➤ Precursors of labor in multiparous women

Pregnancy is a period that lasts from the moment of conception of a child until its birth. On average, it lasts about 40 weeks or 10 obstetric months. According to clinical standards, the start date of pregnancy is usually set by the first day of the last menstrual period, so the gestation period is about 38-39 weeks.

Childbirth is considered normal if delivery occurs at 38-42 weeks. With the help of a mass of laboratory tests and instrumental studies, specialists can calculate the approximate date of birth, but these assumptions are not always quite accurate. An expectant mother who already has children can guess about the approaching birth by carefully observing her body.

Precursors of labor in multiparous women are a set of symptoms that appear in a woman who is about to give birth again a few days before the birth of the child.

Difference between signs in primiparous and multiparous

The anatomical structure of the uterus of a woman who has previously been in labor differs in a pregnant woman for the first time. The fact is that when passing through the birth canal, the fetal head exerts high pressure on the cervix, promoting its stretching. Due to this, it becomes more elastic, pliable and wider. Therefore, the first stage of labor in women who give birth again proceeds more quickly and less painfully. As a rule, it lasts from 3 to 7 hours, and for a primigravida it lasts from 6 to 12 hours.

Due to the fact that the body is better prepared for the process, signs of labor in multiparous women appear a little later, about a week before delivery. Also, their clinical picture may be more pronounced. In women pregnant for the first time, these manifestations are observed much earlier - approximately 15-20 days before the birth of the child.

For some mothers who give birth again, signs preceding the birth of a child may appear a day before it. Therefore, multiparous women need to carefully monitor their body from 34-35 weeks. The preparedness of the birth canal can affect the speed of the first period of delivery, so you should not delay your trip to the maternity hospital.

It is important to know that when contractions that are characterized by cyclicity appear, a woman giving birth again should go to the maternity hospital, since the first period of delivery may not always be accompanied by the development of pain or other manifestations.

If more than 8-10 years have passed between the birth of the last child and the new pregnancy, then the harbingers of labor in multiparous women may appear 12-14 days before delivery. This is due to the fact that over such a long period the woman’s body is completely restored, and the birth canal loses its elasticity.

Also, a woman should not be guided by how her previous pregnancy proceeded, since the influence of many factors (size of the fetus, height of the uterine fundus, the presence of concomitant diseases, etc.) can affect childbirth. Therefore, the appearance of signs can be observed at an earlier or later period, in comparison with the first birth.

If the first birth was carried out using a cesarean section, then the warning signs will appear in the same way as in women giving birth to a child for the first time. This is because the cervix did not stretch as the baby did not pass through the birth canal.

When is a caesarean section performed?

Statistics from recent decades show that caesarean sections are being performed more and more often all over the world. According to WHO, this operation for medical reasons should be prescribed no more than 15% of cases. But in reality this number is much higher (in a number of European countries - almost half of all births).

A caesarean section is a medical operation in which childbirth occurs surgically through an incision in the uterus. This method has been known since the times of Ancient Rome. But the conditions under which the operation is carried out have, of course, changed markedly since then. Everything goes quite quickly and, as a rule, only takes an hour. It is the latter fact that is often decisive when women opt for a cesarean section “at will”: some are afraid of hours of contractions, others are afraid of ruptures and stretching of the uterus, etc.

However, a caesarean section is not a cosmetic procedure. For medical reasons, it is prescribed only if there is a threat to the life and health of the mother or baby. Compared to natural childbirth, the risks for both the woman and the baby in the case of a cesarean section are many times higher.

When is a caesarean section performed electively, as prescribed by a doctor?

The woman’s pelvis is too narrow and/or the fetus is too large;
Placenta previa (the placenta covers the entrance to the uterus);
Scars on the uterus from previous operations, threat of rupture;
Multiple pregnancy;
A number of diseases not related to pregnancy (cardiovascular diseases, risk of retinal detachment, varicose veins, viral diseases of the urinary tract, etc.).

