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Generic activity. Normal and pathological discharge before childbirth Why does blood flow during contractions?

Throughout her pregnancy, the woman had to deal more than once with changes in the nature of vaginal discharge. Firstly, it is greatly influenced by the hormonal background of the pregnant woman, which constantly changes over time. Secondly, very often it is during this period that thrush worsens or first manifests itself, annoying with cheesy discharge with a characteristic sour odor. Thirdly, it is likely that there was a threat of disruption, which is indicated. And it is precisely this discharge that expectant mothers fear most.

Now, at the end of the term, you can almost breathe easy: the release of blood before childbirth in the vast majority of cases will mean its imminent onset. But it’s still too early to completely relax: even on the eve of the baby’s birth, premature placental abruption may begin.

Bloody discharge before labor is a sign of its onset

One of the most reliable signs of labor beginning is, which is always accompanied by discharge. The plug may come out during childbirth (then the woman will not notice it) or come out at once as a whole clot, for example, while taking a shower, which may also go unnoticed.

But also often the mucus plug comes off in parts, gradually, and at the same time the woman notices a white-yellow mucous discharge on the underwear, which may contain streaks of blood - pinkish, brown or brown. This is a sure sign that there is very little time left before meeting the most desirable creature. From the moment the mucus plug begins to come off, the mother should stop any activities that could lead to infection entering the womb (sexual relations, taking a bath and swimming in stagnant bodies of water).

Almost all women discussing spotting before childbirth on forums confirm that they went into labor within a day or two from the moment they discovered small amounts of bloody mucus on their underwear. Obstetricians note that the darker the blood, the less time there is to walk with the belly. Please note that it can take from a few hours to 2 weeks before delivery.

Other safe causes of spotting before childbirth

The passage of the mucus plug is the most likely cause of bleeding before childbirth, which is an absolute physiological norm. But there may be other safe reasons for the phenomenon that worries you.

A pregnant woman can observe slight discharge of blood from the vagina after an examination in a gynecological chair, and not necessarily immediately after an appointment with a doctor, but perhaps even within a few hours after that.

It’s the same after sexual intercourse, and it’s quite normal for two days after sex. The reason for the appearance of bloody discharge in both of these cases is mechanical irritation of the cervix, which is already preparing to begin its opening.

When to go to the hospital

We pay special attention to the fact that bloody discharge before childbirth in all the cases described above should not be profuse. Normally, these are scanty smearing traces or small inclusions, usually brownish, but can also be red. If bleeding begins, then you need to go to the hospital without delay, without wasting a second! It is also necessary to see a doctor if, after the mucous plug begins to drain, the blood discharge begins to increase or the child changes his motor activity.

Bloody discharge before childbirth, observed 2 weeks before its expected onset and earlier, also cannot be ignored: be sure to notify your doctor about this.

Especially for Elena Kichak

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” when 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 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 a sense of excitement (and mild panic). Coming 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

Note the moment when one contraction begins and its duration (for example, from 30 seconds to 1 minute).
Then note when the next contraction begins. If it is not felt within 9 minutes, then the regularity of contractions is 10 minutes.
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.
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 he 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 birth 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 (such original 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 membranes from inflammation. When the cervix shortens and the uterine os 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.

Back pain

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 exhausting 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 upcoming important work, 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 these are: 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 begins 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.

During the period of bearing a child, a woman should especially carefully monitor changes in the body. The greatest concern is the first trimester, when there is a risk of miscarriage, and the last month. Discharge before childbirth is a physiological feature that indicates the preparation of the female body for the birth of a baby.

But it is important to evaluate the nature of these discharges, since the color and smell may indicate the presence of complications. You can keep your baby healthy and avoid problems during childbirth by detecting them in a timely manner.

It is important for a woman in the last month of pregnancy to know what discharge should be present before giving birth. This will help distinguish the physiologically occurring process of preparing the body from pathological conditions. Normally, abundant mucus appears first, then the plug comes out and water pours out. The fact that not everything is in order is indicated by bloody, cheesy white and greenish discharge with an unpleasant odor.

Pink discharge before labor appears because the plug that previously covered the cervix may contain a small amount of blood. The mucus is slightly colored by it, but does not contain blood streaks. If the color turns red, this indicates early placental abruption or placental previa. Both are dangerous for the child, so immediate medical attention is necessary.

Brown, pink, brown discharge before childbirth is not bleeding. They are mixed with mucus, insignificant and appear, as a rule, less than a day before the birth of the child. At this time, you can begin preparing for departure to the maternity hospital: collect all the necessary things and documents, warn close relatives.

