are characterized by periodicity and rhythm. For example, a fight lasts 20-30 seconds, and then there is a 20-minute pause - this is repeated many times in a row, and the time intervals hardly change.

At the beginning of the onset of labor pains, a woman in labor or her relatives should inform the doctor about the onset of labor, call an ambulance or go to the maternity hospital on their own.

Reasons for the onset of labor

By the beginning of childbirth, a lot of complex processes take place in the body of a pregnant woman, which, being in close relationship, provide the beginning of such a reflex act as labor activity.

The main reason for the onset of labor is the readiness of the uterus for the birth of the unborn child and the maturity of the fetus.

Ready for childbirth uterus:

• gaining sufficient weight and size;
• her neuromuscular apparatus is ready for contractile activity;
• fully mature placenta.

2 or 3 weeks before the onset of labor, the uterus is released from the excess of part of the nerve fibers. This provides a reduction in pain during childbirth and increases the contractility of the walls of the uterus.

Several factors influence the onset of labor:

• neuro-reflex - as a result of a decrease in the excitability of the brain, an increase in the excitability of the spinal cord and an increase in the sensitivity of the muscle fibers of the uterus to oxytocin, an increased contractile activity of the uterus is produced;
• hormonal- in the end pregnancy the production of progesterone decreases and the production of a complex of estrogens increases, which stimulate the onset of labor;
• neurohumoral - at the end of pregnancy in the body of a woman, the synthesis of oxytocin, prostaglandins, serotonin and other bioactive substances increases, which increase the sensitivity of the uterus to substances that cause active contraction of its muscles;
• bioenergy - a sufficient amount of substances (glycogen, ATP, phosphorus compounds, electrolytes and trace elements) accumulate in the mother's body, which make the uterus capable of increased contractile activity;
• mechanical - the ripened uterus loses its ability to stretch, and in response to the motor activity of the fetus and an increase in the level of oxytocin-like hormones, it begins to actively contract;
• trophic and metabolic - the accumulation in the body of a mature fetus of some waste products leads to its active movement, and degenerative processes in the mature placenta and the full maturation of the muscle fibers of the uterus contribute to the onset of labor.

The state of the nervous system of the woman in labor is of primary importance in the formation of all mechanisms for the onset of labor, since it is she who ensures the readiness of the uterus for natural childbirth.

All of the above factors, being in close relationship, contribute to the appearance of contractions, which are replaced by attempts and end with the expulsion of the fetus from the uterine cavity and the birth of the placenta.

Harbingers of the onset of labor

Harbingers of childbirth are a set of signs that indicate the imminent onset of active labor activity. There are many harbingers of the onset of childbirth, but for each woman their totality is individual and depends on the characteristics of the body of the expectant mother.

Harbingers of childbirth:

• Dropping of the abdomen.
  Such a change, which is determined externally by a slight downward displacement of the abdomen, is individual for each pregnant woman, and may not always be noticed on its own. In nulliparous women, this harbinger may appear 2-4 weeks before the day of delivery, and in multiparous women, a few days or immediately before childbirth.


• Gait changes.
  The nature of the gait changes after the prolapse of the abdomen. The woman begins to walk "waddling" due to the pressure of the baby's head on the pelvic bones and the bottom of the uterus.


• Changes in the nature of urination and defecation.
  A prolapse of the abdomen can cause more frequent urination or urinary incontinence as the uterus puts more pressure on the bladder. The mechanical impact of the pregnant uterus on the intestinal wall can provoke constipation, and in some cases diarrhea, a few weeks or days before delivery.


• Change in the nature of secretions from the genital tract.
  Discharge from the vagina under the influence of hormonal changes becomes more abundant and liquid. In some cases, to exclude the discharge of amniotic fluid, a special test is performed by an obstetrician.


• Removal of the mucous plug.
  This harbinger of labor can occur 2 weeks before the onset of labor, and a few hours before it begins. In some cases, the mucous plug does not come off entirely, but in small portions. In practice, this sign looks like a discharge of vaginal discharge (sometimes mixed with a small amount of blood). A pregnant woman should inform her obstetrician-gynecologist about the discharge of the mucous plug.


• Decrease in the body weight of the expectant mother.
  A few days before giving birth, a pregnant woman may notice that she weighs 1-2 kg less. This weight loss can be explained by the removal of excess fluid from the body under the influence of changes in the hormonal background.


• Reducing the number of fetal movements.
  The fetus, a few weeks before birth, moves less frequently. This is due to its rapid growth. The future baby becomes crowded in the uterine cavity, and its movements are difficult.


