How to know when to go to the hospital. Signs of the onset of labor: when it is time to go to the hospital. Drainage of amniotic fluid
The last weeks of pregnancy are a time of excitement for every woman.
After all, the real date of birth does not always coincide with the one that the doctor has determined for you.
It is especially difficult for expectant mothers giving birth for the first time.
The first contractions, the discharge of water, a change in the shape of the tummy - all this is known in theory. But what the harbingers of childbirth will be in practice is still a mystery to mothers.
We will try to dispel all your doubts and tell you how it really starts.
The first signs of childbirth
The normal time to start labor is 37-38 weeks. , lasting up to 41.5 weeks, is considered post-term.
But each pregnancy is individual: perfectly healthy and strong babies are sometimes born both at 36 weeks and at 42.
Childbirth begins suddenly in very rare cases. Most often they are preceded by the following symptoms (harbingers of childbirth):
1 The mucus plug comes off. A dense clot of mucus closes the cervix, protecting the fetus from possible infection. When the uterus contracts, the mucous plug is forced out. This usually happens 1-2 days before the birth, but sometimes the cork can leave a week before real contractions.
Evidence of the discharge of the mucous plug will be characteristic abundant discharge. Their consistency is quite thick, there may be impurities of pinkish and yellowish color.
2 Outflow of water. This symptom occurs strictly 24 hours before the onset of labor.
There is a rupture of the amniotic sac, and the waters that serve as the main nutrient medium for the baby come out.
The period when the baby is without amniotic fluid protection should not exceed 12 hours.
A long anhydrous period threatens with infection and complications during childbirth.
Water can drain quickly, or leaks can be observed for some time. The color of the released water should be transparent or very light.
In the presence of cloudy, greenish or bloody impurities, the expectant mother should immediately consult a doctor.
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3 real contractions. The most pronounced symptom of the onset of labor. Thanks to contractions, the cervix opens up so that the baby's head can easily pass through the birth canal.
4 Painful sensation in the lower back. There will be periodic "shooting" pain, somewhat reminiscent of the sensations at the onset of menstruation. This symptom appears no more than 2-3 days before delivery.
If such pain haunts you constantly, be sure to tell your doctor. This may indicate that the baby is taking the wrong position, and you will have to consider the option caesarean section.
5 Abdominal prolapse. This occurs 2-3 weeks before the onset of labor.
The placenta descends lower to the pelvic region, while the pelvic bones diverge to the sides.
As a result of uterine prolapse, heartburn stops in a woman, digestion improves and it becomes easier to breathe. True, this will make it more difficult for you to sit and walk.
6 Frequent urination. Due to the increased pressure of the descending uterus on bladder you may have frequent urge to urinate. And some of them may be false. The same factor affects the frequent defecation.
7 Change motor activity baby. A few days before the birth, the expectant mother may notice that the child behaves differently than before. His tremors may intensify or, conversely, subside for a longer time.
8 "Nesting" syndrome. Rather, a psychological, but very common sign of an early birth. A woman has a natural desire to create all the conditions in the house in order to soon bring a tiny family member into it.
At this time, you are unlikely to want to go out to meet with friends: the priority will be home cleaning and creating comfort in the children's room.
If not you, then your family and friends will certainly notice a change in your mood. Sharp mood swings will be replaced by calmness, harmony and a desire to smile.
9 weight loss. Often, mothers lose their appetite before childbirth, and over the last week of gestation, they lose up to 2 kg in weight. This can also be explained by frequent urination and defecation.
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How to distinguish real contractions from false ones?
It is better to go to the hospital when you fully feel the signs of the onset of labor. If labor activity is unsteady, you don’t need to call an ambulance: you will simply waste your time and, possibly, end up in the pathology department.
Often, women who are carrying a baby for the first time take false (training) contractions for real ones.
The main difference between training fights and real ones is almost complete painlessness.
You may notice only slight discomfort when walking. Real contractions are very painful, much more unpleasant than menstrual cramps.
For real fights, the growing strength of pain is characteristic. Contractions always occur regularly, but as labor approaches, their rhythm becomes more frequent.
Some women have a feeling of petrification of the abdomen during labor pains. When you touch your stomach, you will feel a hard and very elastic surface. This effect can last up to 1 minute, then the tension subsides.
While training contractions can be “calmed down” by taking a warm shower or changing body position, labor pains can’t be dealt with.
How does labor begin in primiparas?
In mothers expecting their first-born, signs of childbirth are diagnosed 1-2 weeks before the end of the pregnancy. Among the multiparous, the percentage of rapid births is greater.
