When to go to the hospital to negotiate. When and in what should I go to the hospital for the first and second births? Determining the date of birth by ultrasound

Of course, such an abundance of conflicting and unreasoned recommendations only adds to the expectant mother's anxiety: after all, the wrong advice on hospitalization for childbirth, put into practice, can turn into serious problems during childbirth. And the health of mother and baby largely depends on how this important process goes, in particular, on timely observation and timely medical care.

When is it time to go to the hospital - when will the stomach drop?

The change in the shape of the abdomen on the eve of childbirth is associated with the “starting position” occupied by the baby before the start of the process. The fetus presses its head against the bones of the small pelvis, dragging the uterus down. As a result, the stomach seems to sag, sinking lower, resembling a pear in shape. The expectant mother can pay attention not only to the external change in the shape of the abdomen, but also to changes in well-being. For example, to increase stool and urination (the baby's head puts more pressure on the rectum and bladder) and the disappearance of shortness of breath (the lowered bottom of the uterus stops pressing on the diaphragm, making breathing easier). A lowered belly is evidence of preparation for childbirth, but does not require immediate hospitalization.
Firstly, from the moment the shape of the abdomen changes to the onset of labor, it can normally take ... about two weeks! Secondly, the prolapse of the abdomen is not a mandatory attribute of the precursors and the onset of childbirth: sometimes this simply does not happen. Whether the abdomen drops on the eve of childbirth or not depends on the shape of the pelvis future mother, and also - on the amount of water, size and presentation of the fetus (head or buttocks down).

How to understand what you are giving birth: water

Indeed, if the future mother's water breaks, you must immediately go to the hospital. However, in most cases, you should hit the road much earlier! The fact is that childbirth does not necessarily begin with an outpouring amniotic fluid. Depending on the volume of water, the location of the fetus in the uterus, the size of the baby and the duration of pregnancy, the membranes can break at the beginning, middle, and even at the very end of the process. In some cases, the fetal bladder does not burst on its own, and the baby is born in the fetal membranes.
Birth "in a shirt" - in a fetal bladder filled with liquid - is deadly for a newborn: after all, having been born, he must inhale air, not water. The old Russian saying "happy - born in a shirt" implies that this person does not care at all, since he remained alive in such a dangerous situation. Despite the fact that many women consider the discharge of water to be the beginning of childbirth, their outflow simultaneously with the onset of contractions or even before them is not at all the norm. In fact, a whole fetal bladder filled with water should participate in the birth process: during the first contractions, when the opening is still very small, it tenses and puts pressure on the neck, causing it to stretch.

Staying at home after the start of regular contractions and waiting for the water to flow is completely wrong. Ideally, the fetal bladder should remain intact until the middle (!) Of the first stage of labor - until the cervix opens by 4–5 cm. the first stage of labor - until the cervix is ​​\u200b\u200bfully dilated. Sometimes in the middle of childbirth, against the background of a whole fetal bladder, the contractions gradually begin to weaken. In this case, to normalize labor activity the doctor opens the bubble.

When it's time to go to the hospital: the cork has gone

Cork is a jelly-like mass in the form of lumps or strands of yellowish, pink or brown color. This discharge from the genital tract, properly called cervical mucus, does not necessarily appear at the onset of labor. As well as the prolapse of the abdomen, cork discharge is a harbinger of childbirth - a manifestation of changes in the body of a pregnant woman shortly before the birth of a baby. During pregnancy, the cork filling the cervical canal protects the fetus from the adverse effects of the bacterial flora of the vagina. Before childbirth, the cervix softens and begins to open slightly. In this case, the mucous plug may stand out (or may remain inside the cervical canal and stand out during childbirth). Sometimes the cork is separated "in several passes" - not immediately, but in 2-3 days. It can also take 7-10 days from the first discharge of cervical mucus to the onset of labor.
Sometimes preliminary dischargetraffic jams it just doesn't happen! The appearance of mucous secretions from the cervix at the end of pregnancy (as well as the absence of these secretions) is considered normal and does not require a visit to the maternity hospital.