• Training bouts.
  Closer to the date of birth, the uterus begins to increasingly come into increased tone, which is expressed in the feeling of training contractions. They differ from labor pains in a number of features: short duration, irregularity, weak pain sensations (reminiscent of pain during menstruation), spontaneous disappearance after a change in body position or rest.


• The manifestation of the instinct of "nesting".
  Many women in the last days and even hours before childbirth begin to prepare their homes for the upcoming birth of a child. These actions can be expressed in the fact that a woman begins to diligently clean, wash, and even start repairs.


• Changes in the cervix.
  Only an obstetrician-gynecologist can notice such a harbinger of an approaching birth when examining a woman on a gynecological chair. Under the influence of estrogen hormones, the cervix shortens and becomes more elastic by the 38th week. The external os of the cervix begins to open before the onset of labor pains.

Harbingers of childbirth in primiparous and multiparous women have their own characteristics.

Harbingers of the onset of labor - video

Signs of the onset of labor

Reliable signs of the onset of labor are:
1. contractions;
2. Outflow of amniotic fluid.

These two signs always indicate the onset of labor and every pregnant woman should know how they proceed.

Contractions

True, or labor pains are called contractions of the muscle fibers of the uterus, which occur at regular intervals, and which a woman cannot control. It is this sign that indicates the moment of the onset of childbirth.

The first true contractions are accompanied by minor pain, which most women compare with pain during menstruation. The pain is tolerable and can be given to the lower back or localized in the lower abdomen. Most women in labor begin to feel contractions at night. Some women note that during labor pain the uterus “hardens”, i.e. if during the contraction the woman in labor puts her hand on her stomach, then she can feel a hard, tense uterus.

You can determine the truth of contractions using a stopwatch. Their periodicity and constant occurrence, which is not eliminated by a change in body position, taking a warm bath or rest, indicates the onset of labor.

At first, contractions occur at intervals of half an hour (in some cases more often). With each contraction, the woman in labor begins to feel not only soreness, but also rhythmic contractions of the muscles of the uterus. Gradually, contractions become more noticeable, and their frequency, duration and intensity increase. With each contraction, the amniotic sac and the head of the fetus press against the fundus of the uterus, causing a gradual opening of the cervix.

Outflow of amniotic fluid

In the classical course of childbirth, the outflow of amniotic fluid occurs after the opening of the cervix to 3-7 cm. Under the pressure of the fetus, the amniotic membrane is torn, and part of the amniotic fluid is poured out.

A woman in labor, with a classic outpouring of water, may seem to have involuntarily urinated. In some cases, water is poured out gradually, in small portions. In this case, a woman may notice the appearance of wet spots on her underwear or bedding and experience such sensations as when separating vaginal or menstrual flow.

Sometimes the rupture of amniotic fluid can occur before the onset of regular contractions and dilatation of the cervix, or much later than the full opening of the os of the uterus. These conditions do not always mean that there will be a pathology of childbirth or the fetus, but usually gynecologists use various special tactics for the further conduct of such labor to prevent possible complications.

Signs of the onset of labor - video

Contractions at the beginning of labor

Obstetrician-gynecologists distinguish three phases of labor pains:

Initial (hidden) phase:

• the duration of the fight is 20 seconds;
• the frequency of contractions is 15-30 minutes;
• opening of the cervix - 0 or up to 3 cm.

The duration of the initial phase is from 7 to 8 hours.

Active phase:

• the duration of the fight is 20-60 seconds;
• the frequency of contractions is 2-4 minutes;
• opening of the pharynx of the uterus - 3-7 cm.

The duration of the active phase is from 3 to 5 hours. Usually it is in this phase that the amniotic fluid is poured out.

Transitional (transient) phase:

• the duration of the fight is 60 seconds;
• the frequency of contractions is 2-3 minutes;
• opening of the pharynx of the uterus - 7-10 cm.

The duration of the transition phase is from half an hour to an hour and a half.

Labor pains occur in the first stage of labor (the period of disclosure).

Beginning of labor in primiparas

Probable harbingers of childbirth in primiparas have their own characteristics. As a rule, they have a more pronounced time difference between the day of birth and the date of the appearance of precursors. Some expectant mothers are overly emotional and take any slight ailment for the harbingers of childbirth. If they do not know about this or that sign, they may not notice them.

From time immemorial, the birth of a child was considered a great sacrament. Midwives in Russia enjoyed special honor, and not every woman could become a midwife: she had to have impeccable health, her children had to be healthy, her thoughts had to be pure.

Even during pregnancy, midwives taught the expectant mother an old slander that they read to children in the womb: “From you, my light, my droplet, I myself will take all the trouble. My love will be your dome, all patience will be a cradle, and consolation by prayer. I am waiting for you, my light, like the land of dawn, like the grass of dew, like the flowers of rain.
The sound of these gentle words had a beneficial effect on both the baby and the mother, creating the right mood for the upcoming birth.

