Whether to go to the hospital in advance. When and in what you need to go to the hospital for the first and second births

First, you need to know the expected calendar date of birth. The duration of pregnancy for each woman is individual; on average, it is 280 days, or 40 weeks, fluctuations from 38 to 42 weeks are considered normal.

How to find out the date of birth?

There are various ways to calculate the due date. Some try to determine the day of conception and count the days from it. However, the day when sexual intercourse occurred and the day of conception itself may not coincide, since spermatozoa are able to maintain their viability and “wait” for an egg in the woman’s genital tract for several days.

Determination of the date of birth by menstruation

The most common way to calculate the due date is “by menstruation”. This is usually a well documented event. It is necessary to remember exactly the first day of the last menstruation, from the beginning of which it is proposed to count 280 days. And even easier - add another 7 days to the date of the first day of the last menstruation and count back three months. For example, the last menstruation began on September 5th. Then childbirth can be expected on June 12 (5 + 7 days = 12, 9th month of September - 3 = 6th month of June). But this method will be unreliable if the woman has an irregular menstrual cycle or she does not remember the date of the menstruation.

Our due date calculator will help you calculate your due date based on your period.

Determining the date of birth by ultrasound

In modern conditions, the date of birth is determined quite accurately, focusing on the data of an ultrasound examination (ultrasound) performed before the 12th week of pregnancy. In late pregnancy, the error in determining the term using ultrasound increases. This is due to the fact that the dimensions of the fetus, which the doctor is guided by in his calculations, at the end of pregnancy have large individual fluctuations.

In the same way, the calculation is made on the basis of the date and duration of pregnancy established at the first visit to the doctor (the method “on the first appearance at the antenatal clinic”). The sooner your doctor determines your due date, the more accurate your due date predictions will be.

Determining the date of birth by fetal movements

You can roughly calculate the date of birth and the first movement of the fetus: in nulliparous women, this occurs on average at 20 weeks, and in multiparous women, at 18 weeks. Of course, these are very subjective sensations, because the moment of the first movement of the child is not always well distinguishable.

You can find out about full-term pregnancy and upcoming childbirth by several signs. Approximately in 1 - 2 weeks, the so-called "harbingers" of childbirth appear.

Harbingers of childbirth

Most women notice at the end of their pregnancy that their belly has “drooped” and it has become easier to breathe. This is because during a full-term pregnancy, the amount of amniotic fluid decreases slightly, and the head of the fetus is pressed against the entrance to the woman's small pelvis. The uterus becomes more excitable, it “trains”, prepares for the upcoming big work. Irregular, painless tension of the uterus and a feeling of heaviness in the lower abdomen and in the lower back are called “pregnancy contractions”. It is not always possible even for a doctor to say with certainty whether labor is starting or preparatory contractions are taking place. If such a state of increased irregular excitability of the uterus continues for 1-2 days, then it is better to contact maternity hospital where they can assess whether the child suffers.

A few days before delivery (or on the day of delivery), light mucous discharge may appear from the genital tract, sometimes with small streaks of blood. Usually they say that "the mucous plug has come off." This is a favorable sign of softening and "ripening" of the cervix.

In many women, towards the end of pregnancy, colostrum is secreted from the nipples - the precursor of mother's milk.

A healthy woman with a favorable pregnancy can stay at home until the onset of labor. If there are deviations in the state of health of a woman, pregnancy has complications, if signs of fetal suffering are established, then, of course, the last 1-2 weeks (and more if necessary) should be in the maternity hospital under the supervision of specialists. Recently, many women, especially city dwellers, prefer to go to the maternity hospital in advance. This is obviously due to the general deterioration in the health of the population, the desire of the family, if possible, to insure against various accidents.

When is it time to go to the hospital?

So, at home, you felt some changes in your condition. There was heaviness, a slight pain in the lower back, in the lower abdomen, the uterus tensed up and became very dense to the touch. At first, the contractions and relaxation of the uterus are irregular, lasting 5-10 seconds with long breaks (up to half an hour). Then their frequency and intensity increase. This started the fight. If you are giving birth for the first time and live close to maternity hospital, then you can wait until the contractions become regular - once every 5 to 7 minutes. If the birth is repeated, then immediately with the onset of contractions, you should go to maternity hospital. Repeated births are usually faster than the first, there is a risk of giving birth outside a medical institution.

