Discharge at 9 months. How labor begins
– the most emotionally intense for everyone expectant mother period, because after it the finish line and future motherhood are already visible on the horizon. It is not surprising that all the weeks of this month are full of thoughts and worries about the future and the baby. A pregnant woman constantly looks at herself and listens to own feelings: What if labor starts? Of course, the pregnancy, 33 weeks of which is already behind us, is about to end. However, the woman must live her ninth month in a your own body no less carefully than before.
Child development in the ninth month of pregnancy
Pregnancy, 38 weeks of which is already in the past, is usually marked by the baby moving to a characteristic position: its head approaches the entrance to the pelvis and presses against chest, the torso bends, the arms are crossed on the chest, the legs are bent and pressed against the tummy. The baby is thus preparing for the upcoming passage through birth canal.
Every woman who is 9 months pregnant should know that the onset of labor at 37-42 weeks (the date is counted from the first day of the last menstruation) is considered timely, and the fetus is completely ready for birth. A mature fetus has a body length of more than 47 cm and a weight of more than 2600 g. And during the developmental period in the ninth month, the baby is still growing quite rapidly: he can gain up to 28 g of weight per day.
These days, there is an active accumulation of iron in the baby’s liver: it is necessary for hematopoiesis in the first year of his life. The fetus’s lungs are fully mature and ready to provide oxygen to the body. little man. The heart still works in a special way, but after birth its mode of functioning changes. The hole in the central septum closes, shutting off the lungs from the circulatory system during intrauterine development. After birth, the baby's blood circulates through the lungs. And here the immune system in the ninth month of development, the fetus is not yet fully ready for the independent existence of the organism. Before birth, mothers reach the baby through the placenta, but after he is born, they will reach breastfeeding from milk.
If a pregnancy, during which the woman fully carried the baby for 37 weeks, ends in childbirth, then already at this stage the baby appears with light pinkish skin, a developed layer of subcutaneous fat, and a cheese-like lubricant will remain in the folds of the skin. But if labor is delayed, the lubrication gradually disappears, and the baby may be born with slightly wrinkled skin, as if it had been in water for a very long time. When a child is born mature, he breathes air, screams loudly, and can suck well. It does not need to be heated additionally, since it can retain heat on its own. The child has pink cheeks with subcutaneous fat, fairly soft skull bones, elastic cartilage of the nose and ears. Vellus hair on the body remains only on the shoulders and in the folds of the skin.
Most male babies have testicles descended into the scrotum at birth; only about 1% of boys do not have testicles descended into the scrotum at birth. Such babies should remain under the supervision of a specialist surgeon. A newborn baby has already accumulated meconium in the intestines - dark primary feces, which consists of previously dead intestinal cells, vellus hair and everything that the child swallowed along with amniotic fluid.
Appearance of a woman in the ninth month of pregnancy
Pregnancy, during the 34th week of which the woman’s belly was actively enlarging, ends, and this month the belly no longer enlarges. Now the pregnant woman's uterus is elevated from pubic symphysis approximately 36-40 cm. At the very end of the month, a woman can already know how many kilograms of weight she has gained over the entire period of bearing a child. Basically, this figure varies depending on the individual characteristics of each expectant mother. But on average, a woman gains from 8 to 15 kg. By the way, on last weeks While carrying a baby, many women can even lose some weight by getting rid of excess fluid. Otherwise, the woman’s appearance has not changed significantly in recent weeks. But psychological condition very tense, since both the body and consciousness are in anticipation of the upcoming birth. Doctors advise trying to relax as much as possible and devote last days rest. After all, the pregnancy, 39 weeks of which the woman was dedicated to herself, will soon end, and time for a break will not appear soon.
Well-being of a woman in the ninth month of pregnancy
Pregnancy, the 9th month of which is just beginning, is characterized by intensive growth of the fetus, as well as active restructuring of the female body for the upcoming birth. All these processes contribute to active change hormonal balance V female body. The content in the body gradually increases. This hormone, produced by, is responsible for the release of prostaglandins, which stimulate uterine contractions and, accordingly, the onset of contractions. This month circulatory system increases the production of red blood cells: this prepares for large blood loss during the birth process.
On at this stage As the baby develops, a woman may notice that discharge from the genitals becomes more frequent and abundant. In her sleep, the expectant mother may be periodically disturbed convulsions , which are a consequence of a lack of calcium or potassium . At 9 months it can clearly appear on the legs.
A woman who is in her ninth month of pregnancy feels a certain lethargy and inertia. It is difficult for her to concentrate, forgetfulness and absent-mindedness constantly appear. However, sometimes periods of inertia are suddenly replaced by sharp outbursts active work: This is how the “nesting” effect characteristic of the last weeks of pregnancy manifests itself.
What are the harbingers of labor?
When the 9th month of pregnancy arrives, the woman gradually notices the appearance of some completely new sensations for her. All of them directly indicate that childbirth is already approaching. Such sensations may already occur several weeks before giving birth. However, in some cases, pregnancy, 40 weeks of which is behind, is not marked by such harbingers. They appear only a few hours before birth.
First of all, the woman feels that her stomach has dropped a little. This happens when the baby's head enters the pelvic cavity. Accordingly, the pressure on the diaphragm is no longer as strong as before, and it becomes easier and more free for the woman to breathe. In addition, attacks stop and changes in appetite are possible.
However, due to the drooping of the baby's head, the woman also notes that urination and bowel movements have become even more frequent. And due to changes in hormonal balance, the appearance of loose stool.
Another harbinger of labor is a slight decrease in a woman’s weight due to decreased appetite and fluid loss before childbirth.
The so-called mucus plug comes out of the cervical canal: it is a lump of mucus, either colorless or slightly stained with blood. Sometimes a woman can find it on her underwear. Immediately before birth, the fetus becomes less active: it is already quite cramped inside. But all these harbingers manifest themselves individually in each special case, therefore, a woman must understand that labor can begin without its manifestation.
A woman in her ninth month of pregnancy should know that there are two main signs of labor. First of all, these are the beginnings contractions – uterine contractions, which gradually become regular. If contractions are real, then they initially appear every 15-20 minutes, and over time, the intervals of contractions begin to increase. When a woman experiences 3-4 contractions in half an hour, it means it’s time to go to maternity hospital.
The second sign of the beginning labor activity- This water breaking . When amniotic sac breaks, the woman does not feel pain. And even if there are no contractions, then after the water breaks, the pregnant woman should immediately go to the hospital.
What can worry a woman in her ninth month of pregnancy?
Pregnancy, 36 weeks of which has already passed, may again have the same symptoms that the woman noted at the very beginning. So, the ninth month is characterized by fainting and dizziness. But such phenomena occur when expectant mother lies on the back, as the uterus puts pressure on the inferior vena cava, and as a result, blood flow to the heart is disrupted. As a result, it decreases, which leads to fainting. Therefore, in the last weeks of pregnancy, it is best to sleep on your side.