Childbirth is the culmination of pregnancy and in most cases proceeds as a normal physiological process.

The expectant mother wants to know everything about childbirth: to know the signs of labor, the onset of labor, the symptoms of labor and labor, when they begin, at what point you need to rush to the maternity hospital, how painful the labor is and how long it lasts.

Each woman in labor is an individual, and childbirth proceeds differently, but almost all women in labor experience the main signs of an early birth: the uterus contracts during contractions; the cervix becomes smoother, thinner, then opens; the child turns and moves along the birth canal; you give birth to a baby, then the placenta, the umbilical cord and the membranes. The whole process takes from several hours to a day (sometimes more) and is the beginning of motherhood, and for the child - the transition to an autonomous existence.

Everything is important in this process: the mechanism of childbirth, physiological characteristics, feelings and experiences of the mother, her psychological state.

The onset of labor is not always clear, especially the signs of labor in primiparous mothers. Experts believe that the child is the initiator of the onset of labor. By the 40th week, and sometimes even earlier, due to the rapid growth of the child, the amount of amniotic fluid decreases, it is more and more difficult for the baby to move. The placenta has grown old, and the baby receives insufficient amounts of nutrients and oxygen.

The child experiences very unpleasant sensations, his adrenal cortex is activated and a large amount of cortisol, the stress hormone, is released. In response, the hormonal balance in the mother's body changes. As a result, the uterus becomes very sensitive to biologically active substances produced by the woman's placenta and pituitary gland. It begins to shrink - regular contractions appear, followed by childbirth.

Changes also occur in the body of the expectant mother: the amount of estrogens that prepare the uterus for childbirth increases, and, as a result, the cervix shortens and softens, the uterus begins to contract regularly.

Signs of the onset of labor

Pain in the lower back, a feeling of increasing pressure in the groin area is accompanied by a feeling of fatigue and heaviness. You can't find any comfortable position for a long time. This pain is different from normal low back pain and may resemble premenstrual pain. This symptom may occur a few days before delivery, often in combination with other symptoms.

Frequent bowel movements can be mistaken for a common disorder, but in this case it is caused by prostaglandins causing the bowel to empty to make more room for the baby to move down.

Secretion of mucus streaked with blood

Throughout pregnancy, the cervix contains thick mucus, which can be released at the end of pregnancy, when the cervix begins to thin and open. In rare cases it may look like a mucus plug, more often the mucus is thinner and may contain blood streaks. The appearance of blood can occur a few days before childbirth, but it can also happen after the onset of contractions.

Bloody discharge is common late in pregnancy after a vaginal examination, as this procedure often causes some bleeding from the cervix. It is easy to make a mistake and take these secretions as a sign of childbirth. If this blood is pink or bright red and mixed with mucus, this is undoubtedly a harbinger of childbirth; after examination, the blood is brownish.

Progressive uterine contractions

Contractions that become longer, stronger and more frequent are the harbingers of childbirth. At the beginning of labor, contractions are usually felt as a pulling pain that radiates in the lower back. As labor progresses, contractions become painful. Uterine contractions shorten the muscle fibers of the body of the uterus, stretch the cervix and expel the fetus from the uterus.

Opening of the fetal bladder

The opening of the fetal bladder, also called the discharge of amniotic fluid, can occur before the onset of contractions in 10-12% of cases. Then the intensifying contractions begin shortly after the water breaks or within a day. In most cases, the fetal bladder does not open until the development of the birth process. When the bladder ruptures, there may be a sudden "pop" accompanied by the flow of amniotic fluid, or there may be a gradual, uncontrolled leakage of fluid. The opening of the amniotic sac may feel like urination.

If your waters broke before contractions, note the time, color, smell, and describe the amount of fluid (trickle or stream). Normally, the liquid is clear and practically odorless. The green color of the amniotic fluid indicates the presence of meconium (original feces) in them, which can cause stress in the child and require urgent action. You should not use tampons in this case to keep the flow. Notify your doctor immediately. Depending on your condition and the position of the baby, the doctor will decide whether to wait for regular contractions or urgently induce labor. In some cases, if the child did not have time to block the exit from the cervix at the time of the outpouring of water, the umbilical cord may prolapse.

With an early opening of the fetal bladder, due to the risk of infection, you should not use the bathroom, it is better to take a shower. With strong contractions, there is no increase in the risk of infection in the uterus, so the bath, if necessary during childbirth, should be postponed until the onset of strong contractions.

