The last weeks of pregnancy are the most exciting. A woman can't wait to find out when the birth will begin, how it will be, how her baby will look like. Moreover, this applies to those women who give birth for the first time. At the same time, they are also interested in the question of how labor begins, so as not to confuse malaise and training with signs of a baby. It is important to monitor all changes in the body, and then you can easily understand that it is time to go to the hospital. This article will help you figure it out.

How to find out about the approach of childbirth in order to be able to prepare and get to the hospital?

This question interests every expectant mother, especially a primiparous one. The body itself will tell you that labor will begin soon. All his changes will tell for themselves that it's time to give birth soon. The main thing is to listen to him and pay attention to every little thing.

The prenatal period is considered to be from the 38th week of pregnancy. It is from this moment that you can notice the symptoms before childbirth, the harbingers of the fact that it will soon be time to give birth. At this time, training contractions appear. They are irregular, occur mainly when the position of the body changes. In primiparous, they appear in 5 or more days before giving birth. They prepare the uterus for a future event, so do not worry and immediately go to the hospital. How then do you know that you are giving birth? The present are distinguished by their periodicity and rhythm. If their interval is 10-15 minutes, and they last at least a minute, then you can safely go to the hospital.

What are the harbingers of childbirth in primiparous? In fact, they are the same, no matter what kind of childbirth. When preparing the body, loose stools can be observed, and the urge to go to the toilet is even more frequent. The baby becomes less mobile due to lack of space. However, the main feature is that the appearance of contractions in primiparas is less intense and rapid. Leakage becomes the harbingers of premature birth amniotic fluid or their outpouring.

The main signs of incipient labor

The onset of labor has its own characteristic features for primiparous and multiparous women. The first signs of childbirth are the appearance of regular contractions, discharge of water. Going to the hospital, if the contractions are periodic, appear very rarely, and mainly with sudden movements, it is not worth it. These are not signs of the onset of labor, but training contractions.

In the first pregnancy, signs of labor start early and do not coincide with the date of the event. So, how is primiparous labor going? The first signs of childbirth in primiparas may begin another 1-2 weeks earlier. There are pain in the lumbar region, nausea, vomiting, abdominal prolapse is observed. Generic signs in the form of contractions and discharge of water are quite long. This is due to the inelasticity of the previously nulliparous birth canal, as well as the need to open the cervix, the process of which takes longer.

Signs of childbirth in primiparous often consist in the appearance of a burning sensation in the lower abdomen. It could be emotional changesassociated with nervous overstrain from the unknown signs of the onset of labor and the approaching process. What week does primiparous labor begin? The answer is strictly individual. The fetus can be ready to appear at either 38 weeks or 42 weeks.

Harbingers of the second birth usually begin at 37 weeks. Signs of the onset of labor are developing much more rapidly than in the firstborn. The first signs of an imminent birth can be seen just 1-2 days before delivery. The abdomen of multiparous usually descends already in front of the hearth itself. The birth canal is more prepared, so the process is much faster. The main signs of childbirth and a second pregnancy are the appearance of contractions, the interval of which is getting smaller.

10 signs of approaching labor

The course of pregnancy and childbirth is individual for each woman. Including signs of approaching childbirth, not all are necessarily observed in the aggregate, but each future mother there are special combinations. How then do you know that the birth is coming soon? So, the following signs indicate their approach:

1. Discharge of the mucous plug

A mucous plug is needed to protect the baby from infections. When the cervix is \u200b\u200bdilated, the mucous plug is released, which can be whole or in portions. This sign can be noticed both two weeks before childbirth, and before the very beginning of the baby's birth process. It looks like a discharge of vaginal discharge. In some cases, bloody discharge is allowed.

2. Water discharge

The outpouring of waters indicates the beginning of labor. This process can take place in different ways. Water can flow out even before the onset of contractions, it can leak a little, and in some situations it is necessary to pierce the fetal bladder so that they come off.