How to understand that you are giving birth - contractions

Despite the persuasiveness of this statement, even it is not always true! During pregnancy, a woman periodically experiences uterine contractions - training bouts Braxton Hicks. At the beginning of pregnancy, such contractions are extremely rare - 1-2 contractions per week, and are completely painless. They are felt simply as a slight tension in the uterus. As the gestational age increases, contractions may appear more often - up to several times a day in the form of single (separate) short, painless abdominal tensions that occur at different times of the day. These contractions occur in absolutely all pregnant women. However, not everyone feels them. Of course, such contractions, which are a variant of the norm, do not require going to the maternity hospital. Approximately 2 weeks before the expected date of birth, the expectant mother may have new sensations - false, or precursor contractions. In terms of strength and sensations, they are very similar to real contractions, with which childbirth begins. These are periodically repeated sensations of undulating tension of the uterus, sometimes accompanied by "sipping" in the lower abdomen and in the lower back. Unlike real, labor pains, precursors do not lead to the opening of the cervix and end rather quickly.

Harbinger contractions may occur every day during the week before childbirth, may disturb the expectant mother 1-2 times on the eve of childbirth, or may not appear at all. The presence of precursor contractions, as well as their absence, is the norm and does not require a visit to the doctor.

When you need to go to the hospital - better in advance!

Supporters of this point of view justify their position simply: a pregnant woman will be under the supervision of doctors all the time, so it is calmer for doctors, relatives, and herself. Despite the apparent logic of this statement, it cannot be considered absolutely true. More precisely, this advice is not universal - early antenatal hospitalization is needed only in special occasions, or, as doctors say, "according to indications":

• In preparation for a planned operation caesarean section: in order to reduce the risk of surgical complications, the pregnant woman must be examined and prepared in advance. In this case, the expectant mother is recommended to go to the hospital no later than 38 weeks of pregnancy. The woman is hospitalized in the department of pathology of pregnant women and a preoperative examination plan is prescribed.
• If complications of pregnancy are detected on the eve of childbirth. In this case, early hospitalization in the maternity hospital will help to fully examine, correct the identified health problems and monitor the condition of the fetus during treatment. It is necessary to go to the hospital in advance, for example, with gestosis (late toxicosis of pregnant women, manifested by increased blood pressure, edema and the appearance of protein in the urine), impaired blood flow in the placenta, fetal growth retardation, and the threat of premature placental abruption.
• With an exacerbation of common chronic diseases, since any violation of the health of the expectant mother can affect the condition of the fetus and preparation for childbirth.
• If a woman has previously undergone surgery on the uterus, she is also hospitalized in the maternity hospital no later than the 38th week of pregnancy: at this time, it is necessary to control the condition of the postoperative scar.
• With a tendency to overwear. In the absence of harbingers of childbirth for a period of more than 40 weeks, a pregnant woman is recommended antenatal hospitalization. In the maternity hospital, the expectant mother undergoes an examination, the purpose of which is to exclude the fact of overgestation (a condition in which the body of the expectant mother ceases to cope with the life support of the baby and his condition worsens), control the level of placental blood flow and monitor the condition of the fetus. If necessary, a pregnant woman is prescribed therapeutic measures to prepare for childbirth.

In other cases go to the hospital early is not necessary. On the contrary, this excessive precaution can often do a pregnant woman a disservice. When hospitalized in the department of pathology of pregnant women, the expectant mother is limited in physical activity, which adversely affects her blood circulation.
Often in the maternity hospital, pregnant women do not sleep well: neighbors in the ward, noise coming from the children's and maternity wards, morning procedures (tests, thermometry) interfere. However, the most harmful factor unreasonable stay in the antenatal ward - scary stories about childbirth, which expectant mothers tell each other “out of nothing to do”. Hypodynamia, insomnia and "horror movies", forcing fear of childbirth, negatively affect the physiological and psychological readiness for childbirth.

From the first weeks of pregnancy, every pregnant woman begins to worry about questions: where to give birth, what things you need with you, which method of delivery to choose. But after almost nine months of pregnancy, the woman chose the maternity hospital, she clearly knows what to take.

There remains one important question - when should you go to the hospital?

I don’t want to go very early, but I don’t want to be late, and then give birth in an ambulance or even at home. But, unfortunately, no doctor can accurately determine the date and time of birth.

Therefore, you should know a few things that will help prepare for childbirth and arrive at the hospital on time.

What should every expectant mother know?

The gestational age at which a child is considered full-term varies significantly according to different experts and, on average, is in the interval between 39 and 42 weeks.