We remind: if you feel regular contractions (after 15-20 minutes lasting 20-30 seconds), as well as in case of leakage or outpouring of amniotic fluid, you should immediately go to bed and call an ambulance or go to the hospital yourself.

In some cases, the appearance of signs of the so-called "imaginary childbirth" is possible:

- spasms are irregular, their frequency and tension do not increase;

- there is pain rather in the underbelly than in the sacrum;

- spasms disappear during walking or after changing position;

- fetal movements increase during spasm. Such contractions usually accompany the moment when the child enters the pelvic area.

Remember: you should not be afraid that you will disturb the doctor or your loved ones in vain. If you have signs of an approaching birth at any time of the day or night, you should go to the hospital. In this case, it is better to play it safe.

By the end of pregnancy, women, especially those preparing to become a mother for the first time, are afraid not to notice that childbirth is beginning. There are a number of signs that point to this. But especially suspicious pregnant women are ready to interpret any ailment or change in the body as the beginning of labor. That is why it is so important to monitor your well-being and the behavior of the baby. This will help prepare for an important event and arrive at the hospital on time.

Content:

Physiological signs of close birth

As a rule, changes in the body before childbirth are associated with changes in the hormonal background of a woman, the readiness of the uterus for childbirth, the maturation of the placenta and the maturity of the fetus. Harbingers of childbirth during a normal pregnancy appear at 38-39 weeks, but some women may experience earlier. Primiparas begin to notice signs of labor days, even weeks before, while women expecting their second and subsequent babies may experience familiar symptoms in just a few hours.

"Dropping belly"

On this basis, in the old days, grandmothers predicted an early birth. The sign is based on changes in the body that occur at the end of pregnancy. With cephalic presentation, shortly before childbirth, the fetal head drops lower, stands in the small pelvis, as doctors say. Accordingly, the upper part of the uterus also descends and no longer presses on the stomach, lungs and other organs. It is not always possible to notice on your own that the stomach has dropped, but the woman feels how it has become easier to breathe, shortness of breath stops tormenting when walking and climbing stairs, heartburn disappears if she has been pestering in recent months.

When the abdomen drops before childbirth, the navel protrudes even more, and the skin on the abdomen stretches more. It is at this stage that the rapid appearance of stretch marks is possible.

Frequent urination, change in bowel habits

This is also a physiologically explicable sign. The lowered head of the child with greater force presses on the bladder, as a result of which it cannot be filled to the full volume, and the urge to urinate occurs much more often. The woman notices that although she began to go to the toilet more often, the volume of urine excreted has decreased significantly.

The strong pressure of the pregnant uterus on the intestines provokes constipation. Shortly before childbirth, there is a sharp increase in the hormone oxytocin, which, on the contrary, causes loosening of the stool. If frequent constipation is abruptly replaced by diarrhea, this sign indicates an approaching birth.

Drawing pain in the lower back and lower abdomen

Before childbirth, for a more comfortable movement of the child through the birth canal, sprains occur, softening of the cartilage, the pelvic bones gradually move apart, which causes discomfort, and in some women quite noticeable pain. At this time, gait and posture change. Many women also experience pain in the pubic region caused by the pressure of the fetus on the pelvic bones.

Increasing secretions

White semi-liquid discharge before childbirth signal the imminent discharge of the mucous plug. Some pregnant women worry that amniotic fluid is leaking. In fact, water leakage is not as common as it seems. It is observed in the case when the rupture of the fetal bladder occurs not at the uterine os, but at one of the walls of the uterus. If there is any doubt about the nature of the discharge, then it is worth visiting a doctor. With the help of a special test, he will determine the presence of amniotic fluid in the secretions.

Changes in the cervix

The gynecologist will tell you about changes in the cervix at the next weekly examination. The cervix shortens and is 1-2 centimeters, the uterine os begins to open. It was then that doctors talk about opening the cervix by 1 or 2 fingers.

At this time, the fetal membranes are close, they are available for all kinds of infections, so intimate hygiene should be more thorough. Required toilet genitals and change of linen twice a day. For washing, it is not necessary to use soap every time: it dries the mucous membrane. You can use a decoction of chamomile. Baths at this time should not be taken, they should be replaced with a warm shower.

Removal of the mucous plug

The uterine pharynx during pregnancy is closed by the so-called mucous plug, which holds the baby and does not allow infection to penetrate inside. Abundant discharge in the form of a clot of mucus indicates that the cork has moved away, and soon the cervix will open. In some women, disclosure occurs gradually, in others, childbirth begins immediately after the cork is released.

