The pregnancy has come to an end, and childbirth, no matter how much the expectant mothers want it, is inevitable. But what frightens women most about the birth process? Of course, contractions during childbirth. Fears are aggravated by all sorts of stories from friends, mothers, grandmothers and others about how difficult it was for them during labor.

IN in this case We can only suggest one thing: don’t listen to anyone, each person’s body is structured differently, which means everything happens differently. Some people easily endure pain, while others feel bad from being pricked by a rose thorn. Knowledge about the birth process, how to reduce pain during labor and how to breathe correctly during this time will help you get rid of fears of upcoming pain during childbirth.

Childbirth and its periods

Childbirth is the complex physiological process that ends pregnancy. Depending on the gestational age, childbirth is divided into premature (up to 36 weeks), urgent, that is, between 38 and 41 weeks, and late, which occurs at the 42nd week. The birth process itself is divided into 3 periods:

• 1st period is called the period of opening of the uterine pharynx or the period of contractions;
• 2nd period is the period of expulsion (i.e. birth) of the fetus;
• 3rd period – afterbirth (in this phase the afterbirth is born).

The longest period of childbirth is. It is characterized by contractions and the pain that accompanies them. The expulsion period is mistakenly considered by many women to be childbirth. Although it normally lasts 5 - 10 minutes and is accompanied by attempts that occur against the background of contractions and push the fetus out of the uterus. The third period is the expulsion (birth) of the placenta, which is also normally short and lasts 5 – 15, maximum 30 minutes. It becomes clear that childbirth is not only the process of giving birth to a baby, but also contractions, at the end of which the amniotic fluid and the birth of the placenta (“baby place” or placenta).

Contractions: what are they and what are they for?

Contractions are involuntary uterine contractions (carried out by the muscle layer), which occur regularly and are necessary to expel the fetus from the uterus. Contractions are classified into false and true.

The expectant mother begins to feel contractions before childbirth or false ones several weeks before the onset of labor. For the first time, such uterine contractions occur after 24 weeks. They are characterized by short duration, only a few seconds (less often a minute), irregularity, the intervals between contractions range from 10 - 15 minutes to half an hour and last no more than two hours. Occurring at the end of the gestation period means the approach of childbirth. Such uterine contractions are also called training contractions, since they prepare the woman’s body, in particular the uterus, for the upcoming work during childbirth.

True contractions mark the beginning of labor. It is impossible not to notice and miss them, as most women, especially those giving birth for the first time, are afraid of. Firstly, the onset of labor is preceded by numerous precursors, especially great importance has discharge of the mucous plug (3 – 7 days before birth). Secondly, amniotic fluid may leak. And thirdly, contractions have their own parameters, knowing about which even a primigravida woman cannot doubt the beginning of labor.

Contractions are necessary for the uterine os to open, first the baby’s head will pass through it, and then the entire baby. The uterine os is the external and internal os cervical canal. Normally, before the onset of labor, the uterine os is closed (closed) or allows the tip of a finger to pass through. To facilitate the expulsion of the fetus from the uterine cavity, the uterine pharynx opens up to 10 - 12 cm. This opening is called complete. In addition, during the first stage of labor, due to contractions, not only the opening of the cervix occurs, but also the movement of the presenting part of the fetus along the planes of the small pelvis. When the cervix opens completely and the baby’s head passes the bony ring of the pelvis and ends up on the pelvic floor (that is, in the vagina), attempts occur, which indicates that the second stage of labor has begun. Attempts and contractions are related to fetal expulsion forces, it becomes clear that childbirth without contractions is impossible.

Contractions: how to recognize them

As already mentioned, it is impossible to miss contractions, even if a woman is preparing to become a mother for the first time. But you shouldn’t believe films that very often show this situation: a woman in the last stages of pregnancy has full health Labor suddenly and violently begins, and after a couple of hours she becomes a happy mother. Yes, such situations are not excluded, but this applies to rapid labor, which lasts no more than 4 hours for first-time mothers, and during the second birth, 2 or less hours pass from the start of uterine contractions to the birth of the child.

True contractions (normally) begin gradually, gradually increasing, and the interval between them decreases. How to understand that contractions have begun if it is the first birth? You need to listen to yourself. Feelings may vary. Some compare uterine contractions with menstrual pain, while others experience nagging pain or stretching in the lumbar region, gradually spreading to the lower abdomen, encircling the woman. True contractions, as they write on many Internet sites, do not refer to the harbingers of labor, but to the beginning of labor. To recognize contractions during childbirth, you should know their characteristics:

• contractions are always regular and resume after certain periods of time;
• the duration of uterine contractions increases, and the interval between them shortens;
• pain (if any) gradually increases.

Another sensation that the expectant mother experiences during uterine contractions, especially if she is not bothered by pain, is that the uterus “turns to stone.” This is easy to determine by hand. From the beginning of the contraction, the uterus contracts and becomes hard to the touch, and towards the end it gradually relaxes.

How long do contractions last? When labor has just begun, each uterine contraction lasts 10–15 seconds; over time, contractions lengthen and by the end of the first period they reach 1–1.5 minutes (60–90 seconds). The breaks between contractions are at first 10–15 minutes, then they become shorter and shorter, and in the pushing period contractions occur on average after 1.5–2 minutes, but possibly after a minute.

Phases of contractions

Due to the fact that the cervix opens unevenly, and the fetus moves along the bone ring at different speeds, the period of contractions is divided into three phases:

First (latent phase)

Its beginning coincides with the establishment of regular contractions, and it ends with the smoothing of the cervix and its dilation to 3–4 cm. Contractions last from 20 to 45 seconds, occur every 15 minutes, the phase itself lasts up to 6 hours. This phase is called “latent” due to painlessness or mild pain and does not require drug pain relief.

