Many pregnant women often wonder about the upcoming date childbirth, and women who are about to give birth for the first time are especially worried. As a rule, they are very afraid of not recognizing the onset of labor in time and confusing it with a temporary illness. In many cases, a woman's careful observation of the changes that occur in her body will help resolve these worries.

Already at 38 weeks, the prenatal period begins, when the first precursors of labor and the first, still irregular (training) contractions occur. Such contractions appear irregularly, and they go away after a change in body position or a short rest. In first-time mothers, such training contractions of the uterus can last five, and in some cases even more, days before giving birth. When they appear, there is no need to worry and urgently go to the maternity hospital, but the expectant mother should inform her doctor, family and friends about such changes in her body.

When the first signs of leakage or rupture of amniotic fluid appear, which may indicate the onset of labor or premature labor, the woman should immediately notify the doctor or independently contact a medical facility to decide on further hospitalization.

If a woman has learned to recognize training contractions, then she will be able to distinguish them from the onset of labor, or true contractions. These sensations are difficult to confuse with any other symptom, since they are characterized by periodicity and rhythm. For example, a contraction lasts 20-30 seconds, and then there is a 20-minute pause - this is repeated many times in a row, and the time intervals hardly change.

At the onset of labor pains, the woman in labor or her relatives must notify the doctor about the onset of labor, call an ambulance, or go to the maternity hospital on their own.

Reasons for the onset of labor

By the beginning of labor, many complex processes occur in the body of a pregnant woman, which, being in close interconnection, ensure the beginning of such a reflex act as labor.

The main reason for the onset of labor is the readiness of the uterus for the birth of the unborn child and the maturity of the fetus.

Uterus ready for childbirth:

• gains sufficient weight and size;
• her neuromuscular system is ready for contractile activity;
• The placenta matures completely.

2 or 3 weeks before the onset of labor, the uterus is freed from an excess of some nerve fibers. This reduces pain during childbirth and increases the contractility of the uterine walls.

The process of onset of labor is influenced by several factors:

• neuro-reflex – as a result of decreased excitability of the brain, increased excitability of the spinal cord and increased sensitivity of the muscle fibers of the uterus to oxytocin, increased contractile activity of the uterus is produced;
• hormonal- at the end pregnancy the production of progesterone decreases and the production of the estrogen complex increases, which stimulate the onset of labor;
• neurohumoral – at the end of pregnancy, the woman’s body increases the synthesis of oxytocin, prostaglandins, serotonin and other bioactive substances, which increase the sensitivity of the uterus to substances that cause active contraction of its muscles;
• bioenergy – a sufficient amount of substances (glycogen, ATP, phosphorus compounds, electrolytes and trace elements) accumulate in the mother’s body, which make the uterus capable of enhanced contractile activity;
• mechanical - a mature uterus loses its ability to stretch, and in response to the motor activity of the fetus and an increase in the level of oxytocin-like hormones, it begins to actively contract;
• trophic and metabolic – the accumulation of certain waste products in the body of a mature fetus leads to its active movement, and degenerative processes in the mature placenta and the complete maturation of the muscle fibers of the uterus contribute to the onset of labor.

The state of the nervous system of the woman in labor is of primary importance in the formation of all mechanisms for the onset of labor, since it is she who ensures the readiness of the uterus for natural childbirth.

All of the above factors, being closely interrelated, contribute to the appearance of contractions, which are replaced by pushing and end with the expulsion of the fetus from the uterine cavity and the birth of the placenta.

Harbingers of the onset of labor

Precursors of labor are a set of signs that indicate the imminent onset of active labor. There are many precursors to the onset of labor, but for each woman their totality is individual and depends on the characteristics of the expectant mother’s body.

Harbingers of childbirth:

• Abdominal prolapse.
  This change, which is determined by an outwardly slight downward displacement of the abdomen, is individual for each pregnant woman and cannot always be noticed independently. In primiparous women, this precursor may appear 2-4 weeks before the day of birth, and in multiparous women, a few days or immediately before birth.


• Gait changes.
  The nature of the gait changes after the abdomen drops. The woman begins to waddle due to the pressure of the baby's head on the pelvic bones and the fundus of the uterus.


• Changes in urination and bowel habits.
  A drooping abdomen may cause increased urination or urinary incontinence as the uterus puts more pressure on the bladder. The mechanical impact of the pregnant uterus on the intestinal walls can provoke constipation, and in some cases, diarrhea, several weeks or days before birth.


• Changes in the nature of discharge from the genital tract.
  Vaginal discharge becomes more abundant and thin under the influence of hormonal changes. In some cases, to exclude the discharge of amniotic fluid, an obstetrician performs a special test.


• Removal of the mucus plug.
  This harbinger of labor can occur 2 weeks before the onset of labor, or several hours before it begins. In some cases, the mucus plug does not come off entirely, but in small portions. In practice, this sign looks like the discharge of vaginal discharge (sometimes mixed with a small amount of blood). A pregnant woman should inform her obstetrician-gynecologist about the passage of the mucus plug.


• Reduced body weight of the expectant mother.
  A few days before giving birth, a pregnant woman may notice that she weighs 1-2 kg less. This weight loss can be explained by the removal of excess fluid from the body under the influence of changes in hormonal levels.


• Decreased number of fetal movements.
  The fetus moves less often a few weeks before birth. This is due to its rapid growth. The unborn baby becomes cramped in the uterine cavity, and his movements are difficult.


• Training contractions.
  Closer to the date of birth, the uterus begins to increasingly become more toned, which is expressed in the sensation of training contractions. They differ from labor contractions in a number of features: short duration, irregularity, mild pain (reminiscent of pain during menstruation), spontaneous disappearance after a change in body position or rest.


• Manifestation of the "nesting" instinct.
  Many women in the last days and even hours before giving birth begin to prepare their home for the upcoming birth of a child. These actions can be expressed in the fact that a woman begins to diligently clean, do laundry, and may even start repairs.

The last weeks of waiting are over. Contractions begin. The climax of the entire pregnancy is coming - a few more hours and you will see your baby. Of course, you will worry and worry about the outcome of labor, but if you are well prepared and understand what to expect, what happens at each stage of labor, then your courage will also return. Give life to a child! After all, this is such happiness! Prepare yourself, master techniques and methods of relaxation and breathing control in advance - they will help you maintain composure and cope with pain. And don’t be alarmed if during contractions something doesn’t turn out quite as you expected.