The cork may come out 2 weeks before delivery. Sometimes the cork comes out not entirely, but in parts, so it is not always recognized. You can guess that it is she, by the nature of the discharge: transparent, dense, possibly with streaks of blood.

Change in the nature of fetal movements

Many pregnant women at 38-39 weeks notice a decrease in the number of fetal movements. Its movement is difficult and not so intense, since it becomes crowded in the uterus before childbirth.

Video: Harbingers of an approaching birth

There are also psychological harbingers of childbirth associated with changes in the hormonal background of a woman. Of course, such signs are very subjective and it can be quite difficult to draw conclusions based only on them.

mood swings

Frequent mood swings, unreasonable tearfulness, irritability are associated with an increase in the hormone oxytocin before childbirth. A couple of days after the baby is born, this mood will continue. With the restoration of the balance of hormones, the psychological state also stabilizes.

The nesting instinct

A few days before giving birth, a woman has an irresistible desire to prepare an apartment for the appearance of a baby. This is expressed in the fact that she takes out and puts children's things in place, fills the crib, irons clothes, finds a place for a bath. In general, he arranges everything so that the child and the mother herself are comfortable. Some women may have an irresistible desire to start repairs in the apartment, get rid of all that is superfluous.

Video: How the instinct of "nesting" in pregnant women is explained

Reliable signs of close birth

If before that the signs did not manifest themselves clearly, the woman was based on the words of the doctor and her own feelings and sensations, then reliable signs indicate that childbirth will begin in the next day:

1. Tone of the uterus. The uterus shrinks, “hardens”, which is felt good if you put your hand on your stomach. It occurs, as a rule, already at the initial stages of contractions and contributes to the advancement of the baby to the uterine pharynx during childbirth.
2. contractions. The first phase, latent, is characterized by sipping the lower abdomen. Many women confuse contractions in this phase with false ones. However, gradually they increase, the interval between them becomes shorter. This is already an active phase. At this time, you should go to the hospital.
3. Departure of amniotic fluid. If the waters have broken, this does not mean that the child will be born immediately. Often the water breaks at the very beginning of labor, when the cervix is ​​not yet open. Then the doctors talk about the anhydrous period, and the card of the woman in labor will definitely indicate how long it lasted. It happens, on the contrary, with the full opening of the cervix, the fetal bladder remains intact. In this case, it is pierced so that the child can safely pass through the birth canal.

Important to remember: If the waters break outside the maternity ward, you should immediately go there. A long anhydrous period can lead to infection of the fetus, birth injuries. You need to try to remember the color and smell, as well as the presence of impurities (for example, blood, meconium) in the amniotic fluid and tell the doctor about everything upon arrival at the maternity hospital. By the nature of the amniotic fluid, he will draw a conclusion about the condition of the child.

Signs of preterm labor

Premature births are considered to occur between the 28th and 36th weeks of pregnancy. They can occur for various reasons, proceed both rapidly and gradually. Preterm labor usually begins suddenly, but some signs may indicate them:

• feeling of heaviness in the lower abdomen;
• frequent finding of the uterus in good shape;
• sharp descent of the abdomen;
• feeling of pressure on the pelvic bones;
• growing pains of a cramping nature.

If you find one or more signs of childbirth, you should immediately consult a doctor. In most cases, preterm labor can be stopped.

The death of a person is a very sensitive topic for most people, but, unfortunately, each of us has to deal with it one way or another. If the family has bedridden elderly or oncological sick relatives, it is necessary not only for the guardian himself to mentally prepare for an imminent loss, but also to know how to help and alleviate the last moments of the life of a loved one.

A person who is bedridden for the rest of his life constantly experiences mental anguish. Being in his right mind, he understands what inconvenience he causes to others, imagines what he will have to endure. Moreover, such people feel all the changes that occur in their body.

How does a sick person die? To understand that a person has a few months / days / hours left to live, you need to know the main signs of death in a bedridden patient.

How to recognize the signs of impending death?

Signs of death of a bedridden patient are divided into initial and investigative. At the same time, one is the cause of the other.

Note. Any of the following symptoms may be the result of a long-term and there is a chance to reverse it.

Changing the routine of the day

The daily regimen of an immobile bedridden patient consists of sleep and wakefulness. The main sign that death is near is that a person is constantly immersed in a superficial sleep, as if dozing. With such a stay, a person feels less physical pain, but his psycho-emotional state seriously changes. The expression of feelings becomes scarce, the patient constantly withdraws into himself and is silent.

Edema and discoloration of the skin

The next reliable sign that death is inevitable in the near future is the appearance of various spots on the skin. These signs before death appear in the body of a dying bedridden patient due to a disruption in the functioning of the circulatory system and metabolic processes. Spots occur due to the uneven distribution of blood and fluids in the vessels.

