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The onset of labor signs and symptoms in nulliparous. Signal bleeding - a symptom of the onset of labor

In modern obstetrics, pregnancy is considered full-term at 38 weeks. Carrying a child for more than 41.5 weeks is considered overbearing. Thus, urgent, that is, on-time births fit into the interval from 270 to 290 days. However, there are women who give birth to completely normal, healthy and full-term babies at 36 or 42 weeks. Moreover, these weeks can be counted in different ways, from the immediate date of conception or from the first day of the last menstruation. Taking into account the individual characteristics of each woman, it would be more fair to talk not about the actual term of childbirth, but about the most probable interval when they can occur. This interval usually varies from 2 to 5 weeks, i.e. in terms of 38 to 42 weeks.

Going to the hospital with unsteady labor activity, a woman in labor runs the risk of being “stuck” in the pathology department for several days or being subjected to immediate stimulation. Therefore, it is better to go to the maternity hospital with an already established labor activity. And in order to be able to navigate this, it is not always necessary to call a specialist. For example, there are a number of phenomena that accompany the last weeks of pregnancy, which are called harbingers of childbirth. The presence of one or more harbingers suggests that the birth is coming soon, and it’s not worth it, for example, to go on a visit to the country, but it’s too early to go to the maternity hospital.

dress rehearsal

Pain in the lower abdomen and lower back

In the last 3-4 weeks before childbirth, periodic pulling pains in the lower abdomen and lower back may appear. They may be spasmodic. The appearance of such pain is a consequence of increased excitability of the NS, as well as displacement of the vertebrae in the sacrum, which can lead to nerve infringement. Sometimes, as a result of such an infringement in the last weeks of pregnancy, the leg may be periodically taken away and immobilized. This phenomenon has a physiological basis and after childbirth disappears without a trace.

In addition, there may be a feeling of fullness, tingling and pain in the pubic region, which is associated with an increase in pressure of the presenting part of the fetus on the symphysis (pubic bone). Wearing a bandage helps to alleviate this condition, as well as frequent rest in a prone position. This phenomenon also disappears after childbirth.

Lowering of the abdomen

2-4 weeks before childbirth, the pregnant woman's stomach drops ("slides"). As the abdomen lowers, the woman notes that it has clearly changed its shape and seems to have become smaller. This makes it much easier to breathe and eat. This occurs as a result of the lowering of the presenting part of the fetus, due to which the diaphragm, stomach and lungs are released.

Excitability of the uterus

Due to the increase in the excitability of the uterus, it begins to respond more and more to any stimuli. Very often, even 5-6 weeks before birth, tonic tension of the uterus occurs. First 1-2, then 3-4 times a week, and closer to childbirth and 1-2 times a day, the uterus can become very tense. At the same time, it becomes solid and this tension is present for quite a long time.

false contractions

In addition to the tonic tension of the uterus, 3-4 weeks before the birth, its periodic contractions may occur, which are called the harbingers of childbirth or false contractions. Harbingers do not lead to the development of labor activity. False contractions are also called Braxton Hicks contractions. Apparently, this pundit quite often felt false contractions, which did not lead to the development of labor activity in him, so he entered the history of obstetrics.

False contractions can appear after 7-10 minutes (and sometimes after 4-5 minutes) and last for 2-3 hours, and then fade away. They wear unsystematic character, but can be accompanied by quite severe pain in the sacrum, lower back, lower abdomen. Sometimes women experience much more discomfort and anxiety from false contractions than from labor.

False contractions in most cases are noticed by multiparous women, who are much more wary of everything that happens to them. A primiparous woman notices them only if she has hypersensitivity. A warm bath helps to cope with the discomfort that occurs during false contractions. If you immerse yourself in water at a comfortable temperature for 20 minutes - 1 hour, false contractions either subside completely, or go much less often, and at the same time their intensity becomes noticeably less.

appetite and weight

1-2 weeks before childbirth, a woman may become worse appetite and disappear that debilitating feeling of acute hunger, which was observed throughout pregnancy. She begins to treat food more calmly. Such indifference and even refusal to eat are especially evident in the last 3-4 days before childbirth. Sometimes a woman stops wanting to eat only a day before giving birth, and in some cases her appetite does not suffer at all before giving birth.

Approximately 7-10 days before childbirth, a woman's weight may drop by 1-2 kg. Weight loss does not always occur, but, in any case, there is a stop in weight gain. 1-2 weeks before the birth, the woman's weight stabilizes and its increase is no longer observed. Reducing or stabilizing the weight of a pregnant woman before childbirth is associated with an increase in the release of fluid from her body.

Thus, by the end of pregnancy, conditions are created for a very unstable balance, which is about ready to be disturbed in the direction of the development of labor activity, but childbirth occurs only at a certain point in time.