Second (active phase)

As soon as the uterine os has opened by 4 cm, the active phase begins. This phase is characterized by intense labor and fairly rapid dilatation of the cervix. The active phase lasts 3–4 hours, the duration of uterine contractions reaches 60 seconds, and the intervals between them last 2–4 minutes. When the cervical opening reaches 8 cm and the amniotic sac is intact, it should be opened (timely amniotomy).

Third or deceleration phase

It begins with cervical dilatation up to 8 cm and ends with full dilatation. If contractions occur during the first birth, then the third phase lasts 40 minutes - 2 hours. In the case of a second birth, there may be no deceleration phase. Uterine contractions last 1 – 1.5 minutes and are repeated every minute.

Based on the above, it is easy to calculate how long labor and childbirth last in general. So, the duration of the 1st period and labor in general for first-time mothers is approximately 10 - 12 hours. At repeated births this distance is reduced to 6 – 8 hours. If the duration of labor exceeds the specified norms, they speak of protracted labor.

When is it time to go to the hospital?

If contractions start before childbirth, when to go to the maternity hospital? As often happens, especially among first-time mothers, they arrive at the maternity hospital either too early (which makes the woman in labor very nervous) or late. To avoid this or that situation, let’s decide when it’s time to call ambulance.

It is quite simple to understand that contractions have begun, especially in the case of the first birth. Uterine contractions are characterized by regularity, that is, they are repeated every 10 minutes, and then the interval between contractions slowly but surely begins to shorten to 7, then to 5 minutes, and so on. Since this is the first birth, when the woman herself establishes regular contractions with an interval of 5 - 7 minutes, it is time to call the ambulance station. If the birth is repeated, then the regularity of contractions, as a rule, is established almost immediately, and the periods of rest between them decrease quickly. Therefore, it is necessary to call doctors immediately to avoid haste when entering the maternity hospital, when dilation is complete and it’s time to go to the birth table. The risk of so-called road births also increases (especially in big cities, where travel is often difficult due to traffic jams).

In addition, it is necessary to call an ambulance immediately in the following cases:

• discharge of amniotic fluid (this often happens in a dream, the woman wakes up in a wet bed and thinks with horror that she has wet herself);
• suspicion of rupture of water (a light, odorless liquid is leaking or suspicious watery discharge has appeared);
• appeared bloody, with clots or without dark or scarlet discharge (placental abruption cannot be ruled out).

The onset of labor and the appearance of regular contractions makes the woman and her family fuss and get nervous. Therefore, it is necessary to pack your bag for the maternity hospital in advance, according to a previously compiled list, so that in the rush and bustle you do not forget something important. Before the ambulance arrives, the expectant mother, as well as her relatives, should calm down and tune in to a favorable outcome. important event(sometimes the ambulance team does not know who to assist first: the woman in labor - to accompany her into the car or her excited relatives).

How to relieve labor pain

It cannot be said that the pain of childbirth is so unbearable that it is easier to die than to survive it. I repeat, if you believe the stories of friends and relatives, it was so hard and bad for all of them during the contractions, the pain was so unbearable that they decided to relive it again, giving birth to a second or third child. Did you smile? This means that the devil is not as terrible as he is painted. Everything in this life can be experienced, and childbirth is a natural process and is inherent in nature. To reassure expectant mothers, I would like to bring one more known fact: Men could not bear the pain that a woman experiences during labor. What does this mean? This only confirms that women are much stronger and more resilient than men, therefore nature gave women, not men, the opportunity to bear and give birth to a child.

Undoubtedly, pain to one degree or another will accompany contractions, but there is not always a need for drug pain relief, and does your unborn baby need it? There are a number of recommendations, following which the pain during contractions, if not disappear, will at least decrease.

How to relieve pain during childbirth:

Psychoprophylactic preparation

Such preparation begins in the second half of pregnancy. During classes at the “school of mothers”, doctors and midwives cover in detail the entire process of childbirth, from A to Z, answer questions and tell you how to behave in each stage of labor, how to breathe correctly and how you can help yourself during contractions to ease them . Women's main fears originate in ignorance of the process, what to expect and how to behave in a given situation. Good psychoprophylactic preparation will not only eliminate the gap in knowledge of the birth process, but will also set the expectant mother up for a successful outcome of childbirth and for the happy anticipation of meeting her child.

"Cast out demons"

By demons we mean fears of the upcoming birth. You shouldn’t relive the upcoming process in your soul again and again, stress yourself out and think about the pain, how to survive it, or about possible complications. Otherwise it is formed vicious circle: the more you are afraid, the more likely to occur complications and severe pain during contractions. Remember that all thoughts are material, to put it scientifically, negative emotions “give an instruction” to the brain, and it will try to bring this attitude to life. One should await childbirth not with fear, but with joy, because for so many long months a woman has carried a baby under her heart, how she wants to meet him and get to know him as soon as possible.

Warm water

If contractions begin at home and time allows, it is recommended to take a warm but hot bath (provided that the amniotic fluid has not broken). Warm water will help you relax as much as possible and relieve tension in the uterine muscle, contractions will become softer, and the opening of the cervix will accelerate. If your water has broken, you can take a warm shower. In the maternity hospital, upon admission, the woman in labor is also sent to the shower, where she can stand under the warm streams for her own pleasure.

Maximum relaxation

If contractions start at home and there are long breaks between them, you need to ensure comfort and relaxation. You can listen to pleasant music, watch your favorite movie, calmly drink tea (if you don’t have to) and even take a nap. The first period, especially for first-time mothers, is quite long, so the woman needs to gain strength and energy for childbirth.