Problems with the senses

Older people often have problems with vision, hearing and tactile sensations. In bedridden patients, all diseases are exacerbated against the background of constant severe pain, damage to organs and the nervous system, as a result of circulatory disorders.

Signs of death in a bedridden patient are manifested not only in psycho-emotional changes, but the external image of a person will certainly change. Often you can observe the so-called "cat's eye". This phenomenon is associated with a sharp drop in eye pressure.

Loss of appetite

As a result of the fact that a person practically does not move and spends most of the day in a dream, a secondary sign of approaching death appears - the need for food is significantly reduced, the swallowing reflex disappears. In this case, in order to feed the patient, they use a syringe or probe, glucose, and a course of vitamins is prescribed. As a result of the fact that a bedridden patient does not eat or drink, the general condition of the body worsens, problems with breathing, the digestive system and “going to the toilet” appear.

Violation of thermoregulation

If the patient has a discoloration of the limbs, the appearance of cyanosis and venous spots - a lethal outcome is inevitable. The body consumes the entire supply of energy to maintain the functioning of the main organs, reduces the circle of blood circulation, which in turn leads to the appearance of paresis and paralysis.

General weakness

In the last days of life, a bedridden patient does not eat, experiences severe weakness, he cannot move independently and even rise to relieve himself of natural need. His body weight is drastically reduced. In most cases, the processes of defecation and can occur arbitrarily.

Altered consciousness and memory problems

If the patient has:

• memory problems;
• a sharp change in mood;
• bouts of aggression;
• depression - this means the defeat and death of the parts of the brain responsible for thinking. A person does not react to the people around him and ongoing events, performs inadequate actions.

Predagony

Predagonia is a manifestation of a protective reaction of the body in the form of a stupor or coma. As a result, metabolism decreases, breathing problems appear, necrosis of tissues and organs begins.

Agony

Agony is the dying state of the body, a temporary improvement in the physical and psycho-emotional state of the patient, caused by the destruction of all vital processes in the body. A bedridden patient before death may notice:

• improvement of hearing and vision;
• normalization of respiratory processes and heartbeat;
• clear consciousness;
• reduction in pain.

Symptoms of clinical and biological death

Clinical death is a reversible process that appeared suddenly or after a serious illness, and requires urgent medical attention. Signs of clinical death, manifested in the first minutes:

If a person is in a coma, attached to a ventilator (ALV), and the pupils are dilated due to the action of medications, then clinical death can only be determined by the results of an ECG.

With the provision of timely assistance, within the first 5 minutes, you can bring a person back to life. If you provide artificial support for blood circulation and breathing later, you can return the heart rhythm, but the person will never regain consciousness. This is due to the fact that brain cells die earlier than the neurons responsible for the life of the body.

A dying bedridden patient may not show signs before death, but clinical death will be recorded.

Biological or true death is the irreversible cessation of the functioning of the body. Biological death occurs after clinical, so all the primary symptoms are similar. Secondary symptoms appear within 24 hours:

• cooling and rigor of the body;
• drying of mucous membranes;
• the appearance of cadaveric spots;
• tissue breakdown.

Behavior of the dying patient

In the last days of their lives, the dying often remember what they have lived, tell the brightest moments of their lives in all colors and details. Thus, a person wants to leave as much good about himself as possible in the memory of loved ones. Positive changes in consciousness lead to the fact that a recumbent person tries to do something, wants to go somewhere, while being indignant that he has very little time left.

Such positive mood swings are rare, most often the dying fall into a deep depression, show aggressiveness. Doctors explain that mood changes can be associated with taking strong narcotic painkillers, the rapid development of the disease, the appearance of metastases and jumps.

A bedridden patient before death, being bedridden for a long time, but in a healthy mind, ponders his life and actions, evaluates what he and his loved ones will have to endure. Such thoughts lead to a change in the emotional background and peace of mind. Some of these people lose interest in what is happening around them and in life in general, others become withdrawn, others lose their minds and the ability to think sensibly. The constant deterioration of the state of health leads to the fact that the patient constantly thinks about death, asks to alleviate his situation by euthanasia.

How to relieve the suffering of the dying

Bedridden patients, people after trauma or having an oncological disease, most often experience severe pain. To block these, strong painkillers are prescribed by the attending physician. Many pain relievers are only available with a prescription (eg Morphine). In order to prevent the emergence of dependence on these drugs, it is necessary to constantly monitor the patient's condition and change the dosage or stop taking the drug when an improvement appears.