By what signs can you understand that childbirth has already begun?

For 1-3 days or a few hours before childbirth, brownish mucus, similar to the beginning of menstruation, may begin to stand out from the genitals of a woman. It can come out with a pop (indeed, as if a “cork” popped out, which is associated with the strength of intrauterine pressure due, for example, to a large fetus weight: over 4.5 kg), or it can flow out gradually, in small portions. The appearance of a mucous plug indicates the beginning of the opening of the cervix. This is a definite sign of beginning labor. The abundance of secretions and the features of their appearance are individual. In quite rare cases, the secretions of the glands of the cervix are so meager that the mucous plug does not appear at all before childbirth. In other cases, on the contrary, the maturation of the cervix is very slow, and the secretion of its glands is very intense. In this case, the mucous plug may begin to stand out 7-14 days before the onset of labor. However, in the vast majority of cases, the mucous plug appears with the onset of labor or a few hours before it begins.

Contractions

Undoubted evidence of the onset of labor activity are regular contractions, i.e. periodic contractions of the uterine muscles, going with a steady rhythm. Labor pains are always accompanied by dilatation of the cervix, and they cannot be neutralized by relaxing procedures, such as taking a warm bath. But if a woman has had false contractions several times the day before, it can be difficult for her to orient herself in her feelings and distinguish between labor pains. If the appearance of contractions is accompanied by brown discharge from the genitals, then we can speak with full confidence about the onset of labor.

Digestive system

On the eve of childbirth, as a rule, there is a bowel movement. A woman can repeatedly go to the toilet, and at the same time the stool comes out in a slightly larger volume than is usually the case. Immediately before the onset of childbirth, i.e. a few hours before the onset of labor pains, nausea, vomiting, complete loss of appetite, or indigestion may occur. This reaction of the digestive system is associated with the action of hormones that stimulate labor. These phenomena can occur both together and separately and accompany the appearance of the first weak contractions. In addition, the first contractions may be felt as abdominal pain, increased peristalsis, and frequent empty urination.

pain

Sometimes childbirth begins with the appearance of vague dull pain in the lower abdomen and lower back or girdle pain (lower abdomen and lower back). They can be of a periodic nature, or they can serve as a painful background, i.e. continue without stopping.

Chills

Quite often, all these phenomena are accompanied by a feeling of cold and chills. Labor chills may accompany the onset of labor.

Do not rush to go to the hospital if you do not have any complications. At home, contractions are much easier to tolerate than in the hospital. The optimal time to go to the maternity hospital is when the contractions are regular - 5/45, i.e. in five minutes for 45 seconds. If you are not confident in yourself, then go right away, perhaps in the hospital you will be calmer. And one more undoubted indication for going to the maternity hospital is the departure of water. If the waters have broken, you must immediately go to the hospital.

Shortly before the long-awaited first meeting with her baby, the expectant mother shows some sensations and signs that indicate the approach of childbirth. They are called harbingers. It is especially important to know about them for those women who are pregnant for the first time in order to properly prepare for the upcoming event.

What are the harbingers of childbirth

This is the name of a number of sensations and symptoms that a primogeniture experiences at different periods. According to this or that harbinger, a woman can approximately determine how soon labor will begin and decide on a trip to the hospital. It is worth noting that a large number of signs are distinguished, but this does not mean that any primipara will necessarily experience them all. Each week of gestation is characterized by its own harbingers of childbirth.

How to understand that a primipara has started contractions

So called the feeling of pain that accompanies the process of opening the cervix. Many primiparas take training fights for real ones and go to the hospital. You can tell them apart if you learn to listen to your body well. Before that, in primiparas, they have a mucous plug, but if this happened, for example, simultaneously with urination, it may remain invisible. Then there is already a pulling and aching pain.

Labor pain is recognized not only by the occurrence of pain, but also by the feeling of contraction of the uterus, “petrification”. The pain resembles that which a woman experiences during menstruation, begins in the lower back, diverges to the sides, and then to the stomach. Gradually, it increases significantly, it is difficult to endure it. There are such signs of the onset of labor in primiparas:

labor pains do not end, which is completely uncharacteristic for training;
the time interval between them is constantly shortening;
pain with each contraction increases, its duration increases.

Characteristic signs of childbirth during the first pregnancy weekly

Their list is very large. For some women, it is not enough to know about the harbingers of childbirth in primiparas, so they look for other signs, become overly superstitious and wary. In fact, you need to understand what symptoms may appear in the last weeks of pregnancy and be prepared for this. As a rule, their number increases gradually, if childbirth does not occur. Some primiparous harbingers do not exist at all, especially multiparous ones, while others show one or more. This is influenced by the individual characteristics of the body:

age of the primiparous;
list of chronic and previously transferred diseases;
body structure;
condition of internal organs, reproductive system.