In the days preceding childbirth, a woman very often loses her balance and periodically feels impending weakness. Therefore, it is extremely important to take very good care of your own health. If, however, a fall could not be avoided, the woman should immediately see a doctor. At least at this stage, the child is reliably protected by subcutaneous fat and amniotic fluid.
Sometimes the expectant mother is very worried about a “protracted” pregnancy. But if post-term pregnancy lasts one to two weeks, then doctors are not concerned about this situation. However, with an even more prolonged pregnancy, as well as if there are signs of discomfort for the fetus, labor may be stimulated or performed. Doctors determine post-term pregnancy if the period is from last menstrual period exceeded 42 weeks. This phenomenon is typical for those women who have certain diseases, have previously suffered from, or had disorders menstrual cycle etc. Post-term pregnancy is characterized by aging of the placenta, which, in turn, can lead to fetal hypoxia. This dangerous condition, therefore, if the woman is post-term, it is advisable to go to the hospital.
Research in the ninth month of pregnancy
Now, when there is only one month left before the birth, the pregnant woman visits the doctor every week. The doctor must determine whether the woman feels normal, whether she has edema, measures arterial pressure, weight, height of the uterine fundus, abdominal circumference. also in mandatory tests are carried out to determine the sugar and protein content in the urine.
As an additional study at this stage of pregnancy, it is advisable to conduct a general blood test to determine the level of and. This is important due to the risk of large blood loss during the upcoming birth.
Even if the pregnancy, which is already 35 weeks past, is progressing normally, a vaginal examination should be performed during this period to assess the maturity of the cervix. A smear is also taken to examine the flora. A repeat vaginal examination is performed if the 40th week of pregnancy ends and labor does not occur.
During the weekly test, the doctor also listens to the fetal heartbeat to assess whether the baby is developing normally. If necessary, additional ultrasound is prescribed, and Doppler ultrasound is also possible.
On last month pregnancy, sometimes a woman is recommended to undergo additional ultrasonography, in order to determine some parameters of the fetus, its position and condition.
Even if a pregnancy, 36 weeks of which has passed safely, does not cause any unpleasant moments now, maintain an active sex life at this time, doctors in most cases still do not recommend it. The fact is that during sexual intercourse the uterus becomes very excited, which can lead to premature onset of labor. But if pregnancy drags on, sexual intercourse can stimulate the onset of labor. Therefore, in this case, having sex is even welcome.
If a woman suddenly begins to experience severe abdominal pain, and at the same time discharge appears, she should immediately consult a doctor.
This period is the real final straight, so it is extremely important not to go far from home, since labor can begin at almost any moment. Therefore, when a woman is 9 months old, leaving home, she must have all the documents with her, exchange card, clean diaper.
What to take to the maternity hospital?
Sometimes a woman, to prevent unforeseen situations, goes to the maternity hospital even before contractions begin on the eve of childbirth. But in most cases, the expectant mother expects contractions at home.
Most women prepare the entire contents of bags intended for a trip to the maternity hospital even earlier. At the 9th month they should be fully prepared and wait for the crucial moment. It is very important to take everything with you necessary documents. You should take the necessary personal hygiene items, underwear to the maternity hospital (it is possible to use disposable panties instead of regular panties), special bra for nursing mothers, sanitary pads (two large packages: one for normal discharge, one for the rich). The woman also prepares the clothes that she will wear in the maternity hospital, and, if desired, also. For the child, you should prepare a package of diapers, some items of baby cosmetics (powder, cream), diapers, and baby clothes. And, of course, you should go to the maternity hospital with positive attitude: This the most important condition so that everything goes smoothly and the child is born easily.
We are reaching the finish line. There is very little time left, and the miracle that you have been dreaming about all this time will happen. The less time remains until this long-awaited moment, the more you think about how it will happen. You listen and look closely at yourself, waiting for signs of an approaching birth. And even though this month is the last, you also have to live it. May you remember it as one of the happiest months of your life.
What happens in the body of the expectant mother
You no longer grow in size. From the pubic symphysis, the uterus rises 36-40 cm, differently for everyone.
By the end of the ninth month of pregnancy, the total weight gain averages from 8 to 15 kg. Moreover, in the last weeks you may not recover at all.
The total weight gain is:
. placenta – 10%
. fruit – 30%
. amniotic fluid – 10%
. increase in blood and tissue fluid volume – 25%
. increase in uterine weight – 10%
. increase in “fat depots” – 15%
Already from the beginning of the ninth month, your body began to restructure at an accelerated pace from “preserving pregnancy” to “giving birth.” The placental clock, designed by nature, counts down the last days of your pregnancy. From the 36th week, the placenta begins to reduce its hormonal production, primarily progesterone. Relative placental insufficiency and the fetus begins to lack components for nutrition and respiration. In addition, due to high fetal growth rates and decreased amniotic fluid the uterus grasps him more and more tightly. In response to stress, the fetal adrenal glands begin to secrete a large number of cortisol - stress hormone. In addition, it is believed that normal course childbirth is possible only when a “generic dominant” is formed in the pregnant woman’s brain.
In response to these processes, the mother's hormonal balance changes. The level of oxytocin, a pituitary hormone, increases in a woman’s blood, which ensures the release of prostaglandins and the release of other substances that stimulate contraction of the uterine muscle. The state of readiness for childbirth is most accurately manifested when determining the “maturity” of the cervix during vaginal examination.
Your hematopoietic system intensively produces red blood cells in preparation for blood loss during childbirth. Physiological anemia of pregnant women loses its severity as the number of red blood cells begins to match the volume of plasma.
future child
With an occipital presentation at 38 weeks, the fetal head usually descends to the entrance to the small pelvis and occupies a characteristic position: the baby’s torso is bent, the head is pressed to the chest, the arms are crossed on the chest, and the legs are bent at the knees and hip joints and pressed to the tummy. In this position, the baby will move along the birth canal during childbirth.
Determining the gestational age and date of birth is difficult due to the fact that it is often difficult to establish exact date release of the egg from the ovary and the time of fertilization. Therefore, childbirth is considered timely at 37-42 weeks from the first day of the last menstruation, provided that there are signs of fetal maturity.
The concept of fetal maturity is defined as follows: characteristic features.
Ripe fruit has a body weight of 2600 grams and a length of more than 47 cm. In the ninth month of pregnancy, the baby gains weight daily from 14 to 28 g per day. Determining the exact weight of the unborn child is extremely difficult; the error in such measurements ranges from 0.5 to 1 kg, even when using ultrasound.