HOW TO DETERMINE THE BEGINNING OF CONTRACTIONS

YOUR ANXIETY that you will miss the onset of contractions is absolutely groundless. Although false contractions that occur in the last weeks of pregnancy can sometimes be mistaken for the beginning of labor, you will not confuse real contractions with anything.

SIGNS OF CONTRACTS

Appearance
By opening slightly, the cervix pushes out the blood-stained mucus plug that clogged it during pregnancy.
What to do This can happen a couple of days before contractions start, so wait until the abdominal or back pain becomes constant or the amniotic fluid has broken before calling your midwife or hospital.

Leakage of amniotic fluid
Rupture of the amniotic sac is possible at any moment. The water may flow out in a stream, but more often it oozes out little by little - it is retained by the child’s head.
What to do Call a midwife or ambulance immediately. Hospitalization is safer, even if there are no contractions yet, since infection is possible. In the meantime, place a waffle towel to absorb moisture.

Uterine contractions
At first they make themselves felt as dull pain in the back or hips. After some time, contractions will begin, similar to the sensations during painful menstruation.
What to do When contractions become regular, fix the intervals between them. If you think contractions have started, call your midwife. As long as they are not very frequent (up to 5 minutes) or painful, there is no point in rushing to the maternity hospital. The first birth usually lasts quite a long time, 12-14 hours, and part of this time is best spent at home. Walk slowly, stopping to rest. If your water has not yet broken, you can take a warm shower or have a light meal. The maternity hospital may advise you not to arrive before the contractions intensify and begin to repeat every 5 minutes.

HARNESSES OF CONTRACTS
Weak uterine contractions occur throughout pregnancy. In the last few weeks, they become more frequent and more intense, so sometimes they can be mistaken for the beginning of contractions. When you feel such contractions, get up, walk around and listen to see if they continue and if the pauses between them become shorter. Precursors of contractions are usually irregular.

FREQUENCY OF CONTRACTS
Monitor the dynamics of contractions over the course of an hour: beginning and end, intensification, increase in frequency. When contractions stabilize, their duration should be at least 40 seconds.

FIRST PERIOD

AT THIS STAGE, the muscles of the uterus contract to open the cervix and allow the fetus to pass through. During the first birth, contractions last on average 10-12 hours. It is possible that at some point you will be overcome by panic. No matter how well prepared you are, the feeling that something is happening to your body beyond your conscious control can be frightening. Stay calm and try not to disturb your body, do what it tells you. It is now that you will truly appreciate the presence of your husband or girlfriend nearby, especially if they know what contractions are.

BREATHING IN THE FIRST PERIOD OF LABOR
At the beginning and end of the contraction, breathe deeply and evenly, inhaling through your nose and exhaling through your mouth. When the contraction reaches its peak, resort to shallow breathing, but now inhale and exhale through the mouth. Don't breathe like this for too long - you may get dizzy.

ARRIVAL AT THE MATERNITY HOSPITAL

At the reception department you will be met by a nurse-midwife who will carry out all the formalities and preparatory procedures. Your husband may be next to you at this time. If you are giving birth at home, you will be prepared for the birth in the same way.

Midwife Questions
The midwife will check the registration records and your exchange card, and will also check whether your water has broken and whether there has been any release of mucus plug. In addition, he will ask a series of questions about the contractions: when did they start? how often do they happen? How do you feel? what is the duration of the attacks?

Survey
Once you have changed, your blood pressure, temperature and pulse will be taken. Your doctor will do an internal examination to determine how dilated your cervix is.

Fetal examination
The midwife will feel your stomach to determine the baby's position and use a special stethoscope to listen to the baby's heart. It is possible that she will record the fetal heartbeat through a microphone for about 20 minutes - this recording will help determine whether the child receives enough oxygen during uterine contractions.

Other procedures
You will be asked to provide urine to be tested for sugar and protein. If your water hasn't broken yet, you can take a shower. You will be directed to the prenatal ward.

INTERNAL INVESTIGATIONS
The doctor will, if necessary, conduct internal examinations, monitoring the position of the fetus and the degree of dilatation of the cervix. Ask him questions - you should also know what is happening. Usually the uterus dilates unevenly, as it were. in jerks. The examination is carried out in the intervals between contractions, therefore, if you feel the next contraction approaching, you will have to inform the doctor about it. You will most likely be asked to lie on your back, supported by pillows, but if this position is uncomfortable, you can lie on your side. Try to relax as much as possible.

CONTRACTS
The cervix is ​​a ring of muscles that are normally closed around the uterine os. The longitudinal muscles that form the walls of the uterus extend from it. During contractions, they contract, pulling the cervix inward and then stretching it enough to allow the baby's head to pass through the uterine os.
1. The cervix relaxes under the influence of hormones.
2. Weak contractions smoothly smooth the cervix.
3. Strong contractions cause the cervix to dilate.

PROVISIONS FOR THE FIRST STAGE OF LABOR
During the first period, try to try different body positions, finding the most comfortable one for each stage. These positions must be mastered in advance so that at the right moment you can quickly take the appropriate pose. You may suddenly feel like it would be better to lie down. Lie not on your back, but on your side. The head and thigh should rest on pillows.

Vertical position
At the initial stage of contractions, use some kind of support - a wall, a chair or a hospital bed. You can kneel if you wish.

Sitting position
Sit facing the back of a chair, supported by a pillow. The head is lowered on the hands, the knees are spread apart. Another pillow can be placed on the seat.

Leaning on my husband
During the first stage of labor, which you will probably endure on your feet, during contractions it is convenient to place your hands on your husband’s shoulders and lean on him. Your husband can help you relax by massaging your back or stroking your shoulders.

Kneeling position
Kneel down, spread your legs and, relaxing all your muscles, lower your upper body onto the pillows. Keep your back as straight as possible. In the intervals between contractions, sit on your thigh.

Four point support
Kneel down, leaning on your hands. This is convenient to do on a mattress. Move your pelvis forward and backward. Don't hunch your back. Between contractions, relax by lowering yourself forward and resting your head on your hands.

LABOR PAIN IN THE BACK
In cephalic presentation, the baby's head pushes against your spine, causing back pain. To make it easier:
during contractions, lean forward, placing your weight on your hands, and make forward movements with your pelvis; walk at intervals
In the intervals between contractions, let your husband massage your back.

Lumbar massage
This treatment will relieve back pain and also calm and reassure you. Let your husband massage the base of your spine, pressing on it with the heel of his palm in a circular motion. Use talcum powder.