3. Contractions

A sign of contractions are wave pains that appear first in the lower back and move down the abdomen. They are of a regular periodic nature. Gradually, there is an increase in pain. In primiparas it usually lasts longer than in multiparous ones.

4. Back pain

On later dates pregnancy, back pain begins to appear due to a change in the center of gravity, the appearance of false contractions, the production of the hormone relaxin, and the preparation of the cervix. Painful sensations are regular. Longer pains that turn into excruciating torture, which are of an irregular nature, may indicate pathologies that require a specialist examination.

5. Abdominal prolapse

In primiparous women, the abdomen becomes lowered two weeks before delivery. If the pregnancy is not the first, then this can happen just a day or two before giving birth. This is the so-called preparation of the baby for birth. It descends into the pelvic area, pressed against the exit. At the same time, he puts even more pressure on the bladder, which is why urination becomes more frequent.

6. Frequent urination and bowel movements

Increased urination is associated with a change in the position of the child and its lowering into the pelvic area. However, women often wonder why the discharge during bowel movements becomes more abundant and thinner. This is due to the effect of hormones that relax the cervix on the intestines, resulting in diarrhea. Symptoms are relevant 27 days before delivery.

7. Changes in fetal activity

The activity of the fetus before childbirth becomes much less noticeable, as it grows and lacks space in the mother's uterus.

8. Changes in appetite and weight loss

Shortly before giving birth, a woman who ate well throughout her pregnancy may lose her appetite. If she ate poorly throughout the pregnancy, then before childbirth, on the contrary, the appetite may increase. Also during this period, the absorption of fetal waters occurs, due to which the milestones are slightly reduced.

9. Nesting syndrome and unexpected mood swings

One of the signs of an imminent birth is the desire to actively prepare for the birth of a baby. The woman withdraws into herself, begins to do cleaning, laundry and other household chores. At the same time, the mood becomes very changeable. She can laugh and cry in a minute.

10. Soft neck

This symptom can only be considered by an obstetrician-gynecologist during examination. The cervix becomes smoother and more elastic due to the action of hormones.

Thus, it is not so difficult to determine the onset of labor. How do you know when labor is about to begin? The main thing is to listen to your body, its changes and not panic. After identifying signs of imminent birth, you need to go to the hospital. Do not forget that childbirth in primiparas is usually less rapid than in the second and subsequent pregnancies.

The first harbingers of the approaching birth in a cat give the owner important information. Even with a planned mating, the period for bearing offspring may differ and your pet may need help. Let's take a closer look at how to determine the gestational age of a cat and what signs indicate that labor will begin soon.

The gestation period for kittens in domestic cats is 61-67 days, normally, pregnancy lasts 63 days. For full control over the course and establishing the exact date of birth, the owner must know the date of conception.

Note! It is believed that mild prolongation in cats is safer than premature birth.

Note! Some cat breeds are allowed to be bred only after specific DNA tests.

For reinsurance, immediately after determining the pregnancy and its term, the cat is recorded on a planned one with the expectation of a gestation period of 63 days. Naturally, if a cesarean section is not needed, it is deliberately not performed. A pregnant cat should be seen by a veterinarian at least four times.

About a week before the expected due date, the cat is examined or x-rayed. After the examination, the veterinarian determines the exact number of kittens in the litter. This procedure is necessary by determining the size of the litter, the owner and the veterinarian can be sure that labor is over after the complete expulsion of kittens and afterbirth.

Advice: during childbirth, record on paper the order of birth of kittens, their gender, weight and yield of the placenta.

If the date of conception is unknown, the owner and the veterinarian have to rely on data on fetal formation, behavioral and physiological changes in the cat to determine the gestational age and the expected date of birth.

Behavioral signs

After discovering that your cat is pregnant, it is necessary to show it to the veterinarian. If the date of conception is unknown, the veterinarian will not be able to determine the expected date of birth. However, the veterinarian can determine, and based on these data, the range in which the birth will occur is established.