The skin of a mature newborn is light, pale pink, the subcutaneous fat layer is well developed, and there are remains of cheese-like lubricant in the folds of the skin. If for some reason the birth is delayed, then a decrease in lubrication leads to maceration of unprotected areas, first of all “bath” piles and palms appear. Mature newborn screams loudly, breathes, sucks well, retains heat and does not need special heating. His face is smooth, there are thick cheeks - the result of an increase in subcutaneous fat and intensive sucking training thumb. The skull is still quite soft, which makes it easier for the baby's head to pass through the birth canal. Ear and nasal cartilages are elastic. The child has already lost most of the vellus hair on his body, with the possible exception of only the shoulders and those places that are hidden in the folds of the skin. My toenails have grown completely.
In boys, the testicles are lowered into the scrotum; in girls, the clitoris and labia minora are covered by the labia majora. In very few full-term boys (about 1%), the testicles do not descend into the scrotum at the time of birth, which requires mandatory observation by a surgeon. A dark substance accumulates in the intestines - meconium, primary feces. In the last week, the child has accumulated a lot of waste products in the intestines. This is meconium - the original feces: the baby will push it out after birth. However, sometimes he is able to do this even before birth: then he is born covered with a rather unappetizing black-green mucus. Meconium consists of dead intestinal cells, as well as flaky skin cells, decayed blood cells, germinal vellus hairs and other components swallowed along with amniotic fluid.
The child is completely ready for the upcoming changes. Iron accumulates in his liver, which will help hematopoiesis in the first year of life. The lungs are fully matured to provide him with oxygen. The heart is preparing to work in a completely different mode: immediately after birth, the hole in the central septum will close, which, as it were, turns off the lungs from the circulatory system, and blood will begin to circulate through the lungs.
The only thing that has not yet reached maturity is the immune system. While the baby receives your antibodies through the placenta, after birth he will receive them from breast milk.
Feelings of the expectant mother
This month gives you a whole range of new sensations indicating the approach of childbirth. All these sensations are harbingers of childbirth. They may appear a couple of weeks before birth, or maybe a few hours before it.
"Dropping" of the abdomen. This is due to the fact that the fetal head enters the pelvic cavity. Sometimes women even visually notice that the stomach has dropped down, but more often this is judged by indirect signs. As a result of moving the child, pressure is relieved from the diaphragm and stomach, breathing becomes easier, heartburn goes away, and appetite changes. In multiparous women, this rarely occurs before labor begins.
Drawing pain. Spasms and a feeling of discomfort in the lumbar region, sacrum, and groin are associated not only with pressure from the child, but also with an increase in the extensibility of the connective tissue. In addition, false contractions may appear, which can be as painful as true ones, but disappear when you change your position or start moving around the room.
Frequent urination and defecation. After the head moves into the pelvic cavity, the uterus presses on the bladder, and therefore it has to be emptied more and more often. Birth hormones affect a woman's intestines, and some women may experience mild abdominal cramps and loose stools. Almost like before an exam. :)
Insomnia . It's hard to find at this time comfortable position to sleep, you have to get up often to go to the toilet; false contractions at night disturb you much more often; in addition, cramps in the leg muscles may bother you during sleep.
Reducing body weight. Before the onset of labor, some women lose weight from 1 to 2 kg. This is how the body prepares for childbirth.
Loss of mucus plug. As the cervix ripens, it becomes softer, shorter, moves to the center of the small pelvis, and its canal begins to open slightly. All this leads to the fact that a lump of colorless, yellowish, or slightly blood-stained mucus is pushed out of the cervical canal, which you will find on your underwear after some time.
Changes in fetal activity. The baby is no longer pushing so actively, he feels cramped, his movements are more like rocking.
The manifestation of precursors of labor is very individual and optional. Labor can begin without any warning signs at all. If you have any doubts, consult a doctor, he will evaluate this or that symptom from a medical point of view.
Psychology of the ninth month of pregnancy
Normal in emotional state The expectant mother in the last month of pregnancy is dominated by the processes of lethargy and inertia. She becomes somewhat forgetful, absent-minded, withdrawn, and has difficulty concentrating. This is necessary to create " generic dominant"in the brain. However, against the background of apparent calm, changes in mood are still frequent, when one moment passes from pouring tears to uncontrollable laughter. The state of calm and fatigue can be replaced by periods of vigorous “nesting” activity: even in the middle of the night you can rush to wash, clean, wash or iron something.
Analyze your emotional state. Maybe you are overly excited or tense. Think of yourself as a bowl that can only be filled with clean water, and don't allow any debris to get into it. It is very important to communicate with the child during this period. It senses your mood and mood for childbirth, and depending on your condition, it receives “joy” hormones or “stress” hormones. Invite your child into this world, call him to meet you.
Decide finally where you will give birth. At the same time, be sure to find out when the maternity hospital you have chosen closes for cleaning, and if necessary, select a “backup option.” Think again about having your husband or someone close to you at the birth. Just remember that this is only possible if you both really want it. Not the best option- the presence of the father at the birth, who was persuaded. This can affect not only your emotional state, but also the course of labor itself. It takes time for a man to realize that he is a father.
Possible deviations from the norm
In the later stages of pregnancy, you can again remember its beginning - fainting returns. However, now this may not happen in a stuffy subway car, which would be easy to understand, but at home, in bed. This is how it manifests itself "inferior vena cava syndrome" when a heavy pregnant uterus compresses the inferior vena cava, interfering with blood flow to the heart. In response to this, blood pressure reflexively drops sharply, causing fainting. To avoid these troubles, you should only rest while lying on your side.
On later pregnancy, the sense of balance is impaired, weakness and dizziness may occur. Now is not the time to jump and rush after the departing bus, as you did before. Take care of yourself and your baby - avoid falls in every possible way. Be very careful, especially in winter when the streets are slippery. When going up or down the stairs, hold on to the railing. Fortunately, falls usually do not have serious consequences for either mother or baby. Your stomach, uterus and amniotic fluid provide good protection for the fetus. But if you fall, be sure to consult a doctor. Let him check if everything is okay with you. In some cases, the fall may not be so harmless. Placental abruption- one of the most serious consequences of a fall or blow. In this case, the placenta separates from the uterus prematurely (with normal course pregnancy and childbirth, placental abruption occurs only after the birth of the child), which leads to significant blood loss of the mother and threatens the life of the fetus. When placental abruption occurs, the fetus stops receiving blood from the umbilical cord, which is attached to the placenta, and the supply of oxygen and nutrients from the mother’s blood to the fetus stops. Possible fetal death. Symptoms of placental abruption are not the same in different cases. May be observed heavy bleeding from the genitals, or it may not exist at all. There may be a lack of fetal movement, severe constant pain in the lumbar spine and abdomen, and changes in the shape of the uterus. Ultrasound is used to diagnose placental abruption. However, sometimes a blood clot between the placenta and the wall of the uterus may not be visible, which makes diagnosis very difficult. If the diagnosis is confirmed, immediate delivery by cesarean section is indicated.
