What are fights and how are they?

There is probably nothing worse for pregnant women than the upcoming labor pains. They are waiting and afraid at the same time. They are credited with terrible pains, women in labor tell each other in dark tones about them. So are the fights as they can be, how to distinguish one species from another, how to behave in order to alleviate the pain and speed up the birth of the long-awaited toddler, we will tell in this article.

Contractions - a word that came to the medical terminology of the people. Women have long noticed that the birth of a child is accompanied by a feeling of contraction and relaxation inside the abdomen. Describing this phenomenon with the verbs “seizes”, “grabs”, women gave rise to the official name of the beginning of active labor activity. The description stuck and entered into all textbooks on obstetrics.

Fight is the tension of the muscles of the uterus. The body of the uterus is a smooth muscle, and its neck is round. Voltage can be synchronous, and can be quite autonomous. Pregnant women usually have a lot of questions that cause not only labor pains, which bring the moment of childbirth nearer, but also other uterine contractions, which, according to reviews, can occur in the middle of pregnancy and before childbirth - at 37 weeks and later.

When the contractions begin, depends on their type, the number of births that the woman had previously had, on her individual susceptibility to pain, on the child's readiness for her own birth, on the mass of other factors and causes. Let's look at what are uterine cramps, called contractions.

Knowing the description of each type of uterine spasms, a woman can easily distinguish one from another. It should be noted that not only primiparous women sometimes find it difficult to determine what is happening with them, but also those who already have a generic experience, because with each subsequent pregnancy, feelings may differ significantly. There are three types of uterine contractions that are not considered pathological and do not need treatment: false, precursor (preliminary) and true (generic).

The female half of humanity is obliged to the description of this phenomenon by the English doctor John Braxton-Hicks, who in the 19th century, while practicing in one of London hospitals, observed and described them in women during pregnancy. In honor of him, the false contractions were called Brexton-Hicks contractions, and women often simply call them "sweats" or "brextons."

Such contractions are short, episodic and very irregular, intermittent tension of the walls of the uterus. The woman simply feels that the "belly is stone." This happens all at once. Similarly, spontaneously, the tension drops. There is no need to speak about any intensity, regularity of repetition of false contractions.

This phenomenon defies logical explanation, so it is believed that such stress attacks of the uterus are a kind of preparation of the female body for childbirth. Other experts believe that they are a consequence of over-stimulation of the cerebral cortex inherent in pregnant women. Not all of these cramps are observed, not always and at different times.It is noticed that during the first pregnancy they can appear already in the middle of the term of gestation, after the twentieth week. And for multiparous, training contractions of the muscles of the uterus are usually indicated only by the end of pregnancy, shortly before delivery.

Such abbreviations look quite harmless and, in fact, are completely harmless. They do not accelerate the onset of labor, do not affect the opening of the uterus, do not interfere with the development of the fetus. And the discomfort that a woman can feel when the uterus suddenly comes to a tone is easily eliminated: “No-shpy” pills, candles with papaverine, a warm shower, a slow walk with a slow step in fresh air, a change in body position, and calm and even breathing. allow you to stop the spasm and return the muscles of the uterus to a relaxed state.

Such uterine contractions already have a well-founded origin: they symbolize the beginning of active preparation of women for childbirth. Most often, before childbirth, there appear smarting sensations combined with episodic tension of the uterus. The nature of the discharge changes: they become more abundant. Sometimes, on the background of precursory contractions, a mucus plug jams off, which closed the cervical canal throughout the entire gestation period.

Such cuts are more worthy of being called training ones, since they really are a kind of rehearsal: the cervix begins to smooth, soften. During the birth process, she will need to open from 0 to 11–12 centimeters, and therefore the tissue of this circular muscle should be prepared for it in advance.

Structural cells of the uterus, of which it consists, begin to accumulate a special protein substance - actomyosin. It will give myocytes the ability to shrink when labor begins. And the placenta and pituitary together begin to produce oxytocin, a hormone that triggers the process of uterine contraction.