Many women who are carrying second or more babies begin to notice the appearance of the precursors of childbirth only after 38 weeks.
There are situations when it is not so easy for a woman to determine whether she is really going into labor or whether it is still too early to go to the hospital. But still, there are some signs that will tell you for sure that the time "h" has already come.
Premonition
In the last weeks before giving birth, you probably did not find a place for yourself from impatience to give birth to a long-awaited baby. Preliminary calculations do not determine the exact date of delivery, since the normal time of delivery is from the 38th to the 42nd week of pregnancy.
Physiological changes
However, shortly before the birth, physiological changes occur that will definitely tell you that it will not be long to expect the appearance of the baby. Just before delivery, your belly should drop a little as the baby's head sinks deeper into the pelvic ring. This can happen about 1-2 weeks before the birth, but it can happen just the day before. Most likely, you will feel some relief in breathing, and the gynecologist will note the descent of the bottom of the uterus. Shortly before childbirth, you will feel more strongly Braxton Hicks contractions, during which the uterus “trains” before childbirth. Some women feel an increase in lower back pain, and some even clearly feel how the baby's head is pressing on the cervix. In most cases, if this is the first birth, the frequency and strength of contractions increase quite slowly, at intervals of 24 hours, so you will have to be patient to wait until it is time to go to the hospital. Many pregnant women find it easier to relax and unwind at home, making childbirth easier and painless. But you can only stay at home if you have your first birth and the amniotic sac is still intact. From the moment when the contractions begin to repeat every 10 minutes and last at least a minute, you need to call an ambulance or go to the hospital in your car.
Braxton Hicks contractions
Often a woman, having felt false contractions (Brexton-Hicks contractions), takes them for real ones, but such contractions stop after a while and resume after a few days. Sometimes Braxton Hicks contractions are strong enough to mislead a woman. However, be aware that these contractions are preparation for childbirth, due to which the cervix ripens, so that in right moment childbirth was less traumatic.
Signs of the onset of labor
The main sign that you are about to give birth and it's time to go to the hospital is waste of amniotic fluid. The amniotic sac bursts, and part of the fluid flows out - this process is completely painless, and depending on where the gap is located, the amniotic fluid will either literally pour out, or the fluid will ooze drop by drop. If the waters have broken even before the contractions start, still go to the hospital immediately. Since the barrier that protected your baby from infections has already been destroyed, it is best to be under the supervision of specialists from now on. The color of the amniotic fluid is importance, so take a closer look at them: if the liquid is light or slightly yellowish, then everything is fine with you. If it has a greenish tint, be sure to inform the doctor about this, as this is a sign of oxygen starvation of the fetus and immediate measures must be taken so that the baby is born as soon as possible. At first, it can be difficult to distinguish real contractions from Braxton Hicks contractions. However, a sign that you are going into labor is that the contractions will become more frequent and stronger and cause you more and more anxiety. Gradually, prenatal contractions will be perceived as periodic bouts of pain, accompanied by pain in the lower back, hips, calves and rectum. The mucous plug that has been covering the cervix throughout pregnancy and protecting the baby from infection comes out, signaling that the cervix is “ripe”. Slightly pinkish discharge, consisting of liquid mucus with a small admixture of blood, may appear as early as two weeks before childbirth, although very often the mucous plug leaves just before childbirth.
Women who are preparing to become mothers should know exactly when to go to the hospital. This issue is especially relevant for primiparas.
An obstetrician, a gynecologist should tell the expectant mother what happens to the body during contractions and discharge of water, so that she understands when it is time to go to the hospital.
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Classmates
The question of when to go to the hospital during the first pregnancy, all women are puzzled. The doctor leading the pregnant woman should inform her about the state of health, on which the nature of the delivery will depend. At 35-36 weeks, the expectant mother will find out the planned place of birth, so that at the 39th week of pregnancy, when it is time to go to the maternity hospital, there will be no unnecessary problems.
A woman undergoes numerous examinations that reflect the condition of the baby and the pregnant woman herself. The decision when to go to the maternity hospital for nulliparous is based on an assessment of the results of all studies and risks on an individual basis.
During the first pregnancy, childbirth can last an average of 12 hours and begin with pulling cramping sensations that appear with temporary regularity. If such pains appear in the period from 37 weeks, the onset of labor should be suspected and it should be understood that it is time to go to the hospital, as recommended by the doctor according to the plan.
The contractions have begun - is it time already?
Contractions are muscular uterine contractions. Their appearance marks the fact that the woman began to give birth. You should immediately go to the hospital during contractions, when the cervix begins to open. This is especially true in the second and subsequent pregnancies, because a woman gives birth much faster than for the first time in her life.