Harbingers of childbirth at 37 weeks of gestation

Symptoms:

This is the week when the belly drops before childbirth in primiparas, its shape changes. This is very visible in the photo. The uterus moves into the pelvic area. At the same time, a woman breathes much easier, her heartburn finally disappears. Previously, by the shape of the abdomen, they even tried to determine who would be born: a boy or a girl.
The pressure on the intestines and bladder increases, so the pregnant woman goes to the toilet more often.
The body weight of the primipara decreases. Weight does not increase anymore because a lot of fluid comes out of the body.
The pelvic bones expand, which is accompanied by discomfort and sometimes severe pain.
The center of gravity is transferred, so the gait changes. People around say that the woman began to look different.

38 weeks pregnant

At this time, such harbingers of childbirth in primiparas may appear:

a slight increase in the volume of secretions;
periodically the stomach aches and pulls;
the mammary glands become even larger, colostrum is possible;
movements are felt less and less;
this week, a mucous plug may already stand out, which indicates the onset of labor in the coming days (this is normal, the fetus is already fully full-term).

39 weeks pregnant

Characteristic harbingers of childbirth in primiparas:

The mood of a woman changes often and strongly. She feels the instinct of "nesting". Pregnant women, for example, carefully clean the house, prepare children's things. This change indicates that the first signs of childbirth in primiparas will appear very soon.
Training prenatal contractions begin. As a rule, this happens at 39 weeks, but sometimes the harbingers of childbirth appear earlier. Contractions are irregular. Taking a bath with warm water helps to get rid of the pain. Some, on the advice of a doctor, take No-shpu.
Vaginal discharge is abundant, it can be either transparent or beige, milky, light brown, sometimes with bloody streaks.
Constipation stops.
At this time, the mucous plug often leaves, which indicates the birth of a baby within two to seven days.
The weight of the primipara becomes less by a kilogram and a half.

40 weeks pregnant

If a woman has reached this period, then she will feel such harbingers of an early birth in primiparas:

Appetite suddenly disappears, there is almost no desire. Weight by this time is reduced by another one or two kilograms.
The cervix becomes soft and short, however, this symptom is noticeable only to the doctor, the woman will not be able to feel it. On examination, a specialist can also determine that the fetal head has become in the small pelvis.
The child is already very large. In the uterus, he is cramped, so he moves much less. Only rare jolts and kicks will be felt. Just before giving birth, the baby may become, on the contrary, overly active.
There may be leakage of amniotic fluid, which must be reported to the doctor.
A woman has loose stools (diarrhea), sometimes there are bouts of vomiting. So the body reacts to the upcoming stress and tries to “bring out” everything superfluous from itself in order to more easily transfer the load. Often these symptoms are a sign that labor will begin in a couple of days.
The mucous plug should come off completely or in parts. After that, it is not recommended to take a bath or swim in open places, so as not to catch the infection.
The last symptoms before childbirth are contractions, regular and painful. Gradually they increase, and the gap between them is reduced. Then the amniotic fluid leaves, which indicates the beginning of labor. If this does not happen, the doctor can pierce the fetal bladder, this is quite acceptable.

What to do if there are signs of an approaching birth

Many people want to get to the hospital as soon as possible, but this is an unnecessary worry. The appearance and strengthening of the harbingers of childbirth suggests that they will occur no later than in a week or two. From now on, you need to behave more correctly: rest a lot, do not lift weights, spend time in the fresh air. Moderate exercise and walking will help. When real contractions begin and their frequency decreases, you should go to the hospital. If the waters have receded, it is advisable to get to the maternity facility as quickly as possible.

There is always a risk of preterm labor, so you should contact your doctor immediately, regardless of the gestational age, if you notice that:

vaginal bleeding has begun;
the color of the departed waters is not transparent or pinkish, but yellow, green or any other uncharacteristic;
the child has completely stopped moving in the stomach, does not respond to your touch;
attempts began;
vomiting lasts more than a few hours;
unusually severe or acute pain in the abdomen, back, or other parts of the body.

Video: how childbirth begins in primiparas

The woman waits with special trepidation and love. She does not know much, because everything that is happening now, and will happen in the future, is for the first time. When there is very little left before the X-hour, the excitement builds. Expectant mothers are afraid to miss the moment of the onset of childbirth, they are worried, wondering “does it hurt?”, they dream that everything will pass as soon as possible, and they and the baby will be happy.