The preparatory process in the body usually takes from several days to several weeks. If a woman is waiting for the first child, precursor short-term reductions may appear a couple of weeks before delivery. If pregnancy is not the first, sometimes precursors occur immediately before the onset of labor and are often quite naturally regarded as prenatal.

Do I need to run to the doctor? Most likely not, if there are no other complaints. At the scheduled admission, it is imperative to mention the appearance of precursors so that the doctor can assess the degree of maturity of the cervix. In addition to periodic spasms in the uterus and tingling in her neck, a woman can pay attention to other symptoms of childbirth approaching, which begin (but not always) shortly before the baby is born: diarrhea, insomnia, nausea, sometimes even vomiting after eating (organism "Cleared" before the responsible test), expressed anxiety, anxiety, mood swings. If you feel sick, you need to consult a doctor.

Such contractions are a real gift of nature to a woman. They cause cervical dilatation. The process of its discovery begins with the first true contraction, which is very important for the baby to leave the uterus, in which he grew and developed over nine calendar months. A distinctive feature of such bouts - a clear order and consistency. They occur at a certain time and at intervals that are also approximately equal. This is the main feature of real fights from everyone else.

At first, the true contractions of the uterus are short and recur infrequently, gradually the spasms become more and more protracted and prolonged, and the intervals of rest between them become shorter. Throughout the stage of contractions, the cervix gradually opens.The stronger the contractions at the end of the period, the greater the disclosure becomes.

Labor contractions are completed after the disclosure is complete, the baby's head under the pressure of the uterus can pass through the neck and the fetus begins.

The purpose of contractions is quite obvious: rhythmic contractions increase the pressure inside the uterus, which leads to the opening of the cervix, to the discharge of amniotic fluid, to the beginning of the expulsion of the baby.

Real contractions will begin when the painstaking and multi-step process of internal preparation (from the physiological level to the hormonal level) is completed - and not a day before. The preparation process is very individual. Exactly because of this reason Women who become pregnant on the same day can give birth two weeks apart.

The onset of labor is the moment that pregnant women are so afraid to miss. Obstetricians have a professional joke on this subject, which says: "If you doubt, give birth, then you definitely do not give birth, because labor contractions can not be confused with others." Indeed, in addition to the fact that real uterine contractions, indicating the launch of the mechanism of labor, have a certain temporal pattern, they are distinguished by completely different sensations.

If the forerunner and false episodes of tonus are manifested only by slackening in the lower abdomen and a slight feeling of aches, then the true ones are more like ebbs and flows: the pain originates somewhere in the middle of the back, goes to the lower back, belts, goes to the stomach. Then, in the reverse order, the uterus relaxes.

The expectant mother, expecting the appearance of the firstborn, needs to be prepared for the fact that the period of contractions will be longer for her: the muscles of the uterus and the birth canal are not very elastic - the cervix opens more slowly.

As soon as a woman notices cramping attacks and realizes that they occur every 30–40 minutes and last for 15–20 seconds each, we can safely say that the birth has begun. These first cuts will be called latent, since the birth has begun, but so far they are hidden (latent) character.

This stage during the first birth can last up to 10 hours, until the cervix does not open to about 3-4 centimeters. The contractions themselves will grow very smoothly, gradually, they will become longer, the intervals of relaxation between them will be shorter. Then the stage of active contractions will begin. The duration of contractions will reach 50 seconds, and they will be repeated every 4–6 minutes. The uterus will open another 3-4 centimeters, and by the end of the stage disclosure will be about 7 centimeters. Active contractions should be more painful than hidden ones, and this is quite natural. But this stage lasts less than the previous one - from 3 to 5 hours.

The last stage of labor is transitional. He is the boundary between contractions and attempts. It lasts from half an hour to an hour and a half during the first birth. Contractions are the longest: each lasts about a minute, such cramps recur every 1-2 minutes. At the end of the period, the woman begins to feel a strong desire to visit the toilet in a big way. This symbolizes the beginning of the reward period, when the obstetrician will lead everything.