Active behavior

Active behavior during contractions means walking and taking comfortable positions at the time of uterine contraction. Not so long ago, a woman in labor was prescribed to be in a horizontal position during the first period. To date, it has been proven that movement in a vertical position forces the dilation of the cervix (the presenting part presses on the cervix), and facilitates contractions. You can rock your pelvis, dance, or make circular movements with your hips.

Massage

The first stage of childbirth is the time for Sami massage. You can perform the massage yourself, but it is better to entrust this task to your husband (if he is present at the birth). You can stroke your stomach with light movements during contractions (but only clockwise). It is also allowed to massage the lower back and sacrum, press with fists on points on the sides of the spine in the lumbar region and apply pressure thumbs in the places of the anterior superior pelvic spines (they are easy to identify - the parts of the pelvis that protrude the most from the front).

Correct posture

At the moment of contraction, the woman in labor takes the most comfortable position for her. This can be tilting the body forward with emphasis on the wall or headboard (as an option - the husband), while the legs are spread shoulder-width apart. You can stand on all fours or squat down; it is also convenient to raise one leg, placing it on a chair, leaning on a wall (bed, window sill). Many maternity hospitals today have special large balls on which you can jump during uterine contractions or lie down. When choosing and adopting a comfortable position, it is important not to forget about proper breathing.

Breathe correctly

Proper breathing will not only reduce pain during contractions, but will also provide maximum oxygen flow to the fetus. It is not recommended to scream during contractions. Firstly, when screaming, breathing is held, which means that oxygen does not reach the child. Secondly, screaming consumes a lot of energy, which will still be needed during the pushing period. And thirdly, by screaming you simply scare the child (yes, he thinks that if the mother is screaming, then everything is not all right).

Let's get distracted

Helps relieve pain or at least forget about various distractions. You can read poetry or sing songs, repeat the multiplication tables out loud, or perform simple arithmetic operations.

Trust in the doctor

Another important point that affects the intensity of pain in the first period is trust in the doctor. If you don’t like the doctor for some reason or you instinctively don’t trust him, ask to change the obstetrician. But the best option is a preliminary agreement with the doctor who will deliver the baby.

Case Study

I observed a young primigravida woman. Somehow I won her trust, and she decided that I should deliver the baby. And then one day, on a weekend, early in the morning the doorbell rang. I open it and see this woman who says that she started having contractions and she came to pick me up to take me to the maternity hospital. She did not come alone, of course, with her husband. I asked how long ago it started and is it tolerable so far? She replied that it was tolerable, the contractions had been going on for about 4 hours, the water had not broken. Well, since this is the case, there is no hurry, we drank tea, talked and laughed, and slowly went to the maternity hospital (the hospital can be seen from the window of my house). When the woman in labor was registered, the sizes of the abdomen and pelvis were measured (the pelvis, by the way, turned out to be normal), I determined the position of the fetus and its presentation, listened to the heartbeat and invited the woman to the gynecological chair. During the examination, it turned out that the opening of the uterine pharynx was complete, the head was already on its way to exit the pelvis. About an hour later we gave birth to a healthy, full-term baby boy.

To summarize, I would like to note why the woman did not experience pain, but only minor discomfort during contractions:

1. sufficient pelvic size and medium-sized fetus;
2. a positive attitude towards childbirth and its successful completion;
3. husband support;
4. unlimited trust in the doctor.

Correct breathing

Proper breathing during childbirth and labor not only relieves pain, but also helps the mother in labor relax as much as possible, provides the body of both mother and fetus with oxygen, and promotes the opening of the uterine pharynx. Unfortunately, many women approach the need to learn proper breathing with a fair amount of skepticism, not believing in its “miraculous” capabilities, but in vain. How to breathe correctly during labor and childbirth is taught at the “school of mothers”, at 30–32 weeks. It is necessary to master the breathing technique so that all movements are performed automatically, this will make the process of childbirth easier in the future.

Breathing technique

How to breathe correctly depends on the strength of the contractions and their phase. It is important to follow the rule: the longer and more intense the contractions, the faster the breathing. Correct breathing techniques:

Breathe deeply and slowly

This method of breathing is recommended in the latent phase of contractions, when they do not yet cause pain, but only bring discomfort. We inhale short and fast, and exhale slowly and long. You need to inhale through your nose and exhale through your mouth, with your lips stretched out like a tube. It is recommended to count while breathing: while inhaling, count to 3, while exhaling, count to 5.

Candle technique

As soon as the contractions gain strength and become longer, we breathe frequently and shallowly. We inhale through our nose, exhale through our mouth with elongated lips. We breathe so often and not deeply, as if we were blowing out a candle. Towards the end of the contraction, you can return to deep, slow breathing. The slight dizziness that appears after this breathing technique is due to hyperventilation of the lungs. Also, frequent shallow breathing promotes the release of endorphins (“joy hormones”), which reduce pain.

Big candle technique

By the end of the first stage of labor, we switch to the “big candle” technique. We breathe with effort, inhaling as if through a stuffy nose, and exhaling through almost closed lips.

Breathing in case of early attempts

When the cervix is ​​not fully dilated and the head begins to descend, early attempts occur, which are contraindicated and can cause cervical ruptures. In this case, it is recommended to change the position of the body (stand up or squat), at the beginning of the contraction breathe a “candle” (superficially and often), then inhale briefly and repeat the “candle”. Breathe in this manner until the end of the contraction. In the intervals between uterine contractions, we breathe freely.

“Doggy” technique

We breathe frequently and shallowly, but keep our mouth open (we inhale and exhale through our mouth).

Breathing while pushing

At the beginning of the attempt, we inhale as deeply as possible and push into the perineum, trying to push the baby out. Avoid pushing on the face (otherwise, retinal blood vessels will rupture and headaches will occur). During the contraction you need to push three times. As soon as the head is born, we stop pushing and breathe “like a dog.” After the command, the pushing is resumed, during which the baby is born.