There is a danger of fast and rapid childbirth, when the fetus is expelled in a shorter time period than expected. Therefore, if contractions occur before childbirth, it is urgent to go to the hospital when the baby has just begun its journey.
With what interval of contractions can not be postponed?
During a different period before childbirth, women feel false contractions, characterized by irregularity and painlessness. Primiparas often cannot distinguish between false contractions and true generic ones and wonder what kind of contractions to go to the hospital with.
Birth pains:
- go at regular intervals;
- painful and their intensity depends on the pain threshold of the woman in labor;
- there is a decrease in the interval between contractions;
- pain increases from contraction to contraction.
With what interval of contractions to go to the hospital depends on the state of health of the woman. But it is better to call an ambulance when detecting the regularity of uterine contractions, without waiting for the opening of the cervix.
If there is a minute between contractions, then the birth is already in full swing and the cervix is fully opened.
If the amniotic fluid broke
The outpouring of water during normal delivery indicates the end of the first birth period and the full disclosure of the uterine cervix. If the waters have broken, you need to go to the hospital when the amniotic sac is opened, immediately more than a minute, because there is very little left before the birth of the baby. In the second period, the mother needs to start pushing to expel the baby from the uterus. When the waters have broken, you should go to the maternity hospital with repeated births faster because of the possibility of giving birth before reaching the hospital.
What feelings make you understand about the imminent start?
About when to go to the hospital during pregnancy, in addition to contractions and outflow of amniotic fluid, the woman will be prompted by the exit of the mucous plug that closes the uterine cervix. It is an accumulation of dense mucus about three milliliters in volume and can go out a maximum of two weeks before childbirth, or maybe already during contractions. The presence of blood streaks in the cork is normal and should not frighten the expectant mother.
Amniotic fluid and mucous plug
During the second and third births
It is easier for a woman to understand when to go to the hospital during the second birth, since she can focus more accurately on her feelings experienced during the first delivery.
Going to the hospital during the third birth, when cramping regular pains began, is necessary as soon as possible to ensure the safety of the mother and the child, who will be born within five hours.
How to understand that it's time to go to the hospital, a gynecologist will tell a pregnant woman. There are the following methods for determining the date of birth of a baby:
- according to the gynecological examination;
- by the number of expected conception;
- according to the last menstruation;
- by the first movement of the fetus.
A woman prepares for delivery in advance, visiting a gynecologist and narrow specialists, undergoing examinations. A positive result of the preparation is the participation in the classes of the school for pregnant women, where they will competently talk about when to go to the hospital, how to behave there, and about the first steps in caring for a newborn baby. It is useful to prepare not only morally, but also physically, so that the body reacts correctly, and the muscles relax and tighten where necessary. Breathing, yoga and walking will help with this.
When you need to go to the hospital, the question arises of what should be taken from the essentials. Birthing bag includes:
- documents: passport, insurance, exchange card, referral, sick leave;
- clothes for mom: bathrobe, shirt, underwear, socks, washable slippers;
- hygiene items: pads, wet wipes, toilet paper, soap, toothpaste, brush, comb, shampoo;
- mug and spoon;
- clothes for the baby: diapers, bonnets, undershirts, sliders;
- for a baby: diapers, disposable diapers, cotton pads, diaper cream, pacifier.
Approximate contents of the bag in the hospital
Conclusion
- should be aware of the timing of the trip to the hospital, which in each case is individual and depends on the health of the woman and her baby.
- Gynecologists need to familiarize pregnant women with the order of the appearance of contractions, the features of the opening of the cervix and the discharge of amniotic fluid.
- Starting from week 37, a woman should be ready to go to the hospital, knowing about the delivery procedure and the rules for caring for a newborn baby.
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This is by far the very first and most visible sign of impending labor. The baby's head descends into the birth canal, the muscles of the uterus stretch, and it seems to rush down after the fetus. The abdomen drops and becomes similar in shape to a pear. In addition, the pregnant woman notices some changes in her health: frequent stools and urination (since the head of the fetus puts more pressure on the bladder and rectum). There are also positive changes - it becomes easier to breathe, heartburn and belching do not bother, the fetus no longer presses so hard on the stomach and diaphragm.
In fact: It would seem that this is a sign that it is time to go to the hospital. But no, it's early. As a rule, the stomach drops 1-3 weeks before the X hour. It is worth noting that this happens only in primiparas. If you are going to the hospital for the second or third time, then the tummy drops right before the birth. In addition, much depends on the shape of the woman's pelvis, on the size of the fetus, on its position in the uterine cavity - forward with the head or buttocks.