The main harbinger are precursor contractions - painless contractions of the abdominal muscles. Such contractions appear at any time, are irregular, quickly disappear after taking antispasmodic drugs.

With the help of precursor contractions, the woman's body begins to prepare for the upcoming labor activity.

Less commonly, a few days before childbirth, women fix in the form of a small amount of mucus that appears in the vagina. This plug serves as additional protection at the entrance to the cervix.

A little about the beginning of labor

When should you go to the hospital? The answer is simple - at . However, there is emergency reasons when a delay in admission to the maternity hospital threatens with various complications.

Such reasons are the appearance of spotting and prenatal rupture of amniotic fluid.

generic activity represents, which are regular, painful and repeated at regular intervals.

Gradually, the frequency of contractions increases, while the contractions are not stopped by the use of conventional antispasmodic drugs, what distinguishes them from forerunner contractions.

It can be difficult to distinguish between these two types of contractions, in which case it is better to play it safe and go to the hospital.

Appearance may accompany normal labor (opening of the cervix is ​​accompanied by minor damage to blood vessels), but most often the appearance of blood is a sign of placental abruption and other pathological conditions.

The development of placental abruption threatens the death of the fetus and mother, therefore, if even a small amount of blood appears, it is better to call an ambulance.

Outflow of amniotic fluid usually easy to determine - amniotic fluid often has a large volume, although, again, there may be little water, their gradual leakage may take place.

The feeling of the appearance and discharge of water (not mucus) from the vagina is also an indication for calling an ambulance.

In conclusion, it should be said that in the presence or with a complicated course of pregnancy, prenatal hospitalization in a hospital is planned in advance. All other cases are under the jurisdiction of the woman herself.

So when is the best time to go to the hospital? It is better to come to the hospital earlier than to worry later - will the ambulance arrive in time?

It is also worth insuring primiparous, because first births usually take a long time, up to 10-13 hours, repeated births proceed much faster.

First, you need to know the expected calendar date of birth. The duration of pregnancy for each woman is individual; on average, it is 280 days, or 40 weeks, fluctuations from 38 to 42 weeks are considered normal.

How to find out the date of birth?

Exists various ways calculation of the date of birth. Some try to determine the day of conception and count the days from it. However, the day when sexual intercourse occurred and the day of conception itself may not coincide, since spermatozoa are able to maintain their viability and “wait” for an egg in the woman’s genital tract for several days.

Determination of the date of birth by menstruation

The most common way to calculate the due date is “by menstruation”. This is usually a well documented event. It is necessary to remember exactly the first day of the last menstruation, from the beginning of which it is proposed to count 280 days. And even easier - add another 7 days to the date of the first day of the last menstruation and count back three months. For example, the last menstruation began on September 5th. Then childbirth can be expected on June 12 (5 + 7 days = 12, 9th month of September - 3 = 6th month of June). But this method will be unreliable if the woman has an irregular menstrual cycle or she does not remember the date of the menstruation.

Our due date calculator will help you calculate your due date based on your period.

Determining the date of birth by ultrasound

In modern conditions, the date of birth is determined quite accurately, focusing on the data of an ultrasound examination (ultrasound) performed before the 12th week of pregnancy. AT late dates pregnancy error in determining the term using ultrasound increases. This is due to the fact that the dimensions of the fetus, which the doctor is guided by in his calculations, at the end of pregnancy have large individual fluctuations.

In the same way, the calculation is made on the basis of the date and duration of pregnancy established at the first visit to the doctor (the method “on the first appearance at the antenatal clinic”). The sooner your doctor determines your due date, the more accurate your due date predictions will be.

Determining the date of birth by fetal movements

You can roughly calculate the date of birth and the first movement of the fetus: in nulliparous women, this occurs on average at 20 weeks, and in multiparous women, at 18 weeks. Of course, these are very subjective sensations, because the moment of the first movement of the child is not always well distinguishable.

You can find out about full-term pregnancy and upcoming childbirth by several signs. Approximately in 1 - 2 weeks, the so-called "harbingers" of childbirth appear.