If the discharge before childbirth is white, looks like cottage cheese and has a sour smell, then most likely a fungal infection - thrush - has spread into the vagina. The disease must be treated urgently, since it significantly complicates the birth process for the mother and can harm the health of the child. Candidiasis in a woman in labor reduces the elasticity of the vagina and increases the risk of ruptures.

Green and yellow discharge before childbirth also indicates an infection (trichomoniasis, gonorrhea, chlamydia) or inflammatory processes in the pelvic organs. In any case, immediate medical attention is required.

Mucus discharge

The mucus released before childbirth can be thick, viscous, transparent or white with a slight tint. You can take a small amount of mucus with two fingers; when you separate them, its consistency (strength, viscosity) will be clearly visible.

Mucous discharge before childbirth indicates the ripening of the cervix. They are most noticeable after waking up, when a woman moves from a horizontal to a vertical position. After some time, the discharge begins to darken and turn brown - this means that there are several hours left before the birth of the baby.

Exit of the mucus plug

During pregnancy, the lumen of the cervix is blocked by a mucous plug, which protects the fetus from infection. By the end of gestation, the walls become elastic and open. Under the influence of hormones, the plug softens and comes out.

It is impossible to predict exactly when this will happen: for some women two weeks before giving birth, for others a few hours.

If the mucus plug comes off all at once, it looks like the white of an egg or a jellyfish. Often this process goes unnoticed because it occurs while visiting the toilet or taking a shower.

In addition, the plug may come out gradually, over one or two days, then it will look like the usual clear or white discharge before childbirth.

After the mucus plug comes off, you should not take a bath, you should refrain from sexual intercourse, pay more attention to intimate hygiene, and change your underwear more often. During this period, the uterine cavity becomes open to infection.

Leakage of amniotic fluid

Unlike a mucus plug, the leakage of amniotic fluid cannot be ignored. They are a liquid whose volume ranges from 0.5 to 1.5 liters. Normally, it is transparent, has a slightly sweet odor or does not smell of anything. Sometimes, along with the water, particles of lubricant come out, protecting the baby’s integument in the uterine cavity. They look like small white flakes.

The process of discharge of amniotic fluid also occurs in different ways. Sometimes the liquid pours out all at once, this often happens after visiting the toilet or with a sudden change in body position. In other cases, it gradually leaks. Exactly how this will happen depends on where the bladder ruptures - near the cervix or above.

If the amniotic fluid is yellowish or greenish in color, cloudy, this may indicate that:

the child experiences oxygen starvation;
there is a presentation of the fetus;
premature placental abruption began.

Blood discharge and changes in the color of amniotic fluid require an immediate call to the ambulance team. Trying to get to the maternity hospital on your own can be harmful and further complicate the situation.

When should you see a doctor?

You should see an obstetrician-gynecologist if you have discharge that differs from normal daily discharge. A specialist will be able to accurately determine their character and tell whether everything is in order. If the discharge is white, curdled, yellow or green with an unpleasant odor, then a visit to the doctor is necessary.

An infectious disease in late pregnancy is dangerous to the health of the child and negatively affects the birth process. After the plug comes out, pathogenic microflora can easily enter the uterine cavity.

An immediate call to an ambulance is necessary if bleeding develops. Copious discharge of bright scarlet blood is dangerous for the life of mother and child.

You should seek medical help if the discharge is accompanied by cramping pain in the lower abdomen. Most likely, this is a sign of the onset of labor. Moreover, this can happen even before the amniotic fluid breaks.

At the end of her term, a pregnant woman should know what discharge is normal before childbirth. Physiological changes of this kind by the end of the term consist of three stages: mucus secretion (ripening of the cervix), discharge of the plug and amniotic fluid. In all cases, you need to pay attention to the color, structure and smell of the discharge.

As you know, the calmness of a woman in labor, as well as her “disposition” to follow the instructions of the doctor and midwife, largely determine the outcome of the birth. Let's talk about what the “correct” behavior of a woman is at each stage of this complex process and how to behave during childbirth.

Labor activity

Periods of labor

As a rule, the process of childbirth begins with contractions - involuntary contractions of the muscles of the uterus. Contractions open the cervix. The first stage of labor begins with the onset of regular labor and ends with the complete opening of the cervix (10-12 cm).

If labor begins with contractions, then it is necessary, if possible, to remember the time of the first contraction, and then clearly (preferably on paper) record the time of contractions: what time each contraction begins and how long it lasts. Such records will help your doctor determine the time of the onset of regular labor, judge its correctness and timely diagnose the weakness of labor, in which the intervals between contractions become large and the contractions themselves become short. Recording contractions will help you take your mind off the pain that may accompany them. In addition, in this way you will be able to distinguish true contractions from false ones. If during true contractions the duration of contractions of the uterine muscles increases and the intervals between contractions decrease, then during false contractions the intervals between contractions are different and tend to increase.