When is a caesarean section performed urgently after contractions have started?

When labor takes too long or labor activity suddenly stops;
In case of acute oxygen deficiency and problems with the child’s heartbeat;
With premature placental abruption;
If there is a risk of uterine rupture.

What should you know if you are scheduled for a caesarean section?

The doctor monitoring your pregnancy will most likely report the need for surgery during the first examinations. Especially if you already have a history of uterine surgery or have chronic diseases.
The operation itself is most often scheduled for the end of the third trimester of pregnancy—at 38–39 weeks. Most caesarean sections are performed under local anesthesia (epidural or spinal anesthesia). This way, you will most likely have the opportunity to put your baby to your breast immediately after birth.
The work of surgeons is hidden from the woman in labor using a small curtain. And only after the doctor removes the baby through an incision in the uterus (in most cases horizontal), you will be able to see your baby.

What should you consider if you are considering having a caesarean section without a compelling medical reason?

The likelihood of complications developing in both mother and baby is much higher. You will have a longer recovery after childbirth: while the stitch is healing, your mother will need constant help.
There may be difficulties establishing breastfeeding.
Negative effects of anesthesia and antibiotics received during surgery for the baby.
Difficulty regaining fertility: Research shows that a cesarean section may make it more difficult for you to become pregnant again.

If you are having a caesarean section for medical reasons, remember that this is a vital necessity for your baby, and you are doing everything right. If you are choosing surgery out of uncertainty and fear, you may want to reconsider the situation.

Many expectant mothers periodically experience anxiety. Once you cope with it, you will probably believe in the strength of your own body. After all, if natural childbirth is available to you, you should definitely take advantage of this chance.

How do the warning signs of labor appear?

It is worth taking into account that some of the symptoms described below may not appear in a single clinical case. This is not a deviation, it’s just that each woman’s body is unique and can adapt differently to future childbirth.

Prolapse of the uterine fundus. A few days before birth, the fetus is pressed by the presenting part (which is most often the head) to the lower part of the uterus, lowering it lower so that it is closer to the entrance to the pelvis. The fetus tries to take the most comfortable position so that at the time of contractions its movement along the birth canal is as fast and efficient as possible.

As a result of these changes, the uterine fundus descends, due to which this part of the muscular organ no longer puts pressure on the internal organs, diaphragm, abdominal aorta, etc. Women note the disappearance of shortness of breath, heaviness in the stomach after eating, belching and a burning sensation disappear.

However, such a change in the position of the fetus and uterus may be accompanied by an increase in pressure on the organs located in the pelvis. For example, increased pressure on the bladder will lead to increased diuresis, and the posterior wall of the uterus is located close to the ampulla of the rectum, so when the position of the fetus changes, the number of bowel movements may also increase.

Prolapse of the uterine fundus can be determined if the following changes are present:

the shape of the abdomen changes, it becomes similar not to a ball, but to a pear;
the woman notices ease of breathing, tension in the chest and heartburn disappear;
the urge to urinate increases;
due to the redistribution of weight, posture changes slightly, resulting in a specific “duck” gait;
A palm can easily fit between the chest and stomach.

Abdominal prolapse is one of the main precursors of labor in multiparous women. In primiparous women, this change appears 10-14 days before delivery, and in women giving birth not for the first time - much later (maybe even a day before delivery).

Loss of body weight. Shortly before delivery, the expectant mother may notice a slight decrease in body weight. This is associated with increased diuresis and a possible increase in stool frequency. Therefore, if a woman in labor has a large amount of excess fluid in her body, then physiological losses before childbirth can amount to up to 2-3 kilograms.

The main reason for weight loss is a decrease in progesterone concentration. This is the main hormone responsible for maintaining the pregnancy process from conception to delivery. However, towards the end of pregnancy, its concentration in the blood decreases, and at the same time the concentration of estrogen increases. It is these biologically active substances that help remove excess fluid from the body. A reduction in swelling is immediately noticeable in the wrists, hands, feet and legs.