HOW TO HELP YOURSELF

Move more, walk between contractions - this will help cope with pain. During attacks, choose a comfortable body position.
Stay as straight as possible: the baby's head will rest against the cervix, contractions will become stronger and more effective.
Focus on your breathing to calm yourself and take your attention away from your contractions.
Relax during breaks to save energy for when you need it most.
Sing, even scream, to relieve pain.
Look at one point or object to distract yourself.
React only to this fight, don’t think about the next ones. Imagine each attack as a wave, “riding” which you will “bear” the child.
Urinate more often - the bladder should not interfere with the advancement of the fetus.

HOW CAN A HUSBAND HELP

Praise and encourage your wife in every possible way. Don't be put off if she gets annoyed - your presence is still important.
Remind her of the relaxation and breathing techniques she learned in the courses.
Wipe her face, hold her hand, massage her back, offer to change her position. You need to know in advance what kind of touches and massage she likes.
Be a mediator between your wife and the medical staff. Stay on her side in everything: for example, if she asks for a painkiller.

TRANSITION PHASE

THE HARDEST time of labor is the end of the first period. Contractions become strong and long, and the intervals are reduced to a minute. This phase is called transition. Exhausted, you will probably be either depressed or overly agitated and tearful at this stage. You may even lose track of time and fall asleep between contractions. This may be accompanied by nausea, vomiting and chills. In the end, you will have a great desire to strain and push the fetus out. But if you do this ahead of time, swelling of the cervix is ​​possible. So ask your midwife to check that your cervix is ​​fully dilated.

BREATHING IN THE TRANSITION PHASE
If premature pushing begins, take two short breaths and one long exhale: “oof, oof, fu-u-u-u.” When the urge to push stops, exhale slowly and evenly.

How to stop pushing
If the cervix has not yet opened, in this position, take a double breath and exhale long: “oof, oof, fu-u-u-u” (see above right). You may need pain relief. Kneel down and, leaning forward, put your head in your hands; the pelvic floor should seem to hang in the air. This will weaken the urge to push and make it more difficult to push the fetus out.

HOW CAN A HUSBAND HELP

Try to calm your wife down, encourage her, wipe away the sweat; If she doesn't want it, don't insist.
Breathe with her during contractions.
Put some socks on her if she starts getting chills.
If you start pushing, call your midwife immediately.

WHAT HAPPENS TO THE CERVIX
The cervix, palpable at a depth of 7 cm, is already sufficiently stretched around the fetal head.
If the cervix can no longer be palpated, it means that its dilation has completed.

SECOND PERIOD AS soon as the cervix is ​​dilated and you are ready to push, the second stage of labor begins - the period of expulsion of the fetus. Now you add your own efforts to the involuntary contractions of the uterus, helping to push the fetus out. The contractions have become stronger, but they are less painful. Pushing is hard work, but your midwife will help you find the most comfortable position and guide you on when to push. Don't rush things, try to do everything right. During the first birth, the second stage usually lasts more than an hour.

BREATHING IN THE SECOND STAGE OF LABOR
When you feel the urge to push, take a deep breath and, leaning forward, hold your breath. Take deep, calming breaths between pushes. Relax slowly as the contraction subsides.

POSITIONS FOR EXPELATION OF THE FETUS
When pushing, try to stay straighter - then gravity will work for you.

Squatting
This is the ideal position: the lumen of the pelvis opens, and the fetus comes out under the influence of gravity. But if you haven't prepared yourself for this pose in advance, you will soon feel tired. Use a lighter option: if your husband sits on the edge of the chair with his knees apart, you can sit between them, resting your hands on his thighs.

On the knees
This position is less tiring and also makes pushing easier. Having support from both sides will give your body greater stability. You can just lean on your hands; your back should be straight.

Sitting
You can give birth sitting on the bed, surrounded by pillows. As soon as you start pushing, lower your chin and clasp your legs with your arms. In the intervals between attempts, rest by leaning back.

HOW TO HELP YOURSELF
At the moment of contraction, strain gradually, smoothly.
Try to relax your pelvic floor so much that you feel it sinking.
Relax your facial muscles.
Don't try to control your bowels or bladder.
Rest between contractions, save your strength for pushing.

HOW CAN A HUSBAND HELP
Try to somehow distract your wife between attempts, continue to calm and encourage her.
Tell her what you see, such as the appearance of a head, but don't be surprised if she doesn't pay attention to you.

CHILDREN

THE PEAK OF BIRTH has arrived. The baby is about to be born. You will be able to touch your baby's head, and soon you will be able to hold him in your arms. At first, you will probably be overcome by a feeling of great relief, but it will be followed by surprise, and tears of joy, and, of course, a feeling of immense tenderness for the child.

1. The fetal head approaches the vaginal opening, pressing on the pelvic floor. The top of the head will soon appear: with each push it will either move forward, or perhaps roll back somewhat as the contractions weaken. Don't worry, this is completely normal.

2. As soon as the top of the head appears, you will be asked not to push any further - if the head comes out too quickly, perineal tears are possible. Relax, catch your breath a little. If there is a risk of serious ruptures or any abnormalities in the child, you may have an episiotomy. As the head expands the vaginal opening, a burning sensation occurs, but it does not last long, giving way to numbness, which is caused by strong stretching of the tissue.

3. When the head appears, the baby's face is turned down. The midwife checks to make sure the umbilical cord is not wrapped around the neck. If this happens, it can be removed when the entire body is released. The infant then turns his head to the side, turning around before fully releasing. The midwife will wipe his eyes, nose, mouth and, if necessary, remove mucus from the upper respiratory tract.

4. The last contractions of the uterus, and the baby's body is released completely. Usually the baby is placed on the mother's stomach, since the umbilical cord is still holding it in place. Perhaps at first the baby will seem bluish to you. His body is covered with vernix, and there are traces of blood on his skin. If he is breathing normally, you can pick him up and press him to your chest. If breathing is difficult, the patient's airway will be cleared and, if necessary, an oxygen mask will be given.

THIRD STAGE OF LABOR
At the end of the second stage of labor, you will probably be given an intravenous injection of a drug that increases uterine contractions - then the placenta will come out almost instantly. If you wait for it to peel off naturally, you may lose a lot of blood. Discuss this point with your doctor in advance. To remove the placenta, the doctor places one hand on your stomach and gently pulls the umbilical cord with the other. After this, he must check that the placenta has come out completely.

APGAR SCALE
After delivering the baby, the midwife evaluates his breathing, heart rate, skin color, muscle tone and reflexes, calculating a score on the 10-point Hangar scale. Usually in newborns this indicator ranges from 7 to 10. After 5 minutes, a second count is carried out: the initial score, as a rule, increases.