By contractions after childbirth, women mean contractions in the afterbirth period. After the birth of a child, it is necessary to give birth to an afterbirth. When the afterbirth has separated from the uterine walls, the pain resumes, but not as intense as in the first period. In this case it is not required special effort, just push slightly and the “baby spot” comes out of the uterus.

Women await the birth of their baby not only with trepidation, but also with anxiety. Many are afraid of the pain they will have to experience, others fear for their health and the health of the child. There are also those who are afraid of missing the onset of labor. This is especially true for first-time mothers who do not know how contractions begin. A number of signs will help a woman not to confuse training contractions of the uterus with labor.

1. Latent or hidden period.
2. Active period.
3. Slowdown period.

The most important thing for first-time women is to be able to distinguish the sensations during labor contractions from the sensations during false ones, the symptoms of which are in many ways similar to the latent period of contractions.

They are also called training ones. They occur mainly in first-time mothers from about the 20th week of pregnancy and help the body prepare for childbirth, they also “train” the uterus: making it more elastic and soft. They last on average up to 2 minutes, the interval between them is variable, ranging from 30 minutes to an hour.

There are a number of signs that distinguish training contractions:

• irregular nature;
• contractions do not increase or intensify;
• the interval between them is always different;
• the uterine pharynx does not open (this will be determined by the gynecologist).

Training contractions of the uterus sometimes seem quite strong, but they are not cramping, but are more of an aching, pulling nature. You can easily cope with them if you take a different position, just lie down, take a warm bath, and relax.

Real contractions

A more common name is generic. They are difficult to confuse with other conditions, and women who are going to give birth for the first time easily recognize them. Signs by which you can determine how contractions begin in first-time mothers:

1. Labor contractions of the uterus begin, as a rule, with aching pain in the lower abdomen, lower back, hips, which intensifies over time and has a wave-like character: it either subsides or returns. These pains are often compared to menstrual pain, but during contractions they are regular and increasing in nature, and the intervals between them become shorter every hour. Such contractions do not stop, do not calm down, but only intensify.
2. The uterus tenses, a so-called tone occurs, which can be easily felt by placing your hand on your stomach. The uterus turns to stone, becomes hard, and there is a feeling that it is shrinking and straining. After a while, when the contraction loses its intensity, the uterus relaxes again. Each time the pain and tone intensify. During training contractions, the tone of the uterus is noticeable to a lesser extent.
3. The duration of uterine contractions increases, and the intervals between them become smaller each time. The cervix dilates.

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

Important: If the water breaks at the initial stage of labor, then you need to call an ambulance immediately, since during the waterless period there is a high risk of fetal initiation.

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

Video: How to distinguish pushing from contractions

General differences between training contractions of the uterus and labor contractions

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

When preparing a pregnant woman for childbirth, doctors advise that when she feels contractions of the uterus, write them down: the time when they began and when they ended, after what time the next ones appeared and how long they lasted, whether the pain increases each time or, conversely, subsides. It is advisable to make recordings accurate to the second. Using them, the doctor testifies whether these are false contractions or labor. It is possible to clarify this even by phone if there was an agreement in advance.

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

Worth remembering: During training contractions, the active phase does not occur, that is, the pain does not intensify, their duration does not change, the interval between them fluctuates (usually upward).

Training contractions of the uterus rarely last more than 2-3 hours.

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

What to pay attention to

Many not only multiparous women, but also primiparous women do not feel the preparatory period. The trained uterus of multiparous women does not need “preparation”, moving directly to active contractions. This is why many women who give birth to their second and subsequent babies experience so-called rapid labor, lasting only 4-6 hours.

Primiparas, accustomed to training contractions, often do not pay attention to the first “bells”, skip the latent phase and understand that labor has begun only when the pain intensifies, the stomach “turns to stone”, and the interval between contractions significantly decreases. There is no need to panic, because this is exactly the period when doctors advise going to the maternity hospital. The second phase of contractions lasts up to 5 hours, so there will be enough time.

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

If there are no contractions

Sometimes a primigravida woman does not wait for labor contractions of the uterus. The absence of contractions before 40-42 weeks is considered normal, if hypoxia is not registered in the fetus, the placenta is in normal condition and the pregnancy as a whole is not in danger. As a rule, from the 40th week of pregnancy, a woman is placed in a hospital and there, under the supervision of doctors, she waits for the onset of labor.

If there are no contractions at 42 weeks, labor is induced. In case of conditions that threaten the health of the woman or the unborn child, a decision is made on surgical delivery.

Contractions are what any pregnant woman expects. It is important to understand when they start, what they are and how to properly prepare for them.

A pregnant woman must be prepared for this issue and know what to do when contractions occur.

Contractions- This is a rhythmic, uncontrolled contraction of the muscles of the uterus, which is regular. During contractions, the uterine os opens and the fetus moves through the birth canal. A woman cannot control the beginning and end of contractions. It feels like during contractions there is a stiffening of the abdomen with a high probability of pain syndromes.

• Contractions are the first and longest of the three stages of labor. At this time, the cervix dilates. The second period is pushing, which results in the birth of a child. And the third is the release of the placenta (departure of the placenta).
• Contractions get this name because they lead to a sharp contraction of the abdomen. It feels like you've been grabbed. The compression is localized in the area of ​​the hip joints.

In the process of contractions, the baby’s pituitary gland and placenta are involved. They lead to the appearance of such sensations due to the release of special substances that contribute to the opening of the uterine pharynx.

During contractions, the uterus contracts, its fibers thicken, due to which the pharynx opens to the width necessary for the passage of the fetus.

Full dilatation occurs at 12 cm. At this time, intrauterine pressure increases, leading to rupture of the amniotic sac and loss of water.