Removal of the mucus plug. During pregnancy, a special secretion is released from the lumen of the cervical canal. Externally, it looks like a thick, sticky and slightly jelly-like mass that forms a plug. It completely fills the entire volume of the cervical canal, due to which bacterial flora cannot penetrate from the vagina into the uterine cavity. This allows the cervical mucus, or mucus plug, located in the cervix to protect the fetus from the possible development of an ascending infection.

Before the first stage of labor begins, the cervix begins to soften due to an increase in estrogen concentrations. This leads to a slight opening of the cervix and the release of cervical mucus out. A pregnant woman may notice discharge on her underwear in the form of yellowish-brown mucus, transparent and jelly-like in consistency, it has no odor.

The mucus plug can be released all at once, or it will be released in parts throughout the day. In the second case, there may be a feeling of slight discomfort associated with “sipping” in the lower abdomen. However, most often the release of a mucus plug is not accompanied by any noticeable changes in the woman’s condition. After cervical mucus is discharged, the expectant mother is not recommended to visit a pool, bath or open body of water, as when immersed in water, it will penetrate into the vagina. This significantly increases the risk of infection of the amniotic sac of the fetus.

The appearance of training contractions. False contractions are usually called those contractions that appear immediately before labor, but do not contribute to the dilation of the cervix or the advancement of the fetus along the birth canal. A contraction is a single contraction of the walls of the uterus, which usually lasts a few seconds. At the moment of spasm, the woman notices increasing, and then decreasing, tension in the lumbar region and lower abdomen. If you put your palm on your stomach during a contraction, you can feel that it becomes very hard, and after it is over, it relaxes and becomes soft. Apart from arbitrary short-term spasms, false contractions are not characterized by anything else.

It is quite simple to differentiate between training and real contractions. Often, false uterine spasms are quite weak, irregular, do not cause much discomfort and occur no more often than once every half hour. True contractions are characterized by cyclicality and increasing intensity. Their result is dilatation of the cervix. If there is any doubt about the type of cramping, a simple obstetric examination will suffice to detect visible dilatation.

Training contractions are not an indication for going to the maternity hospital. They can repeat for several hours and then stop. Most women note that they most often occur in the morning and evening hours for several days.

Rush of amniotic fluid. The rupture of amniotic fluid involves the release of a large amount of clear fluid from the vagina. If the integrity of the amniotic bladder is partially disrupted, it can be released in portions. During the rupture of amniotic fluid, the woman does not feel any discomfort. However, if the structure of the amniotic membrane is disturbed, infection of the fetus or aspiration is possible.

In women who give birth repeatedly, the amniotic sac often bursts spontaneously, and contractions begin a few hours later. Sometimes the amniotic membrane does not rupture, so it is opened directly in the maternity hospital.

If the amniotic pods have passed on their own, then the woman needs to immediately go to the maternity ward. In a situation where there is a slight leakage of fluid, the pregnant woman should seek medical help. Diagnostics will help confirm or refute the presence of a defect in the amniotic sac.

Changes in fetal behavior. Most women note that approximately 7-10 days before the birth of the child, its activity decreases. This change is one of the most common. The fact is that changes in the behavior of the fetus are associated with a decrease in space inside the uterus - it simply has nowhere else to move.

If the activity of the fetus has increased, then you should consult a doctor as soon as possible. Such changes may indicate the development of intrauterine hypoxia associated with oxygen starvation. A complete cessation of movement may indicate increased fetal discomfort. In both situations, it is worth seeking medical help to perform cardiotocography.

Strengthening the nesting instinct. The desire to clean up and rearrange furniture from one place to another, increased anxiety - all this may indicate that labor is approaching. These changes in behavior are caused by changes in the functioning of the central nervous system, which slightly distort the mental state of the expectant mother. Other signs of impending labor may not yet appear, but the woman’s psyche begins to gradually prepare for future childbirth.

