The meeting with the baby is about to take place, and the expectant mother listens more and more carefully to what is happening inside her. How not to miss the decisive moment?
There is a theory that the baby gives the signal for the onset of labor. He has grown up, he is already cramped in the uterus, but the main thing is that the placenta has grown old and does not allow enough oxygen to pass to the child.
At this time in the body expectant mother important changes are taking place. The brain is the first to begin preparing for an important event: inhibition processes intensify in its cortex, and the subcortical structures that regulate labor, on the contrary, work more actively. In addition, the ratio of hormones changes. The level of progesterone, which was responsible for maintaining pregnancy for 9 months, decreases, and estrogen and oxytocin, hormones that prepare the uterus for childbirth, increase. Under the influence of estrogen, the cervix softens and shortens, and when prostaglandins and oxytocin come into play, the uterus begins to contract regularly. There are other, quite tangible signs that foreshadow an imminent meeting with the baby.
First hints
3 weeks before giving birth, the expectant mother appears characteristic gait , which some poetically minded people call “proud gait.” It appears because the center of gravity of a pregnant woman shifts and her head and shoulders lean back slightly. Since this makes the body less stable, the expectant mother should be careful.
And 2 weeks before giving birth to a woman it becomes easier to breathe, because the baby’s head descends to the very entrance to the pelvis. You can find out that this has happened by another sign: a palm can already be placed freely between the upper part of the abdomen and the edge of the ribs. However, at the same time, new inconveniences may appear: some women have difficulty bringing their hips together, which means they have problems walking, while others have to visit the toilet more often to empty their bladder, since the baby’s head puts pressure on this organ.
Around the same time, they may appear weak irregular contractions. They are called "false" or "training" because they do not dilate the cervix. Typically, such contractions last for several hours or days in a row, after which they pass. It happens that the expectant mother is brought to the maternity hospital with them. To avoid mistakes, doctors will observe for a while and send the pregnant woman home. If false contractions prevent you from falling asleep or make you very tired, they are relieved with special medications.
1–2 weeks before birth the baby is no longer moving as actively, because he has grown up and is cramped in his mother’s belly. The baby can no longer swim freely in the amniotic fluid and spin from side to side. He sits for a long time in one position, straightening one arm and one leg in turn.
Sometimes a few days before giving birth woman losing weight. Weight loss can be up to 2 kg. One of the reasons is a sharp decrease in the level of progesterone, which retains fluid in the body.
Don't ignore these signals. Just in case, do not go far from home, take documents with you and prepare things that will be useful for you and your baby during your stay in the maternity hospital. Place your things in a bag and keep it in a visible place so that when X hour comes, you don’t waste time getting ready.
Urgent action needed
Regardless of the stage of pregnancy, it is imperative to call an ambulance when:
regular contractions began;
there was blood discharge from the vagina;
amniotic fluid has leaked;
the child does not move for a long time;
Floaters flash before my eyes, my head hurts, and there is heaviness in my stomach.
Waiting it out at home
About 6 hours before birth, the so-called preliminary, or preparatory, period begins - the moment of final preparation of the cervix for an important event. He is accompanied nagging or cramping pain in the lower abdomen and lower back. Gradually, uterine contractions become more and more regular, during each of them the woman feels how the stomach hardens and changes shape, sharpening forward. The duration of contractions increases, the intervals between them decrease.
6–10 hours before the onset of labor, the vagina may come out mucus plug streaked with blood. She closed the entrance to the cervix to germs from the vagina. When, shortly before childbirth, the cervix dilates, a clot of mucus that has formed inside under the influence of estrogen comes out. This is a signal that the cervix has begun to prepare for the birth of the baby. Nevertheless, what is happening cannot yet be considered as the beginning of labor.
When pregnancy proceeds without complications, you should not go to the maternity hospital with the first contractions. No matter how wonderful the conditions are there, a woman will be more comfortable at home. Observe how often contractions occur. If the interval between them exceeds 7–10 minutes, you can safely do household chores. For example, cooking lunch. During contractions, lean on the kitchen table and try to breathe quickly and shallowly. Take care of yourself: take a shower, wash your hair, remove makeup, remove nail polish and trim them, shave your hair in the bikini area.
Remember: you cannot eat during this period. The stomach must remain empty to avoid vomiting, which sometimes occurs reflexively during dilatation of the cervix.
It's time!