The peculiarity of repeated delivery is that all processes (from the preparation of the body to the expulsion of the fetus from the womb) last somewhat faster. After the first birth, the muscles of the uterus, the cervix are not restored until the end - it always remains a little more stretched and elastic than that of the firstborn children.In addition, women already have an idea of ​​the process of childbirth, and therefore they panic less, scamper and fear, which definitely contributes to a faster and less painful labor activity.

The contractions are latent in such women may go unnoticed until they reach a certain intensity and strength. The entire first hidden period of childbirth can take no more than 8 hours, after which active contractions begin, which usually lasts no more than 3 hours. The most painful transitional contractions during repeated labor do not last more than 30–45 minutes, and, according to the doctors, the period most often takes 15–20 minutes and immediately turns into attempts.

Do I need to go to the maternity hospital with the start of regular and repeated contractions? No, it is not necessary if the condition of the woman as a whole is normal and there are no complications. Too early arrival at the maternity hospital will not be beneficial for the woman in labor, because in the hospital ward it is much more difficult to maintain the Spartan calm necessary for light and almost painless births.

Obstetricians recommend to come to the maternity hospital when the cervical dilatation is 2-3 centimeters. It is clear that a woman cannot measure it at home in any way. That is why it is recommended to focus on the frequency of contractions. It is about this or about such an opening of the cervix that contractions are said to repeat every 5–10 minutes.

Primiparous women should come to the maternity hospital when contractions are repeated every 5–10 minutes. Those who give birth are not the first to remember that their disclosure is faster, and therefore it is better to call Ambulance when the interval between uterine spasms is 10–15 minutes.

Note the time interval (interval), you can use the most ordinary stopwatch, but you can use the achievement of science and technology - counter contractions. This application can be put on a smartphone for free. For different operating systems and platforms, there are separate measuring applications. If you suspect a fight, you just need to press a button in the application and repeat it for several subsequent spasms. The program will help to calculate correctly not only the interval, but also the duration of each contraction, as well as select the most appropriate time to be sent to the hospital.

In which case should a woman not detect, count and analyze anything in order to go to the obstetric institution? Only in the event that medical care is required immediately, urgently. These situations include:

• discharge of water (with contractions, on the background of spasms or without contractions);
• the appearance of blood discharge (before labor, during or without them);
• the onset of contractions with obstetric pessary established for weakness of the cervix or surgical sutures placed on the cervix;
• normal initial contractions, but against the background of a general deterioration of well-being (unstable blood pressure, dizziness, dizziness, vomiting, a woman lost consciousness, and so on).

Childbirth, which begins with the appearance of contractions, is the classic and most preferred option. They are called ordinary, uncomplicated. In almost 85–90% of pregnant women, childbirth begins precisely with uterine contractions. But you can never be sure that there will be no complications. These include premature or early discharge of amniotic fluid, untimely detachment of the "children's place", as well as too weak contractions that do not lead to the opening of the neck at the rate in which it is necessary for the normal labor process.

Such a phenomenon is said, if regular contractions do not increase, do not lead to the opening of the neck, or the spasms have stopped altogether. Depending on when this happened, primary and secondary weakness is distinguished.In the first case, we are talking directly about weak contractions, in the second - about weak attempts, when with full disclosure of the expulsion of the fetus does not occur.

The cause of this complication in all cases is hypotension of the uterine muscles. It may develop due to hypoplasia of the reproductive organ, in the presence of fibroids or other neoplasms in or outside the cavity, endometritis, congenital anomalies of the structure of the uterus. A large number of abortions in the past, the presence of scars on the uterus due to earlier operations, the treatment of erosion by cauterization in the past - all this suggests that a woman may develop a primary weakness.

Hormonal imbalances (oxytocin and progesterone, estrogen), obesity in women, preeclampsia, too young or late first childbirth (after 36 years), the very fact of first birth, post-term or premature pregnancy, large fetus, pregnancy with polyhydramnios - all this increases the likelihood that contractions will not be strong enough or labor activity will suddenly stop.