Often, before the onset of contractions, amniotic fluid may be released. The normal content of water in the uterus by the end of pregnancy is up to 1.5 liters. You may feel that a clear, warm fluid is leaking from your vagina (no connection with urination). A little liquid may pour out, or maybe all 1.5 - 2 liters. Be that as it may, if you notice unusually wet laundry - this is a situation in which you must, without delay, go to maternity hospital. If the water has completely poured out or is leaking slightly, this means that the integrity of the fetal membranes has been violated, and the child is no longer protected from the effects of the external environment, primarily from infectious agents. Time is counted by the clock; in such a situation, it is advisable for a child to be born no later than 12 hours after the outpouring of water. Doctor in maternity hospital must determine whether you have a chance of giving birth through the birth canal, or is it better to perform a caesarean section. In most cases, after the outpouring of water, normal contractions begin, and childbirth ends safely.

The above was about typical normal situations at the end of pregnancy. But complications are also possible. There are situations that require special attention and emergency care that a woman with a full-term pregnancy should be aware of. Call an ambulance immediately and go to maternity hospital, If:

Bloody discharge appeared from the genital tract, smearing or “like menstruation”;

The waters are stained with blood;

The pain is very strong, the uterus is painful to the touch, does not relax between contractions;

The fetal movements have become unusually strong, or weak, or painful;

headache, vision became fuzzy (“flies” before the eyes), pain appeared in the epigastric region, blood pressure increased, you cannot urinate.

In any case, if you feel any discomfort, then be sure to consult a doctor who is observing your pregnancy, and at night, contact maternity hospital. Practice shows that it is better to be safe than to underestimate the seriousness of the situation and endanger the life of the child and your own.

1. Determine in advance in which institution you will give birth. Many women prefer to have the same doctor conduct the pregnancy and deliver the baby. In practice, this is not always feasible. The state system for monitoring pregnant women is organized in such a way that the doctor is not necessarily present at the birth of his patient. And in non-state clinics, the obstetrician who observed you, due to various circumstances, may not be next to you at this very moment. However, it should not be taken as a tragedy when an unfamiliar doctor conducts childbirth. Choose a delivery facility with a good reputation; if you are not “assigned” to it on a territorial basis (formal objections may arise during hospitalization), decide in advance for yourself whether you agree to paid services. It is advisable to undergo a set of examinations adopted in this institution, to conclude a service contract.

2. Keep your documents organized, namely:

An exchange card with the data of all analyzes and ultrasound in the III trimester;

Passport;

Insurance policy.

IT IS BETTER TO ALWAYS HAVE THESE DOCUMENTS WITH YOU!

In the absence of medical documents, childbirth is supposed to be carried out in the II obstetric (observation department) or even in a specialized infectious maternity hospital! If you do not have a passport or an insurance policy with you, then there may be problems with the possibility of free birth (under compulsory health insurance). Be careful.

3. Prepare a bag with things: 2 - 3 cotton shirts, 3 - 4 diapers (preferably special disposable ones), 3 - 4 pairs of cotton shorts, pads (largest), bathrobe, washable slippers, 2 - 3 pairs of cotton socks, toiletries, towels .

However, in the maternity ward itself, you will not need anything other than slippers: usually, during childbirth, the necessary linen and clothes are given out in maternity hospital. Everything else, including things for the baby, relatives will bring to you after childbirth.

What to bring with you to the hospital will be prompted by our service List of things to the hospital

It will be more convenient for doctors, and for you too, if, having felt the approach of childbirth, you will not particularly burden your stomach. While waiting for labor to begin at home, limit your diet to light crackers, a cup of broth, and tea.

Trim your nails; you can shave your pubis on your own - these are mandatory procedures before childbirth.

Do not lose your presence of mind, be decisive and collected - you have a hard but joyful work ahead of you. Remember that you are primarily responsible for yourself and your child.

The third trimester is coming to an end, and sooner or later every expectant mother faces a choice - to go to the hospital in advance, or not?

Let's figure out together which option is best for you!