Changes in the stool. Changes in the consistency of stool and increased frequency of bowel movements on the eve of delivery are associated with an increase in estrogen levels and the removal of excess fluid from the body of the expectant mother. Similar changes are observed in all women during menstruation. The frequency of bowel movements may increase up to 2-3 times a day, and in parallel with this, a liquefaction of physiological waste may be observed.

However, we should not forget that increased frequency of bowel movements, development of diarrhea and nausea may indicate the development of foodborne toxic infection. Therefore, if a woman’s condition worsens, it is better to seek medical help.

Changes in urination. Hormones, the production of which increases significantly during the last trimester, affect not only the functioning of the digestive tract, but also the functioning of the urinary system. Changes associated with diuresis may be a signal that labor will begin soon. Multiparous women may experience urinary retention or excessive discharge 2-3 days before delivery.

Time of fetal head descent before birth

The timing of the descent of the fetal head is an individual feature of each woman. Most often, the event occurs at 36-38 weeks of pregnancy, less often - closer to 40 weeks. In case of repeated pregnancy, the uterus drops 2-5 days before birth.

Late uterine prolapse occurs in women with a well-developed abdominal wall. For some, prolapse does not occur at all or occurs several hours before the baby appears. This is not a pathology and does not affect the child’s health in any way.

Relaxed and untrained muscles of the mother’s peritoneum pose a danger to the baby. They do not provide the fetus with sufficient fixation in the pelvis.

You should sound the alarm if the belly drops too early (before week 35) or the changes lead to severe pain or unusual discharge. In this case, there is a high probability of premature birth or miscarriage. You must immediately take a horizontal position, call an ambulance and contact the doctor observing the pregnancy. After hospitalization, the patient is prescribed tocolytic drugs that reduce uterine tone.

How to detect warning signs during repeated births?

A woman who gives birth again needs to know that all subsequent births can be much faster, and the period between the precursors and delivery will be significantly shortened. If in primiparous women changes in well-being can be noticeable within 2-3 weeks, then in multiparous women they can appear within a day.

If you notice changes in your health that are similar to the harbingers described above, then it is better to prepare for the fact that you will soon have to go to the maternity hospital. According to statistics, in multiparous women, the period of pushing can proceed rapidly, so you should get to the maternity hospital as quickly as possible.

You should not make assumptions about the upcoming birth based on past experience, since each birth of a child will proceed in a new way, regardless of how many there were before it. If you remember your first experience with anxiety, then you can be reassured by statistics that confirm that the second and subsequent births, as a rule, are easier and faster.

Women who last gave birth more than 10 years ago should be prepared for the fact that the birth canal has lost its elasticity, so their labor will proceed like the first, and warning signs will appear long before the first contractions.

Each woman begins the process of giving birth differently. For example, some people experience a classic picture - a gradual increase in the intensity of contractions and a reduction in the intervals between them. Others may experience rapid labor - contractions are very active at once, and the intervals between them are short. For others, the preliminary period may be prolonged. Despite significant differences, almost every woman experiences signs of labor in multiparous women. Only the number of symptoms, their intensity and the period of occurrence can differ.

Effect on the mother's body

Abdominal prolapse occurs at different times in all women. In gynecology, this process is also called fetal formation or uterine prolapse. On the one hand, it facilitates the physical condition of the pregnant woman, but on the other, it causes a lot of anxiety and discomfort.

Positive changes

As the fetus descends into the pelvic cavity, it becomes easier to breathe. The baby stops painfully pushing into the ribs, diaphragm, and digestive organs. The woman's belching, shortness of breath, and heartburn disappear.

The mother's body cleanses itself of toxins and harmful substances. During this period, complexion improves, dark circles under the eyes disappear and wrinkles smooth out.