If you find one or more physiological signs of imminent labor, carefully monitor the condition of the cat. The onset of labor is indicated by increased breathing and heart rate. Many cats, especially those with flat and depressed noses, start out intensely. Make sure that the pet keeps its head above the bedding (does not bury its nose in the fabric). If possible, ventilate the area where the nest is located.

Note! Usually, on the day of birth, when feeling the peritoneum, there is no active movement of the kittens.

Harbingers of an imminent birth

usually divided into three stages... The onset of the first stage of labor is called harbingers. Normally, before the onset of contractions, a mucous plug comes out of the birth canal. However, this feature should not be relied on for several reasons. The mucous plug can be very small and come out during urination. This process will be invisible not only to you, but also to the expectant mother. Moreover, many experienced owners report that they observed the rejection of the mucous plug several weeks before delivery.

thank

The site provides background information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. A specialist consultation is required!

Introduction. How to recognize the onset of labor?

Many pregnant women often wonder about the upcoming date. childbirth, and women who have to give birth for the first time are especially worried. As a rule, they are very afraid not to recognize the onset of labor in time and confuse it with temporary malaise. In many cases, a woman's close observation of the changes taking place in her body will help resolve these unrest.

Already at 38 weeks, the prenatal period begins, when the first harbingers of childbirth and the first, as yet irregular (training) contractions appear. Such contractions appear irregularly, and they disappear after a change in body position or a short rest. In primiparous women, such training contractions of the uterus can last for five, and in some cases even longer, before delivery. When they appear, you do not need to worry and urgently go to the hospital, but about such changes in your body future mother must notify her doctor, family and friends.

When the first signs of leakage or discharge of amniotic fluid appear, which may indicate the onset of labor or premature labor, a woman should immediately notify a doctor or independently contact a medical institution to resolve the issue of further hospitalization.

If a woman has learned to recognize training contractions, then she will be able to distinguish them from the onset of labor, or true contractions. It is difficult to confuse these sensations with any other symptom, since they are characterized by periodicity and rhythm. For example, a fight lasts 20-30 seconds, and then there is a 20-minute pause - this is repeated many times in a row, and the time intervals hardly change.

At the beginning of the onset of labor pains, the woman in labor or her relatives must inform the doctor about the onset of labor, call an ambulance or go to the maternity hospital on their own.

Reasons for the onset of labor

By the beginning of childbirth, many complex processes occur in the body of a pregnant woman, which, being in close interconnection, ensure the onset of such a reflex act as labor.

The main reason for the onset of labor is the readiness of the uterus for the birth of the unborn child and the maturity of the fetus.

Pregnant uterus:

• gaining sufficient weight and size;
• her neuromuscular apparatus is ready for contractile activity;
• the placenta fully ripens.

2 or 3 weeks before the onset of labor, the uterus is freed from excess part of the nerve fibers. This reduces pain during labor and increases the contractility of the uterine walls.

Several factors influence the onset of labor:

• neuro-reflex - as a result of a decrease in the excitability of the brain, an increase in the excitability of the spinal cord and an increase in the sensitivity of the muscle fibers of the uterus to oxytocin, an increased contractile activity of the uterus is produced;
• hormonal - at the end pregnancy the production of progesterone decreases and the production of a complex of estrogens increases, which stimulate the onset of labor;
• neurohumoral - at the end of pregnancy in a woman's body, the synthesis of oxytocin, prostaglandins, serotonin and other bioactive substances increases, which increase the sensitivity of the uterus to substances that cause active contraction of her muscles;
• bioenergy - a sufficient amount of substances (glycogen, ATP, phosphorus compounds, electrolytes and microelements) accumulates in the mother's body, which make the uterus capable of enhanced contractile activity;
• mechanical - the ripe uterus loses its ability to stretch, and in response to the motor activity of the fetus and an increase in the level of oxytocin-like hormones, it begins to actively contract;
• trophic and metabolic - the accumulation of some waste products in the body of a ripe fetus leads to its active movement, and degenerative processes in the mature placenta and the complete maturation of the muscle fibers of the uterus contribute to the onset of labor.