If before the start of regular labor (contractions) your amniotic fluid leaks, you need to remember the time at which it leaked or began to leak and get ready for the maternity hospital. The fact is that the amniotic sac is a barrier to infection entering the uterine cavity and the fetus. Therefore, from the moment of rupture of amniotic fluid until the birth of the baby, no more than 12 hours should pass, otherwise the likelihood of infection is very high.

Childbirth can also begin with preliminary pain - nagging pain in the lower abdomen, and more often in the lumbar region, which does not have a periodicity, that is, it occurs at different intervals and has different durations. After observing yourself for 1 - 1.5 hours and realizing that these are preliminary pains, but not contractions, you can take 2 tablets of no-shpa, 2 tablets of valerian and try to sleep. If these actions do not lead to a positive result, then it is necessary to seek help from the maternity hospital, since preliminary pain exhausts the woman and predisposes her to the development of weakness in labor in the future. In the maternity hospital, for preliminary pain, the woman is given medicated sleep and rest.

The appearance of copious bright red bleeding at any stage of labor is a reason to contact the maternity hospital. Such discharge may be a sign of placental abruption, in which the baby experiences an acute state of oxygen deficiency, and the mother experiences bleeding. It should be noted that normally during childbirth there is slightly bloody or bloody discharge.

After you understand (assume) that you are in labor, you should not eat or drink. This is due to the following rules. In the first stage of labor, reflex vomiting may occur during the opening of the cervix. A full stomach predisposes to this trouble. In addition, any childbirth can be considered as a potentially risky situation due to the need for surgical intervention, because theoretically any childbirth can end with a cesarean section, there may be a need for manual separation of the placenta, etc. The listed surgical interventions are carried out against the background of anesthesia, and at the time of giving anesthesia, regurgitation is possible, that is, the release of stomach contents into the oral cavity, and from there into the lungs. A full stomach is a predisposing factor for such complications.

It is very important not to hold your breath during contractions. During the period when the muscles of the uterus tense, the lumen of all uterine vessels narrows, including those that go to the placenta, that is, they nourish the fetus. Therefore, it is extremely important to use any of the suggested breathing techniques. All these types of breathing, used at the moment of contraction, ensure that an increased amount of oxygen enters the woman’s blood, and therefore delivers a sufficient amount of blood to the fetus.

For less painful contractions, a type of breathing that can be called slow is suitable. The ratio of the duration of inhalation and exhalation is 1:2. Inhale through the nose, exhale through the mouth. It is very important to remember that you need to start and end the contraction with a calm inhalation and exhalation.

You can breathe this way not only at the beginning, but throughout the entire birth: everything will depend on your feelings, on the nature of labor and, what is very important, on your psychological and theoretical preparedness.

During the active phase of labor, when contractions become more painful and frequent, you may find it helpful to breathe with a vocal expression of pain. In this case, the exhalation is “sung” or “pronounced” with the vowels o, a or u. In this case, the sound sung should be low; this is important because when pronouncing low sounds, a large group of muscles in the body (including the pelvic floor muscles, cervix) involuntarily relaxes. At high notes, cervical spasm is likely.

Also, for the first stage of labor, you can master breathing “through plump lips.” At the peak of the contraction, inhale through your nose with a loud sniffle, and exhale through your mouth, creating a “puffy lip” and making a “poo” sound.

You can also use the diaphragmatic-thoracic type of breathing. Its frequency is arbitrary: it will be determined by your sensations. At the beginning of the contraction, 3-4 deep diaphragmatic-thoracic inhalations and exhalations are performed. In this case, place your hand on your stomach in the navel area, the other on your chest. During inhalation (contraction of the diaphragm), you should strive to ensure that the hand lying on your stomach rises higher than the hand lying on your chest. When the hand lying on your stomach rises as much as possible, continue inhaling by expanding the chest, raising the hand lying on it.

With the development of labor, as the intensity of contractions increases, and the intervals between them become smaller and smaller, it becomes more and more difficult for many women in labor to realize the types of breathing that we talked about earlier, i.e. slower ones. There is a need to breathe frequently and shallowly – like a dog. The pattern of such breathing is as follows: on the rise - 1-2 diaphragmatic-thoracic inhalations and exhalations, with a deep cleansing exhalation, then inhale and at the peak of the contraction - frequent, shallow breathing, with the tongue pressed to the palate. At the end of the contraction, breathing becomes less frequent - a cleansing exhalation, and at the end - 2-3 diaphragmatic-thoracic inhalations and exhalations. The contraction lasts on average 40 seconds, at home this exercise should be performed for 20 seconds (to avoid hyperventilation - excess air intake, which can lead to dizziness).