Negative changes

As the baby's head descends, it puts pressure on the pubic and hip bones. This causes discomfort when sitting, walking, and while sleeping. To adapt to the new condition, the pregnant woman develops a characteristic “duck” gait, and at night she has to sleep on her side or with a special pillow.

Urinary incontinence is another unpleasant consequence of the last weeks of pregnancy. For some, this causes a number of complexes and even leads to a nervous breakdown. In order not to worry about trifles, wear special pads. They have greater absorbency, unlike regular ones.

The intimate flora after the descent of the fetus becomes more sensitive to various viruses and bacteria. During this period, it is especially important to maintain hygiene, avoid hypothermia and eat right.

2-3 weeks before giving birth, doctors recommend abstaining from sexual activity to avoid increased uterine tone and infection.

Has it really started?

The long wait is about to end and the mother will be able to put her baby to her breast. She feels happy and excited as she approaches the long-awaited end of her pregnancy. But how do you understand that labor has begun and is it possible to relieve the pain?

Of course, each organism is individual. Some pregnant women experience slight anxiety the day before contractions begin, and mild tachycardia, headache or fever may occur. Diarrhea or increased blood pressure may also develop. The expectant mother can ask her doctor all her questions, and he will help relieve her anxiety.

How a doula is useful

We have already talked about how a doula can help you cope with emotions during childbirth. This is the name of an assistant who prepares a woman for the birth of a child (sometimes even before conception), accompanies her during childbirth and helps to establish contact with the baby immediately after his birth. Being a doula is a job that requires first of all a calling, and then special training and preparation. Doula schools in different countries are united into a community: they share knowledge, hold meetings and conferences, celebrate International Doula Day and train “newbies.”

And although this profession has existed as long as humanity itself, the current doula movement arose in response to the needs of modern urban women. After all, unfortunately, the process of childbirth in urban conditions is depersonalized.

A doula may not have a medical education (having her own children is also not necessary), since she does not interfere in the birth process itself and does not bring her own experience into the woman’s personal process.

How a doula can help you

Provide information support. A woman knows at any moment what is happening to her, what stage of the process she is at, what is next, how to prepare for it.
Support emotionally. During childbirth, it’s easy to get scared and wilt, but the assistant “pours” strength and enthusiasm into the woman giving birth, shares her emotions with her and shares her confidence.
Ensure that the woman's wishes are respected. If a woman was preparing for a specific birth plan and wanted, for example, to do without stimulation and pain relief, these intentions can be easily forgotten under the pressure of specialists in the clinic. At this moment, the doula can “share” her persistence with the expectant mother and act as her representative in negotiations with doctors, so that they treat the wishes of the woman in labor with greater respect. If a mother wants the baby to be placed on her stomach, to wait until the umbilical cord pulsates, to allow her to put the baby to her breast and stay with him as long as necessary, a doula will come to the rescue. At this moment, the mother may not have enough of her own strength to insist on her own, and the doula reminds her and the doctors that there is no need to rush.
Take care of the woman. Each doula has her own repertoire of ways to relieve labor pain and cope with contractions and pushing. Some use massage, some use aromatherapy, some “sing” the contractions along with the woman. In addition, there are many movement and breathing techniques that make childbirth somewhat easier. Doulas help women manage labor pain naturally, infusing the process with joy, anticipation, curiosity, and confidence.

Doulas are not doctors, and they do not assist in childbirth themselves. But any of them has the appropriate equipment and is ready to step in if for some reason the doctors don’t have time.

Sudden onset of labor

In some situations, the precursors of labor may not appear in multiparous women, so labor may immediately manifest itself as contractions. Contractions are muscle contractions of the uterus, which contribute to the gradual expansion and shortening of the cervix, moving the baby along the birth canal. They manifest themselves in the form of periodic nagging pain localized in the lower abdomen and lower back. Over time, these sensations become more intense and regular. If contractions begin to appear cyclically, then this is a reason for a trip to the maternity hospital. It is best not to delay seeking medical help; the expectant mother should immediately call an ambulance and report changes in well-being so that the team is informed about the beginning of the first stage of labor.