Post-term pregnancy within a week or two does not cause much concern among doctors, and only in cases where the pregnancy drags on for another longer period or there are signs of fetal distress, they may suggest induction of labor or C-section. Pregnancy is considered post-term if more than 42 weeks have passed since the last menstruation. The reasons for post-term are: various diseases and maternal age, previous abortions, menstrual irregularities, uterine malformations, incorrect positions fetus In post-term pregnancy, the placenta has already served its term, it quickly ages and is less able to supply the child with the substances necessary for his life. In this regard, the risk of hypoxia and fetal death increases. At birth, a post-term baby's skin is dry, flaky and tight, the nails are elongated, and there is no vellus hair or cheese-like lubricant. If you are approaching 42 weeks pregnant, talk to your doctor possible methods labor induction. Relying on the fact that labor will begin if you overload yourself physical labor, it’s not worth it, it has no medical evidence. Try massaging your nipples - this increases the production of oxytocin, which causes uterine contractions.
Necessary medical measures
From now on, your visits to the doctor should become weekly. At each visit, your well-being is assessed, your weight, blood pressure, abdominal circumference and fundal height are measured, a test for protein and sugar in the urine and an examination for edema is carried out.
From additional research in the ninth month they take the last one general analysis blood, primarily to determine the level of hemoglobin and platelets in the blood. These indicators are especially important now, since during childbirth there is always a risk of significant blood loss.
At the end of the eighth - beginning of the ninth month of pregnancy, a vaginal examination is performed. In addition to assessing the degree of maturity of the cervix, such an examination helps determine the position of the fetus and the position of the fetal head relative to the pelvic bones. Material is collected for flora smear examination. If even minimal changes are detected in the smear, the doctor will definitely suggest that you undergo preventive treatment. This is very important, since only a healthy vaginal wall can stretch greatly during childbirth. When inflamed, it tears much more easily than stretches. In addition, in the presence of infection, any injury during childbirth heals very slowly. If your pregnancy has passed forty weeks, you will be offered an additional vaginal examination, which will re-assess your readiness for childbirth. If there are no signs of cervical maturity, then hospitalization may be necessary to create an artificial background in order to prepare your body for childbirth. If there is obvious progress, then there is no need to rush to the maternity hospital, you just need to wait a little.
The doctor evaluates placental function and fetal condition weekly. Most often this is done on the basis of a fetal cardiotocogram, less often by simply listening with a stethoscope. In some cases, additional ultrasound examination, Doppler testing, or biophysical test. The last test is used to assess the condition of the fetus during postterm pregnancy, or when there are doubts about its health. Using ultrasound, the presence of fetal movements, its heart rate, the amount of amniotic fluid, the tone of the fetus and its attempts to make breathing movements are assessed within 20-30 minutes.
If the test result is unsatisfactory, rapid delivery may be indicated. If all is well, the test is repeated after a week. At questionable results carry out control test In a few hours.
Behavior rules
Only some women prefer to go to the maternity hospital a few days before the expected due date; the majority intend to arrive there with the onset of labor, so let’s figure out what is considered the beginning of labor.
There are two main signs of the onset of labor:
1. The appearance of contractions - regular contractions of the muscles of the uterus. It's not strength that matters painful sensations, and their rhythm. Real birth pains should be repeated every 15–20 minutes, and the intervals between contractions should be reduced. When you count 3-4 contractions in 30 minutes, get ready for the maternity hospital.
2. Breaking of water. The amniotic sac may leak, then the water will slowly flow out. It may burst suddenly, then the waters will “gushing out of a bucket.” When breaking amniotic sac no pain is felt.
The amniotic fluid is usually clear, but may be slightly bloody or have a yellowish or greenish tint. For some women, the water breaks before regular contractions appear; such women in labor should go to the maternity hospital immediately. You should also hurry if the waters are very dark or heavily stained with blood.
In the meantime, there are still no signs of the onset of labor, make your last efforts to ensure that the baby is born healthy. It's time to change your diet. During this period, it is not recommended to consume meat in large quantities, as well as fatty cottage cheese, mature cheeses, flour and confectionery. It is better to switch to a non-strict vegetarian diet. Eat more vegetables and fruits, cereals, nuts, fish, low-fat dairy products. Don't forget to limit salt and sugar! Continue to do the stretching exercises recommended when preparing for childbirth, do joint exercises, and learn to relax.
Household affairs
Of course, you should already have a bag with things ready for the maternity hospital. In addition to personal belongings, it must contain your medical documents and passport. This is necessary to avoid unnecessary confusion in last moment. Having prepared for the little things, you can calmly, without nervousness and tension, meet the most important point. When this moment comes, you will have some time to take a shower, put on clean clothes, trim your nails and wash off the polish. For many women, shaving the perineum upon admission to the maternity hospital is a very unpleasant moment. However, this procedure is necessary, as it allows you to control the degree of stretching of the perineum during childbirth, prevent its rupture, and in case of injury, it is better to compare the tissues when suturing. Feelings of embarrassment can be avoided if you perform this simple procedure at home yourself. Just take a brand new razor and treat your skin well with an antiseptic solution or antibacterial soap.
In the last days before giving birth, check again whether everything was bought for the baby, give it to your family detailed instructions for urgent purchases and assembly of a crib.
Stock up on groceries for the duration of your stay in the maternity hospital and for the first days after your return. Don't forget the main thing - a positive, kind attitude towards childbirth. And you will succeed! :)
The last month of pregnancy is the finale of a long journey and a period of agonizing anticipation of labor and birth. long-awaited baby. A baby born at 38-42 weeks of pregnancy is considered full-term, this is exactly the middle and end of the ninth month, but if the baby is born at 36-37 weeks, he is no longer considered premature, but prematurely born. Such a baby is quite capable of independent life, although somewhat more sensitive to external environmental conditions and requires a little more attention and care. With each week of the last month he gains weight and grows, you should be ready to give birth at any moment.
What happens to the body in the 9th month of pregnancy
The last month of pregnancy has arrived, it lasts from the 37th to the 42nd week of pregnancy, on average children are born at 38-40 weeks, and only some a little earlier or later. After 38 weeks of pregnancy, the fetus is considered full term, and labor can begin on any day, only about 5% of babies are born exactly on the expected due date.
At this time, the woman is already quite tired of her situation and which has become very heavy belly, agonizing wait childbirth and frequent training contractions make her tired and irritable. Now you can no longer be afraid premature birth, if problems previously arose during pregnancy or there were complications. Often, with a planned caesarean section, the birth is planned for a period of 38-40 weeks, so that the fetus is as mature and full-term as possible. The last weeks before childbirth are especially difficult for those who will give birth for the first time, since the sensations of real contractions are still unfamiliar and you are often ready to go to the maternity hospital with training ones.