How long can a bedridden patient live? No doctor can give an exact answer to this question. A relative or guardian caring for a bedridden patient needs to be near him around the clock. To more and alleviate the suffering of the patient, you should use special means - beds,. To distract the patient, you can put a TV, radio or laptop next to his bed, it is also worth getting a pet (cat, fish).

Most often, relatives, having learned that their relative needs, refuse him. Such bedridden patients end up in hospitals, where everyone falls on the shoulders of the workers of these institutions. Such an attitude towards a dying person not only leads to his apathy, aggression and isolation, but also aggravates the state of health. There are certain standards of care in medical institutions and boarding houses, for example, a certain amount of disposable products (diapers, diapers) is allocated for each patient, and bedridden patients are practically deprived of communication.

When caring for a bedridden relative, it is important to choose an effective method of alleviating suffering, provide him with everything necessary and constantly worry about his well-being. Only in this way can his mental and physical suffering be reduced, as well as prepare for his inevitable death. It is impossible to decide everything for a person, it is important to ask his opinion about what is happening, to provide a choice in certain actions. In some cases, when there are only a few days left to live, it is possible to cancel a number of heavy drugs that cause inconvenience to a bedridden patient (antibiotics, diuretics, complex vitamin complexes, and hormonal drugs). It is necessary to leave only those medicines and tranquilizers that relieve pain, prevent the occurrence of seizures and vomiting.

Brain reaction before death

In the last hours of a person's life, his brain activity is disturbed, numerous irreversible changes appear as a result of oxygen starvation, hypoxia and the death of neurons. A person may see hallucinations, hear something, or feel as if someone is touching him. Brain processes take a few minutes, so the patient in the last hours of life often falls into a stupor or loses consciousness. The so-called "visions" of people before death are often associated with a past life, religion or unfulfilled dreams. To date, there is no exact scientific answer about the nature of the appearance of such hallucinations.

What are the predictors of death according to scientists

How does a sick person die? According to numerous observations of dying patients, scientists made a number of conclusions:

1. Not all patients have physiological changes. Every third person who dies has no obvious symptoms of death.
2. 60-72 hours before death, most patients lose their response to verbal stimuli. They do not respond to a smile, do not respond to the gestures and facial expressions of the guardian. There is a change in voice.
3. Two days before death, there is an increased relaxation of the neck muscles, i.e., it is difficult for the patient to keep his head in an elevated position.
4. Slow, also the patient cannot close his eyelids tightly, close his eyes.
5. You can also observe obvious violations of the gastrointestinal tract, bleeding in its upper sections.

Signs of imminent death in a bedridden patient manifest themselves in different ways. According to the observations of doctors, it is possible to notice obvious manifestations of symptoms in a certain period of time, and at the same time determine the approximate date of death of a person.

	Development time
Changing the routine of the day	A few months
Swelling of the limbs	3-4 weeks
Perceptual disturbance	3-4 weeks
General weakness, refusal to eat	3-4 weeks
Impaired brain activity	10 days
Predagony	Short-term manifestation
Agony	Several minutes to an hour
Coma, clinical death	Without assistance, a person dies in 5-7 minutes.

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The last weeks of pregnancy are the most exciting. The woman is eager to know when the birth will begin, how it will be, how her baby will look. This is especially true for those women who give birth for the first time. At the same time, they are also interested in the question of how childbirth begins, so as not to confuse malaise and training with signs of the appearance of a child. It is important to follow all the changes taking place in the body, and then you can easily understand that it is time to go to the hospital. This article will help you figure it out.

How to find out about the approach of childbirth in order to be able to prepare and get to the hospital?

This question is of interest to every expectant mother, especially primiparous. The fact that childbirth will begin soon will be prompted by the body itself. All his changes will say for themselves that it's time to give birth soon. The main thing is to listen to him and pay attention to every little thing.

The prenatal period is considered to be from the 38th week of pregnancy. It is from this moment that you can notice the symptoms before childbirth, the harbingers of the fact that it will soon be time to give birth. At this time there are training fights. They are irregular, occur mainly when the position of the body changes. In primiparas, they appear 5 or more days before delivery. They prepare the uterus for a future event, so do not worry and immediately go to the hospital. How then to know that you are giving birth? The real ones are distinguished by periodicity and rhythm. If their interval is 10-15 minutes, and they last at least a minute, then you can safely go to the hospital.

What are the harbingers of childbirth in primiparas? In fact, they are the same, regardless of which births are in the account. When preparing the body, loose stools can be observed, and the urge to go to the toilet is even more frequent. The baby becomes less mobile due to lack of space. However, the main feature is that the appearance of contractions in primiparas is less intense and rapid. The harbingers of premature birth are the leakage of amniotic fluid or their outflow.