There are several main signs that indicate the onset of contractions:

During training contractions, a woman notices pulling sensations in the lower abdomen, but before the start of the first stage of labor they become more intense and painful. Many mothers claim that true contractions are somewhat similar to very severe pain during menstruation.
If you don’t know how to determine if contractions are false or true, then you should try breathing exercises: take a slow and deep breath, then hold your breath for 2-3 seconds and exhale slowly. Training contractions, as a rule, go away after these exercises, but if the contractions are true, then the intensity of the pain will not decrease.
Regularity, a gradual increase in the frequency of contractions and the duration of contractions are the main signs by which it is worth assessing the body’s readiness for childbirth. A woman can take a notepad and pen and record the duration of the spasm and the duration of the relaxation period. Using this method will help ensure that you understand that true contractions have begun, and the doctor will receive information about the dynamics of labor.

Signs of prolapse

Depending on the individual characteristics of the body, a woman may not feel anything when the baby leaves the uterine cavity, or she may experience a whole range of new sensations, some of which may even be painful. Certain symptoms will help you understand that the fetus has sunk into the pelvis.

External signs

The abdomen shifts to the navel area.
The distance between the stomach and chest is equal to the palm of your hand.
The campaign changes - it becomes a “duck”.

Feel

It becomes easier to breathe. The fetus no longer compresses the diaphragm and does not interfere with its filling with oxygen.
Heartburn and belching stop bothering me. The enlarged uterus does not put pressure on the stomach and intestines.
Back pain disappears as the load on the spine is reduced. At the same time, unpleasant sensations appear in the pelvic area, and swelling of the legs increases.
The urge to urinate becomes more frequent. Mild incontinence may occur.
Constipation increases.
A white, odorless discharge appears.

The difference can also be seen with the naked eye in the mirror. If a woman has been watching her belly throughout her pregnancy, she will probably notice changes.

When is it time to go to the maternity hospital?

Sometimes labor may be premature and contractions will appear earlier than the expectant mother expects. Therefore, by the 7-8th month of pregnancy, it is worth collecting all the things that will be useful in the maternity ward and preparing a first aid kit for the baby.

Uterine bleeding is the most dangerous complication, which indicates the premature onset of labor and possible placental abruption. Often, a woman may complain of cramping pain in the lower abdomen and a sharp deterioration in well-being, manifested by weakness and dizziness. If there is bloody discharge from the vagina, you must immediately transport it to the maternity hospital.

The rupture of amniotic fluid is the second most important sign, which indicates that it is time for a woman to go to the maternity hospital. As a rule, after rupture, a gradual opening of the cervix and further delivery begins. However, in some situations, even after the amniotic fluid has broken, labor does not begin. This condition is especially dangerous for the fetus, since prolonging the anhydrous period will worsen its condition.

Another important sign is the transition of training contractions into real ones. In a multiparous woman, dilatation of the cervix may not be accompanied by intense pain. The peculiarity of such a latent course of the first stage of labor is that it proceeds extremely rapidly. After the cervix is fully opened, the baby begins to move through the birth canal, so the woman may simply not have time left to arrive at the hospital on time.

Active phase of onset of labor

Contractions become stronger, longer and more frequent, making it difficult for you to talk when they occur. The cervix is actively dilating. If contractions become painful and occur every 5 minutes for an hour, you need to go to the hospital without delay. This phase of labor lasts on average 5 – 8 hours. If you are giving birth for the first time or the baby is large, it will take longer, but if you have taken oxytocin or have had a vaginal birth before, the process will be faster and is unlikely to take more than an hour.

What to do at this moment

It's okay to walk during this time, but you'll likely want to lean on something during contractions. If you are tired, you can rest by lying on your left side. You can take a shower, a warm bath, or ask for a light massage.