Separately, doctors distinguish psychogenic primary weakness. Under normal health conditions, good tests and the absence of pathologies of pregnancy, for unexplained reasons, a woman does not have a normal uterine contraction, childbirth does not develop. Experts tend to believe that this happens in women who panicky fear of childbirth, and therefore at the psychosomatic level, they unknowingly “slow down” their own childbirth.

Psychogenic weakness occurs in women who do not want to give birth (the child is unwanted, unnecessary, the woman became a victim of rape and became pregnant, left her husband, and so on).

Without the help of doctors with the weakness of labor, women cannot cope. The risk is that the child and the mother may die, the baby may begin irreversible changes in the cerebral cortex due to hypoxia, and may also begin a systemic infection. If contractions are weak, the doctors will do everything to strengthen them: they will inject a dose of oxytocin, they will puncture the fetal bladder, if they haven’t withdrawn their water, they will stimulate labor.

Every tenth woman is faced with premature rupture of amniotic fluid. The role of water for a baby is difficult to overestimate: they protect it from infections, shock, acting as a shock absorber. The anhydrous period is a period of risk for the crumbs: it is threatened by numerous bacteria, viruses, fungi that can penetrate the cervical canal, as well as acute oxygen deficiency if left for a long time without amniotic fluid.

The most common cause of premature water discharge before the development of contractions are infections of the mother's genital tract, as well as infectious diseases that she suffered during the period of gestation of her baby. Also provoking factors include clinically narrow pelvis, improper location of the baby in the uterus, isthmic-cervical insufficiency, reckless rough sexual intercourse shortly before giving birth, multiple pregnancy, severe anemia, gestosis and bad habits of women with whom she did not want to part with during pregnancy obesity. Fall, abdominal injuries can also cause the discharge of water ahead of time.

If the waters are withdrawn from 29 to 37 weeks of gestation, contractions usually begin in about a day, but only in half of the parturient women. For the rest, before the onset of labor, a week can pass, which should be held under the supervision of doctors. If the amniotic fluid is poured from 38 weeks, then after 12 hours, full-fledged contractions can start in 50% of cases, the rest of the independent labor activity can begin after 72 hours.

If it turned out that during the day, which passed after the discharge of water, childbirth did not begin during full-term pregnancy, labor is stimulated by medication. Often the decision on stimulation is made within 6–9 hours after spontaneous discharge of water. If there is no result, make a cesarean section. When the pregnancy is premature, an individual decision can be made to extend it. Doctors will try to give the baby as much time as possible in order to mature.

Normally, the placenta should be exfoliated and come out after the baby is born, in the so-called afterbirth period of childbirth, which is final. But at any stage of contractions or attempts, detachment may occur, which will manifest as severe bleeding from the genital organs, as well as a change in the condition of the fetus (now you understand why CTG sensors are attached to childbirth on the stomach).

This complication is considered the most dangerous. A woman can lose a lot of blood, a child can die from acute severe oxygen deficiency and remain disabled due to total changes in the brain and central nervous system caused by hypoxia. Therefore, there are few options here - Doctors immediately conduct a cesarean section.

The mechanism of birth pain in many ways has not yet been fully studied. But if you consider that the uterus itself does not have nervous sensitivity, many experts believe that the pain does not originate in the uterus, but only in the head: the center of pain is activated by the increased excitation of receptors. This process is influenced by fears, severe stress, the expectation of something terrible and terrible. In medicine, such pains are called corticogenic.

Since the cause of pain in the mechanisms of the brain, it is quite possible to avoid it. Almost all methods of painless delivery are based on this statement, many of which are used in modern maternity hospitals.

Facilitate the fight will help the development of some techniques that have received international recognition. Thus, the technique of childbirth "According to Lamaze" is a complex method, which was described by the French obstetrician Fernand Lamaze in the middle of the last century. It includes breathing exercises, which should be used for contractions, exercises to improve muscle tone, yoga, aromatherapy, meditation, methods of hot and cold contrasting compresses during childbirth, and fitball exercises during contractions.