Myth 2: The cork has come off
Before childbirth, discharge from the genital tract (cervical fluid) becomes abundant, and a few days before the birth of the crumbs, the mucous plug leaves. It protected the fetus from infections, in literally blocking the cervix. It is a thick, transparent, slightly yellowish mucus, which, by the way, can mix with a small amount of blood due to the fact that several small vessels have torn. It is worth noting that the appearance of mucous discharge from the cervix in the last weeks does not mean at all that the time has come for childbirth.
In fact: this is not necessarily a one-time action - sometimes the cork is separated in stages, over several days. It happens that from the first discharge of mucus (cervical fluid) to the onset of childbirth, it takes up to 10 days. There are several more options for the development of events: when the cervix softens and opens slightly before childbirth, the cork can remain in the cervical canal and stand out only during childbirth, or maybe only immediately before childbirth.
Myth 3: If your waters break, you give birth?
A pregnant woman may feel that the water is leaking or that they have gone completely. This means that the fetal bladder has ruptured on its own and there is a threat of infection of the fetus, so the anhydrous period should not be allowed to last more than 12 hours. Nature intended that the whole fetal bladder is actively involved in the process of childbirth - it must put pressure on the cervix so that it stretches during the first contractions.
Normally, this happens after the onset of contractions, but it is not uncommon for the opposite to happen. It depends on the volume of water (normally about 1.5-2 liters), the size of the fetus, how it is located, and the duration of pregnancy. Moreover, the integrity of the fetal bladder can be broken both at the beginning, in the middle, and at the end of childbirth. There are times when it does not break at all and the baby is born in a fetal bladder filled with water, then there is a danger that the baby can take a sip of water with the first breath.
In fact: it is better for a pregnant woman to go to the hospital not when the waters have broken, but much earlier.
Myth 4: Contractions have begun
As you know, during pregnancy from time to time there are “training contractions”. If at first they are rare, no more than 1-2 contractions per week, almost always in the evenings, then as the fetus grows, their frequency increases - up to several times a day. But already 2 weeks before the birth, the pregnant woman has new sensations - the so-called precursor contractions or false contractions. They are quite similar to the real ones - both in strength and in sensations, but do not lead to the opening of the cervix, do not last long. In most cases, false contractions are weak, irregular, although it happens that they are quite noticeable. With them, the uterus periodically tenses up in waves, there are sensations of "sipping" in the lower abdomen and in the lumbar region.
In fact: You need to decide what kind of contractions you have. Real, labor pains are regular and with gradually increasing intensity. In addition, they certainly lead to the opening of the cervix, which does not happen with training contractions.
Myth 5: It is always better to go to the hospital in advance
Everything seems to be logical: let the doctors look after, you never know. But childbirth is a long process, especially for primiparas. Of course, if the state of health future mother inspires fear, then prenatal hospitalization is needed. It is mandatory in case of a planned caesarean section (no later than 38 weeks of gestation), in the presence of scars on the uterus, general chronic diseases, preeclampsia (late toxicosis), blood flow disorders in the placenta, fetal growth retardation, the threat of premature detachment of the placenta. Traditionally, hospitalization is recommended for overdose for examination and observation.
In fact: The tense waiting in the hospital can not always cheer up a healthy pregnant woman, it is better to stay at home, in a calm and familiar environment.
It is urgent to go to the maternity hospital if a woman in the last weeks of pregnancy: - discharge from the genital tract, similar to menstruation, or even just when it “smears”); - water stained with blood is leaking; - the pain during contractions is very strong, the uterus is painful to the touch and does not relax between contractions; - the fetus suddenly began to move very weakly, or, conversely, very strongly; - a woman is worried about a headache, her vision suddenly became blurred (“flies before her eyes”); - there were pains in the epigastric region, increased arterial pressure, inability to urinate.
Tatyana Ustinova
gynecologist, clinic "Baltika", St. Petersburg
The first pregnancy and childbirth is a phenomenon in which previously unknown sensations are known. And many primiparous women are concerned about the question: "How to understand when the birth will begin?".
A sign of the onset of labor is contractions, which begin with short-term painful sensations in the lower abdomen and appear at certain time intervals.
Over time, the contractions become more painful and prolonged, and the pauses between them are shortened, which indicates the imminent birth of the baby.
When to go to the hospital?
In some films, the phenomenon of childbirth is shown very quickly: a woman's water broke and, before she could reach the maternity hospital, she gives birth right at home or in the car in a few minutes. AT real life this does not happen. Usually, from the moment of the first contractions and the outflow of amniotic fluid, and until the baby is born, about 10 hours pass, therefore come in maternity hospital before pushing a woman will always make it.