Most women believe that it is best to wait for childbirth at home. To be with family, relatives and husband until the very last moment, not to see hospital everyday life within the walls of the department of pathology of pregnant women (this is the name of the department where pregnant women are hospitalized in advance to wait for childbirth), it seems to them a paradise. And, in general, they are right in their own way.
Childbirth, as you know, is a slow process, stretching for several (and sometimes even many) hours, and when it all starts, the expectant mother will easily have time to get ready for the maternity hospital, get there and even lie down in the ward before she is taken to the maternity ward.

In what cases is it better to wait for childbirth at home

So, when can you choose not to go to the hospital in advance, but to wait for the start of labor at home?

First of all, you must be sure that you are in good health and the pregnancy is proceeding without complications. To do this, you need to rely not only on the absence of any discomfort, but also your doctor must confirm that your pregnancy is proceeding well. This means that you:

- there is no oligohydramnios, or polyhydramnios;

- there is no placenta previa (the placenta is attached correctly - high on the back wall of the uterus, and does not come too close to the cervix);

- there is no preeclampsia and its signs (high blood pressure, protein in the urine, edema - external and internal);

- there is no threat of termination of pregnancy (or the onset of premature birth);

- there is no cardiac, renal or any other pathology;

- there are no infectious diseases that can be dangerous for the baby in case of vaginal delivery.

- there are no unpleasant sensations (too frequent uterine contractions (Braxton-Higgs contractions), discomfort in the pelvic area, etc.);

- the child feels well (heartbeat is normal, height and weight correspond to the gestational age), and the expectant mother does not smoke or take alcohol.

In this scenario, you can stay at home, but still collect the necessary things for the hospital, because your birth can still start a little earlier 🙂

Why are pregnant women admitted to the hospital before delivery?

Pregnant women who are hospitalized in advance have their own reasons for this.

Some don't want to wait at home for labor because labor comes on suddenly and women don't want to be unprepared. Some already had not very pleasant experience of previous births, when something went wrong, or there were complications, and therefore it is better and calmer for them to stay in the hospital for the last weeks in order to reduce the chances of any unfavorable outcome of events.

But most women who are expecting natural childbirth are hospitalized in the maternity hospital in advance due to the prolongation of the pregnancy. If the 42nd week of pregnancy ends, and childbirth still does not begin, then it is advisable for a woman to be hospitalized in a maternity hospital so that the doctor begins preparations for childbirth. Usually, for this, a woman is given droppers, and the cervix is ​​​​prepared for childbirth using a special gel or kelp, which soften it and help to quickly dilate.

Such procedures are much easier to do in a hospital to be under the constant supervision of a doctor than to come to the maternity hospital every day. Although, a woman usually decides such a question herself, depending on what is easier for her.

Also, there are a number of indications for early hospitalization, such as preeclampsia (late toxicosis), from which the most formidable complications can develop if doctors do not take action.

As a rule, women who are indicated for a planned caesarean section are hospitalized in the department of pathology of pregnant women two weeks before the scheduled operation. In the first week, preparations are underway for the operation: women pass all the necessary tests so that the doctor can choose the method of conducting the operation, choose the type of anesthesia and select the rest of the medicines necessary for the woman in labor. Also, every day a woman receives vitamins in the form of tablets and droppers. At the beginning of the second week, the woman is given a planned caesarean section (one week before the expected natural birth).

Benefits of prenatal hospitalization

- You do not worry about the onset of labor - doctors are always with you;

- every day you get the necessary vitamins and doctors prepare you for childbirth;

- every day the doctor examines you and listens to your baby's heartbeat;

- You do not have to think about household chores, you can take a break from everything and go about your business;

– if necessary, you will receive medical assistance (drugs and droppers that reduce blood pressure, intensive care, etc.);

- You are already fully prepared for childbirth, your things are packed, and you are not afraid of surprises;

- in the ward, as a rule, there are from three to six girls, and you can easily find new friends;

— You do not need to prepare breakfasts, lunches and dinners, here everything is prepared for you;

- you have time to make friends with the doctor who will conduct the birth, and you can ask everything you want to know.

I hope that this article will help you make a little choice. Keep in mind that both options have their pros and cons. It's up to your doctor and you to decide.

Of course, such an abundance of conflicting and unreasoned recommendations only adds to the expectant mother's anxiety: after all, the wrong advice on hospitalization for childbirth, put into practice, can turn into serious problems during childbirth. And the health of mother and baby largely depends on how this important process goes, in particular, on timely observation and timely medical care.