Gradually contractions will intensify and repeat more and more often. It's time to go to the maternity hospital when they continue 20–25 seconds at intervals of 7–10 minutes.
If a woman is expecting the birth of her second or third child, events develop much faster, sometimes even rapidly. In this case, you should go to the maternity hospital as soon as contractions become regular and the interval between them is reduced to 7 minutes.
Another sign that labor has begun is rupture of amniotic fluid. It begins after the rupture of the amniotic sac in which the baby “swims”. Sometimes this happens before labor begins, but it is better for mother and baby if the water leaks out in the midst of labor, when the cervix has already dilated a little. The woman feels a stream of liquid pouring from inside, which, unlike a stream of urine, cannot be stopped by muscle effort. When the water breaks, the baby becomes vulnerable to infections. For this reason, the expectant mother should go to the maternity hospital, even if contractions have not yet begun.
You can go to the maternity hospital by calling “03” and calling an ambulance. But if the expectant mother feels normal, someone close to her, for example the future dad, can take her to the maternity hospital. You shouldn’t get behind the wheel yourself, even if you’re a great driver.
Don't forget to take to the maternity hospital:
- documents - passport, policy health insurance(mandatory or voluntary), exchange card, birth certificate;
- things - washable slippers, bottle mineral water, mobile phone, notepad, pen, favorite book, magazines, player with headphones or tablet (listen to music or watch a movie to distract yourself during contractions), disposable toilet seat covers, toilet paper, paper handkerchiefs, wet wipes.
Everything else, including supplies for the baby, will be brought by relatives after the birth. You will be given a robe and shirt upon admission to the maternity hospital, but you can bring your own.
Which option is closer to you - go to the maternity hospital in advance or come there with contractions?
10. Training(false) contractions– uterine tone, the uterus is preparing to open. uterus: the stomach sometimes turns to stone, sometimes soft..., and pain is not necessary: there can be either completely painless or painful - pulling sensations, like during menstruation. Training contractions are chaotic, disorderly, without dynamics, with an interval between contractions: sometimes 2 minutes, then 2 hours, then 2 seconds, then 20 minutes... If at this moment we go to the maternity hospital, we can be returned home.
The very first training contractions can begin even before the stomach drops (for me they started 2 weeks before the stomach drops), and have a very long interval: Oops! And they forgot - silence for several days/weeks...
11. Generic contractions dynamic, more enhanced, interval between contractions 20 min. and goes downsizing. Indicates that the opening of the w. the uterus has begun.
By this time, everything for the maternity hospital should be ready. Now you can take care of yourself: sex on the path, take a shower, manicure: cut your nails (it is not necessary to cut them very short, you can leave up to 5 mm) and remove the varnish (coating your nails with transparent varnish is allowed, since doctors determine the color under the nail skin state of a woman in labor), shave, call friends...
12. Labor pains are dynamic, interval between contractions 10-5 min. and continues to decline. About 6-7 hours before birth.
At this moment we call an ambulance, regardless of whether the plug and water have broken or not. We're going to the maternity hospital. If your water still doesn’t break, the bladder will be punctured in the maternity hospital.
The strongest and longest labor contraction lasts 1 minute, all other contractions last a few seconds.
The rate of cervical dilatation is 1 cm (1 finger) per hour, full cervical dilatation is 10-12 cm (10-12 fingers) per 10-12 hours.
The contraction pain begins gradually and increases in an increasing order, from completely painless contractions/then: “Oh!” - and they forgot, to: “God, kill me!” - Not like in the movies, - the woman is quiet, calm..., and then suddenly the whole house: “A-aaaa...”, and it began... After 5 minutes. she’s holding a baby in her arms..., - this doesn’t happen in life !
The peak of contractive pain occurs at the moment when sh. The uterus is already fully dilated to 10-12 cm, and the baby descends into the pelvis. In this case, the pain is accompanied by a strong desire to push. At this moment, you should not push under any circumstances, because this may cause your neck to break through. uterus, also at this moment you should never sit on your butt, as this can damage the baby’s head (you can only sit on your haunches or on a fitball; if you are lying down and want to get up, you need to get up avoiding a sitting position), - the first pushing contractions need to be breathed !
When the baby is completely lowered into the pelvis, the cramping pains go away, the midwife sees the back of the baby’s head without touching you, and you can touch the back of the baby’s head with your hand - from now on you can push... It is important to listen to the midwife in everything!