Harbingers of childbirth

Most women notice at the end of their pregnancy that their belly has “drooped” and it has become easier to breathe. This is because during a full-term pregnancy, the amount of amniotic fluid decreases slightly, and the head of the fetus is pressed against the entrance to the woman's small pelvis. The uterus becomes more excitable, it “trains”, prepares for the upcoming big work. Irregular, painless tension of the uterus and a feeling of heaviness in the lower abdomen and in the lower back are called “pregnancy contractions”. It is not always possible even for a doctor to say with certainty whether labor is starting or preparatory contractions are taking place. If such a state of increased irregular excitability of the uterus continues for 1-2 days, then it is better to contact maternity hospital where they can assess whether the child suffers.

A few days before delivery (or on the day of delivery), light mucous discharge may appear from the genital tract, sometimes with small streaks of blood. Usually they say that "the mucous plug has come off." This is a favorable sign of softening and "ripening" of the cervix.

In many women, towards the end of pregnancy, colostrum is secreted from the nipples - the precursor of mother's milk.

A healthy woman with a favorable pregnancy can stay at home until the onset of labor. If there are deviations in the state of health of a woman, pregnancy has complications, if signs of fetal suffering are established, then, of course, the last 1-2 weeks (and more if necessary) should be in the maternity hospital under the supervision of specialists. Recently, many women, especially city dwellers, prefer to go to the maternity hospital in advance. This is obviously due to the general deterioration in the health of the population, the desire of the family, if possible, to insure against various accidents.

When is it time to go to the hospital?

So, at home, you felt some changes in your condition. There was heaviness, a slight pain in the lower back, in the lower abdomen, the uterus tensed up and became very dense to the touch. At first, the contractions and relaxation of the uterus are irregular, lasting 5-10 seconds with long breaks (up to half an hour). Then their frequency and intensity increase. This started the fight. If you are giving birth for the first time and live close to maternity hospital, then you can wait until the contractions become regular - once every 5 to 7 minutes. If the birth is repeated, then immediately with the onset of contractions, you should go to maternity hospital. Repeated births are usually faster than the first, there is a risk of giving birth outside a medical institution.

Often, before the onset of contractions, amniotic fluid may be released. The normal content of water in the uterus by the end of pregnancy is up to 1.5 liters. You may feel that a clear, warm fluid is leaking from your vagina (no connection with urination). A little liquid may pour out, or maybe all 1.5 - 2 liters. Be that as it may, if you notice unusually wet laundry - this is a situation in which you must, without delay, go to maternity hospital. If the water has completely poured out or is leaking slightly, this means that the integrity of the fetal membranes has been violated, and the child is no longer protected from the effects of the external environment, primarily from infectious agents. Time is counted by the clock; in such a situation, it is advisable for a child to be born no later than 12 hours after the outpouring of water. Doctor in maternity hospital must determine whether you have a chance of giving birth through the birth canal, or is it better to perform a caesarean section. In most cases, after the outpouring of water, normal contractions begin, and childbirth ends safely.

The above was about typical normal situations at the end of pregnancy. But complications are also possible. There are situations that require special attention and emergency care that a woman with a full-term pregnancy should be aware of. Call an ambulance immediately and go to maternity hospital, if:

Bloody discharge appeared from the genital tract, smearing or “like menstruation”;

The waters are stained with blood;

Pain very strong, uterus painful to the touch, does not relax between contractions;

The fetal movements have become unusually strong, or weak, or painful;

headache, vision became fuzzy (“flies” before the eyes), pain appeared in the epigastric region, blood pressure increased, you cannot urinate.

In any case, if you feel any discomfort, then be sure to consult a doctor who is observing your pregnancy, and at night, contact maternity hospital. Practice shows that it is better to be safe than to underestimate the seriousness of the situation and endanger the life of the child and your own.

1. Determine in advance in which institution you will give birth. Many women prefer to have the same doctor conduct the pregnancy and deliver the baby. In practice, this is not always feasible. The state system for monitoring pregnant women is organized in such a way that the doctor is not necessarily present at the birth of his patient. And in non-state clinics, the obstetrician who observed you, due to various circumstances, may not be next to you at this very moment. However, it should not be taken as a tragedy when an unfamiliar doctor conducts childbirth. Choose a delivery facility with a good reputation; if you are not “assigned” to it on a territorial basis (formal objections may arise during hospitalization), decide in advance for yourself whether you agree to paid services. It is advisable to undergo a set of examinations adopted in this institution, to conclude a service contract.