When is it time to go to the hospital - when will the stomach drop?

The change in the shape of the abdomen on the eve of childbirth is associated with the “starting position” occupied by the baby before the start of the process. The fetus presses its head against the bones of the small pelvis, dragging the uterus down. As a result, the stomach seems to sag, sinking lower, resembling a pear in shape. The expectant mother can pay attention not only to the external change in the shape of the abdomen, but also to changes in well-being. For example, to increase stool and urination (the baby's head puts more pressure on the rectum and bladder) and the disappearance of shortness of breath (the lowered bottom of the uterus stops pressing on the diaphragm, making breathing easier). A lowered belly is evidence of preparation for childbirth, but does not require immediate hospitalization.
Firstly, from the moment the shape of the abdomen changes to the onset of labor, it can normally take ... about two weeks! Secondly, the prolapse of the abdomen is not a mandatory attribute of the precursors and the onset of childbirth: sometimes this simply does not happen. Whether the belly drops on the eve of childbirth or not depends on the shape of the pelvis of the expectant mother, as well as on the amount of water, size and presentation of the fetus (head or buttocks down).

How to understand what you are giving birth: water

Indeed, if the future mother's water breaks, you must immediately go to the hospital. However, in most cases, you should hit the road much earlier! The fact is that childbirth does not necessarily begin with the outpouring of amniotic fluid. Depending on the volume of water, the location of the fetus in the uterus, the size of the baby and the duration of pregnancy, the membranes can break at the beginning, middle, and even at the very end of the process. In some cases, the fetal bladder does not burst on its own, and the baby is born in the fetal membranes.
Birth "in a shirt" - in a fetal bladder filled with liquid - is deadly for a newborn: after all, having been born, he must inhale air, not water. The old Russian saying "happy - born in a shirt" implies that this person does not care at all, since he remained alive in such a dangerous situation. Despite the fact that many women consider the discharge of water to be the beginning of childbirth, their outflow simultaneously with the onset of contractions or even before them is not at all the norm. In fact, a whole fetal bladder filled with water should participate in the birth process: during the first contractions, when the opening is still very small, it tenses and puts pressure on the neck, causing it to stretch.

Staying at home after the start of regular contractions and waiting for the water to flow is completely wrong. Ideally, the fetal bladder should remain intact until the middle (!) Of the first stage of labor - until the cervix opens by 4–5 cm. the first stage of labor - until the cervix is ​​\u200b\u200bfully dilated. Sometimes in the middle of childbirth, against the background of a whole fetal bladder, the contractions gradually begin to weaken. In this case, to normalize labor activity, the doctor opens the bubble.

When it's time to go to the hospital: the cork has gone

Cork is a jelly-like mass in the form of lumps or strands of yellowish, pink or brown color. This discharge from the genital tract, properly called cervical mucus, does not necessarily appear at the onset of labor. As well as the prolapse of the abdomen, cork discharge is a harbinger of childbirth - a manifestation of changes in the body of a pregnant woman shortly before the birth of a baby. During pregnancy, the cork filling the cervical canal protects the fetus from the adverse effects of the bacterial flora of the vagina. Before childbirth, the cervix softens and begins to open slightly. In this case, the mucous plug may stand out (or may remain inside the cervical canal and stand out during childbirth). Sometimes the cork is separated "in several passes" - not immediately, but in 2-3 days. It can also take 7-10 days from the first discharge of cervical mucus to the onset of labor.
Sometimes preliminary dischargetraffic jams it just doesn't happen! The appearance of mucous secretions from the cervix at the end of pregnancy (as well as the absence of these secretions) is considered normal and does not require a visit to the maternity hospital.

How to understand that you are giving birth - contractions

Despite the persuasiveness of this statement, even it is not always true! During pregnancy, a woman periodically experiences uterine contractions - training bouts Braxton Hicks. At the beginning of pregnancy, such contractions are extremely rare - 1-2 contractions per week, and are completely painless. They are felt simply as a slight tension in the uterus. As the gestational age increases, contractions may appear more often - up to several times a day in the form of single (separate) short, painless abdominal tensions that occur at different times of the day. These contractions occur in absolutely all pregnant women. However, not everyone feels them. Of course, such contractions, which are a variant of the norm, do not require going to the maternity hospital. Approximately 2 weeks before the expected date of birth, the expectant mother may have new sensations - false, or precursor contractions. In terms of strength and sensations, they are very similar to real contractions, with which childbirth begins. These are periodically repeated sensations of undulating tension of the uterus, sometimes accompanied by "sipping" in the lower abdomen and in the lower back. Unlike real, labor pains, precursors do not lead to the opening of the cervix and end rather quickly.