The body is actively preparing for childbirth and the so-called harbingers of labor constantly appear. Two to three weeks before birth, the abdomen lowers due to the insertion of the fetal head into the pelvic cavity and gradual relaxation of the lower segment of the uterus and cervix. At repeated births the stomach may drop immediately before labor or at its beginning. The abdominal circumference may decrease slightly due to relative oligohydramnios, due to changes hormonal levels, which helps during childbirth and reduces the risk of complications (umbilical cord prolapse, malpresentation, placental abruption). It will become easier for a woman to breathe, heartburn and discomfort when eating will decrease.
Pain in the lower back and pelvis may be bothersome; the joints and ligaments soften, which helps during childbirth, but affects the condition of the back and pelvic area. Particularly unpleasant and severe pain can be when lowering the head into the pelvis, pressure in the pubic area, sacrum at night, pain in the perineum and vaginal area, it is difficult to find a position in bed and sleep peacefully. Training contractions can become more frequent and stronger, they later help the uterus actively contract during childbirth. Training contractions are irregular and go away if you calm down and rest on your side, they have the appearance of pulling in the lower abdomen and a feeling that the stomach is turning to stone.
May occur before birth special changes bodies, called the harbingers of labor, along with abdominal prolapse. Such signs include a decrease in body weight within 2 kg due to the convergence of edema and hormonal changes in the body, decreased appetite and physiological cleansing of the body for childbirth. Shortly before giving birth, appetite decreases or disappears completely, there may be loose stools and even diarrhea, nausea and vomiting.
Within a few days or even weeks, the mucous plug may begin to come off - it can come off in parts or entirely, in a lump, as the cervix ripens and the cervical canal opens. The mucus may be yellowish in color, colorless, or streaked with blood. You need to completely pack your bags and documents and be ready to go to the maternity hospital at any time from the start or breaking of your waters, or regular contractions at regular intervals. In the ninth month of pregnancy, a woman must always take an exchange card with her when leaving home.
Fetal development: weight, size and gender
At this time, the baby is already fully formed and ready for birth and life outside the mother’s tummy. The child has everything necessary set reflexes, breathing movements are performed by the lungs, although they are still collapsed and will open only with the first breath. They produce enough surfactant to breathe on their own. Digestive system ripe and ready to eat food and digest it with enzymes, a lot of original feces have accumulated in the intestines, which should only leave after the birth of the child. It was formed from amniotic fluid, epithelial cells, desquamated cells that enter with swallowed water. Meconium has the appearance of a putty-like olive-green mass, odorless.
By the ninth month the baby has a proportional body, smooth skin and pale pink color, the skin vessels are no longer translucent, the fluff (lanugo) has almost disappeared from the body, remaining only a little on the shoulders and back, in the area natural folds along with vernix lubrication, which protects delicate skin crumbs. Now the baby is actively gaining weight and growing in height, it is becoming more and more crowded in the uterine cavity, he is taking the uterine and most optimal position for childbirth - head down, pressing his arms and legs tightly to the body. He does not have the opportunity for active movements, and now it is mainly pushing, tossing and pulling. They are clearly felt by the mother.
The nervous system matures, it becomes more and more perfect, developed and mature. Nervous system regulates the functioning of all internal organs and glands, which allows the body to function as a single system.
This month, the fetal liver actively accumulates iron for further use for the child’s needs in the first months after birth. Iron is essential for creating new blood cells and preventing anemia. The heart has fully formed chambers and valves, except for those openings needed for fetal blood flow, so at birth it will be ready to function new scheme, and the fetal openings will immediately close. Now the oval window and the ductus ductus are open, so that the blood bypasses the lungs, and the baby “breathes” the placenta. At the same time, the lungs themselves, due to the penetration of amniotic fluid into them, perform “breathing” movements and develop.
In boys, the testicles finally descend into the scrotum; in girls, the labia majora cover the labia minora, and the process of genital formation is completed. The immune system is also maturing, although it will still be fully formed after the baby is born. The mother actively transfers antibodies from the main dangerous diseases, which she suffered from herself. By the time of birth, the fetus will reach its final height and weight of 48-56 cm and 2800-4000 g. Girls are usually born smaller than boys, although much depends on the characteristics of the parents and the conditions of pregnancy.
Feel
The main sensations of this month are fatigue and harbingers of childbirth, now the woman clearly feels all the movements and movements of the fetus, the stomach has reached its maximum and it is extremely difficult to carry it. But a couple of weeks before giving birth, it becomes easier to breathe and eat due to the lowering of the abdomen and insertion of the head into the small pelvis. At the same time, pressure and discomfort in the pelvic area will increase - constipation may increase and the urge to urge more often due to pressure from the head on the bladder. There may be pain in the sacrum, pubis and thighs due to irritation of nerve endings.
There may be swelling and the risk of varicose veins, the skin on the abdomen becomes very tight and itchy, and stretch marks may occur. Fainting and dizziness are common due to hypoxia and compression of the vessels by the large uterus. Preparations for childbirth are taking place and weight loss of 1-2 kg, diarrhea and vomiting may occur as an option to cleanse the body before childbirth. A woman feels that her lower abdomen is pulling, and abdominal pain may occur, which indicates the onset of regular contractions and labor.
Discharge
Towards the end of pregnancy, the discharge intensifies, protecting the baby from infections that can enter through the vagina. Now it is important that infection does not develop, as this will be dangerous during childbirth. You should immediately consult a doctor if you have curdled, crumbly or copious milky discharge, and especially yellowish, green, gray, foamy and unpleasant smell. They need to be treated immediately. Such discharge reduces the elasticity of vaginal tissue and leads to complications during childbirth and an increased likelihood of postpartum inflammatory processes.
There is also a gradual removal of the mucus plug - these are transparent or slightly pink lumps of mucus; the plug can come away either gradually or simultaneously, as a lump of mucus. Childbirth will begin soon.
Analyzes and examinations
This month, visits to the doctor will become weekly, it is important to evaluate general state woman, her weight and the presence of edema, blood pressure and determine the level of leukocytes, protein and glucose in the urine before each visit. The doctor will assess the woman's readiness for childbirth and may schedule hospitalization in the maternity hospital in advance or at the onset of labor.
At the beginning of the month, an examination will be carried out on the chair and a smear will be taken for flora; additional blood tests may be prescribed. Scheduled ultrasounds everything has already been completed, but in case of doubts or concerns, the doctor may prescribe additional ultrasound or Dopplerography, fetal CTG. This will help in choosing tactics during childbirth and deciding whether it will be natural or whether a cesarean section is indicated.