The first birth lasts approximately 10-12 hours on average. The second – 5-7 hours on average. Third - even faster.
You can go to the maternity hospital in your own car - by gravity. In this case, admission occurs in the order of the general queue and after those who arrived by ambulance.
But if you decide to go to the maternity hospital by ambulance to the specific maternity hospital you have chosen, the following tips will help you:
1. When the team arrives, explain to the driver which maternity hospital you need to go to and offer the driver money as a reward. Typically, the driver’s remuneration is 500 rubles - 1,000 rubles, but the amount can rise to 5,000 rubles, or even 10,000 rubles. Ambulance must for free take only to the nearest maternity hospital where there are free places or to the maternity hospital indicated by the dispatcher.
If the driver is against taking you where you want for a fee and continues to insist on his own.
2. Refuse the services of this team and call a friend. In this case, they have no right to take any money from you, such as a penalty.
3. When calling a new ambulance, you must inform the dispatcher that you will give birth in a specific maternity hospital and indicate the address of this maternity hospital. In this case, the arriving brigade will be obliged to take you exactly where the dispatcher says and for free, and not where it is closer to them.
If you arrive at the maternity hospital by ambulance, admission occurs without a queue, but in the order of those who arrived by ambulance before you.
And finally: Before leaving for the RD, do not forget to wash off the nail polish. This is very important point, because doctors monitor the condition of the woman in labor by the color of her nails.
Good luck and have an easy birth!
____________________________
P.S.: She called an ambulance to go to the RD when the contractions were occurring with an interval of 5 minutes, and the interval was getting shorter. They arrived quickly, within 5 minutes. The emergency doctor determined the dilatation of the sh. uterus 2 cm (2 fingers). I was asked which taxiway to take me to? I named the desired RD. The doctor asked, if there are no places there, then where to go? I named an alternative option RD. The doctor asked, and if there are no places there, then where...? I said, then it’s at your discretion... Afterwards, she called the desired taxiway to find out about availability there... They took us for free. We drove for about 30 minutes.
There were places in the desired taxiway and they gladly accepted me, because the opening of the highway. the uterus was already 4 cm. As soon as they were registered, they were immediately taken to a separate maternity unit, with the w. uterus 6 cm... I gave birth completely free of charge according to my Birth Plan:
Birth plan
The only thing... Upon discharge, the husband gave an envelope with money to the midwife who handed over his daughter, but this was his personal initiative... The midwife accepted the envelope and, without opening it, put it away...
Details here:My first birth in 2012: Natural vertical, without obstetric assistance!
Video:
When to go to the maternity hospital during contractions:
Every pregnant woman, from the first weeks of pregnancy, begins to worry about questions: where to give birth, what things you need with you, what method of delivery to choose. But now almost nine months of pregnancy are behind us, the woman chose the maternity hospital, she clearly knows what to take.
There is one important question left - when should you go to the maternity hospital?
I don’t want to go too early, but I also don’t want to be late and then give birth in an ambulance or even at home. But, unfortunately, no doctor can accurately determine the date and time of birth.
Therefore, you should know a few things that will help you prepare for childbirth and arrive at the maternity hospital on time.
What every expectant mother needs to know?
The gestational age at which the baby is considered full-term varies significantly according to different experts and, on average, is in the range between 39 and 42 weeks.
The main harbinger are precursor contractions - painless contractions of the abdominal muscles. Such contractions appear at any time, are irregular, and pass quickly after taking antispasmodic drugs.
With the help of precursor contractions, a woman’s body begins to prepare for the upcoming labor.
Less commonly, a few days before giving birth, women notice a small amount of mucus appearing in the vagina. This plug serves as additional protection at the entrance to the cervix.
A little about the beginning of labor
When should you go to the maternity hospital? The answer is simple - at . However, there is emergency reasons when delaying admission to the maternity hospital threatens various complications.
Such reasons are the appearance bloody discharge and prenatal rupture of amniotic fluid.
Labor activity represents pain that is regular, painful and repeated at regular intervals.
Gradually, the frequency of contractions increases, while the contractions are not stopped by the use of conventional antispasmodic drugs, what distinguishes them from precursor contractions.
It can be difficult to distinguish between both of these types of contractions, in which case it is better to play it safe and go to the maternity hospital.
Appearance may accompany normal labor (cervical dilatation is accompanied by minor vascular damage), but most often the appearance of blood is a sign of placental abruption and other pathological conditions.