Harbingers of childbirth

The closer the date of birth, the brighter the precursors appear. If earlier, about 30 years ago, some harbingers of childbirth were perceived by primiparas as signs of malaise, today everything is different. Modern pregnant women, having access to specialized literature and the Internet, are well-read and prepared. Often, such awareness does not play into the hands of a pregnant woman and her doctor, because, waiting for the baby to appear, a woman anxiously listens to everything that happens to her, and is ready to go to the hospital right away, deciding that it has already begun ... Many women come to the maternity hospital department, when, in fact, there are still a few days before delivery.

So, to avoid such situations, we list the main signs that childbirth is close.

Lowering of the abdomen (it becomes easier for a woman to breathe, the tormentor disappears, but it became more difficult to walk or sit). Occurs 2-3 weeks before delivery.
Separation of the mucous plug (can occur both a week before delivery, and 1 day before).
The baby is not so active. This is due to the fact that it is already very crowded there.
Uterine contractions occur. If they are irregular, then they talk about the so-called training.

The fact that childbirth is about to begin is evidenced by other signs. They occur in the preparatory period, which is also called preliminary. In nulliparous women, it is longer than in those who give birth for the second or third time. As a rule, the preliminary period lasts about 24 hours. During this time, the cervix gradually softens, preparing to release the baby. Periodic contractions become stronger and more intense, but these are not real contractions yet. When they become strong and regular, then know: it has begun!

Three periods of childbirth

For women who are about to give birth for the first time, it is very important to know that the birth process is divided into.

The first period is the longest, characterized by strong uterine contractions. First, the duration of contractions is from 30 to 40 seconds, and the interval between them is 15-20 minutes. The closer the moment of childbirth, the longer and stronger the contraction (1-2 minutes), and the time interval between them is getting shorter (3 minutes). At this time, the cervix opens. In primiparas, this period lasts much longer than in multiparous ones: from 8 to 24 hours.

The second stage of childbirth begins with attempts and ends with the expulsion of the fetus, that is, the birth of a child. Attempts occur simultaneously with contractions and contribute to the fact that the fetus begins to move along the birth canal to the exit. At this time, it is very important to clearly follow the instructions of the midwife who monitors the process. Therefore, try to listen carefully to what you are told and do everything exactly as it should.

The third period is postpartum. 10-15 minutes after the birth of a child, the placenta is born, or, as it is called, the placenta. As soon as this happened, the birth is considered to have taken place, and the woman in labor is called the mother.

The duration of the first birth is always longer than the subsequent ones. As a rule, it takes from fifteen to twenty hours.

How to relieve pain?

Pain during the first birth is the strongest. It may sound strange to someone, but childbirth, although hard work, requires. More precisely, you need to relax just in order to reduce pain and help the baby be born into the world. But how to relax if something incredible and frightening happens to the body? To prevent such thoughts from arising, it is important to realize long before the birth that what is happening in the delivery room is the mystery of the emergence of a new life, a dear little man, and everything that happens is wonderful. Be determined that all the negative will pass, and very soon, and you will begin a new life, rich in positive emotions and filled with love.

When the contractions become strong and painful, try to relax, breathe deeply and calmly. It’s good if before that you attended courses for expectant mothers, where you learned different relaxation techniques and. Pain relief also helps Ask your husband to do it. Let the doctor show you where and how to massage. If it brings you relief, you can "hum" the sounds out loud. But you shouldn’t shout: this will not only not bring the desired relief, but it will also take away your strength, and you will still need it.

If the pain from contractions is so unbearable that it causes severe discomfort, consult a doctor. It is possible that you will be offered one of the existing methods of anesthesia.

If you are in pain while pushing, you may be breathing incorrectly or lying down uncomfortably. Try not to tense up or pinch your perineum. This will only aggravate the situation and can greatly harm the baby, because for a successful passage through the birth canal, on the contrary, it is necessary to relax. At the same attempts -. How to breathe properly on attempts, the doctor next to you will tell you. In general, it should be understood and remembered that labor pain is largely subjective: any pain in childbirth can be endured, it is inherent in nature, but if the mother does not pinch, does not strain and tries to properly participate in the birth process, then everything goes fine!

Features of the course of childbirth, based on the age characteristics of primiparous

The most favorable period for the birth of a child in gynecology is the female age from 19 to 25 years. At this time, the girl’s body fully matures in order to bear a healthy strong baby, its resources are not yet depleted, and, as a rule, the woman does not have time to acquire many chronic diseases, the number of which increases with age.

Childbirth occurring earlier or later than the specified age may have some features, obstetricians say. But a favorable outcome depends on the lifestyle of the expectant mother, how she takes care of her health, how she is prepared for childbirth and how aware of how to act in this or that period, as well as on the professionalism of the medical staff taking delivery. So do not worry and worry - everything will be fine! In the meantime, you still have a day or two to prepare - read about breathing techniques in childbirth, various positions in childbirth, how to relax and when to push.