Mom's diet and weight
During this period, the uterus puts maximum pressure on the internal organs and you need to eat right to avoid nausea and vomiting, constipation and other digestive problems. The birth process and the condition of the baby largely depend on the mother’s nutrition. In the last months of pregnancy, it is worth switching to hypoallergenic food, excluding potentially dangerous allergens, and giving up foods that could become a potential source of intestinal infections or poisoning - canned food, raw foods, unboiled milk, poorly fried meat and fish. It is important to pay Special attention products with calcium - dairy products and cottage cheese, yoghurts. Equally important is consuming enough protein in the form of red meat and iron-containing foods. The amount of meat and fish in the diet should be slightly reduced in favor of vegetables and fruits, vegetable oils, grains and light foods. It is worth giving up fatty, fried and spicy foods, excess sauces and spices, steaming, baking, stewing or boiling food. It is worth eating often, but in small portions, avoiding carbonated drinks, fermented foods, excess sweets and carbohydrates. Can be done once a week fasting days in consultation with the doctor. Before giving birth, your appetite may disappear altogether - and this is normal, the body is preparing for hard work and cleanses the intestines.
Cold in the ninth month
In the ninth month, you should protect yourself from a cold, otherwise childbirth may be complicated, and you will have to give birth in an isolated box in the observation department. A cold is dangerous due to disruption of labor, the need to use medications and the danger of its influence on the fetus. Thus, taking paracetamol or its analogues disrupts the process of preparing the cervix for childbirth and further complicates the birth process.
Sex
The issue of intimacy in the ninth month is controversial - this will be determined by the doctor. But usually women's libido is reduced, and with this big belly It's not very comfortable to have sex at all. Many doctors recommend abstinence while the mucus plug is passing, although orgasm itself does not trigger preterm labor. But if there are contraindications, sex will be prohibited - this is leakage of amniotic fluid, placenta previa or low placentation, multiple pregnancy or the presence of isthmic-cervical insufficiency. Difficulties may arise with the choice of poses, since you need to completely eliminate pressure on the stomach. If childbirth is delayed, intimacy is one of natural methods stimulation of labor - a man’s sperm has a softening effect on the cervix.
Fetus in the forty-first week of pregnancy photo: babycenter.com
Congratulations, the finish line is in front of you. There are a few weeks left until we meet a small miracle. But despite the anxiety and fear of the upcoming event, this is a month that you need to live in wonderful emotions.
Already from the 36th week, mood swings will no longer be frequent, and the expectant mother will most likely feel passivity, inertia, and lethargy during this period. This is how nature intended it to be female unpredictability“didn’t do anything wrong” before an important event. All strength is directed to the preparation of internal organs that are directly involved in childbirth. After all, anything can happen at 38 weeks. It is from this moment that the child is considered born at term.
The body begins to move from the “save” mode to “full readiness”. The placenta reduces the production of hormones, primarily progesterone. In its place is the pituitary gland, which will be responsible for the production of oxytocin. Doctors also call it the love hormone. It is he who will stimulate the contraction of the uterus during childbirth. And the more of it, the better and safer they will end. Therefore, at this time, doctors recommend reducing the consumption of flour and sweets and switching to light foods, preferably without meat. In any case, your circulatory system will actively produce red blood cells - red cells. In this way, the body prepares for imminent blood loss.
The doctor will determine the state of readiness during the examination and according to the maturity of the cervix.
By week 38, wherever you are, always carry your passport, exchange card, birth certificate and just in case, a diaper.
Feel
Well-being at 9 months of pregnancy cannot be characterized unambiguously. This period will bring a bouquet of new sensations that indicate imminent birth. In medicine, such premonitions are called “harbingers.” They appear 2 weeks before childbirth, but it happens that they visit a woman several hours before this event.
- "Prolapse" of the abdomen . Visually, it is difficult for the expectant mother to notice this. You will only feel some changes behind you. On the one hand, heartburn will disappear without a trace, it will become easier to breathe due to the gradual lowering of the baby into the pelvic area. On the other hand, for the same reason, pain in the lower back, groin and hips will increase.
- Reducing the child's activity. Due to the lack of space for intense movements, the baby will not persistently push and bother you. In addition, he, like you, senses his imminent birth, so he calms down and humbly “ripens” in his native children's place. If, on the contrary, the tremors intensify, consult a doctor immediately. This may be a sign of hypoxia, that is, lack of oxygen.
- Removal of the mucus plug . This is the name of the protective barrier on the cervix that prevents infection of the fetus throughout the entire period of pregnancy. It is a clot that resembles chicken protein in consistency and volume and is transparent, yellow or brownish in color. It may go away gradually or completely.
- Loss of weight and appetite . Basically, a woman loses up to 2 kg before giving birth. This is a natural process associated with hormonal changes.
- Frequent trips to the toilet . When the baby descends into the pelvic area, he presses the bladder even harder, which now fills faster. Due to hormones, the intestines can also be affected. Light cramps and loose stools are an exam before childbirth.
Harbingers – individual feature every expectant mother. Some observe only some of them, others - not one at all.
How to identify contraction symptoms
Every expectant mother at this stage listens daily to any symptoms, and an alarm bell constantly rings in her head: “Has it started?”
Surely many have already encountered training contractions. They do not cause inconvenience and are not cyclical, unlike real ones. Although at the beginning of the process they may resemble them.
the baby's skin peels a little due to prolonged exposure to amniotic fluid photo: babycenter.com
Heaviness appears in the lower abdomen or lower back, as with the onset of menstruation. Being distracted, a woman may not attach any importance to this. If the symptom does not disappear, then monitor the frequency and regularity. After some time, pain may already be felt, but it is still quite tolerable. Record the duration of the spasm and the interval between the next one. As a rule, contractions will repeat every 20-30 minutes. The main thing is not to worry at this moment. If the pregnancy is healthy, then you shouldn’t fly to the maternity hospital with panic in your eyes just yet. It’s better to calmly start getting ready there (put documents and necessary things in your bag) and breathe deeply. Contractions are not yet so painful, the woman is able to lead a normal life. Talk, take a shower, walk, which will only be beneficial for natural childbirth.
Further, the pain intensifies, the woman feels “shooting” in the sacral area. The intervals between contractions may remain the same. When the pain goes away (and this happens without a trace), the woman returns to her usual state. She should relax and be calm and confident that everything will go well.
As soon as the contractions become more frequent and come once every 10-15 minutes, it’s time to go to the maternity hospital.
Another sign of immediate contact with obstetricians is discharge of amniotic fluid. Ideally, the water bubble bursts just before rapid pushing. If this happens earlier, it happens that even without contractions, health care you need it, as this leads to a sharp oxygen starvation baby. The waters most often recede in large quantities, like a flow that cannot be stopped or unnoticed. Good - odorless and colorless. It is possible that they may leak during the 2 weeks before delivery. Monitor the discharge and report any suspicions to your doctor.