2. Keep your documents organized, namely:

An exchange card with the data of all analyzes and ultrasound in the III trimester;

The passport;

Insurance policy.

IT IS BETTER TO ALWAYS HAVE THESE DOCUMENTS WITH YOU!

In the absence of medical documents, childbirth is supposed to be carried out in the II obstetric (observation department) or even in a specialized infectious maternity hospital! If you do not have a passport or an insurance policy with you, then there may be problems with the possibility of free birth (under compulsory health insurance). Be careful.

3. Prepare a bag with things: 2 - 3 cotton shirts, 3 - 4 diapers (preferably special disposable ones), 3 - 4 pairs of cotton shorts, pads (largest), bathrobe, washable slippers, 2 - 3 pairs of cotton socks, toiletries, towels .

However, in the maternity ward itself, you will not need anything other than slippers: usually, during childbirth, the necessary linen and clothes are given out in maternity hospital. Everything else, including things for the baby, relatives will bring to you after childbirth.

What to bring with you to the hospital will be prompted by our service List of things to the hospital

It will be more convenient for doctors, and for you too, if, having felt the approach of childbirth, you will not particularly burden your stomach. While waiting for labor to begin at home, limit your diet to light crackers, a cup of broth, and tea.

Trim your nails; you can shave your pubis on your own - these are mandatory procedures before childbirth.

Do not lose your presence of mind, be decisive and collected - you have a hard but joyful work ahead of you. Remember that you are primarily responsible for yourself and your child.

Do I need to go to the hospital in advance?

The decision to write an article with this title came as a result of the fact that very often one has to hear the question (request): is it possible to go to the hospital in advance.

I am deeply convinced that you need to come to the hospital with the onset of childbirth. This does not apply to patients with serious complications pregnancy: high blood pressure (especially combined with headache, heaviness in the back of the head), placenta previa, fetal hypotrophy of 2-3 degrees, Rhesus conflict, impaired fetal condition according to cardiotocography and dopplerometry, severe concomitant pathology of the heart, kidneys, blood system, course of which may worsen during pregnancy. In such a situation, it is necessary to be under the supervision of experienced professionals in order to carry out treatment and at any time, if necessary, medical care. But still, such problems during pregnancy are quite rare. Often, healthy patients try to go to the pregnancy pathology department in order to wait for the onset of labor. What is this desire based on?

Many are afraid that when the birth begins, they will not be admitted to the hospital where they intend to give birth. Do not be afraid of this, because. any maternity hospital is obliged to accept any woman for childbirth, except in cases where there is a severe comorbidity (heart, kidney, infectious diseases) and it is safer for the woman herself to give birth in a specialized maternity hospital.

Another problem, more typical for patients with repeated births, is the fear of not getting to the maternity hospital. But repeated births last an average of 6-8 hours. You can go to the hospital with the first signs of labor activity (contractions after 8-10 minutes, amniotic fluid discharge). It is not at all necessary to wait until the contractions are in 1-2 minutes and you want to push.

Sometimes relatives are afraid that they will be confused with the onset of childbirth, and they also try to send the pregnant woman to the maternity hospital in advance. Such fears can be understood, but it’s still better to take care of the psychological comfort not of yourself, but of the expectant mother, since lying in a maternity hospital, even a very good one, without receiving any treatment, but simply waiting for childbirth is extremely difficult. Communication with patients with pathology of pregnancy leaves a negative imprint on the emotional state.
The agonizing expectation of the onset of their own labor against the background of the onset of contractions in other patients also does not lead to an improvement in mood. There are unnecessary fears, resentments against relatives and doctors, who (quite reasonably) treat such patients as healthy. Accordingly, the doctor's bypass is short-lived, and the treatment is reduced to the appointment of valerian. Hence the resentment and complaints about the inattentive attitude of medical personnel. Although such a number of negative emotions could have been avoided by arriving at the hospital with the onset of childbirth.

The depressed emotional state before childbirth also affects the course of childbirth, which is more often complicated by a pathological preliminary period, weakness of labor activity, discoordination of labor activity, and premature rupture of amniotic fluid.