Harbinger contractions may occur every day during the week before childbirth, may disturb the expectant mother 1-2 times on the eve of childbirth, or may not appear at all. The presence of precursor contractions, as well as their absence, is the norm and does not require a visit to the doctor.

When you need to go to the hospital - better in advance!

Supporters of this point of view justify their position simply: a pregnant woman will be under the supervision of doctors all the time, so it is calmer for doctors, relatives, and herself. Despite the apparent logic of this statement, it cannot be considered absolutely true. More precisely, this advice is not universal - early prenatal hospitalization is needed only in special cases, or, as doctors say, "according to indications":

• When preparing for a planned caesarean section: in order to reduce the risk of surgical complications, the pregnant woman must be examined and prepared in advance. In this case, the expectant mother is recommended to go to the hospital no later than 38 weeks of pregnancy. The woman is hospitalized in the department of pathology of pregnant women and a preoperative examination plan is prescribed.
• If complications of pregnancy are detected on the eve of childbirth. In this case, early hospitalization in the maternity hospital will help to fully examine, correct the identified health problems and monitor the condition of the fetus during treatment. It is necessary to go to the hospital in advance, for example, with gestosis (late toxicosis of pregnant women, manifested by increased blood pressure, edema and the appearance of protein in the urine), impaired blood flow in the placenta, fetal growth retardation, and the threat of premature placental abruption.
• With an exacerbation of common chronic diseases, since any violation of the health of the expectant mother can affect the condition of the fetus and preparation for childbirth.
• If a woman has previously undergone surgery on the uterus, she is also hospitalized in the maternity hospital no later than the 38th week of pregnancy: at this time, it is necessary to control the condition of the postoperative scar.
• With a tendency to overwear. In the absence of harbingers of childbirth for a period of more than 40 weeks, a pregnant woman is recommended antenatal hospitalization. In the maternity hospital, the expectant mother undergoes an examination, the purpose of which is to exclude the fact of overgestation (a condition in which the body of the expectant mother ceases to cope with the life support of the baby and his condition worsens), control the level of placental blood flow and monitor the condition of the fetus. If necessary, a pregnant woman is prescribed therapeutic measures to prepare for childbirth.

In other cases go to the hospital early is not necessary. On the contrary, this excessive precaution can often do a pregnant woman a disservice. When hospitalized in the department of pathology of pregnant women, the expectant mother is limited in physical activity, which adversely affects her blood circulation.
Often in the maternity hospital, pregnant women do not sleep well: neighbors in the ward, noise coming from the children's and maternity wards, morning procedures (tests, thermometry) interfere. However, the most harmful factor of an unreasonable stay in the antenatal ward is the terrible stories about childbirth that expectant mothers tell each other “out of nothing to do”. Hypodynamia, insomnia and "horror movies", forcing fear of childbirth, negatively affect the physiological and psychological readiness for childbirth.

If your pregnancy proceeded without complications, then the answer to the question: " When to go to the hospital?» unequivocal: only with the onset of labor, when contractions begin, or if your amniotic fluid has broken (or begun to leak). Do not be afraid that the maternity hospital of your choice will slam the doors in front of you! According to the law, any maternity hospital or medical institution that has a maternity ward is obliged to hospitalize a woman who has labor pains! The only exception is when a woman in labor has a pathology that poses a danger to her life and health, as well as the life and health of her baby. In this case, the woman should be sent to a specialized maternity hospital.

A healthy woman should not go to the hospital in advance (even a few days before the expected birth)! We explain why: the majority of women lying in the antenatal wards have one or another pathology of pregnancy. A healthy woman, communicating with such patients, can get a lot of negative emotions, which is highly undesirable, because for the successful completion of childbirth, a positive emotional mood of the expectant mother is extremely important! In addition, waiting for the onset of labor when your roommates are already in labor is very tiring and mentally draining. There are new fears of pain, of the upcoming birth, a feeling of resentment towards doctors and relatives is overwhelmed, and dissatisfaction with oneself appears. Such a mental attitude can make childbirth a very painful and lengthy process!