Everything will go well! And don't worry - you won't miss the harbingers. Easy childbirth!

Especially for- Olga Pavlova

From Guest

All of the above signs did not apply to me ... (first birth). It is said that the stomach sinks so that it becomes easier to breathe. No, it was also hard to breathe (but! In 2-3 weeks, in a consultation, the voach said that she had dropped a little). Going to the toilet for the most part. No, the chair was as usual. Removal of the mucous plug. No, she passed away at the moment when the waters broke (after that she gave birth 14 hours later). I didn’t really feel the training contractions (they can even begin at week 30), but I began to feel them more clearly in the last 2 weeks just. But with real fights, of course, this cannot be compared;). In general, in fact, there were no clear signs, so you see everything, individually.

From Guest

I was waiting for the first birth and read a lot of literature and videos. But things didn't go as planned. At 8 in the morning I felt a slight malaise in the form of slight bleeding and tightening of the lower abdomen, as during menstruation. After 10 minutes, the poking was repeated. I began to note the time and time intervals of the incoming pain. The pain increased for 8-5-4-3 minutes. I called an ambulance. In the intervals between sips, I was going to the hospital. I waited 50 minutes for an ambulance, at 9:30 the waters broke and the first battle followed along with the waters. The baby literally fell through the birth canal. A little poked in the lower back at this moment. The ambulance arrived around 10. At 10:30 a.m. the baby appeared after two hits and a little effort. In total, from the moment of the first indisposition to the appearance of the baby, 2.5 hours passed. Very fast, I didn't even know what it was. Didn't suffer. Without anesthesia. True, they sewed up a little and it was impossible to sit for a month. I want another baby. All easy childbirth!!!)))

From Guest

The birth went on for 13 hours. In the maternity hospital, they deceived me and gave me a pill that stimulates childbirth. (I would not drink it). And they said that it helps the uterus to come into an elastic state. The gestational age was 40 weeks. 5 days. so the contractions started at 00:30, they were strong and lasted until 11 in the morning, then the contractions became unbearable, an anesthetic hit me in the spine, at 12:30 attempts began and and at 13:10 I gave birth to a beautiful boy. I spent all the time under the karelnitsa. the cervix was not ready. Of course, childbirth is good, but it was not without breaks. 3 internal stitches were placed. Childbirth was taken by a student. So the next day, the bleeding also opened. These were the first births.

From Guest

In this article:

So the 9 months of waiting are coming to an end, and every pregnant woman wonders what the first symptoms will help her understand that childbirth is starting, at what point to call an ambulance. Doctors talk about signs of incipient labor activity in the mother and fetus.

Harbingers of the imminent onset of childbirth in a woman

After 38 weeks, the pregnancy is considered full-term. Before childbirth, the normal beginning of which is considered to be any time between 38 and 42 weeks, the level of hormones responsible for bearing the fetus decreases in the body of women, and the level of those that stimulate labor activity increases significantly.

Hormonal changes affect both the physical and psychological state of women. The presence of several of the following signs indicates the imminent onset of labor. The first symptoms may appear even a few weeks before childbirth.

One of the main symptoms of approaching childbirth is the prolapse of the abdomen, which occurs due to a tighter entry of the fetal head into the pelvic ring. Many women say that it has become easier for them to sit and breathe, heartburn has disappeared. Obstetricians note the prolapse of the uterine fundus. Although for most this occurs within a few weeks, for some women, the stomach drops right before childbirth.

Very often, to train the body before childbirth, Braxton-Hicks contractions occur (precursor, false, training). They can be quite long and intense. Unlike true false contractions, they are not regular, do not increase in intensity and duration, often resemble menstrual pain, and usually stop if the woman relaxes or takes a warm bath. If you were able to fall asleep, these are definitely training bouts.

Many women experience nausea, loose stools, and even vomiting during the prenatal period. According to doctors, these signs indicate the process of opening the cervix. However, one must be careful, constantly drink water in small quantities in order to prevent dehydration of the body, because these symptoms can accompany poisoning and intestinal infection.

In some cases, in women in the last stages of pregnancy, urination may become more frequent, which occurs due to increased pressure of the uterus on the lower abdomen, in particular the bladder. As a result, swelling disappears. It is also believed that this indicates the ridding of the body of excess, cleansing before childbirth. Those of the women who are regularly weighed may notice a weight loss of 1-2 kilograms.

Some of the pregnant women experience pain in the lumbar region and pressure in the lower abdomen.
The discharge of the mucous plug can occur both immediately before childbirth, and 2 weeks before them. Mucus is located in the cervical canal and protects the fetus from infection. When it stands out, the child continues to be reliably protected by the amniotic membrane.