The development of placental abruption threatens the death of the fetus and mother, so if even a small amount of blood appears, it is better to call an ambulance.
Rush of amniotic fluid it is usually easy to determine - amniotic fluid often has a large volume, although, again, there may be little water, and there may be a gradual leakage.
The feeling of the appearance and discharge of water (not mucus) from the vagina is also an indication to call an ambulance.
In conclusion, it is worth saying that in the presence or complicated course of pregnancy, prenatal hospitalization in a hospital is planned in advance. All other cases are the responsibility of the woman herself.
So when is the best time to go to the maternity hospital? It's better to come to the maternity hospital earlier Why worry later - will the ambulance arrive in time?
Primiparas should also take precautions, because first labor usually lasts a long time, until 10-13 o'clock, repeated births occur much faster.
There are situations when it is not so easy for a woman to determine whether she is really going into labor or whether it is too early to go to the maternity hospital. But there are still some signs that will tell you for sure that the time “h” has already come.
Premonition
In the last weeks before giving birth, you probably couldn’t find a place to rest with impatience to give birth to your long-awaited baby. Preliminary calculations do not determine exact date childbirth, because normal time birth from the 38th to the 42nd week of pregnancy.
Physiological changes
However, shortly before birth, physiological changes occur that clearly indicate that the baby will not be expected for long. Just before giving birth, your belly should drop slightly as your baby's head moves deeper into the pelvic ring. This can happen about 1-2 weeks before the birth, but it can also happen literally the day before. Most likely, you will feel some relief in breathing, and the gynecologist will note prolapse of the uterine fundus. Shortly before giving birth, you will feel more intense Braxton Hicks contractions, during which the uterus “trains” for labor. Some women feel increased pain in the lower back, and some even clearly feel the baby's head pressing on the cervix. In most cases, if this is the first birth, the frequency and strength of contractions increase quite slowly, at intervals of 24 hours, so you will have to be patient to wait until it is time to go to the hospital. Many pregnant women believe that it is easier to relax and unwind at home, which will make childbirth easier and more painless. But you can only stay at home if you are in labor for the first time and the amniotic sac is still intact. From the moment contractions begin to repeat every 10 minutes and last at least a minute, you need to call an ambulance or go to the maternity hospital in your car.
Braxton Hicks contractions
Often, a woman, having felt false contractions (Braxton-Hicks contractions), mistakes them for real ones, but such contractions stop after a while and resume after a few days. Sometimes Braxton Hicks contractions are quite strong and mislead a woman. However, know that these contractions are preparation for childbirth, thanks to which the cervix ripens, so that at the right time the birth will be less traumatic. 
Signs of the onset of labor
The main sign that you are about to give birth and it’s time to go to the hospital is loss of amniotic fluid. The amniotic sac ruptures, and some of the fluid flows out - this process is completely painless, and depending on where the rupture is located, the amniotic fluid will either literally pour out, or the fluid will ooze out drop by drop. If your water breaks before contractions start, still go to the hospital immediately. Since the barrier that protected your baby from infections has already been destroyed, it is best to be under the supervision of specialists from now on. The color of the amniotic fluid is important, so take a closer look at it: if the fluid is light or slightly yellowish, then everything is fine. If it has a greenish tint, be sure to inform your doctor about this, as this is a sign of oxygen starvation of the fetus and immediate measures must be taken so that the baby is born as quickly as possible. At first, it can be difficult to distinguish real contractions from Braxton Hicks contractions. However, a sign that you are going into labor is that your contractions will become more frequent, stronger, and more distressing. Gradually, prenatal contractions will begin to be perceived as periodic attacks of pain, accompanied by pain in the lower back, hips, calves and rectum. The mucus plug, which covered the cervix throughout pregnancy and protects the baby from infections, comes out, signaling that the cervix is “ripe.” A slightly pinkish discharge consisting of thin mucus with a small admixture of blood may appear up to two weeks before birth, although very often the mucus plug comes off just before birth.
This is, of course, the very first and most visible sign of impending labor. The baby's head drops into the birth canal, the muscles of the uterus stretch, and it seems to rush down after the fetus. The abdomen drops and becomes pear-shaped. In addition, the pregnant woman notices some changes in her health: frequent bowel movements and urination (because the fetal head puts more pressure on the bladder and rectum). There are also positive changes - it becomes easier to breathe, heartburn and belching are no longer bothersome, the fetus no longer puts so much pressure on the stomach and diaphragm.