The less time remains until this long-awaited moment, the more you think about how it will happen. You listen and look closely at yourself, waiting for signs of an approaching birth. And even though this month is the last, you also have to live it. Let him be remembered as one of the happiest in your life.
What happens in the body of the expectant mother?
The belly no longer increases in size. From the pubic symphysis, the uterus rises 36-40 cm - it’s different for everyone.
By the end of the ninth month of pregnancy, the total weight gain averages from 8 to 15 kg. Moreover, in the last weeks you may not recover at all.
Already from the beginning of the ninth month, your body began to restructure at an “accelerating pace” from “preserving pregnancy” to “preparing for childbirth.” The placental clock, designed by nature, counts down the last days of your pregnancy. From the 36th week, the placenta begins to reduce the production of hormones, primarily progesterone. Relative placental insufficiency develops, and the fetus begins to lack components for nutrition and respiration. In addition, due to the high growth rate of the fetus and the decrease in the amount of amniotic fluid, the uterus envelops it more and more closely. In response to stress, the fetal adrenal glands begin to secrete large amounts of cortisol, the stress hormone. In addition, it is believed that the normal course of labor is possible only when a “birth dominant” is formed in the pregnant woman’s brain - a state of the brain that ensures proper regulation of labor - while the work of the cerebral cortex is somewhat inhibited, and the areas of the brain that control internal organs, in particular the organs involved in childbirth.
In response to these processes, the mother's hormonal balance changes. The level of oxytocin, a pituitary hormone, increases in a woman’s blood, which ensures the release of prostaglandins and the release of other substances that stimulate contraction of the uterine muscle. The state of readiness for childbirth is most accurately manifested when determining the “maturity” of the cervix during vaginal examination.
Your hematopoietic system intensively produces red blood cells - this is preparation for blood loss during childbirth, so the manifestations of anemia (decreased hemoglobin) may decrease.
The total weight gain is:
- placenta - 10% (800-1300 g);
- fruit - 30% (3000-3500 g);
- amniotic fluid - 10% (700-900 g);
- increase in blood and tissue fluid volume - 25% (1300-1800 g);
- increase in uterine weight - 10% (8oo-100 g);
- increase in “fat depots” - 15% (800-1300 g).
future child
With an occipital presentation at 38 weeks, the fetal head usually descends to the entrance to the pelvis and occupies a characteristic position: the baby’s torso is bent, the head is pressed to the chest, the arms are crossed on the chest, and the legs are bent at the knee and hip joints and pressed to the tummy. In this position, the baby will move along the birth canal.
Determining the gestational age and date of birth often presents certain difficulties, since it can be difficult to determine the exact date of release of the egg from the ovary and the time of fertilization. Therefore, childbirth is considered timely at 37-42 weeks from the first day of the last menstruation, provided that there are signs of fetal maturity.
A mature fetus has a body weight of 2600 g and a length of more than 47 cm. In the ninth month of pregnancy, the baby gains daily weight from 14 to 28 g per day. Determining the exact weight of the unborn child is extremely difficult; the error in such measurements ranges from 0.5 to 1 kg, even when using ultrasound.
The skin of a mature newborn is light, pale pink, the subcutaneous fat layer is well developed, and there are remains of cheese-like lubricant in the folds of the skin. If for some reason the birth is delayed, then a decrease in lubrication leads to maceration of unprotected areas - the skin becomes wrinkled, as after a long stay in water, the “bath” feet and palms appear first. A mature newborn screams loudly, breathes, sucks well, retains heat and does not need special heating. His face is smooth, there are thick cheeks - the result of an increase in subcutaneous fat and intensive training in thumb sucking. The skull is still quite soft, which makes it easier for the baby's head to pass through the birth canal. Ear and nasal cartilages are elastic. The child has already lost most of the vellus hair on his body, with the possible exception of only the shoulders and those places that are hidden in the folds of the skin. Fingernails and toenails cover the nail beds.
In boys, the testicles are lowered into the scrotum; in girls, the clitoris and labia minora are covered by the labia majora. In very few full-term boys (about 1%), the testicles do not descend into the scrotum at the time of birth, which requires mandatory observation by a surgeon. A dark substance accumulates in the intestines - meconium, primary feces. Meconium consists of dead intestinal cells, as well as exfoliated skin cells, broken blood cells, germinal vellus hairs and other components swallowed along with amniotic fluid.
The child is completely ready for the upcoming changes. Iron accumulates in his liver, which will help hematopoiesis in the first year of life. The lungs are fully matured to provide him with oxygen. The heart is preparing to work in a completely different mode: immediately after birth, the hole in the central septum will close, which prenatal period as if it turns off the lungs from the circulatory system, because when the baby is in the womb, the blood in the lungs is not enriched with oxygen, since the fetus does not breathe. After birth, blood will begin to circulate through the lungs. The only thing that has not yet reached maturity is the immune system. While your antibodies reach your baby through the placenta, after birth he will receive them from breast milk.
Feelings of the expectant mother
This month gives you a whole range of new sensations indicating the approach of childbirth. All these sensations are called “harbingers” of childbirth. They may appear a couple of weeks before birth, or they may appear a few hours before.
"Dropping" of the abdomen. This is due to the fact that the fetal head enters the pelvic cavity. Sometimes women even visually notice that the stomach has dropped down, but more often this is judged by indirect signs. As a result of moving the baby, pressure is relieved from the diaphragm and stomach, it becomes easier to breathe, heartburn goes away, and appetite changes, as the fetal head drops immediately on the eve of birth.
Frequent urination and defecation. After the head moves into the pelvic cavity, the uterus puts even greater force on the bladder, and therefore it has to be emptied more and more often. Childbirth hormones affect a woman's intestines; some expectant mothers may experience mild abdominal cramps and the appearance of loose stools - much like before an exam.
Reducing body weight. In connection with what is happening hormonal changes Before the onset of labor, some women lose weight from 1 to 2 kg. Appetite decreases slightly and fluid loss occurs.
Loss of mucus plug. As the cervix matures, it becomes softer, shorter, moves to the center of the small pelvis, and its canal begins to open slightly. All this leads to the fact that a lump of colorless, yellowish or slightly blood-stained mucus is pushed out of the cervical canal, which you will find on your underwear after some time.
Changes in fetal activity. The baby is no longer pushing so actively, he feels cramped, his movements are more like rocking.
The manifestation of precursors of labor is very individual and optional. Labor can begin without any warning signs at all. If you have any doubts, consult a doctor - he will evaluate this or that symptom from a medical point of view.