AFTER CHILDBIRTH
You will be cleaned and, if necessary, stitches will be placed. The neonatologist will examine the newborn, the midwife will weigh and measure him. To prevent the baby from developing a rare disease associated with insufficient blood clotting, he may be given vitamin K. The umbilical cord is cut immediately after birth.

Question and answer "I'm afraid of injury during childbirth. Is there such a danger?"
Don’t be afraid, there is no such danger - the vaginal walls are elastic, their folds can stretch and allow the fetus to pass through. “Should I breastfeed my baby immediately after birth?” You can give breastfeeding, but if the baby doesn’t take it, don’t insist. In general, the sucking reflex in newborns is strong, and when they suck, they are in a good mood.

ANESTHESIA

CHILDREN RARELY painless, but pain also has a special meaning: after all, every contraction is a step towards the birth of a baby. You may need painkillers, depending on how your contractions are progressing and your ability to cope with the pain. You may be able to overcome it using self-help techniques, but if the worsening pain becomes unbearable, ask your doctor for pain medication.

EPIDURAL ANESTHESIA
This anesthesia relieves pain by blocking the nerves of the lower body. It is effective when contractions cause back pain. However, not every hospital will offer you an epidural. The time of its use should be calculated so that the effect of the anesthetic ceases by the 2nd stage of labor, otherwise labor may be slowed down and the risk of episiotomy and forceps may increase.

How does this happen
Epidural anesthesia requires approx. 20 minutes. You will be asked to curl up with your knees touching your chin. An anesthetic will be injected into the lower back with a syringe. The needle is not removed, which allows you to administer an additional dose if necessary. The effect of the anesthetic wears off after 2 hours. It may be accompanied by some difficulty in movement and trembling in the hands. These phenomena will soon pass.

Action
On you The pain will pass, clarity of consciousness will remain. Some women experience weakness and headache, as well as heaviness in the legs, which sometimes lasts for several hours.
Per child None.

NITRIC OXIDE WITH OXYGEN
This gas mixture significantly reduces pain without completely eliminating it and causes euphoria. Used at the end of the 1st stage of labor.

How does this happen
The gas mixture enters through a mask connected by a hose to the apparatus. The effect of the gas appears after half a minute, so at the beginning of the contraction you need to take several deep breaths.

Action
On you The gas dulls the pain, but does not relieve it completely. When you inhale, you will feel dizzy or nauseous.
Per child None.

PROMEDOL
This medicine is used in the 1st stage of labor, when the woman in labor is excited and finds it difficult to relax.

How does this happen
An injection of promedol is administered into the buttock or thigh. The onset of action is after 20 minutes, duration is 2-3 hours.

Action
On you Promedol manifests itself in different ways. For some, it has a calming effect, relaxing, causing drowsiness, although the consciousness of what is happening is completely preserved. There are also complaints about loss of self-control and intoxication. You may feel nauseous and shaky.
Per child Promedol can cause respiratory depression and drowsiness in a child. After childbirth, breathing can be easily stimulated, and drowsiness will disappear on its own.

ELECTRO-STIMULATION
The electrical stimulation device reduces pain and stimulates the internal pain coping mechanism. It works on weak electrical impulses that affect the back area through the skin. A month before giving birth, find out if there is such a device in the maternity hospital and learn how to use it.

How does this happen
Four electrodes are placed on the back where the nerves leading to the uterus are located. The electrodes are connected by wires to the manual control panel. With its help you can regulate the current strength.

Action
On you The device reduces pain at the initial stage of labor. If contractions are very painful, the device is ineffective.
Per child None.

MONITORING THE CONDITION OF THE FETAL

DURING the entire period of labor, doctors constantly record the fetal heart rate. This is done with a regular obstetric stethoscope or using an electronic monitor.

OBSTETRIC STETHOSCOPE
While you are in the delivery room, the midwife regularly listens to the fetal heartbeat through the abdominal wall.

ELECTRONIC FETAL MONITORING
This method requires sophisticated electronic equipment. In some hospitals, such monitoring (control) is used throughout labor, in others - occasionally or in the following cases:
if labor is induced artificially
if you have had an epidural
if you have complications that could threaten the fetus
if abnormalities are detected in the fetus.
Electronic monitoring is absolutely harmless and painless, but it significantly limits freedom of movement - thus you cannot control contractions. If your doctor or midwife has suggested continuous monitoring, find out if this is really necessary.

How does this happen
You will be asked to sit or lie down on a couch. The body will be supported with pillows. Adhesive tapes with sensors will be placed on the abdomen to detect the fetal heartbeat and record uterine contractions. The instrument readings are printed on paper tape. After the amniotic fluid has broken, the baby's heart rate can be measured by placing an electronic sensor near his head. This monitoring method is the most accurate, but not very convenient. Some maternity hospitals use radio wave monitoring systems with remote control (telemetric monitoring). Their advantage is that you are not tied to bulky equipment and can move freely during contractions.

SPECIAL DELIVERY METHODS
EPISIOTOMY
This is a dissection of the vaginal opening to prevent rupture or to shorten the second stage of labor if the health of the fetus is threatened. To avoid an episiotomy:
learn to relax your pelvic floor muscles
When expelling the fetus, stay straighter.

Indications
An episiotomy will be needed if:
the fetus has a breech presentation, a large head, other abnormalities
you are in premature labor
use forceps or vacuum
you don't control your attempts
the skin around the vaginal opening does not stretch enough.

How does this happen
At the climax of the contraction, an incision is made into the vagina - downwards and, usually, slightly to the side. Sometimes there is no time for an anesthetic injection, but you still won’t feel pain, since partial numbness of the tissues also occurs due to the fact that they are stretched. Suturing after an episiotomy or rupture may be quite lengthy and painful - a complex procedure that requires special care. Therefore, insist that you have a good local anesthetic. The suture material dissolves on its own after some time and does not need to be removed.

Consequences
It's normal to feel discomfort and inflammation after an episiotomy, but the pain can be severe, especially if it becomes infected. The incision heals in 10-14 days, but if something bothers you then, consult a doctor.

FRUIT EXTRACTION
Sometimes forceps or vacuum extraction are used to help the baby be born. The use of forceps is possible only when the cervix is ​​fully dilated and the fetal head has entered it. Vacuum extraction is also permissible in case of incomplete dilatation - in the case of protracted labor.

Indications
Forced extraction is performed:
if you or the fetus have any abnormalities during childbirth
in case of breech presentation or premature birth.