The main signs of incipient labor

The onset of childbirth has its own characteristics for primiparous and multiparous women. The first signs of childbirth are the appearance of regular contractions, the discharge of water. It is not worth going to the hospital if the contractions are periodic, they appear very rarely, and mainly with sudden movements. These are not signs of the onset of labor, but training contractions.

In the first pregnancy, the signs of childbirth begin in advance and do not converge with the date of this event. So, how are births in primiparous? The first signs of childbirth in primiparas can begin 1-2 weeks earlier. There are pain in the lumbar region, nausea, vomiting, abdominal prolapse is observed. Generic signs in the form of contractions and discharge of water are quite long. This is due to the inelasticity of the previously nulliparous birth canal, as well as the need to open the cervix, the process of which takes longer.

Signs of childbirth in primiparas often consist of a burning sensation in the lower abdomen. It can also be emotional changes associated with nervous strain from the unknown signs of the onset of labor and the approach of the process. In what week does labor begin in primiparas? The answer is strictly individual. The fetus can be ready to appear at both 38 weeks and 42 weeks.

Harbingers of the second birth usually begin at 37 weeks. Signs of the onset of labor activity develop much more rapidly than in primogeniture. The first signs of imminent labor can be seen just 1-2 days before the birth. The belly in multiparous people usually drops already in front of the hearths themselves. The birth canal is more prepared, so the process is much faster. The main signs of childbirth and the second pregnancy are the appearance of contractions, the interval of which is getting smaller.

10 signs that labor is approaching

The course of pregnancy and childbirth is individual for each woman. Including signs of approaching childbirth are not necessarily observed all together, and each expectant mother has her own special combinations. How then to know that the birth is coming soon? So, the following signs speak of their approach:

1. Removal of the mucous plug

The mucus plug is essential to protect the baby from infections. When the cervix opens, the mucous plug is discharged, which can be whole or in portions. This sign can be seen both two weeks before childbirth, and before the very beginning of the process of giving birth to a baby. It looks like a discharge of vaginal discharge. In some cases, bleeding is allowed.

2. Outflow of water

The outpouring of water indicates the beginning of labor activity. This process can take place in different ways. Water can pour out even before the start of contractions, it can leak a little, and in some situations it is necessary to pierce the fetal bladder so that they move away.

3. Contractions

A sign of contractions are wave pains that appear first in the lower back and move down the abdomen. They have a regular periodic character. Gradually there is an increase in pain. In primiparas, they usually last longer than in multiparous ones.

4. Lower back pain

In late pregnancy, lower back pain begins to manifest itself due to a change in the center of gravity, the appearance of false contractions, the production of the hormone relaxin, and the preparation of the cervix. Pain is regular. More prolonged pain, turning into excruciating torture, having an irregular character, may indicate pathologies that require examination by a specialist.

5. Abdominal prolapse

In nulliparous women, the abdomen becomes lowered two weeks before childbirth. If the pregnancy is not the first, then this can happen just a day or two before the birth. This is the so-called preparation of the baby for the birth. It descends into the pelvic area, pressed against the exit. At the same time, it puts even more pressure on the bladder, which is why urination becomes more frequent.

6. Frequent urination and bowel movements

Increased urination is associated with a change in the position of the child and its lowering into the pelvic area. However, women often wonder why the discharge during bowel movements becomes more plentiful and liquid. This is due to the effect of hormones that relax the cervix on the intestines, resulting in diarrhea. Symptoms are relevant 27 days before delivery.

7. Change in fetal activity

The activity of the fetus before childbirth becomes much less noticeable as it grows and there is not enough space for it in the mother's uterus.

8. Change in Appetite and Weight Loss

Shortly before giving birth, a woman who has eaten well throughout her pregnancy may lose her appetite. If she ate badly throughout the pregnancy, then before giving birth, on the contrary, her appetite may increase. Also during this period, the absorption of fetal water occurs, due to which the landmark is slightly reduced.

9. Nesting syndrome and unexpected mood swings

One of the signs of an imminent birth is the desire to actively prepare for the birth of the baby. The woman withdraws into herself, begins to do cleaning, laundry and other household chores. At the same time, the mood becomes very changeable. She can laugh, and in a minute cry.

10. Soft neck

This sign can only be considered by an obstetrician-gynecologist during examination. The cervix smoothes and becomes more elastic due to the action of hormones.

Thus, determining the onset of labor is not so difficult. How do you know when labor is about to begin? The main thing is to listen to your body, its changes and not panic. After identifying signs of imminent childbirth, you need to go to the hospital. Do not forget that childbirth in primiparas is usually less rapid compared to the second and subsequent pregnancies.