The state of primary importance in the formation of all mechanisms of the onset of labor is nervous system women in labor, since it is she who ensures the readiness of the uterus for natural childbirth.

All of the above factors, being in close relationship, contribute to the appearance of contractions, which are replaced by attempts and end with the expulsion of the fetus from the uterine cavity and the birth of the placenta.

Harbingers of the onset of labor

Harbingers of childbirth are called a set of signs that indicate early start active labor. There are many harbingers of the onset of childbirth, but for each woman, their totality is individual and depends on the characteristics of the organism of the expectant mother.

Harbingers of childbirth:

• Abdominal prolapse.
  Such a change, which is determined externally by a slight downward displacement of the abdomen, is individual for each pregnant woman, and cannot always be noticed independently. In primiparous women, this harbinger may appear 2-4 weeks before the day of childbirth, and in multiparous women - a few days or immediately before childbirth.


• Gait changes.
  The gait pattern changes after abdominal ptosis. The woman begins to waddle because of the pressure of the baby's head on the pelvic bones and the fundus of the uterus.


• Changes in the nature of urination and bowel movements.
  Abdominal prolapse can cause increased urination or urinary incontinence as the uterus puts more pressure on the bladder. The mechanical effect of the pregnant uterus on the intestinal walls can provoke constipation, and in some cases diarrhea, several weeks or days before delivery.


• Changes in the nature of discharge from the genital tract.
  Vaginal discharge under the influence of hormonal changes becomes more abundant and fluid. In some cases, to exclude the discharge of amniotic fluid, a special test is performed by an obstetrician.


• Discharge of the mucous plug.
  This harbinger of labor can occur 2 weeks before labor starts, and several hours before labor starts. In some cases, the mucous plug does not come off entirely, but in small portions. In practice, this symptom looks like a discharge of vaginal discharge (sometimes mixed with a small amount of blood). The pregnant woman should inform her obstetrician-gynecologist about the discharge of the mucous plug.


• Decrease in body weight of the expectant mother.
  A few days before giving birth, a pregnant woman may notice that she weighs 1-2 kg less. This weight loss can be explained by the elimination of excess fluid from the body under the influence of changes in the hormonal background.


• Reducing the number of fetal movements.
  The fetus, a few weeks before delivery, moves less frequently. This is due to its rapid growth. The future baby becomes cramped in the uterine cavity, and his movements are difficult.


• Training bouts.
  Closer to the date of birth, the uterus begins to come to increased tone, which is expressed in the sensation of training contractions. They differ from labor pains in a number of features: short duration, irregularity, mild pain sensations (reminiscent of pain during menstruation), spontaneous disappearance after a change in body position or rest.


• The manifestation of the "nesting" instinct.
  Many women in the last days and even hours before childbirth begin to prepare their homes for the upcoming birth of a child. These actions can be expressed in the fact that a woman begins to diligently clean up, wash, and may even start repairs.


• Changes in the cervix.
  Only an obstetrician-gynecologist can notice such a harbinger of an impending birth when examining a woman on a gynecological chair. Under the influence of estrogen hormones, the cervix shortens and becomes more elastic by 38 weeks. The external cervical os begins to open before the onset of labor pains.

Harbingers of childbirth in primiparous and multiparous women have their own characteristic features.

Harbingers of the onset of labor - video

Signs of the onset of labor

The reliable signs of the onset of labor are:
1. Contractions;
2. Rupture of amniotic fluid.

These two signs always indicate the onset of labor and every pregnant woman should know how they proceed.

Contractions

True, or labor pains are called contractions of the muscle fibers of the uterus, which occur at regular intervals, and which a woman cannot control. It is this sign that marks the moment of the onset of labor.