How does this happen

Forceps You will be given pain relief - inhalation or intravenous anesthesia. The doctor applies forceps, wraps them around the child’s head, and gently pulls it out. When applying forceps, pushing is completely eliminated. Then everything happens naturally.
Vacuum extractor This is a small suction cup connected to a vacuum pump. It is brought through the vagina to the fetal head. While you push, the fetus is gently pulled through the birth canal.

Consequences
Forceps may leave dents or bruises on the fetus's head, but they are not dangerous. After a few days these marks disappear.
Vacuum The suction cup will leave a slight swelling and then a bruise on the baby's head. This too will gradually go away.

STIMULATION OF LABOR
Stimulation means that contractions will have to be induced artificially. Sometimes methods are used to speed up contractions if they are going too slowly. Physicians' approaches to stimulation often vary; so try to find out what the practice of inducing labor is in the area where you will be giving birth.

Indications
Contractions are induced artificially:
if, when labor is delayed for more than a week, signs of abnormalities in the fetus or dysfunction of the placenta are detected
if you have high blood pressure or any other complications that are dangerous for the fetus.

How does this happen
Artificially induced labor is planned in advance, and you will be asked to go to the maternity hospital in advance. There are 3 methods of stimulating contractions:
1. The hormonal drug cerviprost is injected into the cervical canal, softening the cervix. Contractions can begin in about an hour. This method is not always effective during the first birth.
2. Opening of the amniotic sac. The doctor makes a hole in the amniotic sac. Most women do not experience any pain. Soon uterine contractions begin.
3. A hormonal drug is administered intravenously through a drip that promotes contraction of the uterus. Ask for an IV to be placed on your left arm (or right arm if you are left-handed).

Consequences
The introduction of a hormonal drug is preferable - you can move freely during contractions. When using an IV, contractions will be more intense and the intervals between them will be shorter than during normal labor. Besides, you have to lie down.

BUTICAL PRECTION
In 4 cases out of 100, the baby comes out with the lower body. Childbirth in this position of the fetus is longer and more painful, so it must take place in a hospital. Since the head, the largest part of the baby's body, will be the last to appear during birth, it is measured in advance with an ultrasound scanner to ensure that it will pass through the pelvis. An episiotomy will be required; Caesarean section is often used (in some clinics it is mandatory).

TWINS
Twins must be delivered in a hospital because forceps are often used to remove them. In addition, one of them may have a breech presentation. You will likely be offered an epidural. There will be one first stage of labor. There are two second pushes: first one child comes out, followed by the second. The interval between the birth of twins is 10-30 minutes.

C-SECTION

With a CESAREAN section, the baby is born through an open abdominal wall. You will be informed in advance about the need for surgery, but this measure may be caused by complications during childbirth. If a caesarean section is planned, an epidural will be used, meaning you will be awake and able to see your baby right away. If the need for surgery occurs during contractions, then epidural anesthesia is also possible, although general anesthesia is sometimes required. It is difficult to come to terms with the fact that you cannot give birth normally. But these experiences can be overcome if you prepare yourself psychologically.

HOW DOES THIS HAPPEN
Your pubic area will be shaved, an IV will be placed in your arm, and a catheter will be inserted into your bladder. They will give you anesthesia. If you have an epidural, a screen will probably be placed between you and the surgeon. Typically a horizontal incision is made, then the surgeon uses suction to remove the amniotic fluid. The child is sometimes removed using forceps. After the placenta is delivered, you will be able to hold him in your arms. The operation itself lasts about five minutes. Stitching takes another 20 minutes.

Incision
The bikini incision is made horizontally, above the upper pubic line, and once healed it is almost invisible.

AFTER OPERATION
After giving birth, you will not be allowed to lie down for a long time without getting up. Walking and movement are completely harmless for you. The incision will still be painful for the first few days, so ask for pain relief. Stand straight, supporting the seam with your hands. After two days, start light exercise; in another day or two, when the bandage is removed, you can swim. The stitches are removed on the 5th day. In a week you will feel quite good. Avoid heavy exercise for the first 6 weeks. After 3-6 months the scar will fade.

How to breastfeed
Place the child on pillows so that his weight does not put pressure on the wound.

Contractions are involuntary contractions of the smooth muscles of the uterus. They are necessary for the baby to be born. With the onset of regular contractions, the first stage of labor begins. There are also false contractions, which can also be called training contractions. They prepare the woman’s body for the upcoming birth.

information If you imagine that the uterus is an inflated ball with a baby inside, then with the help of cramping contractions the knotted part of the ball is stretched and the baby is pushed out. In order for a child to be born through the natural birth canal, the cervix must smooth out and its canal expand to 10-12 centimeters. It is contractions that ensure this complex process.

How contractions begin

If a woman is about to give birth for the first time, she will not be familiar with the sensations during contractions, but during subsequent births they will not be confused with anything. How can you understand that contractions have begun before childbirth? The onset of labor can occur in different ways.

• For some women, before giving birth, contractions begin in the form of pain in the lumbar region;
• For others, they resemble menstrual pain;
• For others, it is cramping, weak pain throughout the abdomen.

But what all these manifestations of contractions at the beginning of labor have in common is their regularity and inevitable end with the birth of a child.

Feel

At the beginning of contractions, the painful sensations are mild, short-term in nature, come after 15-20 minutes and last about 5-10 seconds. Usually for the first 2-3 hours they do not cause the woman much discomfort. At this time, it is better to rest as much as possible and gain strength. Further, the pain becomes more and more intense, and the contractions themselves become more frequent and longer. At the end of the first period, uterine contractions last about a minute, and the periods between them decrease to 1-2 minutes. What characterizes pain during contractions is their gradual increase, reaching a peak and the same gradual decline. In between contractions, a woman can take a breath and rest, as the pain goes away altogether.

At the end of the period of cervical dilatation, it seems that one contraction is followed by another with an almost imperceptible period of relaxation. Usually at this time, pushing is added (contraction of the muscles of the diaphragm, abdominal wall and perineum, which the woman can slightly control). They manifest themselves as a strong desire to push in response to the pressure of the fetal head in the pelvic area. With the advent of pushing and full dilatation of the cervix, the second stage of labor begins - exile. If before this the maximum pain was felt in the lumbar and abdominal areas, then with the beginning of the second stage of labor its peak occurs in the perineal area.

False contractions

Throughout pregnancy, a woman may experience irregular, mild, cramping abdominal pain. They can occur during physical activity, sudden movements, a full bladder, activity of the baby, or during sexual intercourse. There is no need to worry if these sensations do not last long and go away when the cause that caused them is eliminated.