Big role belongs to doctors of antenatal clinics, who, being reinsured and fearing for the health of patients, hospitalize them in the maternity hospital even if minimal deviations in the state of health are detected (sometimes without them): minor edema, a single detection of protein in the urine, fetal hypotrophy of the I degree, Rh-negative blood no antibodies, slight oligohydramnios or polyhydramnios, premature aging placenta without disturbing the condition of the fetus according to CTG and Doppler sonography, prevention of miscarriage at 39-40 weeks of pregnancy, etc. Of course, in such a situation, patients, not possessing professional knowledge, cannot take responsibility for their health. If you have any doubts whether it is worth going to the maternity hospital in the direction of the antenatal clinic, you can consult the advisory department of the maternity hospital to determine the advisability of hospitalization.

The same applies to a planned caesarean section. If it is known that the operation is due, there are no complications of pregnancy, and the fetus feels normal, then you can not go to the maternity hospital in advance, but come on the day of the operation, having carried out the necessary examination and preparation for the operation on an outpatient basis. But for this, you need to consult in advance at the maternity hospital, clarify the list of examinations, the nature of the preoperative preparation and the date of the operation.

Every pregnant woman, especially if she is expecting a baby for the first time, sooner or later asks the question: How to understand that it is time to go to the hospital? In addition to the obvious "symptoms" of the onset of labor, such as contractions or amniotic fluid, there are also so-called harbingers of childbirth, which allow you to prepare in advance and understand that the birth of a baby is just around the corner.

What are the harbingers of childbirth?

Harbingers are certain signs by which one can assume the onset of labor activity soon.

For recent weeks gestation is characterized by a change in hormonal levels. As a result of the obsolescence of the placenta, the level of progesterone produced by the body is reduced, which was responsible for the preservation and normal course of pregnancy throughout all nine months. It was on the amount of this hormone that the normal tone of the uterus, the formation of a mucous plug, the development of the baby, the supply of oxygen and other necessary substances to it, etc. depended. Instead of progesterone, estrogen begins to be intensively produced, which is necessary to prepare the female body for the upcoming birth. It provides elasticity and patency of the birth canal, as well as the speed of opening the cervix. In addition, as soon as the required amount of estrogens accumulates, a nerve impulse will be sent to the brain, and labor will begin.

Harbingers of childbirth become an external response to hormonal changes that occur before childbirth in the body of the expectant mother. Their appearance is absolutely normal, so you should not worry and urgently consult a doctor if a woman has found one or several signs at once. At the same time, there is no need to worry if a pregnant woman does not notice them, since this does not mean at all that preparation for childbirth is not taking place. This only indicates that it passes unnoticed by a woman.

It is important to note that the harbingers of childbirth can appear a week or even two before childbirth. They do not mean that labor activity will begin immediately. As a rule, a reduction in the time between the appearance of the first signs and childbirth is characteristic of multiparous women. In this case, the precursors may appear in 1-2 days.

What are the symptoms of the imminent onset of labor?

Among the main symptoms of soon start generic activity, we can distinguish:

1. Relaxation of the stool. In order to facilitate the upcoming birth and the passage of the baby through the birth canal, the body begins to remove everything superfluous from itself. As a result, diarrhea may occur. It can occur several times a day, but is accompanied by dehydration, as well as a change in the color and smell of feces. As a rule, this symptom, unlike the others, appears almost before childbirth in 1-2 days. However, it may be absent if the woman is multiparous.
2. Weight loss. As a result of hormonal changes, excess fluid is removed before childbirth. It is the greater, the stronger the swelling during pregnancy. The fluid was retained in the body under the influence of progesterone, but its reduction leads to its release, which contributes to weight loss from 0.5 to 3 kg.
3. Isolation of the mucous plug. A mucous plug created from a special secret of the cervical canal is necessary during pregnancy to protect the fetus. It is needed to prevent infection from entering the uterine cavity from the vagina. Estrogen softens the cervix, opens its canal, resulting in a yellowish-brown discharge, transparent or jelly-like, but without an unpleasant odor. The mucus plug can come out completely or in parts. Usually not accompanied painful sensations, however, the presence of pulling, mild pain, as before menstruation, is also a variant of the norm. As soon as the cork has moved away, the baby does not protect anything from bacteria, so it is not recommended to take a bath, you can only use the shower.
4. "Dropping of the abdomen". As a rule, the child is in head presentation. Before giving birth, his head pulls the uterus down, clinging to the entrance to the small pelvis and preparing to move along the birth canal. Thanks to these changes, the uterus stops pressing so hard on the diaphragm, as a result, a woman can feel the following improvements - shortness of breath disappears, heartburn and a feeling of heaviness stop. However, the pressure on the organs located in the pelvic area increases, as a result, the urge to go to the toilet increases.
5. The discomfort. As a result of sprains, as well as a rush of blood to the pelvic organs, unpleasant sensations may appear in the lower abdomen, in the lumbar region or slightly lower. The pain should not be strong, it resembles a pulling sensation before menstruation. Discomfort can manifest itself both when the mucus plug is released or training contractions, and for no apparent reason.
6. Training bouts. Precursor contractions are the contraction of the walls of the uterus for a few seconds. The expectant mother feels how the uterus tenses, “hardens”, and then relaxes, while the cervix does not open. It is not difficult to distinguish them - they are irregular, or the gap between them is very large. In addition, they are weak and not accompanied by pain. Real contractions increase over time, they become more frequent and last longer.
7. Neck changes. Only a doctor can determine them during the next examination. The neck is significantly shortened, from about 4 to 1 centimeter, and also softens.