The first true contractions are accompanied by minor painful sensations, which most women compare to pain during menstruation. The pain is tolerable and can radiate to the lower back or be localized in the lower abdomen. Most women in labor begin to experience contractions at night. Some women note that during a labor contraction, the uterus "turns to stone", that is, if a woman in labor places her hand on her stomach during a labor contraction, she can feel the hard, tense uterus.

You can determine the truth of the contractions using a stopwatch. Their frequency and constant occurrence, which is not eliminated by a change in body position, taking a warm bath or rest, indicates the onset of labor.

In the beginning, contractions occur at intervals of half an hour (more often in some cases). With each contraction, the woman in labor begins to feel not only soreness, but also rhythmic contractions of the muscles of the uterus. Gradually, the contractions become more noticeable, and their frequency, duration and intensity increase. With each contraction, the amniotic sac and the head of the fetus press against the fundus of the uterus, causing the cervix to open gradually.

Outpouring of amniotic fluid

In the classical course of childbirth, the outflow of amniotic fluid occurs after the cervix opens up to 3-7 cm. Under the pressure of the fetus, the amniotic membrane ruptures, and part of the amniotic fluid is poured out.

A woman in labor, with the classic outpouring of water, may think that she involuntarily urinated. In some cases, the water is poured out gradually, in small portions. In this case, a woman may notice the appearance of wet spots on underwear or bedding and experience sensations such as when the vaginal or menstrual flow is separated.

Sometimes rupture of amniotic fluid can occur before the onset of regular contractions and the opening of the cervix, or much later than the full opening of the pharynx of the uterus. These conditions do not always mean that there will be a pathology of childbirth or fetus, but usually gynecologists use various special tactics for the further management of such labor to prevent possible complications.

Signs of the onset of labor - video

Contractions at the beginning of labor

Obstetricians-gynecologists distinguish three phases of labor pains:

Initial (hidden) phase:

• bout duration - 20 seconds;
• the frequency of contractions is 15-30 minutes;
• dilation of the pharynx of the uterus - 0 or up to 3 cm.

The initial phase lasts from 7 to 8 hours.

Active phase:

• bout duration - 20-60 seconds;
• the frequency of contractions is 2-4 minutes;
• the opening of the pharynx of the uterus is 3-7 cm.

The active phase lasts from 3 to 5 hours. Usually, it is in this phase that the amniotic fluid flows out.

Transient (transient) phase:

• fight duration - 60 seconds;
• the frequency of contractions is 2-3 minutes;
• opening of the pharynx of the uterus - 7-10 cm.

The duration of the transitional phase is from half an hour to one and a half hours.

Labor pains occur in the first stage of labor (the period of disclosure).

The beginning of labor in primiparous

Probable harbingers of childbirth in primiparous have their own characteristics. As a rule, they have a more pronounced time gap between the day of birth and the date of appearance of the precursors. Some expectant mothers are overly emotional and take any slight ailment for the harbingers of childbirth. If they do not know about this or that sign, they may not notice them.

According to statistics, in 50% of cases, childbirth outside the hospital begins in women who are pregnant a second or more times. This is due to the transience of the processes - all stages are faster, there is less time for fees and hospitalization. Therefore, if the signs of imminent birth in multiparous women are identified in time, the risks of complications will decrease.

The first harbingers

The first signs of the beginning of labor in multiparous appear brighter than the first time. In 2-3 weeks, the psychological state changes - irritability increases, sleep becomes anxious, appetite decreases. The fetus changes position in the womb, the pressure on the pelvic ring increases, this causes pain in the pubic area, lumbago in the lumbar region, but there are other harbingers.

How to find out that a multiparous child will soon be giving birth:

1. training fights;
2. weight loss;
3. the appearance of colostrum;
4. nesting syndrome;
5. change in gait;
6. change of mood.

Training bouts. In the third trimester of pregnancy, multiparous mothers experience false contractions, spasms appear from the 21st to the 39th week. The birth canals are prepared for the release of the fetus in advance, the muscles of the organs are developed. During such training, the cervix is \u200b\u200bgradually shortened, preparing for disclosure. There is no pain, there is a slight pulling sensation in the lower abdomen.