But there are also cases when early hospitalization in the maternity hospital is necessary. These include pregnancies that occur with complications (placenta previa, fetal developmental delay, as well as other pathological conditions), as well as the presence of serious hospitalizations in a woman, for example, diabetes mellitus, heart and kidney disease, high blood pressure, deviations in the formula blood. In such cases, in the last months of pregnancy, a woman needs to be constantly under the close supervision and control of medical workers. Also, pregnant teenagers (girls under the age of 17-18) are subject to mandatory hospitalization (approximately one to two weeks before the expected date of birth).

If the doctor who monitors your pregnancy sends you for early hospitalization to the maternity hospital, but does not explain what caused such a need, then you will not need to consult another doctor (you can even seek help from the hospital doctors in the maternity hospital). It is possible that your doctor is just playing it safe, and you can expect the start of labor at home with peace of mind. However, it may also be that your doctor simply could not explain correctly how serious your situation is, and what consequences there may be due to refusing hospitalization! In any case, you should not ignore the prescriptions of your doctor, but it is worth sorting out everything and finally finding out when to go to the hospital- now or with the onset of labor pains? If something remains incomprehensible and unclear to you, ask without any hesitation, ask to be explained in detail what exactly is happening to you and your baby, as well as what the consequences of refusing hospitalization and treatment may be. Remember that the health (and sometimes life) of not only yours, but also your child depends on your decision and your consciousness!

The decision to write an article with this title came as a result of the fact that very often one has to hear the question (request): is it possible to go to the hospital in advance.

Another problem, more typical for patients with repeated births: fear of not getting to the hospital. But repeated births last an average of 6-8 hours. You can go to the hospital with the first signs of labor activity (contractions after 8-10 minutes, amniotic fluid discharge). It is not at all necessary to wait until the contractions are in 1-2 minutes and you want to push.

Sometimes relatives are afraid that they will be confused with the onset of labor, and they also try to send the pregnant woman to the hospital in advance. Such fears can be understood, but it’s still better to take care of the psychological comfort not of yourself, but of the expectant mother, since lying in the maternity hospital, even if it’s very good, without receiving any treatment, but simply waiting for childbirth is extremely difficult. Communication with patients with pregnancy pathology leaves a negative imprint on the emotional state.
The agonizing expectation of the onset of their own labor against the background of the onset of contractions in other patients also does not lead to an improvement in mood. There are unnecessary fears, resentments against relatives and doctors, who (quite reasonably) treat such patients as healthy. Accordingly, the doctor's bypass is short-lived, and the treatment is reduced to the appointment of valerian. Hence the resentment and complaints about the inattentive attitude of medical personnel. Although such a number of negative emotions could have been avoided by arriving at the hospital with the onset of childbirth.

The depressed emotional state before childbirth also affects the course of childbirth, which are more often complicated by a pathological preliminary period, weakness of labor, discoordination of labor, and premature rupture of amniotic fluid.

A large role belongs to doctors of antenatal clinics, who, being reinsured and fearing for the health of patients, hospitalize them in the maternity hospital even if minimal deviations in the state of health are detected (sometimes without them): minor edema, a single detection of protein in the urine, fetal malnutrition of the I degree, Rh- negative blood without antibodies, slight oligohydramnios or polyhydramnios, premature aging of the placenta without disturbing the condition of the fetus according to CTG and dopplerometry, prevention of postmaturity at 39-40 weeks of pregnancy, etc. Of course, in such a situation, patients, not possessing professional knowledge, cannot take responsibility for their health. If you have any doubts whether it is worth going to the maternity hospital in the direction of the antenatal clinic, you can consult the advisory department of the maternity hospital to determine the advisability of hospitalization.

The same applies to a planned caesarean section. If it is known that the operation is due, there are no complications of pregnancy, and the fetus feels fine, then you can not go to the hospital in advance, but come on the day of the operation, having carried out the necessary examination and preparation for the operation on an outpatient basis. But for this you need to consult in advance