How to understand that it was the mucous plug that stood out? It is transparent, colorless, may be streaked with blood; quantity - about 20 ml. If the cork came out more than 2 weeks before the due date (estimated date of birth) or the cork was painted in some color, you need to seek medical help, otherwise there is no cause for concern

The psychological sign of an approaching birth is the “nesting instinct”, when a woman tries to stay at home as much as possible, choosing a cozy corner, or cleans, erases, irons, preparing a “nest” for her child. Here you should not overdo it with physical activity and save energy for the upcoming birth.
All of the first manifestations of approaching labor listed above do not require immediate medical attention, but in case of any doubt, it is better not to be shy and consult a doctor.

Fetal symptoms

Usually, a few days before the birth, the baby becomes less active: he has grown up, and it is increasingly difficult for him to move in a cramped space. However, if a woman feels less than 10 series of movements per day, it is necessary to consult a doctor to exclude the risk of developing fetal hypoxia.

The main signs of incipient labor

The main sign of the development of labor activity is the development of contractions, that is, an increase in their intensity, an increase in duration and a decrease in the intervals between them. The first contractions usually appear as pulling pains in the lower abdomen or lower back, lasting several seconds at intervals of 15-20 minutes. Often contractions are accompanied by chills. You should not worry when chills appear, this is one of the natural reactions of the body before childbirth.

The outflow of amniotic fluid is the second reliable sign of the onset of labor. In this case, the liquid should be light or yellowish, colored water may indicate an oxygen starvation of the child in the womb or an infection. Rupture of the amniotic membrane can occur both immediately before childbirth, and many hours before them.

When to call an ambulance?

If your water has broken, you should immediately go to the maternity ward: the longer the child is without water, the higher the likelihood of complications.
With regular increasing contractions, when the interval between them is 7-10 minutes. If it takes more than 30 minutes to go to the hospital, it is better to call an ambulance without waiting for such a short interval.
If bleeding occurs.

In primiparous and multiparous women, the symptoms of the onset of labor are the same, however, in the second childbirth, as a rule, they proceed more rapidly than if the childbirth is the first, therefore, if signs of labor activity are manifested in women who have already given birth, it is better to immediately go to a medical facility.

Easy childbirth and health to you and the baby!

Childbirth at term never begins suddenly for a woman, which is especially feared by primiparous pregnant women. The beginning of regular labor activity is preceded by the harbingers of childbirth, which prepare the expectant mother for the birth of the baby and remind her of the imminent birth. And although the harbingers are necessarily manifested by certain signs, some women may not notice them.

How does the body prepare for childbirth?

Aging of the placenta
The placenta, which produces hormones, plays a leading role in preparing the body for childbirth. From the 36th week, the ratio of secreted hormones changes: the production of progesterone, which is responsible for relaxing the smooth muscles of the uterus and prolonging pregnancy, decreases, and estrogens begin to be synthesized in greater quantities. Estrogens trigger the formation of uterine contractile proteins, due to which the susceptibility of myometrial cells to stimulation increases. In addition, high levels of estrogen increase the amount of prostaglandins in the uterus, which, in turn, trigger the release of oxytocin in the maternal and fetal pituitary glands and destroy progesterone.

Generic dominant
The normal course of childbirth depends on the formation of a “birth dominant” in a pregnant woman, which replaces the “pregnancy dominant” in the brain. In about 2 weeks, there is an increase in the electrical activity of those parts of the brain that are responsible for the birth process. In addition, the formed “birth dominant” or “full readiness of the body for childbirth” increases the synthesis of oxytocin, a contracting hormone in the pituitary gland.

fruit maturity
Due to the rapid growth of the fetus towards the end of pregnancy and the decrease in the amount of amniotic fluid, the uterus covers the unborn child more tightly. In response to this stress factor, the fetal adrenal glands in large quantities begin to synthesize cortisol, the stress hormone. Which in turn "spurs" the production of prostaglandins in the maternal body. Labor begins when a sufficient amount of both prostaglandins and oxytocin accumulate in the mother's body. And up to this point, estrogens “work”, which prepare the tissues of the birth canal (cervix, vagina and perineum), increasing their elasticity and suppleness.

Ripening of the cervix
The cervix is actively involved in the birth process, the course of childbirth and their completion depend on its condition. By the end of the gestational period, the cervix begins to "mature", that is, to undergo morphological changes due to the components (collagen, elastin, connective tissue). As a result of the changes taking place, the connective tissue softens, its hydrophilicity increases, and the muscle bundles “diverge”. The neck becomes pliable, easily stretchable and soft along its entire length, including the internal pharynx. The vaginal part of the cervix is shortened (less than 1.5 - 2 cm, normally up to 4 cm). The cervical canal straightens and smoothly passes into the internal pharynx. The sutures and fontanelles of the fetal head can be palpated through the vaginal fornix.