Differences from true ones:

• intermediate intervals up to 6 hours;
• a maximum of 3.5 hours in a row;
• the duration of one contraction is not more than 50 seconds;
• no lumbago;
• pass if you change the position;
• painless.

85% of women who are pregnant for the second time calmly tolerate false contractions, since the body is ready for the onset of childbirth. In maternity facilities, second-births enter only with the onset of true signs.

Weight loss. 2 weeks before the approach of labor, the pregnant woman will lose about 2-3 kg of weight. The reasons are the release of excess fluid from the body, a decrease in edema, a deterioration in appetite, due to hormones and anxiety. This phenomenon is physiologically normal; by the end of pregnancy, the amount of progesterone that retains fluid decreases. Sometimes a woman does not lose weight, but stops weight gain in last month - this is normal.

The appearance of colostrum. One of the most striking first signs of an approaching birth in multiparous. Colostrum is secreted from the beginning of the 3rd trimester, but when the uterus is ready for the release of the fetus, the color of the secreted fluid changes to transparent with a white tint. Stimulating the nipples will increase lactation after the baby is born.

Nesting Syndrome.It is explained by psychological excitement, a change in hormonal levels. The state of health before childbirth among multiparous is not stable, previous worries are remembered, a home for the baby is being set up. Linen, towels, hygiene items are purchased, mom sterilizes baby care items. Cleaning is easy, the stomach is not felt.

Gait. The center of gravity is directed forward, due to the decrease in the height of the uterus, the abdomen shifts down. The distance between the chest and the upper abdomen increases, the shape changes to sloping. Therefore, in order to "hold the fetus" while walking, the shoulders are pulled back, as opposed to.

Change of mood. Feelings before childbirth in multiparous are less pronounced than in the first pregnancy. The pain syndrome is more developed, the fetus sinks faster, the neck is already trained, the pressure on the nerve endings worries. Hormonal changes also affect sleep, irritability appears, but without panic.

Each manifestation does not always mean an imminent birth. But, if a woman feels anxious, it's time to prepare a bag for the hospital.

Signs

Statistics show no difference between the number of pregnancies and the term of delivery. The approximate date of birth, established by the gynecologist, is accurate only in 15% of cases.

How many weeks do multiparous women give birth? In the period from 37 to 42 weeks of pregnancy, in the absence of disease. If the precursors of early birth appeared earlier, prematurity of the fetus is likely, later - pathology from postmaturity.

When a woman is not expecting her first child, the upcoming birth is felt vividly. In recent days, mothers do not feel heaviness, their working capacity increases, the depression state goes away.

Signs:

1. drooping of the abdomen;
2. remission of the fetus;
3. diarrhea;
4. frequent urge to use the toilet;
5. discharge of the cork;
6. outpouring of amniotic fluid;
7. true contractions.

Approximately in this sequence, symptoms of imminent birth appear in multiparous after 37 weeks of pregnancy. The fetus is approaching the exit from the uterus, the pressure is transferred to the pelvic organs. Therefore, it is normal for a woman to frequently want to urinate, even with an empty bladder.

Due to the change in position and large size, the baby becomes cramped in the womb, so his movements are constrained. The woman has an unusual feeling of fading of movements, but CTG during this period shows good cardiac activity of the child.

By week 37, progesterone gives the leading role to the hormone estrogen, which softens the walls of the uterus. Due to the tension of the uterine tissues and simultaneous descent to the exit of the fetus, the cervical opening will gradually stretch and by the time of delivery it will be 3-5 cm.The same hormone also affects the intestines, there is a desire to empty it, due to the concomitant pressure on the pelvic organs, there is diarrhea before childbirth.