When the cervix has dilated to 8–10 cm, the most active part of labor begins. The contractions are getting stronger, coming every 2 - 3 minutes and lasting a minute or longer.
You may feel shivering and chills between contractions, and feel hot during contractions.
The baby moves to the pelvic area, if he has not done so before, and there is a feeling of pressure on the rectum and the desire to push.
Most often, bleeding appears at this moment - don’t worry, this is normal.
There is often a feeling of nausea.

Before labor begins, many (but not all) doctors ask the woman to give her an enema. This is a voluntary procedure, but expectant mothers often agree because then they won't have to worry about having a bowel movement during labor, although this is completely normal. This means they will be able to feel more comfortable while pushing. It is better to consult your doctor in advance and choose a plan of action that is more suitable for you.

Many women in this phase of labor turn to pain relief, such as an epidural.

However, there are many ways to relax and relieve pain, since much of the pain is caused by fear, and not by a real physical process.

Here are a few tricks:

Ask for a light massage;
Look for a more comfortable body position;
Apply a cool or warm compress to your forehead;
You may want silence and no need to communicate, since contractions take all your attention; but maybe you will want to get support from a doula - your assistant during childbirth, about whom we will talk in more detail below - as well as from the child’s father or another loved one;
Focus on the fact that with each contraction you are helping the baby to be born.

What to take with you to the maternity hospital?

Every woman should make sure that by the second half of the second trimester she has a bag ready for a trip to the maternity hospital. It should contain documents (passport, exchange card, insurance, birth contract, if any) and essential things that will be useful during childbirth and while staying with the baby in the hospital.

The mother in labor must take with her:

a nightgown and robe, in which she will be in the maternity hospital after the birth of the child (it is better to give preference to natural fabrics);
several pairs of socks and slippers;
postpartum pads and disposable diapers;
hygiene items: soap, towel, toothbrush and toothpaste, comb;
a couple of bottles of water and cookies for a snack.

It is worth making sure in advance that all things are collected for a comfortable stay for the baby in the maternity hospital with his mother. Place in your bag a couple of warm rompers, overalls and vests, bonnets, several flannel and cotton diapers, a warm blanket with a duvet cover and socks.

In what cases does the stomach not fall?

Several factors influence fetal descent on the eve of labor:

woman's physical fitness level;
fetal weight;
nature of presentation;
what kind of pregnancy is it?
number of fruits.

If there are several days left before the appointed date, and the position of your stomach has not changed, do not panic. Perhaps you simply have underdeveloped muscles, a narrow pelvis, or a second pregnancy. Analyze your general condition and the presence of accompanying symptoms.

Tactics of action for the expectant mother when signs of labor appear

In first-time mothers, labor usually begins with not very strong contractions. Their intensification usually occurs within a day, or even more. Therefore, there is no urgent need to immediately call an ambulance and rush to the hospital: you can wait until the interval between contractions is 10–15 minutes, and they themselves last at least a minute. However, you can stay at home unless your water has broken yet.

If the expectant mother is multiparous, then she should not delay going to the maternity hospital, because the baby can be born very quickly (the first stage of labor in some cases goes unnoticed, and when the baby begins to pass through the birth canal, there may be no time left for the trip) .

A multiparous woman should immediately go to the hospital at the first sign of labor

During the first contractions of a pregnant woman, it is better to have a snack to give the body strength for the upcoming energy-consuming process. You should also prepare all the necessary things and documents in advance, because when the pain intensifies, it will be difficult for the woman to concentrate on getting ready. It is worth thinking about the trip itself in advance: under no circumstances should the expectant mother get behind the wheel herself.