Types of contractions

In addition to real contractions, a woman during pregnancy can also feel false (training) contractions. They are also called Braxton-Hicks contractions. It is important to be able to distinguish between them so as not to panic and not go to the maternity hospital ahead of time.

What is the difference between false contractions and real ones?

• Training contractions begin at 20 weeks of pregnancy. They prepare the uterus for childbirth, making it softer and more elastic.
• The duration is about 2 minutes with intervals of 30 minutes to an hour.
• They have a chaotic irregular nature of varying duration and interval.
• Doesn't get stronger over time.
• During such contractions, the uterus does not open. This is determined by the gynecologist.
• During the normal course of pregnancy, pregnancy occurs without discharge.
• Disappears when changing occupation, after a warm shower.

Real contractions or labor contractions have a number of specific signs:

• Accompanied by aching pain in the lower abdomen and lower back. They have a wavy character. They do not weaken over time, but intensify. The duration of the contraction is 20-30 seconds with an interval of 20-30 minutes.
• The uterus tenses and becomes toned. The stomach becomes hard to the touch. When the contraction subsides, the uterus relaxes, but with the next wave it turns to stone again.
• The duration of uterine contractions increases, and the interval between them decreases. Contractions last about 45 seconds with breaks of 5-6 minutes.
• Real contractions may be accompanied by bleeding.
• The opening of the uterus occurs.

When contractions start

There are certain physiological signs (so-called precursors) by which one can judge the imminent onset of labor pains:

• Stomach sinks. The fetus turns over in the womb, taking a position upside down and resting on the pelvic floor. As a rule, this happens 1-3 weeks before birth. The woman begins to breathe better, but numbness appears in the pelvis and the urge to urinate becomes more frequent.
• The mucus plug comes off. The plug may come out completely or in parts. It looks like a cloudy yellowish-brown mucus. May contain reddish or brownish veins. Departure occurs both one to two weeks before birth and an hour before it.
• The baby begins to move less, since he is already cramped in the womb.
• The pelvic bones expand. A woman may feel nagging pain in the lower back.
• Leaking or leaking amniotic fluid. In the first case, the amount of watery discharge increases. And in the second, a sufficiently large amount of liquid is poured out, which is difficult not to notice.
• Cervical dilatation. If the pharynx is dilated by 2-3 cm, it means that labor will begin in the next few days or hours. The degree of dilation is determined by the doctor during examination.

During the first pregnancy, a woman may intuitively feel that labor will begin soon. This is caused by discomfort in the abdominal area.

This phase is called latent and in some women it can go unnoticed.

If you are 38 weeks or more pregnant, you can understand that contractions are no longer training in nature, first of all, by the fact that they cannot be weakened by changing position or a warm bath.

In first-time mothers, contractions resemble pain during menstruation. The process is identical. But in the first case, the pain becomes not just aching, but girdling and cramp-like.

How long do contractions last?

The duration of contractions in firstborns is usually 8-10 hours before the start of pushing. This gives time to get ready and come to the maternity hospital.

Of course, it is better not to delay going to the hospital, since the birth process is individual for everyone, and it would be prudent to get to the maternity hospital under the supervision of obstetricians as quickly as possible.

In multiparous women, the duration of contractions is slightly shorter, about 6 hours.

If all signs point to labor pains, but the pregnancy is less than 38 weeks, you should immediately call an ambulance and go to the hospital to avoid fetal hypoxia or pregnancy fading. You should also see a doctor if you experience chills, headaches, eye pain, or spotting.

What to do if contractions start?

If you determine that contractions are not training in nature, but are the first stage of the birth process, you need to record the duration of contractions and the interval between them.

At this time, it is better to stop all your household chores, rest and save the strength that you will need for the period of pushing. You can lie down, sit, walk around.

When the interval between contractions reaches 5-6 minutes, the pregnant woman needs to go to the maternity hospital.

When the contraction lasts 1-2 minutes, and the break between them is reduced to 1 minute, the woman in labor should already be in the maternity hospital, because this indicates complete opening of the uterine os and the imminent start of pushing.

• The most important thing is to remain calm. The expectant mother should try to relax as much as possible and think about the good, and not succumb to panic attacks and worries.
• It is important to breathe correctly, this eases the pain during contractions. Breathing must be kept even and deep.
• Soreness does not appear in the uterus itself, but in the muscles surrounding it. You need to learn how to relax them correctly to create favorable conditions during childbirth.
• The appearance of pain during contractions is largely due to nervous tension and anxiety. This is especially true for first-time mothers.
• You need to try to pull yourself together, because childbirth is a natural process that every woman goes through.

If contractions don't come

There are cases when pregnant women do not experience contractions even after 40-42 weeks. In this case, the pregnant woman is placed in a hospital, where she awaits the start of labor under the supervision of doctors.

Doctors monitor the condition of the baby in the womb, its heartbeat, motor activity.

If contractions don't come naturally after 42 weeks of pregnancy or there is a threat to the health or life of the baby, doctors decide to induce labor. To do this, a special drug is administered to stimulate uterine contractions.

In some cases, a decision is made to undergo surgical delivery.

However, in most cases, childbirth proceeds normally, so there is no need to allow yourself to have negative thoughts.

How to relieve pain from contractions?

Simple tips can provide real help while waiting for your baby to arrive soon.