During contractions you should not tense up - you should try to relax as much as possible. Tension prevents the opening of the cervix, the process of childbirth is delayed, which negatively affects both the condition of the woman in labor and the condition of the fetus. When the opening of the cervix is already large and close to full (10-12 cm), the tension prevents the head from moving along the birth canal, which prolongs labor.

After several hours of contractions, with a large opening of the cervix (more than 5-6 cm), as a rule, amniotic fluid is discharged. After the discharge of amniotic fluid, it is necessary to lie down and not get up, since the discharge of water, especially with polyhydramnios, can entail the umbilical cord or the fetal hand. Therefore, immediately after the release of amniotic fluid, a vaginal examination is performed, during which the head is pressed tightly against the pelvic bones, and the above-described complications no longer arise. The doctor records the fact that the head is pressed and, if necessary, spreads the membranes of the amniotic sac so that this happens during the examination and complications are excluded.

If the doctor does not give any special instructions, then during the first stage of labor (contractions) you can walk and take any comfortable vertical positions. The only thing you should not do is sit on a hard surface (chair, bed, etc.). This is due to the fact that by occupying any vertical position - standing with support on the headboard of a bed or chair, hanging on an assistant's neck or on a rope - you contribute to the advancement of the presenting part of the fetus along the birth canal. But you can sit on a ball or on the toilet if your doctor allows it. At the end of the first stage of labor, a situation may arise in which it is necessary to somewhat speed up the movement of the head along the birth canal (for example, when the opening of the cervix is already complete, and the head is moving slowly), or, conversely, to slow it down (for example, with premature birth) . In the first situation, the woman in labor is asked to squat, and in the second, she is asked to lie on her side.

It is very important to empty your bladder regularly during the first stage of labor. This needs to be done every two hours. A filled bladder interferes with intense contractions of the uterus.

Attempts

What to do during pushing

After several hours of contractions (8-10 hours during the first birth and 4-6 hours during the second), the cervix opens completely and a transition period begins when the baby’s head begins to intensively move down the birth canal.

After a while you will want to push, but call your doctor or midwife before doing so. You will be examined and then allowed to push. By the period of pushing, the cervix should be completely open, and if you start pushing on your own, for example, with the cervix not yet fully open, then cervical rupture will occur. Premature pushing can also have adverse effects on the fetus. The fact is that during movement along the birth canal, the fetal head configures, that is, the unfused bones of the head come one after another.

Thus, the size of the head gradually becomes smaller. If you start pushing before the head has “shrinked,” injuries (bleeds in the brain) may occur. In this case, the adaptation period for the baby will be more difficult. Some women in this situation become restless and scream. As a result, oxygen does not enter the lungs, and an oxygen deficiency is created in the blood, including the placental blood, which affects the condition of the child. At this stage, the woman in labor will also be helped by breathing like a “sob.” As the contraction rises, you exhale cleansingly and take a deep, full breath, then your breathing quickens and becomes shallow; three or four shallow inhalations must be completed with an intense exhalation, sharply blowing through lips elongated into a tube, as if you were blowing out a candle or inflating a balloon. (This is exactly how a person breathes when he sobs). You can breathe on a count: one, two, three - exhale; one, two, three - exhale. At this stage of labor, doggy breathing is also suitable.

After the baby is born, your task is to give birth to a child's place. This is not difficult - to do this, you just need to push again after the midwife asks you to do so.

It will be easier to follow these tips if you remember that the most precious thing she has - the life and health of her child - depends on the reasonable behavior of a woman during childbirth.

According to statistics, this figure is 200 ml, which corresponds to 0.5% of total body weight. At the same time, the expectant mother’s body prepares for blood loss in advance. Thus, already in the first trimester, the volume of circulating blood increases, and closer to childbirth, blood clotting increases, which insures the body from large expenses. In addition, already during childbirth, the woman’s body starts a mechanism that stops bleeding.

What happens at the physiological level?

After the birth of the child and the placenta, the placenta separates from the walls of the uterus, and a small wound forms in the place to which it was recently attached. It is at this very moment, which can last up to half an hour, that the body turns on protection against large blood loss.

When it leaves the uterus, it contracts and contracts, thus blocking the blood vessels. Because of this, clots form in the vessels, which stops bleeding. Over the next two hours, the new mother's uterus should contract and contract. This is why women put ice on their stomach. After all, as you know, under the influence of cold, muscles continue to contract.

In what cases do we talk about bleeding?

If a woman has lost 500 ml of blood or more, doctors call it bleeding. To avoid such situations, it is important to follow all doctor’s instructions during pregnancy and not skip routine examinations. In 9 months, the doctor will draw up a complete picture of the condition of your body: how many pregnancies you had before this one, whether you have scars after a cesarean section, tumors, chronic diseases, problems with blood clotting, etc.