Psychology 9 months
Normally, the emotional state of the expectant mother in the last month of pregnancy is dominated by the processes of lethargy and inertia. She becomes somewhat forgetful, absent-minded, withdrawn, and has difficulty concentrating. This is necessary to create a “generic dominant” in the brain. However, against the background of apparent calm, changes in mood are still frequent, when one moment passes from pouring tears to uncontrollable laughter. The state of calm and fatigue can be replaced by periods of vigorous nesting activity, when you can suddenly rush to wash, clean, wash or iron something.
Analyze your emotional state. Maybe you are overly excited or tense. It is very important to communicate with the child during this period. He senses your mood and attitude towards childbirth and, depending on your condition, receives “joy hormones” or “stress hormones”.
Decide finally where you will give birth. At the same time, be sure to find out when the maternity hospital you have chosen closes for cleaning, and if necessary, select a “backup option.” Think again about having your husband or someone close to you at the birth. But remember that this is possible only if both of you really want it. It is not the best option for the father, who was persuaded, to be present at the birth. This can affect not only your emotional state, but also the course of labor itself. It also takes time for a man to realize that he is a father.
Possible deviations from the norm
In the later stages of pregnancy, you can again remember its beginning - fainting returns. However, now this may not happen in a stuffy subway car, which would be easy to understand, but at home, in bed, if you are lying on your back. This is how “inferior vena cava syndrome” manifests itself, when a heavy pregnant uterus compresses the inferior vena cava, disrupting blood flow to the heart. In response to this, blood pressure reflexively drops sharply, causing fainting. To avoid these troubles, you should rest only lying on your side, preferably on the left: this position ensures optimal blood supply to the fetus.
In late pregnancy, your sense of balance is impaired and you may experience weakness and dizziness. Now is not the time to jump and run after the departing bus, as you may have done before. Take care of yourself and your baby - avoid falls in every possible way. Be very careful, especially in winter when the streets are slippery. When going up or down the stairs, hold on to the railing. Fortunately, falls usually do not have serious consequences for either the mother or the baby: your stomach, uterus and amniotic fluid provide good protection for the fetus. But if you fall, be sure to consult a doctor: let him check if everything is okay, because in some cases the fall may not be so harmless.
Post-term pregnancy within a week or two may not cause much concern to doctors, and only in cases where the pregnancy drags on for an even longer period or there are signs of fetal distress can they suggest induction of labor or a caesarean section. Pregnancy is considered post-term if more than 42 weeks have passed since the last menstruation. The reasons for post-maturity are: various diseases and age of the mother, previous abortions, menstrual irregularities, uterine malformations, and abnormal fetal positions. In post-term pregnancy, the placenta has already served its term, it quickly ages and is less able to supply the child with the substances necessary for his life. In this regard, the risk of hypoxia and fetal death increases. At birth, a post-term baby's skin is dry, flaky and tight, the nails are elongated, and there is no vellus hair or cheese-like lubricant. If your pregnancy is approaching 42 weeks, you will certainly be offered hospitalization. There is no point in hoping that labor will begin if you overload yourself with physical labor: there is no medical evidence for this.
Required medical events
By the ninth month, your visits to the doctor should become weekly. At each visit, your well-being is assessed, weight, blood pressure, abdominal circumference and fundal height are measured, tests are carried out for protein and sugar in the urine and an examination for edema.
From additional studies, in the ninth month, the last general blood test is taken - primarily to determine the level of hemoglobin and platelets. These indicators are especially important now, since during childbirth there is always a risk of significant blood loss.
At the end of the eighth - beginning of the ninth month of pregnancy, a vaginal examination is performed. In addition to assessing the degree of maturity of the cervix, such an examination helps determine the position of the fetus and the position of the fetal head relative to the pelvic bones. Material is collected for flora smear examination. If even minimal changes are detected in the smear, the doctor will definitely suggest that you undergo preventive treatment. This is very important, since only a healthy vaginal wall can stretch greatly during childbirth. When inflamed, it tears much more easily than stretches. In addition, if there is an infection, any injury during childbirth heals very slowly. If your pregnancy has "jumped" beyond 40 weeks, you will be offered an additional vaginal examination, which will re-assess your readiness for childbirth. If there are no signs of cervical maturity, then you may need to be hospitalized to create an artificial background in order to prepare your body for childbirth. If there is obvious progress, then there is no need to rush to the maternity hospital, you just need to wait a little.
The doctor evaluates placental function and fetal condition weekly. Most often this is done on the basis of a fetal cardiotocogram (CTG), less often - by simply listening with a stethoscope. In some cases, additional ultrasound examination, Doppler ultrasound (study of blood flow in the vessels of the fetus, placenta, umbilical cord) or biophysical test. The latter is used to assess the condition of the fetus during postterm pregnancy, or when there are doubts about its health. Using ultrasound, the presence of fetal movements, its heart rate, the amount of amniotic fluid, the tone of the fetus and its attempts to make breathing movements are assessed within 20-30 minutes.
If the test result is unsatisfactory, rapid delivery may be performed. If all is well, the test is repeated after 3-4 days. If the results are questionable, a control test is performed after a few hours.
Behavior rules
In order to know exactly when to go to the maternity hospital, let’s figure out what is considered the beginning of labor.
There are two main signs of labor:
The appearance of contractions- regular contractions of the uterine muscles. What is important is not the strength of the painful sensations, but their frequency. Real labor contractions should be repeated every 15-20 minutes, and the intervals between them should be reduced. When you count 3-4 contractions in 30 minutes, get ready for the maternity hospital.
Discharge of water. When the amniotic sac ruptures, no pain is felt. Amniotic fluid is usually clear. After the rupture of amniotic fluid, you should hurry up and get ready and go to the maternity hospital, even if there are no contractions.
Try not to be away from home for a long time or too far. Always and everywhere carry a passport, exchange card, birth certificate, and a diaper, just in case.
Of course, you should already have a bag of things ready that you will take to the maternity hospital. In addition to personal belongings, it must contain your medical documents and passport. This is necessary to avoid unnecessary last-minute hassle. By carefully preparing, you will be able to face the most important moment calmly, without nervousness and tension. When it comes, you will have a little time to take a shower, put on clean clothes, trim your nails and wash off the polish (a manicure will interfere with your care for your baby). For many women, shaving the perineum upon admission to the maternity hospital is a very unpleasant moment. However, this procedure is necessary, as it allows you to control the degree of stretching of the perineum during childbirth, prevent its rupture, and in case of injury, it is better to compare the tissues when suturing. Feelings of embarrassment can be avoided if you perform this simple procedure at home yourself. In the last days before giving birth, reconsider whether everything has been purchased for the baby, and give your family detailed instructions for urgent purchases.
Stock up on groceries for the duration of your stay in the maternity hospital and for the first days after your return. Don't forget the main thing - a positive, kind attitude towards childbirth. And you will succeed!