• First of all, the psychological attitude is important. Primiparas who are faced with new sensations for the first time, as a rule, experience more than women who give birth again. A connection has been established between nervous tension and the degree of pain during childbirth. It is important to set yourself up positively, to understand that your goal is to give your child life, and for this you can endure a little. You need to remember that your restless state is passed on to the baby; shortness of breath can lead to oxygen starvation of the fetus. And he still has a hard day ahead - the birth from his mother’s cozy tummy.
• Proper breathing will help relieve wave-like pain during contractions. You need to abstract from extraneous thoughts and make sure that it is deep and even. You need to inhale through your nose and exhale through your mouth. This will speed up the opening of the uterus.
• Before the contraction begins, take a position that is comfortable for you. Try to find a suitable position until you feel less pain during contractions.
• Massage can help cope with soreness. It is necessary to massage the ischial bones with circular movements of the hand, and the area near the tailbone with a clenched palm. If your husband or mother is with you in the delivery room, they will help you with this procedure.
• Also, the so-called deception of the brain helps many people cope with pain. During an attack, try to switch your thoughts to something pleasant or calculate some kind of logical chain.

Conclusion

Understanding all the physiological processes during childbirth will help you accurately recognize the onset of real contractions and not confuse them with training ones, calm your nerves and gain confidence in the positive course of the birth process.

Knowing some simple tricks to relieve pain during contractions will help you control the process and save energy.

Pregnancy is coming to an end, and childbirth, no matter how scary it sounds for the expectant mother, is inevitable. However, the main frightening factor for women is not the birth itself, but the contractions during childbirth. Stories from grandmothers, mothers and friends about how difficult it was to cope with the pain during labor only make the situation worse.

In such cases, there is only one piece of advice: listen less to others, because each organism is individual, so any processes in it proceed differently. Some people can easily cope with the pain, while others lose consciousness with a slight injection. Therefore, in order to cope with fears, you should study the birth process and learn how to breathe correctly during childbirth.

Childbirth and its periods

Childbirth is a complex physiological process that completes the period of pregnancy. Depending on what stage of gestation the birth occurred, there are premature birth(up to 36 weeks), term birth that occurred at term (38-41 weeks), and late birth (42 weeks). The birth process itself is divided into three periods:

the period of contractions or the period of opening of the uterus;

period of expulsion - withdrawal of the fetus (birth of a child);

succession period - removal of the birth place.

The longest period is the period of cervical dilatation. At this time, contractions and accompanying pain are present. Most women consider the period of expulsion of the fetus to be childbirth, but normally this process lasts 5-10 minutes and is characterized by attempts that follow from contractions. Thus, the fetus is pushed out of the uterus. The birth of the placenta is also a short stage and lasts about 5-15 minutes, with a maximum of 30 minutes. From the above it follows that childbirth is not only the process of expulsion of the fetus, but also a period of contractions with the discharge of amniotic fluid and the birth of a child’s place (placenta).

Contractions

Contractions are involuntary uterine contractions that occur due to the muscle layer of the organ. They occur regularly and are required for the advancement of the fetus from the uterus. Contractions are divided into true and false.

A pregnant woman begins to experience contractions before childbirth (false contractions) several weeks before the birth of the child. For the first time, such uterine contractions are recorded after 24 weeks. They are distinguished by their short duration (from several seconds to a minute), irregularity, the interval between shocks ranges from 10-15 minutes to 2 hours. False contractions that occur at the final stage of gestation indicate that labor is imminent. Such uterine contractions are also called training contractions, since thanks to them the woman’s body prepares for the upcoming work of the uterus during childbirth.

True contractions are the starting point of labor. It is impossible to let them in or not notice them; such an opinion and fear is inherent in women who give birth for the first time. Firstly, the onset of labor is indicated by the harbingers of the process, special meaning has discharge of the mucus plug (usually 3-7 days before the onset of labor). Secondly, amniotic fluid may leak. Thirdly, contractions have characteristic parameters, knowing about which it is difficult to doubt the onset of labor, even if they are the first for a woman.

Contractions are required for the opening of the uterus to occur, since the baby’s head will first pass through it, and then the torso and limbs. The uterine os is the internal and external os of the cervical canal. During the normal course of labor, the uterine os is in a closed state and can allow a maximum of the tip of the finger to pass through. During the birth process, to facilitate the passage of the baby, it opens up to 10-12 centimeters. This disclosure is called complete.

In addition, during the birth process, contractions ensure the movement of the fetus along planes in the pelvis. When the cervix is ​​fully dilated and the fetal head passes the bony ring of the pelvis and reaches the pelvic floor (vagina), pushing occurs, which indicates the beginning of the next stage of the birth process. Contractions and pushing are the forces that expel fetuses, without which the process of childbirth is impossible.

How to recognize contractions

As mentioned earlier, contractions cannot be missed, even if the woman is giving birth for the first time. However, one should not trust films where such situations quite often occur: a woman is in the last stages of pregnancy and suddenly, without the slightest prerequisites, labor occurs, which ends after a couple of hours, and she is already happy mom. Yes, such situations cannot be completely excluded, but they refer to rapid labor, lasting no more than 4 hours for first-time women. If it is the second birth, two or less hours pass from the start of uterine contractions until the birth of the baby.

True contractions begin (in the normal course) gradually and gradually increase, and the interval between contractions decreases. In order to understand that contractions have begun, you need to listen to yourself. The sensations can be quite varied. Some compare uterine contractions to pain during menstruation, for others it is a pulling or nagging pain in the abdomen that spreads to the lumbar region, which eventually becomes girdling. True contractions are the beginning of labor. In order to recognize labor contractions, you need to know their characteristics:

pain increases systematically (gradually);

contractions are always regular with breaks for certain periods of time;

the duration of uterine contractions gradually increases, while the interval between contractions decreases.

Another sensation that most expectant mothers describe during labor is “petrification of the uterus” (especially if the pain is not very bothersome). This condition is easily determined by palpation. With the onset of contractions, the uterus contracts and hardens, and towards the end of the birth process it gradually relaxes.

