Marina Shalimova, obstetrician-gynecologist, candidate of medical sciences:
“The hormones give a signal to the onset of labor: shortly before the responsible event, the level of progesterone“ guarding ”the pregnancy decreases, but the number of estrogens, hormones preparing the uterus for childbirth, grows. Under their influence, the cervix softens and shortens, and in order for contractions to occur, prostaglandins and oxytocin come into play – thanks to them, the uterus begins to contract regularly.
These hormonal changes and the first contractions of the uterus (similar to menstrual pain) can go unnoticed, especially if they start at night and do not interfere with sleep. And yet many women feel good about how something is going wrong with them.
Some become too active and run to the store to have time to buy something at the last moment, others vigorously rejoice or, on the contrary, get nervous. Other “news” appear along with mood changes: for example, the desire to empty the bladder occurs more often and stronger than usual.
Do not neglect these signals and just in case do not go far from home.
Gradually, the contractions of the uterus become more regular, and during each of them the woman feels her stomach hardening and changing shape, sharpening ahead. At first, these sensations pass quickly; then the duration of contractions increases, and the intervals between them decrease.
If the amniotic fluid has not yet been poured out, it is necessary to go to the maternity hospital when the contractions begin to repeat every 15 minutes and last for 20–30 seconds. However, sometimes it happens that contractions, even regular and very painful, turn out to be false and do not reveal the cervix.
Only a doctor can determine what is happening, which is why in any case it is better to get ready for the maternity hospital.
6–8 hours before the birth, a mucus plug covering the entrance to the cervix to the microbes from the vagina comes out. Outwardly, this is a small lump of mucus, sometimes with blood. His appearance is a signal that the cervix began to prepare for the birth of a baby, but nevertheless, what is happening can not be regarded as the beginning of labor.
Sometimes a woman doesn’t notice a cork coming out at all, so other precursors of labor deserve much more attention: contractions and discharge of amniotic fluid.
After the rupture of the amniotic bladder, in which the child “floats”, the amniotic fluid begins to flow out. Sometimes this happens before the onset of contractions, but for mother and baby it is best if the water flows in the midst of childbirth, when the cervix has already managed to open up a bit. At the same time, the woman feels how a stream of liquid is pouring from inside, which, unlike a stream of urine, cannot be stopped by the force of muscles.
After the water has withdrawn, the child becomes vulnerable to infections, so the expectant mother should immediately go to the maternity hospital, even if the contractions have not yet appeared.
There are situations when you need to call an ambulance without fail, regardless of the gestational age:
- you started having regular contractions (it doesn’t matter if the amniotic fluid was removed or not);
- bright blood discharge from the vagina appeared;
- poured amniotic fluid;
- you feel bad: flies before your eyes, a headache, heavy stomach pain;
- you have a fever;
- the child does not move for a long time. ”
Anton Olenev, obstetrician-gynecologist of maternity hospital № 25:
“Already from the beginning of the 38th week of pregnancy, the expectant mother needs to be prepared for the fact that she needs to go to the hospital at any time. But even when the responsible event comes, the most important thing is to keep calm.
If the first pregnancy took place without complications, the initial stage, when the cervix opens, will take a lot of time, so there is no reason for excitement and haste.
If you feel that the contractions have begun, observe how often they occur. If the interval exceeds 7-10 minutes, you can safely do household chores, take a shower or just walk around the apartment.
If you attended classes for future mothers, you will have in your arsenal a list of things you can do: for example, to do special exercises, breathing exercises, and to ride an inflatable ball.
If everything is in order with the future mother and baby, you should not go to the maternity hospital with the first contractions: no matter how wonderful the conditions are there, the woman will still be more comfortable at home. It is best to spend most of the first period in your home, and when the contractions become painful, you can safely go to the hospital.
If the expectant mother expects a second or third baby, the development of events can be faster, and sometimes even rapid. In this case, it is necessary to go to the maternity hospital as soon as the contractions become regular and the interval between them is less than 7 minutes.
One of the main signs that the birth of a baby is just around the corner is the appearance of amniotic fluid. If they are light (a greenish shade of water means that the baby does not have enough oxygen) and the child moves as usual, you have a couple of hours left to safely get to the hospital by your car. But if the water is greenish, it is better to immediately call an ambulance.
Call the number listed in the exchange card – this is the telephone number of the obstetric unit of the ambulance service. These specialists will come to you even if you just dial “03” and say that a pregnant woman needs help.
Try to prepare in advance all that you may need during childbirth. The most important thing that should never be forgotten is the exchange card, the main document of the future mother.
In addition, you will need a passport and insurance policy with a birth certificate. Everything else will be given to you in the hospital. If you wish, you can take along rubber slippers, a disposable razor, a mobile phone with a charger, gaskets, napkins, a bottle of water without gas.
Other things you will need after delivery, and your loved ones will be able to pass them on. ”