The closer the date of birth, the frequency of cramping pain usually increases. However, what distinguishes true contractions during pregnancy from contractions is their regularity. If you experience cramping pain, you need to note the time of its onset, observe the interval between them, and their duration.

important A watch with a second hand will help you identify contractions. If these sensations continue for an hour or two, and the interval is at least 15-20 minutes with a duration of about 20 seconds, then you need to get ready for the maternity hospital.

What to do if contractions start

If you are about to give birth for the first time (and you have determined for yourself that the first signs of true contractions have begun), you have time to calmly get ready for the maternity hospital. It is better, of course, that the bag for the maternity hospital is ready in advance (from 34-35 weeks of pregnancy), since in a hurry you can forget something. What to do at home before giving birth:

• Get in a good mood and have an easy birth. Think about the fact that very soon you will hug and kiss your long-awaited baby and put him to your chest. It is important to understand that it depends on you how the birth will go, and you must do everything to make it easier for the baby during this important period. Of course, pain during labor and childbirth is unpleasant, to put it mildly, but the end justifies the means. Try to do your best, and doctors and midwives will help you with this.
• It would be nice to take a warm, relaxing shower or bath, and shave your genitals.
• If there are no pregnancy complications, and the contractions are not yet too intense (after 15 minutes), then you can stay at home for a while, because a familiar environment will make it easier to cope with the pain. You can turn on pleasant music or a movie. At the beginning of labor, it is recommended to move so that everything goes faster. You can also cook food for your beloved husband. But you should not delay your trip to the maternity hospital if it is far away or you cannot reach it in a short time (half an hour).
• If the doctor did not say that you have indications for a cesarean section, you can have a little snack: drink a cup of tea, juice or water, eat something light but rich in complex carbohydrates (pasta from durum wheat, banana, vegetables), because you will need a lot of energy.
• While the contractions are not very strong, try to get more rest, especially if they started late in the evening, since you may have to give birth only in the morning.
• Of course, if this is not your first birth, and the previous ones were rapid, then you should not delay your trip to the maternity hospital. It is better to call an ambulance immediately.

Breath

It is very important for both the woman and the child. It helps to cope with pain during contractions and pushing. Sometimes, when you feel severe pain, it seems that it is easier to bear it by holding your breath, but this is only an imaginary relief. If a woman holds her breath at the peak of a contraction, then at this time oxygen does not enter the body, and, as a result, fetal hypoxia develops (oxygen starvation). This is especially dangerous during the period of exile, because the child is already being squeezed by the bones of the mother’s pelvis. It can also lead to the production of large amounts of lactic acid in the muscles, which will result in even more soreness and weakness.

However, sometimes the safety of mother and baby can only be ensured with the help of medical intervention.

Changes may occur in your body indicating that a crucial moment is approaching. Women feel them several weeks before giving birth - with varying degrees of intensity - or do not feel them at all.

The duration of the difficult process of bringing a baby into the world can vary greatly. For the first birth, it averages 13 hours, for repeated births - about eight. Doctors consider the beginning of labor to be the dilatation of the cervix with regularly recurring contractions.

Over the past 50 years, the average duration of this process has been halved, asin severe cases, a caesarean section is now performed in a timely manner. Spontaneous contractions often begin at night when the body relaxes. Many children prefer to look at this world for the first time in the dark. According to statistics, most births occur at night.

What exactly causes labor pains is a question to which the answer is not yet known. What is clear is that the child himself plays an important role in this process. But exactly what mechanisms provide the decisive impetus remains a mystery.

Recent studies suggest that contractions begin under the influence of a protein substance produced by the child, the so-called SP-A protein, which is also responsible for the maturation of the lungs.

Consultation with a gynecologist. Braxton Hicks contractions are usually difficult to distinguish from real labor contractions. During the third trimester, false labor contractions become more intense and frequent if you are active or dehydrated. If you feel them, sit in a cool place, elevate your feet, drink something and rest. If the intervals between contractions increase and their intensity decreases, then they are false. If they become more frequent or severe (especially if they occur every 5 minutes), call your doctor. I always tell patients that no one has ever described their sensations as “spastic” while giving birth to a child. As a rule, the intensity of labor contractions, during which the child passes through the birth canal, is described as follows: “I can’t walk or talk.”

You've seen it in countless movies. Sudden realization: the woman in labor needs to be taken to the hospital URGENTLY! The woman becomes a real fury, spewing curses (“You did this to me!”). Doubled over in terrible pain, she stops moaning only to unleash another round of curses at her poor, panic-stricken husband, who suddenly forgets everything he learned in the Lamaze course, loses his bag prepared for the trip to the maternity hospital, and inevitably sends car straight into a traffic jam, where he ends up having to deliver the baby himself.

The truth is that most couples have plenty of time to realize that labor has actually begun. No one knows exactly what triggers this mechanism, but they are approaching quite quickly. Here are some signs that will tell you it's time to grab your bag and the baby in labor - and get in the car.

Labor begins - signs of labor

Most women give birth to their children earlier or later than the estimated date indicated on the exchange card.

Moreover, most often the deviation in both directions does not exceed ten days. Ultimately, the expected date of birth only plays the role of a guideline. Only 3% to 5% of children are born exactly on this day. If the doctor said that your baby will be born on December 31st, you can be sure that you will not give birth on New Year's Eve.

Loose stool

This is due to hormonal changes caused by prostaglandins.

And this makes sense: your body begins to cleanse the intestines to free up more space inside the body for the baby.

Estimated date of birth (EDD)

This is the day on which your baby is statistically likely to be born. Most give birth somewhere between 37 and 42 weeks. Although many women don't give birth exactly on their expected date, you should definitely know it so you can be prepared. The closer it is, the more attention you need to pay to your bodily sensations and possible signals of the onset of labor. When you turn over the calendar and see the month in which the birth is due, you will feel excitement (and mild panic). Soon!

Contractions - first signs of approaching labor

In 70-80% of cases, the onset of labor announces itself with the appearance of real labor pains. They cannot be immediately distinguished from training ones, which you may have noticed for the first time a few weeks ago. At these moments, the abdomen hardens and the uterus contracts for 30-45 seconds.

The pain caused by contractions is well tolerated at first: you can even walk a little if you want. As soon as a certain regularity is established in the contractions, you will, without any prompting, put everything aside and listen to what is happening inside you.

As contractions gradually intensify, it is recommended to perform the breathing exercises that you were taught in childbirth preparation courses. Try to breathe as deeply as possible, inhale from your stomach. Your baby also has to do hard work during birth. And oxygen will be very useful to him for this.