One of the signs of childbirth in multiparous women is diarrhea 5-6 times a day, one day before the main event. By the end of the day of intestinal activity, the plug comes off. It is a mixture of cervical mucus, leukocytes, collagen fibers, which during pregnancy protect the fetus from external infections. This first sign of imminent birth in multiparous women requires urgent hospitalization, as the water will drain. If the amniotic fluid is poured out, the baby should not stay inside for more than 12 hours.

The initial volume of amniotic fluid is about a liter, this amount is between the head and the outlet. The rest will come out with the placenta. The outpouring passes in a powerful stream, it is difficult to miss it. The color of the liquid is transparent, odorless. Multiparous during the release of amniotic fluid should be in the hospital, since the second birth takes place rapidly, in 3-5 hours. Strong contractions are coming soon.

The frequency of contractions before childbirth in multiparous at the very beginning is 25-30 minutes. The gap will decrease, by the time of delivery it will be about a minute. By this time, the neck is already open by 12-13 cm.

Signs. Women believe in signs of an imminent birth, for example, if you take hair in your mouth, the contractions will become more intense, but will pass easily. Also, popularly, after sending the woman in labor to the hospital, it is impossible to take out the personal belongings of the mother and the unborn child from the house.

Stages

The duration of labor in multiparous children is 3-5 hours, there are cases of permission for pregnancy in 2 hours. But the pain is high, the risks of complications remain, especially if no more than 5 years have passed since the birth of the first child.

1. dilation of the uterus;
2. exit of the fetus through the birth canal;
3. release of postpartum tissues.

How long does childbirth last for multiparous? Individually, from 3 to 5 hours from the start of noticeable contractions. The main time is spent preparing the channels for the course, the faster it passes, the closer the baby is born.

Stage 1. The onset of labor is the beginning of labor. There is a gradual opening of the cervical canal. Uterine contractions intensify, at the beginning the interval between spasms is up to half an hour, by the end of the first stage of labor, the frequency is reduced to 1.5-2 minutes. In second-births, the preparation stage lasts no more than 3 hours. When the neck is open 12-13 cm, the pain subsides, the contractions cease to be uncontrollable. The period of the fetal movement along the birth canal begins.

Stage 2. The pain is dulled. The woman in labor can control her pushing by following the instructions of the obstetrician. The contraction lasts about a minute, with a deep breath in between. During the contraction of the uterus, it is required to completely exhale air, while simultaneously pushing the fetus outward with the internal muscles. Actions continue until the child is released.

How long do multiparous attempts last? About 1-1.5 hours. During the second period, at least 20 attempts are made. It is not the pushing force that matters, but the timing. Therefore, the main thing is to listen to the obstetrician.

Stage 3. After the baby is born, the body is freed from unnecessary tissues - the placenta, membranes, umbilical cord. Uterine contractions continue, cleansing takes place in 1-2 attempts. This period during childbirth is the shortest.

The periods of childbirth and their duration in multiparous in percentage terms look like this: 1st period - 80% of the total time, 2nd - 15%, 3rd period - 5%. If attempts have begun, it means that in the near future the baby will be in the hands of the mother.

When to go to the hospital

By the end of 36 weeks, the bag should be collected in the hospital. With severe training contractions, indigestion, or changes in discharge is not caused ambulance... Until the uterus is fully ready, it may take a few more weeks or false spasms develop into true ones. But there are unequivocal harbingers of close childbirth, in which an urgent need to go to the hospital.

Signs:

• regular contractions;
• discharge of the cork;
• outpouring of amniotic fluid.

60% of women had no prerequisites for childbirth. The multiparous did not feel the contractions of the organ. The period between the passage of the mucous plug and the birth of the baby was less than 1.5 hours. Therefore, it is recommended to pack up things for the hospital in advance, as the journey may take no more than 20 minutes.

When there are no signs, the condition before childbirth is normal - abdominal petrification is monitored. If the sensation recurs and the period is more than 37 weeks, it is time for the multiparous woman to go to the hospital.

When the 41st week of pregnancy ends and labor does not begin, the woman is admitted to a hospital for examination. At this time, there is a high probability that stimulation with special drugs will be applied.