Head Configuration

Head configuration represents changes in its shape due to external pressure. A certain configuration of the head may occur before birth, as a result of Braxton-Hicks contractions. The most common form of head configuration is that the parietal bones overlap each other. The head configuration results in a decrease in the minor oblique and an increase in the major oblique diameter of the head. These changes are very important for narrowing of the pelvis and asynclitic insertion of the head. In these circumstances, the ability of the head to change is of great importance in spontaneous vaginal delivery and operative vaginal delivery.

Vaginal delivery

When the fetus begins to be born (“head tapping”), the maternity unit staff observes asepsis and puts on sterile medical clothing, masks and gloves (prevention of maternal and fetal infection and self-protection). The necessary tools include two clamps, scissors and a suction device.

During the birth of the fetal head, techniques are used aimed at protecting the perineum from trauma (regulation of pushing, maintaining intervals between pushing, careful, controlled removal of the head). With one hand, the perineum is supported (“removed” from the head) and gentle pressure is applied to the fetal chin in an upward direction, and with the second, gentle pressure is applied (flexion of the head) to prevent its premature extension and injury to the perineum, as well as massage of the labia before birth (“teruption”) ") heads.

Immediately after the birth of the head (before the birth of the shoulders), the contents of the upper respiratory tract of the fetus are suctioned. If there is meconium in the amniotic fluid, the contents of the newborn's oropharynx and nasopharynx are carefully suctioned using a special catheter before the birth of the shoulders, when the newborn's chest is still compressed by the mother's birth canal and he cannot take his first breath (preventing meconium aspiration).

After complete suction of the mucus, check for the presence of entanglement of the umbilical cord around the fetal neck. If such a condition exists, and the doctor is confident that labor will end soon, the umbilical cord is cut between two clamps. If labor may be complicated by shoulder dystocia (difficult delivery of the shoulder girdle, for example, in the case of fetal macrosomia), efforts are made to hasten the birth of a fetus with an intact umbilical cord.

After external rotation of the head towards the mother's thigh, the birth of the anterior shoulder is assisted by applying downward pressure on the head with the palms. Once the anterior shoulder is visualized, pressure is applied to the head in the opposite direction (upward) to assist in the delivery of the fetal posterior shoulder. After the head and shoulders are born, light traction is applied to speed up the birth of the rest of the fetal body. After this, the umbilical cord is crossed between two clamps and the newborn is handed over to the mother or midwife, and, if necessary, to a pediatric neonatologist who is in the delivery room.

Reviews from women about the onset of labor

At the end of the third trimester of pregnancy, a woman’s body, as a rule, tells her that labor is imminent. There are many of these precursors: they are physiological and psychological in nature, and also relate to the behavior of the fetus. Only true contractions and rupture of amniotic fluid directly indicate the onset of labor. Nevertheless, each organism is individual, and the long-awaited moment may well come completely unexpectedly, so the expectant mother in the last weeks of gestation should always be ready for a trip to the maternity hospital.

Higher philological education. Experience as a proofreader, editor, website maintenance, teaching experience (first category).

“Then laughter, then tears”

Curious changes also occur in the woman’s psyche. The expectant mother develops a kind of “lethargy” and “calmness.” This is explained by the fact that inhibition processes predominate in the cerebral cortex, and the woman becomes somewhat absent-minded, forgetful, and less anxious. All this has its natural validity. Such changes are necessary so that extraneous thoughts and emotions do not interfere with concentration on the birth of a child and the formation of the so-called “generic dominant”.

Frequent changes in mood, characteristic of the entire period of pregnancy, are especially pronounced before childbirth. This is due to the processes occurring during this period in the central nervous and endocrine systems of the pregnant woman. The state of fatigue and inertia may unexpectedly give way to periods of vigorous activity.

Some women, shortly before giving birth, experience a desire for “nesting”: they clean everything, wash it, clean it, wash it. In addition, the term “nesting” refers to the behavior of a pregnant woman when, closer to giving birth, she becomes withdrawn, avoids prying eyes and literally wants to hide from the whole world in some cozy, warm corner of the house. This also happens unconsciously, instinctively.