The method of "Hypnotic childbirth", developed by Soviet scientists Platonov, Velvovsky, Bekhterev, and also supplemented by Professor Lurie, involves the creation of the correct settings in the head (from which, as we found out, and the main birth pain) pregnant. The word therapy in the prenatal period makes it possible to reduce generic pains as much as possible, to eliminate the pathological fear and horror of the birth process of the baby.

A woman can learn proper breathing during bouts and attempts in female consultation at free classes in the school of future mothers. Most often, future pregnant women are taught the method of breathing according to Kobas. The technique is named after obstetrician Alexander Cobos, who was a big fan of the scientific works of Fernand Lamaz, about whom we spoke above.

The system of breathing exercises for Kobas is based on the saturation of the body with oxygen and a certain relaxation in the most different stages of labor contractions. With oxygenation, the body begins to produce endorphins, which have an analgesic effect, and the ability to relax certain muscle groups relieves the intensity of pain at the physical level.

During the first fights and the entire latent latent period, Alexander Kobas recommends breathing deeply, breathing in slowly and exhaling even more slowly. According to this technique, active contractions need to be “breathed out” quickly, using short and staccum breathing exercises (“The Engine”, “Doggie”, “Candle”). Short repeated exhalations are recommended only at the peak of spasm, between contractions breathing for a long time to stay deep and calm so that the baby does not experience oxygen deficiency, and the mother's body continues to produce a unique pain medication - endorphins.

Poses that will help a woman to survive the period of labor more easily can be both for a “single program” and for joint birth, in which the partner of the woman in labor will have a special role as an assistant, and not an outside observer.

It has long been proven and many methods of natural anesthesia childbirth described that the horizontal position for women with contractions - not the best. Yes, it is convenient, but only for obstetricians. It will be much easier for the parturient woman to endure uterine spasms while standing on the ball, on all fours.

The best, according to women, are the "cat pose" and the vertical stand. In the first case, a woman stands in the knee-elbow position and slightly bends her back in the lower back, not forgetting about proper breathing. In the second case, she stands with a support on the wall, the back of a bed or a chair, on a partner, on whom you can also hang on if you grab your neck with your hands.

Massage or self-massage of a special zone, which is under special stress during childbirth, helps to improve blood circulation, relieve pain. This place is the area of ​​the sacrum, or the so-called Michael's Rhombus. It is located in the center of the waist perpendicular to the tailbone. It is possible to make the contractions less painful by rubbing this area, turning the cams - this is the minimum program.

You should not be afraid of contractions for the reason that doctors are always ready to help a woman in labor. If techniques and exercises are unfamiliar to her, or the effect of anesthesia could not be achieved, the woman can rely on epidural anesthesia from the period of active contractions.

A dose of anesthetic is injected into the epidural space of the spine. The puncture is done in the space between the vertebrae of the lumbar spine. The procedure is performed by an experienced anesthesiologist, and the injection itself is practically not felt. After it, the sensitivity of the lower part decreases, contractions occur (they cannot be controlled), but the sensations in the woman are dull, smoothed. However, she does not lose the ability to walk, sit, because such anesthesia differs from epidural anesthesia with a lower dose of drugs and the absence of muscle relaxants in the injected mixture.

Women who are tired of wearing a baby, who are on the last days of pregnancy, or who are carrying a baby, are often interested in what can cause labor contractions and the onset of labor. Doctors strongly advise against this, as contractions always begin in a timely manner when the woman’s body and the child are ready for it.

Folk councils, such as sex to stimulate contractions, foods that can be eaten for delivery (caraway oil, for example), tips to burden yourself more with homework, and as a result, “fights fights” can be dangerous. Thus, sex is prohibited after the discharge of the mucous plug and the discharge of water, as well as with the beginning of the opening of the neck. Products do not have a pronounced effect on childbirth, and physical activity can lead to the discharge of water or placental abruption. Also, do not try to strengthen the opening of the cervix or contractions with medicines.

The best thing is to be patient and wait for the baby to be asked to come to the light. If, even at 42 weeks of pregnancy, contractions do not begin, they will be stimulated by completely different methods - medicamentous, and this will be done under vigilant medical supervision in the maternity hospital.

For information on how labor contractions begin, see the following video.