After maturation (“mature”), the cervix is located along the longitudinal axis of the pelvis, the external pharynx is in a straight line connecting the ischial bones. The "maturity" of the neck is determined in points according to the Bishop scale (in Russia). On this scale, each symptom (length, patency of the cervical canal, location and consistency) is evaluated in points (0 - 1 - 2).

Degrees of maturity of the cervix:

"immature" neck - dense or slightly softened, long, the external pharynx is closed or passes the tip of the finger, is rejected backwards;
“not mature enough” - the neck is shortened, softened, the cervical canal is passable for one finger, in primiparous to a closed internal pharynx, deviated anteriorly or posteriorly;
"mature" - the neck is soft throughout, shortened or smoothed as much as possible, located along the axis of the small pelvis - centered, the cervical canal is easily passable for the finger, you can feel the presenting part, landmarks (sutures, fontanelles), fetal bladder.

Harbingers of imminent childbirth is a set of external signs that reflect the ongoing changes in the body and are felt by the pregnant woman. That is, the harbingers of childbirth testify to the preparation for childbirth and their imminent onset. The time of appearance and duration of the precursors of childbirth are individual for each woman and even differ in the same pregnancy in different pregnancies.

How long before birth do their precursors appear? Harbingers of childbirth can appear 2 hours - 2 weeks before the development of regular labor

Descent of the uterine fundus
On the eve of childbirth, the bottom of the uterus sinks, or, as pregnant women say, “the belly sank”. If, up to about 37 weeks, the height of the uterine fundus increased by an average of 1 cm weekly and amounted to 37–41 cm, then before the onset of childbirth, the uterus drops by a couple of cm (in multiparous people, this happens in a couple of hours or with the onset of regular contractions). This symptom is due to pressing the head to the entrance to the small pelvis, which is explained by the adoption of the fetus in the most convenient position by the beginning of the contractions.

The shape of the abdomen also changes, it becomes sloping, as a result of which the pressure of the uterus on the diaphragm and internal organs decreases, and the woman notes the disappearance of shortness of breath, belching and heartburn disappear, as well as a feeling of heaviness in the stomach after eating (the stomach is located more freely).

The lowered and pressed head of the child, in turn, puts pressure on the rectum and bladder, which is manifested by increased urination and the urge to defecate. In addition, the pressure of the presenting part on the muscles, ligaments and nerve receptors can cause pain in the lower extremities and lower abdomen.

Changes in urination and stool

As mentioned above, due to the pressure of the fetal head on the ureter, urination becomes frequent (the pregnant woman notes that she gets up several times at night to go to the toilet). In addition, the body tries to get rid of the "excess" fluid, which is necessary to thicken the blood on the eve of childbirth and reduce blood loss, and therefore the volume of urine excreted increases.

The nature of the stool also changes, it becomes more frequent and becomes more liquid, which is due to an increase in the content of estrogen and the loss of fluid by the mother's body. In some cases, there may be diarrhea and slight abdominal cramps, and the frequency of defecation reaches 2 to 3 times a day.

Fetal activity
By the end of pregnancy, the fetus has reached its maturity, that is, it has gained the required weight (about 3 kg), and its organs are ready for extrauterine existence. The uterus has already reached its maximum size and stops growing, the unborn child in its cavity becomes crowded. As a result, the expectant mother begins to notice that the baby has become less likely to move, and if the “serious” fetal movements disappeared as early as 34–36 weeks (turns, flips), then “small” movements (poking with arms or heels became less frequent and very noticeable, and even painful.

Frequent mood swings
On the eve of childbirth, people around the pregnant woman, and the expectant mother herself, note mood instability. A woman is easily excited and just as easily becomes inhibited, apathetic, thoughtful. Emotional lability is explained by ongoing changes in the nervous system.

Navel protrusion
Before childbirth, from about 37 to 38 weeks, many pregnant women begin to notice that their navel protrudes strangely. This is due to many reasons. Firstly, there is some softening of the connective tissue, which is necessary primarily for stretching the ligaments of the small pelvis and tendons of the muscles of the vagina and perineum during the passage of the fetus through the birth canal. Secondly, the muscles of the anterior abdominal wall and the skin of the abdomen are stretched. And, thirdly, intrauterine pressure increases significantly. Of course, the protrusion of the navel as a harbinger of childbirth should not be discussed in the case of significant polyhydramnios or multiple pregnancy, since all of these factors are explained by the excessive size of the uterus.