Braxton Hicks contractions (preparatory). These contractions of the uterine muscles begin early, although you may not notice them. You will feel tension in the uterus. Such contractions are brief and painless. Sometimes there are several of them, they follow each other, but usually they stop quickly. Closer to labor, Braxton Hicks contractions help prepare the cervix for the process.

Go to the clinic immediately!

Regardless of the onset of contractions, if the baby stops moving, the membranes are ruptured, or there is vaginal bleeding, you should immediately go to the clinic.

Braxton Hicks contractions are a “warm-up” before the real contractions begin. They can start and stop several times and often stop when you are active (for example, while walking). Early labor contractions will be uneven in intensity and frequency: some will be so strong that you will lose your breath, others will simply resemble spasms. The intervals between them will be either 3-5 or 10-15 minutes. If you talked to your doctor for 15 minutes discussing whether labor had started or not, and never stopped, it was most likely a false alarm.

Learn to recognize contractions

During the early stages of labor, contractions lasting about 30 seconds may occur every 20 minutes.

• The first contractions are similar to spasmodic menstrual pain (radiating pain). The muscles of the uterus begin to contract so that the cervix opens to the full 10 cm.
  
• Late contractions feel like severe menstrual pain or reach an intensity you never imagined.
  
• When contractions become very strong and the rhythm of contractions becomes regular, it means it has begun for real!
  

There are no mandatory standards for when you can come to the maternity hospital. But if contractions occur every 5 minutes for an hour and make you freeze in pain, no one will prevent you from appearing in the maternity ward. Make an action plan with your doctor, taking into account the time it takes to travel.

• If you live near a maternity hospital, wait until the contraction rhythm is 1 every 5 minutes for an hour, and then call and tell your doctor that you are going.
  
• If the maternity hospital is 45 minutes away from you, then most likely you should leave when the contractions are less frequent.
  

Discuss this with your doctor in advance so you don't panic during labor. Remember that with the onset of the active stage, the cervix in most women dilates by 1-2 cm per hour. So do the math: 6-8 hours before you start pushing. (But if at your last doctor’s appointment you were told that your dilation was 4 cm, it is better to come to the maternity hospital early.)

Consultation with a gynecologist. I caution expectant parents, especially if this is their first pregnancy, that there may be a few “false alarms.” My wife is an OB/GYN and she made me take her to the hospital 3-4 times while pregnant with each of our three children! If she couldn't tell for sure, who could? I always tell patients: it is better for them to come and be checked (if it is premature, they will simply be sent home) than to give birth on the side of the road.

Timing is everything

How to calculate the time and rhythm of contractions? There are two ways. Just pick one and stick with it and watch things unfold.

Method 1

1. Note the moment when one contraction begins and its duration (for example, from 30 seconds to 1 minute).
   
2. Then note when the next contraction begins. If it is not felt within 9 minutes, then the regularity of contractions is 10 minutes.
   
3. It can become confusing if contractions occur more frequently. Always note the time from the start of one contraction to the start of the next.
   
4. If a contraction lasts a whole minute, and the next one begins 3 minutes after the end of the previous one, then contractions occur once every 4 minutes. When their frequency increases, it is difficult to concentrate on counting. Ask someone close to you to count the contractions for you.
   

Method 2

Almost the same, but here you start counting the time from the end of one contraction to the end of the next.

Opening and effacement of the cervix

Imagine your cervix as a big, plump donut. Before childbirth, it begins to thin and stretch. Expansion (opening) and thinning (flattening) can occur over a period of weeks, a day, or a few hours. There is no standard for the time frame and nature of the process. As the due date approaches, your doctor will make conclusions about the condition of the cervix as follows: “Dilatation 2 cm, shortening 1 cm.”

Abdominal prolapse

This happens when the fetus descends to the entrance to the pelvis and, as it were, “gets stuck” there, i.e. no longer moves inside. During Braxton Hicks contractions, it moves even further into the lower pelvic region. Imagine the child moving into the “start” position. This process begins for all women at different times, for some - only before childbirth. For many, the news of fetal descent is both good and bad news. It’s now becoming easier to breathe and eat, but the pressure on the bladder and pelvic ligaments makes you run to the toilet more and more often. Some expectant mothers even begin to think that the baby might simply fall out, because it is now so low. During the exam, your doctor will determine how low in the pelvis your baby is, or what his “position” is.

Abdominal prolapse occurs when the child seems to “fall” and descends towards the entrance to the pelvis. Head first, the baby moves into the pelvis, thereby preparing to travel through the birth canal. However, for women who experience abdominal prolapse a few days or weeks before giving birth, this symptom is a “false clue”, and for some it does not happen at all until the start of active labor. Braxton Hicks contractions become stronger, the baby gradually moves lower into the pelvis, the pressure on the cervix increases, and it softens and thins.

Rupture of membranes

In 10-15% of cases, the onset of labor is heralded by premature rupture of the membranes, which occurs before the first contractions appear.

If the baby's head is firmly established in the pelvis, then the loss of amniotic fluid will not be so large-scale.

You will know that the amniotic sac has ruptured by copious discharge of clear, warm fluid from the vagina.

Rupture of the amniotic sac does not cause any pain, since there are no nerve fibers in its membrane. Sometimes the amniotic fluid may be green in color: this means that the baby has already passed his first stool. Record the time of rupture of the membranes and the color of the discharged fluid, and inform the midwife or the maternity ward of the clinic. Here you will receive instructions on your next steps.

It is very rare that the amniotic sac ruptures in its upper part, with amniotic fluid draining out only drop by drop. Then they can easily be mistaken for urine or vaginal discharge, especially if the bladder is slightly weak. If you suspect that amniotic fluid is breaking, call your doctor immediately or go to the maternity hospital. A short inspection will clarify the situation.

As a rule, rupture of the membranes does not lead to dramatic consequences. Usually, contractions occur spontaneously within the next 12-18 hours, and childbirth occurs naturally. In the absence of contractions, they are artificially stimulated with appropriate medications to reduce the risk of infection for mother and child.

Breaking of water

Sometimes the amniotic sac is referred to by the strange, biblical-sounding term “fetal sac.” When it bursts (either naturally or by a doctor), it means that labor will occur within 24-48 hours. As a rule, the doctor decides not to take risks and not wait more than 24 hours after opening the bladder, especially if the baby is born at term, because there is a danger of infection.