Duration of contractions

At the initial stage of labor, each contraction of the uterus lasts 10-15 seconds; as we move towards the second stage of labor, the duration of contractions is 60-90 seconds. The breaks between contractions are initially 10-15 minutes; as the process progresses, the intervals become shorter. During the pushing period, the break is 90-120 seconds, and in some cases even 60 seconds.

Phases of contractions

Considering that the dilation of the cervix occurs unevenly and the fetus moves along the bone ring at different speeds, the period of contractions is usually divided into three separate phases:

The first, or latent phase.

The beginning of the phase coincides in time with the establishment of regular uterine contractions, and the end of the phase is reflected in the smoothing of the cervix and its opening to a diameter of 3-4 centimeters. The duration of uterine contractions in this phase is 20-45 seconds, and the intervals between contractions last about 15 minutes, the duration of the phase itself is about 6 hours. This phase is usually called latent (hidden), since at this stage the pain is either mild or absent altogether, and accordingly, drug pain relief is not required.

Second, or active phase.

Immediately after the cervix dilates to 4 centimeters, the active phase enters into force. This phase is characterized by rapid dilatation of the cervix and intense labor. It lasts about 3-4 hours, while the duration of contractions increases to 60 seconds, and the intervals shorten to 2-4 minutes. If the cervix has reached dilatation to a diameter of 8 centimeters, and amniotic sac remains intact, then a timely amniotomy (opening of the amniotic sac) should be performed.

Third phase (deceleration phase).

It comes into force when the opening of the uterine pharynx reaches 8 centimeters in diameter, and ends with its maximum opening. If contractions are present during the first birth, the duration of the third phase ranges from 40 minutes to 2 hours. If this is the woman’s second birth, then the deceleration phase may be absent altogether. Uterine contractions last 60-90 seconds, and the period between repetitions is 1 minute.

Based on the information above, it is easy to calculate the total duration of contractions, as well as labor in general. Thus, the duration of the first stage of labor for primiparous women generally ranges from 10 to 12 hours. If the birth is repeated, then the distance of the first period is reduced to 6-8 hours. If the duration of the first stage of labor exceeds the specified time, one should speak of protracted labor.

When should you go to the hospital?

Many people are interested in the question: “When should I go to the maternity hospital after contractions start?” Quite often, especially if the first birth is planned, women arrive at the maternity hospital too early (which causes excessive nervousness of the mother in labor), or, conversely, are late. In order to avoid such situations, you should determine when it is time to call an ambulance.

It is quite simple to understand that contractions have begun, especially during the first birth. Uterine contractions become regular, and the interval between contractions reaches 10 minutes, gradually it begins to decrease, first to 7 minutes, then to 5 and beyond. When the woman herself determines that the period between contractions is within 5-7 minutes, she should call an ambulance. With repeated births, the regularity of contractions is established almost immediately, and the intervals between contractions quickly decrease. Accordingly, you should call a doctor right away in order to avoid rushing to enter the maternity hospital, when, with the cervix fully dilated, you only need to be on the birth table once you arrive. In such cases, the likelihood of road births also increases (this problem is especially relevant for large cities with difficult traffic (“traffic jams”)).

In addition, you should immediately contact an ambulance in the following cases:

discharge of amniotic fluid (very often this happens in a dream, and the woman, waking up, thinks that she wet herself);

suspicion of rupture of amniotic fluid (light liquid begins to leak, or light, rather liquid, odorless discharge appears);

bloody discharge with clots, scarlet or dark in color, appeared (placental abruption probably occurred).

The onset of labor with regular contractions makes not only the woman, but also her family nervous and fussy. Thus, the bag required for admission to the maternity hospital must be collected in advance, according to the existing list, so as not to miss something important in a hurry. Before the ambulance arrives, relatives should support the expectant mother psychologically and set her up for a positive outcome of the event (quite often, after the ambulance arrives, the doctor does not know who to help first, the woman in labor or her semi-fainting relatives).

Relief of labor pain

It cannot be said that the pain of childbirth is so unbearable that it would be easier to die than to survive it. We repeat once again, believe the stories of loved ones about how unbearable and painful it was for them during childbirth, that almost every second of them gave birth to another or more children. So it wasn't that hard. Every woman in her life must go through this natural process, because this is the only way to become a happy mother.

Undoubtedly, soreness and sometimes intense pain will accompany the process of contractions and expulsion of the fetus. Yes, you can relieve pain with medications, but does the unborn child need it? In addition, there are a number of techniques and recommendations that can be used to significantly reduce pain during contractions or even disappear altogether.

How to relieve labor pain?

Psychoprophylactic preparation.

Such preparation begins in the second half of pregnancy. During classes in antenatal clinic(the so-called “school of mothers”), midwives and a doctor explain in detail the entire process of childbirth and answer questions that interest expectant mothers. The algorithm of behavior at each stage of labor is explained, as well as the technique of proper breathing to ease contractions and relieve pain. The main fears of women come from ignorance of the process itself and lack of information about how to behave correctly in a given situation. Competent psychoprophylactic preparation not only eliminates gaps in understanding childbirth, but also sets the pregnant woman up for a positive outcome and meeting her unborn child.

Let's abstract ourselves from fears.

There is no need to constantly replay the upcoming birth process in your head and worry about possible pain, or think about how to survive possible complications. If this is not stopped, a vicious circle is formed in which more woman worries and is afraid, the greater the likelihood of complications arising against the background of nervous tension. You should expect childbirth not with fear, but with joyful feelings; after carrying a baby for such a long time under your heart, you have the opportunity to see him and hold him to your breast.

Warm water.

If contractions appear at home and time allows, then doctors recommend taking a warm, but under no circumstances hot, bath (only if the amniotic fluid has not broken). A warm water bath promotes maximum relaxation and relieves tension in the uterine muscles, which leads to softer contractions and faster dilatation of the cervix. If your water has already broken, you can take a warm shower. In the maternity hospital, the arriving woman in labor is also sent to the shower, where she can relax under the streams of warm water.