Weight loss
Before childbirth, almost all pregnant women note a decrease or stabilization of weight, by 0.5 - 2 kg. This symptom is associated with the excretion of excess fluid by the kidneys and a decrease in the severity of edema. Progesterone, due to the relaxation of vascular tone, retains fluid in the tissues, which causes the general swelling of the body of the pregnant woman. The mother-to-be may notice that gloves and rings are easier to put on, the shoes are not so tight and it becomes easier for her to put on shoes.

Removal of the mucous plug
By the end of pregnancy, the cervix undergoes a maturation process: it softens, shortens, and the cervical canal opens slightly and becomes passable for the fingertip in primiparas, and even wider in multiparous ones. In the cervical canal there is a mucous plug - thick mucus that blocked the penetration of pathological microorganisms into the uterus and protected the fetus from intrauterine infection. By the beginning of labor, in about 3 to 10 days, this mucus is liquefied, which is facilitated by estrogens, and is pushed out of the cervical canal. The mucous plug looks like a small colorless lump or yellowish color with streaks of blood. Its volume does not exceed 3 ml. It is possible for the mucous plug to come off in parts, over several days.

The discharge of the mucous plug is sometimes difficult to determine independently, even for multiparous women. Doubts arise - this is a cork or water coming out (it is possible for water to leak with a high opening of the fetal bladder). In case of leakage of water, there will be watery discharge, transparent and with a slightly opalescent hue (yellowish or greenish), increased leakage increases intra-abdominal pressure (cough, defecation, sneezing), in contrast to the discharge of the cork, which occurs in portions, over several days, water leak constantly. In case of any doubt - the water or the cork is leaving - you should immediately go to the hospital.

nesting syndrome
Many women notice extraordinary housekeeping before an early birth. This manifests itself in the form of thorough cleaning, even those places where I didn’t look before, re-washing dishes (cleaning the bottoms of pots) and washing, purchasing necessary and not very clothes for the baby, household chemicals, dishes and other things. The signs of the nesting syndrome are also explained by the influence of estrogen, in addition, endorphins and enkephalins, the so-called hormones of joy or "solar hormones", come into effect. For example, the production of "joyful" hormones increases after eating chocolate, juicy tomatoes and bananas, after playing sports, viewing pleasant pictures and photos. At the end of pregnancy, the production of these hormones is stimulated by the expectant mother's awareness of an early meeting with her child.

Decreased appetite
Weakening of appetite, and sometimes its absence, is also one of the harbingers of childbirth, which is observed a day or three before the onset of labor. This sign is not fraught with danger, and you should not worry. If you don't want to eat, then you don't need to.

false contractions
Contractions that appear on the eve of childbirth are called false or training, since they do not lead to the development of regular labor activity. The appearance of false contractions is another of the harbingers of childbirth and their role is to prepare the myometrium for childbirth and the maturation of the cervix. Such contractions do not lead to the opening of the uterine os and are felt as a hardening of the abdomen in response to fetal movement or physical exertion. Training bouts are characterized by irregularity, low intensity, painlessness and periods of rest between them up to 30 minutes or more. False contractions occur about 4-6 times a day, usually in the mornings and evenings, and last no more than two hours in a row. After some time, the contractions either weaken, or their strength does not change, but may stop in a horizontal position, after taking a warm bath or massage.

Harbingers of childbirth in primiparous and multiparous

Most women, especially those who are preparing to become a mother for the first time, may not notice the listed signs of an imminent birth. The absence of harbingers of childbirth in primiparas does not mean at all that the body is not preparing for childbirth, because many changes can only be established using special tests (oxytocin, mammary) or during a vaginal examination.

More experienced women learn about the approaching birth not only by the appearance of precursors, but also because of their severity. The intensity of the precursors of childbirth in multiparous women is explained by the sensitive reaction of the body to the ongoing hormonal changes.

And it is not at all necessary that all the symptoms listed in the article will appear, indicating the imminent onset of labor. Especially at the same time. Perhaps the occurrence of one or two signs with a different interval in time (from 2 weeks, a day - an hour before delivery). And by the way, the discharge of the mucous plug does not always occur before childbirth, it happens that it is expelled with the onset of regular labor.

When do you need to urgently see a doctor?

At the end of pregnancy, all women should be ready for an immediate trip to the maternity hospital (collect an “alarming” suitcase, documents, shave off the hair on the perineum, remove nail polish), even if the harbingers still “do not smell”. Emergency situations for calling an ambulance:

outpouring of water, especially against the background of complete well-being, in the absence of contractions;
the appearance of bleeding;
rise in pressure (140/90 and more);
the occurrence of severe pain in the abdomen;
the appearance of a headache, flies before the eyes, blurred vision;
lack of fetal movements for 6 or more hours;
development of regular labor activity (2 - 3 contractions in 10 minutes).

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