You should go to the maternity hospital immediately in the following cases:
- With the outflow of amniotic fluid;
- With painful regular contractions, with an interval between them of 15 minutes or less.
- With open bleeding.
You can come to the maternity hospital on your own by contacting the emergency room. Women in the process of childbirth are accepted without a queue. In the absence of this possibility, you should issue a call to " ambulance”, and the team will deliver the woman in labor to the hospital.
Childbirth in primiparas
In primiparous women childbirth lasts from 10 hours and higher. The countdown of labor activity begins with uterine contractions (contractions). Every pregnant woman begins to feel periodic pain in the lower abdomen, accompanied by severe tension in the abdominal muscles (stone) from the beginning of the third trimester of pregnancy. This phenomenon is called “training” contractions or Braxton Hicks contractions. They prepare the body for the birth process in the future.
The main thing for a woman in labor is distinguish training contractions from real ones. They can be differentiated according to the following features:
- Training contractions are short-term, chaotic in nature and quickly stop. With true contractions, the episodes themselves and the pauses between them are almost equal in time, slightly lengthening in the future.
- Unlike Braxton Hicks contractions, pain during true contractions gets worse each time.
- Training fights subside or stop with a change in body position, in contrast to true ones.
It will be useful to download the program "Convulsive Counting" to your smartphone, where you can track the intensity of contractions. If all the symptoms of true contractions are present, the interval between them has decreased to 5-10 minutes, you can pack your things and go to the hospital.
Duration of contractions in multiparous
In multiparous women, the process of childbirth occurs much faster than in primiparas and takes from 7 hours. As a rule, a woman during a second pregnancy prefers to wait out most of the contractions at home and go to the hospital closer to the birth process itself.
However, in some cases this can lead to adverse consequences, since labor can be rapid (the fetal expulsion phase can last only 5 minutes) and the woman in labor simply does not have time to arrive at the hospital.
Women giving birth for the second time should go to the maternity hospital with the outpouring of water, regular contractions, if the pause between episodes is 10 minutes or less.
The first signs of approaching childbirth
The first signs of approaching childbirth in women manifest themselves in different ways. For some, the onset of labor begins with a gradual discharge of water, in others - from their rapid outpouring. For many women, the water already breaks during labor, or they are released in the maternity ward, through the procedure of amniotomy - puncture of the amniotic bladder (this process is absolutely painless).
For some women before childbirth cork comes off- a dense clot of mucus, sometimes with blood impurities, which may be accompanied by spotting. However, this sign should not be assessed as the onset of labor, since the cork can move away a week or a few days before the birth.
What are contractions?
Contractions are periodic contractions of the muscles of the uterine muscles. During each episode, the processes of contraction and stretching of the muscles are carried out in the uterus, along with this, the circular muscle fibers of the cervix are stretched, and its longitudinal muscles are stretched, contributing to disclosure.
Thus, at the time of contractions, dilatation of the cervix, which by the time the fetus is expelled should be 10 cm. Simultaneously with the opening, the baby advances through the birth canal.
At the moment of full disclosure of the cervix, a natural opening of the fetal bladder and outpouring of water takes place. If this does not happen, the bubble is opened mechanically.
The contractions are regular. During fights, muscle spasm in the lower part of the body, the stomach is very tense (hardening), and the woman experiences pain in the abdomen, lower back, coccyx, perineum (for each woman in labor individually).
Pain during contractions undulating character: it starts as if from afar, gradually intensifies, reaches a peak and gradually disappears. In intensity, it can be compared with a spasm of the calf muscles. The only difference is that the muscle spasm in the legs suddenly appears, gives strong unbearable painful sensations and goes unnoticed, and during contractions, the pain manifests itself and goes away gradually.
There are many methods to reduce the intensity of pain during childbirth, both drug and non-drug, which can be used independently: breathing, massage, acupuncture, changing the position of the body.
Feelings of a woman in labor
The emotional feeling of a woman in labor from the moment of the onset of childbirth, contrary to logic, becomes stable, perhaps even some feeling of euphoria. By the way, this paradox can also be attributed to the sign of the onset of childbirth. If up to this point the woman panicked at the onset of training contractions and convulsively collected things, then when true contractions occur, she is extremely calm and in no hurry to go to the hospital.
The outflow of water during rupture of the membranes can be compared with involuntary urination, and a lot of water comes out of the uterine cavity. If the waters depart gradually, then they can be determined by the following sign: tension in the muscles of the press, coughing, laughter is accompanied by a noticeable release of a clear liquid from the vagina.
Contractions feel like undulating spasm lower abdomen.