If your water breaks

When the amniotic sac bursts, it's like a small flood, and it's impossible to predict exactly when or where it will happen. In the third trimester, the amniotic sac, a soft and comfortable “place of stay” for the baby, already contains about a liter of amniotic fluid. (Pour a liter of water on the floor - this is what it might look like.) But remember:

• For some women, the “leakage” is very small.
• Fluid will continue to leak from the sac even after your water breaks because your body will continue to produce it.
• Some women's water does not break spontaneously, and to stimulate labor, the doctor performs an amniotomy by piercing the sac with a long plastic hook.
• The liquid should be colorless. If it is dark (greenish, brownish, yellowish), this may mean that the baby has defecated directly in the uterus (this type of stool is called meconium). This may be a sign of severe stress in the fetus. Call your doctor immediately.

Consultation with a gynecologist. Heavy vaginal discharge during late pregnancy is completely normal. V 10-20% of women at this stage are so significant that they have to wear pads all the time. Blood flow to the vagina and cervix increases in the third trimester, so vaginal secretion also increases. You may not immediately understand whether this is discharge or your water has broken. If you feel “wet,” dry yourself and walk around a little. If fluid continues to leak, call your doctor.

Signal bleeding is a symptom of the onset of labor

Usually, throughout pregnancy, the uterine os remains closed with viscous mucus, which protects the fetal bladder from inflammation. When the cervix shortens and the uterine pharynx opens, the so-called mucus plug comes out. This is also a sign of impending labor. However, labor pains do not necessarily occur on the same day. Sometimes it takes several more days or even weeks before real contractions appear.

Closer to childbirth, mucus may lose its viscosity and come out as a clear liquid. In most cases, this is accompanied by a small, so-called signal, bleeding. It is much weaker than menstrual and completely harmless. However, to be sure, you should talk to your doctor or midwife about this - you should make sure that the bleeding is not caused by other reasons that could threaten you and your baby. Very often, a woman does not notice the separation of the mucus plug at all.

Light spotting or spotting

They may appear due to changes occurring in the cervix as it prepares to open. Contractions soften the cervix and the capillaries begin to bleed. Contractions intensify and spotting occurs. Any pressure on the cervix may cause slight bleeding (due to exercise, sex, straining during bowel movements, or straining the bladder muscles). If you are unsure whether this bleeding is normal, call your doctor.

Removal of the mucus plug

The cervix softens and begins to open, releasing a mucus plug. Sometimes the mucus flows out slowly or the plug may come out in the form of a knotty thick flagellum. Until this moment, mucus acts as a protective barrier in the cervix and is constantly produced by the body, especially a lot closer to childbirth. It's not a sign of impending labor—some women produce mucus for weeks beforehand—but it's definitely a sign that something is starting to change.

Backache

Pain may occur if the baby is positioned facing forward rather than toward your back. If the baby does not turn to his back, they may get worse. Pain may also occur due to the pressure of his head on your spine when contractions begin.

Cozy nest: not only for birds

Pregnant women often have a strong desire to build a cozy nest even before the onset of labor. The surge of “nesting” energy, which contrasts so strongly with the debilitating fatigue of the last trimester, forces expectant mothers to arrange their habitat, turning it into a nice and clean “incubator”. Another sign that you have begun the “nesting” period is the speed with which you try to get everything done, and how demanding you make requests to your family. "Nesting" is usually expressed as:

• painting, cleaning, arranging furniture in the nursery;
  
• throwing away trash;
  
• organizing things of the same type (food in the buffet, books and photographs on the shelves, tools in the garage);
  
• deep cleaning the home or completing “renovation projects”;
  
• purchasing and organizing children's clothing;
  
• baking, preparing food and stuffing it around the refrigerator;
  
• packing a bag for a trip to the hospital.
  

An important caveat: for some pregnant women, “nesting” never occurs, and if such impulses appear, the expectant mother feels too lethargic to do anything.

Symptoms of labor

False contractions are a nagging pain in the lower abdomen, similar to pain during menstruation. If such contractions are not strong and not regular, there is no need to do anything special: this is only preparing the uterus for childbirth. The uterus seems to be testing its strength before the important work ahead, gathering itself and relaxing its muscles. At the same time, you can feel the tone of the uterus - sometimes it seems to gather in a lump and become harder. The uterus can become toned without pain, since the closer the birth gets, the more sensitive and irritable it becomes. This is fine.

The third important harbinger of labor may be the release of the mucus plug. This is a mucous content that “lives” in the cervix, as if clogging the baby’s “house”. The mucus plug may come off in the form of a thick and sticky discharge of a transparent pinkish color.

A woman may not feel the warning signs of labor, although most often the expectant mother still feels preparatory contractions.

A normal first labor lasts approximately 10-15 hours. Subsequent births usually proceed somewhat faster than the first, but this does not always happen. I am an example of this exception, as my second labor lasted 12 hours longer (20 hours) than my first (8 hours).

If a woman’s amniotic fluid has broken, she must go to the clinic immediately. Amniotic fluid protects the baby, and he should not be left without it for a long time. Therefore, if you feel lukewarm, clear water leaking out, call your doctor and get ready to go to the maternity hospital.

Usually, after your water breaks, contractions begin (or they suddenly intensify if you have been in labor before). If contractions have not started, most likely in the maternity hospital they will try to induce labor (with the cervix ready) so as not to leave the baby unprotected for a long time.

Labor usually begins with contractions. Typically, women often begin to feel pain in the lower abdomen and aches in the lower back about a couple of weeks before giving birth. But how then do you understand what it is: preparatory Braxton-Hicks contractions or the beginning of labor?! Such questions and concerns almost always arise among women who are faced, theoretically or practically, with the precursors of childbirth.

It is not at all difficult to distinguish preparatory contractions from the onset of labor! When your stomach starts to swell, be a little more attentive to yourself: is it the same pain as usual, perhaps the painful sensations have lingered a little, or does something else intuitively seem unusual to you?

If you feel that these painful sensations are regular (appear and disappear with little frequency), it makes sense to start timing, counting contractions and writing them down.

Let's say that at about 5 o'clock in the morning you decide that your stomach hurts a little in a special way or for quite a long time. Get a stopwatch (you have it in your phone) and start counting.

At 5 o'clock in the morning pain appeared, a contraction began, it lasted 50 seconds, then there was no pain for 30 minutes.

At 5:30 the stomach begins to pull again, the pain lasts 30 seconds, then nothing bothers you for 10 minutes, etc.

When you see that the pain regularly repeats, intensifies, the duration of contractions increases, and the interval between them decreases - congratulations, you have begun labor.