Maximum relaxation.

If contractions occur at home, long breaks between them should be spent in a state of maximum comfort and relaxation. You can turn on your favorite music, calmly drink tea (only if you don’t have a caesarean section), watch your favorite show. The first stage of labor is very long (especially for first-time women), so it should be used to gain energy and strength for the upcoming active labor.

Active behavior.

Active behavior during uterine contractions is taking comfortable positions and walking during contractions. More recently, in obstetric practice, there were recommendations according to which a woman in the first period should be exclusively in a horizontal position, but today it has been proven that the vertical position only accelerates the favorable dilatation of the cervix and significantly facilitates the process of contractions. You can also make circular movements with your hips or sway your pelvis and dance.

Massage.

The first stage of labor is most suitable for massage. You can perform self-massage, but it is better to involve your husband in this process. You can stroke your stomach with light circular movements (clockwise). It is also allowed to massage the sacrum and lower back, pressing with fists on the sides of the spine and thumbs in the area of ​​the anterior upper spines of the pelvic girdle (they are easily identified, since the bones protrude most here).

Correct posture.

During contractions, the expectant mother should take the most comfortable position for herself. You can lean forward and lean against the headboard or wall, while spreading your legs shoulder-width apart. You can squat down or get on all fours; in some cases, lifting one leg also helps; alternatively, you can put it on a chair and lean against the wall. Many maternity hospitals are equipped with special huge balls that are comfortable to lie on or jump on during uterine contractions. The main thing when taking a comfortable position is not to forget about proper breathing techniques.

Let's breathe correctly.

As mentioned above, proper breathing not only helps reduce pain during contractions, but also maximally saturates the fetus with oxygen. It is not advisable to scream during contractions, because, firstly, during screaming, breathing is held, and accordingly, the fetus does not receive oxygen. Secondly, screaming requires a lot of energy, which is useful during pushing. Thirdly, the child is simply scared, because if the mother screams, then something is wrong.

Let's get distracted.

Various distractions help you forget about pain or relieve it. You can sing songs or read poetry, do arithmetic calculations out loud, or repeat the multiplication tables.

Trust in the doctor.

An important point for influencing the intensity of painful sensations is trust in the attending physician. If the doctor makes the woman in labor worry for any reason, you should ask the obstetrician to replace the doctor. However the best option is an advance agreement with the doctor whom the woman in labor wants to see in the role of delivering the child.

Correct breathing

Proper breathing during labor and childbirth not only alleviates painful sensations, but also relaxes the body as much as possible, saturates the body of the fetus and the expectant mother with oxygen, and promotes the rapid opening of the uterine pharynx. Unfortunately, a significant number of expectant mothers are skeptical about learning the technique of proper breathing, not believing in the “miraculous” possibilities of such a simple matter as breathing, and, as practice shows, they then complain about their skepticism in this matter. Training in correct breathing techniques is carried out in “schools of mothers” (usually at antenatal clinics) for a period of 30-32 weeks. It is necessary to master this technique so that the execution of movements becomes automatic and in the future contributes to easing the course of childbirth.

Breathing technique

Correct breathing primarily depends on the phase and strength of the contraction. It is very important to follow the rule: the more intense and prolonged the contractions, the more often you need to breathe. Correct breathing techniques:

Breathe slowly and deeply.

This breathing technique is recommended for use in the latent phase of contractions, namely during the period when they bring only discomfort and do not cause pain. Inhalation is done quickly and briefly, and exhalation is done as long and slowly as possible. Inhalation should be through the nose, and exhalation through the mouth, while the lips should be folded into a tube. Doctors recommend breathing in counts - when you inhale, count to three, and exhale, counting to five.

“Candle” technique.

As contractions gain strength and contraction duration, you need to start breathing frequently and shallowly. Inhalation is done through the nose, and exhalation is done through the mouth, with the lips “tube”. Breathing should be rapid and shallow, as if trying to extinguish a candle. At the end of the contraction, we return to slow deep breathing. The occurrence of slight dizziness after breathing using the “candle” technique can be explained by hyperventilation of the lungs. In addition, shallow breathing promotes the release of endorphins into the blood, which relieve pain.

“Big candle” technique.

This technique is used after the end of the first stage of labor. Inhalation is carried out with effort (as with a stuffy nose), and exhalation is carried out through almost closed lips.

Breathing during early attempts.

When the cervix is ​​not yet fully dilated and the head begins to descend, early attempts appear, which are contraindicated because they can cause cervical rupture. In such cases, it is necessary to change the position of the body (squat down or stand up), at the beginning of the contraction you need to breathe using the candle technique, then inhale briefly and repeat the “candle” again. You should breathe at this pace until the contraction ends. It is recommended to breathe freely between contractions.

"Dog" technique.

Breathing is shallow and frequent, but the mouth should be open (exhalation and inhalation are done through the mouth).

Breathing while pushing.

Initially, when pushing, we inhale as deeply as possible, and then we push into the perineum, making efforts to push the child out. You should not apply pressure to your face, as this will cause headaches and rupture of blood vessels in the retina. During the contraction you need to push three times. Once the baby's head appears, you should stop pushing and switch to doggie breathing. At the doctor’s command, pushing is resumed, and at this stage the baby is born.

Contractions after childbirth are contractions postpartum period. The fact is that after the baby is born, the baby's place (placenta, placenta) still needs to be delivered. After separation of the placenta from the uterine walls, the pain resumes, however, its intensity is significantly lower than in the first period. In such cases, there is no need for strong pushing; small efforts are enough to release the placenta.