In fact: It would seem that this is a sign that it’s time to go to the maternity hospital. But no, it's too early. As a rule, the stomach drops 1-3 weeks before hour X. It is worth noting that this only happens to first-time mothers. If you are going to the hospital for the second or third time, your tummy will drop right before giving birth. In addition, much depends on the shape of the woman’s pelvis, on the size of the fetus, on its position in the uterine cavity - head first or buttocks forward.
Myth 2: The plug has come off
Before birth, discharge from the genital tract (cervical fluid) becomes abundant, and a few days before the baby is born, the mucous plug comes off. It protected the fetus from infections, literally clogging the cervix. It is a thick, transparent, slightly yellowish mucus, which, by the way, can be mixed with a small amount of blood due to the fact that several small vessels have ruptured. It is worth noting that the appearance of mucous discharge from the cervix in the last weeks does not mean at all that it is time for childbirth.
In fact: This is not necessarily a one-time action - sometimes the cork is separated in stages, over several days. It happens that up to 10 days pass from the first discharge of mucus (cervical fluid) to the onset of labor. There are several other options for the development of events: when before childbirth the cervix softens and opens slightly, the plug may remain in the cervical canal and be released only during childbirth, or maybe only immediately before childbirth.
Myth 3: If your water breaks, are you giving birth?
A pregnant woman may feel that her water is leaking or that it has completely broken. This means that the amniotic sac has ruptured on its own and there is a risk of infection of the fetus, so the water-free period should not be allowed to last more than 12 hours. Nature intended that the entire amniotic sac actively participates in the process of childbirth - it should put pressure on the cervix so that it stretches during the first contractions.
Normally, this happens after the onset of contractions, but there are often cases when the opposite happens. This depends on the volume of water (normally about 1.5-2 liters), the size of the fetus, how it is located, and the duration of pregnancy. Moreover, the integrity of the fetal bladder can be disrupted both at the beginning, in the middle, and at the end of labor. There are cases when it does not rupture at all and the baby is born in the amniotic sac filled with water, then there is a danger that the baby may swallow water with his first breath.
In fact: It is better for a pregnant woman to go to the maternity hospital not when her water breaks, but much earlier.
Myth 4: Contractions have started
As you know, during pregnancy there are “training contractions” from time to time. If at first they occur rarely, no more than 1-2 contractions a week, almost always in the evenings, then as the fetus grows their frequency becomes more frequent - up to several times a day. But already 2 weeks before giving birth, the pregnant woman begins to experience new sensations - the so-called precursor contractions or false contractions. They are quite similar to the real ones - both in strength and in sensations, but they do not lead to dilatation of the cervix and do not last long. In most cases, false contractions are weak and irregular, although it happens that they are quite noticeable. With them, the uterus periodically tenses in waves, and a sensation of “sipping” appears in the lower abdomen and in the lumbar region.
In fact: you need to decide what type of contractions you are having. Real labor contractions are regular and gradually increasing in intensity. In addition, they certainly lead to the opening of the cervix, which does not happen with training contractions.
Myth 5: It’s always better to go to the maternity hospital in advance
It seems that everything is logical: let the doctors look after it, you never know. But childbirth is a long process, especially for first-time mothers. Of course, if the health of the expectant mother is alarming, then prenatal hospitalization is needed. It is mandatory in the case of a planned cesarean section (no later than 38 weeks of pregnancy), in the presence of scars on the uterus, common chronic diseases, gestosis (late toxicosis), impaired blood flow in the placenta, delayed fetal development, and the threat of premature placental abruption. Traditionally, hospitalization is recommended in case of post-maturity for examination and observation.
In fact: Stressful waiting in the hospital cannot always cheer up a healthy pregnant woman; it is better to stay at home, in a calm and familiar environment.
You should urgently go to the maternity hospital if a woman in the last weeks of pregnancy has: - discharge from the genital tract, similar to menstruation or even just “smearing”); – blood-stained water leaks; – the pain during contractions is very strong, the uterus is painful to the touch and does not relax between contractions; – the fetus suddenly began to move very weakly, or, conversely, very strongly; - the woman is worried headache, vision suddenly became blurry (“floaters before the eyes”); – pain appeared in the epigastric region, increased blood pressure, inability to urinate.
Tatyana Ustinova
gynecologist, Baltika Clinic, St. Petersburg