In what cases you need to go to the hospital:

Depending on whether the woman is nulliparous, or the pregnancy is not the first in a row, the birth process will differ significantly, as well as the factors that need to be paid attention to in order to understand that it is time to go to the hospital.

- at first birth

If the mucus plug has gone or any of the forerunners of childbirth listed above have appeared, you should not go to the maternity hospital, they simply will not accept you there, since there may be a few more days or a few weeks before the onset of childbirth. But when regular contractions began (not to be confused with training ones), it's time to get ready. Since the first birth, as a rule, takes at least 12-20 hours, it is not worth going to the hospital or, even more so, calling an ambulance immediately after the onset of contractions. It is necessary to wait until the interval between contractions is about 10 minutes.

It is important to understand that the described procedure applies only to those situations where the pregnancy proceeds without complications, and there is no additional factors such as malpresentation of the fetus or premature discharge of amniotic fluid.

- with repeated births

Repeated births tend to be faster because the cervix softens and dilates much more easily than the first time. On average, the entire process of childbirth in the second and subsequent times takes about 6-7 hours. Therefore, so that the birth of a child does not take place in a place that is completely unsuitable for this, it is necessary to go to the hospital immediately after it becomes clear that the contractions are regular and the interval of contractions is decreasing.

When is emergency help needed?

Do not rush to send to the hospital is only in cases where labor begins without any complications. But there are certain symptoms, in the event of which, you should immediately call an ambulance, as they indicate a risk to the life and health of the child. You need to seek emergency help in the following situations:

1. Drainage or leakage of amniotic fluid. It is important to understand that even a slight leakage of water indicates a violation of the integrity of the amniotic membrane, which means that the child is no longer protected from various infections and environmental influences. Ideally, no more than 10-12 hours should pass between the moment the waters break and the birth itself. When you are in a hospital under the supervision of doctors and timely administration of the necessary drugs, this period may be 24 hours or more (but similar situation considered undesirable).
2. There is a lumpy discharge or bleeding (scarlet blood). Even a small amount of red discharge may indicate placental abruption or the development of other pathological conditions that threaten the life of the child.
3. Sharp pain between contractions. When the contraction releases, the discomfort should also disappear. If acute or aching pain persists all the time, this is an unconditional sign of the presence of complications.
4. Contractions occur more often than once every 5 minutes. If the interval between contractions is rapidly decreasing, then there is less and less time left before delivery. In this case, it is not recommended to get to the hospital on your own. Also, if there is already a rapid birth in the anamnesis, or they have occurred earlier with the next of kin, it is necessary to go to the hospital with the onset of the first regular contractions.

It is important to understand that at the first sign of malaise or deterioration of health, an ambulance must be called immediately, without waiting for the appearance of more serious symptoms.

Finally

The last weeks of pregnancy are an extremely exciting period for every expectant mother, regardless of whether she is going to give birth for the first time, second or third. Harbingers of childbirth are not a reliable guide, as in some cases they may simply not be. Therefore, after the onset of contractions, it is important to remain calm, make sure that contractions are the beginning of labor (and not training contractions), and go to the hospital when the breaks between them are reduced to 10 minutes (first birth) or 15-20 minutes (subsequent).

Especially for- Olga Pavlova