When repeated pregnancy no need to rely on statistics, each case is individual. About 30% of women in labor go beyond the norm, childbirth lasts 10-15 hours, with prolonged contractions, complications. You need to give birth every time, "like the first", diligently and obediently.

The death of a person is a very sensitive topic for most people, but, unfortunately, each of us has to deal with it in one way or another. If the family has bedridden elderly or oncological sick relatives, it is necessary not only for the guardian himself to mentally prepare for the imminent loss, but also know how to help and facilitate the last minutes of the life of a loved one.

A person who is bedridden to the end of his life constantly experiences mental anguish. Being in his right mind, he understands what inconvenience he brings to others, imagines what he will have to go through. Moreover, such people feel all the changes taking place in their body.

How does a sick person die? To understand that a person has several months / days / hours left to live, you need to know the main signs of death in a bed patient.

How to recognize signs of impending death?

Signs of death of a lying patient are divided into initial and investigative. At the same time, some are the cause of others.

Note. Any of the following symptoms can be the result of long-term and there is a chance to reverse it.

Change of daily routine

The daily regimen of an immobile bedridden patient consists of sleep and wakefulness. The main sign that death is close is that a person is constantly immersed in a superficial sleep, as if dormant. With such a stay, a person feels less physical pain, but his psycho-emotional state changes seriously. Expression of feelings becomes scarce, the patient constantly withdraws into himself and is silent.

Swelling and discoloration of the skin

The next reliable sign that death is soon inevitable is the appearance various spots on the skin. Before death, these signs appear in the body of a dying bed patient due to disruption of the functioning of the circulatory system and metabolic processes. Spots appear due to the uneven distribution of blood and fluids in the vessels.

Sensory problems

Older people often have problems with vision, hearing and tactile sensations. In bedridden patients, all diseases are aggravated against the background of constant severe pain, damage to organs and the nervous system, as a result of impaired blood circulation.

Signs of death in a bedridden patient are manifested not only in psycho-emotional changes, but also the external image of a person will certainly change. You can often observe the so-called "cat's eye". This phenomenon is associated with a sharp drop in eye pressure.

Loss of appetite

As a result of the fact that a person practically does not move and spends most of the day in a dream, a secondary sign of impending death appears - the need for food is significantly reduced, the swallowing reflex disappears. In this case, in order to feed the patient, a syringe or probe, glucose is used and a course of vitamins is prescribed. As a result of the fact that the bedridden patient does not eat or drink, the general condition of the body worsens, problems with breathing, the digestive system and "going to the toilet" appear.

Violation of thermoregulation

If the patient has a change in the color of the limbs, the appearance of cyanosis and venous spots, a lethal outcome is inevitable. The body spends all its energy reserves to maintain the functioning of the main organs, reduces the circle of blood circulation, which, in turn, leads to the appearance of paresis and paralysis.

General weakness

In the last days of his life, the bedridden patient does not eat, experiences severe weakness, he cannot move on his own and even rise up to relieve his natural need. His body weight is sharply reduced. In most cases, the processes of bowel movement and can occur arbitrarily.

Altered consciousness and memory problems

If the patient develops:

• memory problems;
• a sharp change in mood;
• attacks of aggression;
• depression - this means damage and dying off of the parts of the brain that are responsible for thinking. A person does not react to the people around him and the events that take place, carries out inappropriate actions.

Predagonia

Predagonia is a manifestation of the body's defensive reaction in the form of a stupor or coma. As a result, metabolism decreases, breathing problems appear, tissue and organ necrosis begins.

Agony

Agony is a near-death state of the body, a temporary improvement in the physical and psycho-emotional state of the patient, caused by the destruction of all life processes in the body. A lying patient before death may notice:

• improvement of hearing and vision;
• normalization of respiratory processes and heartbeat;
• clear consciousness;
• reduction in pain.

Symptoms of clinical and biological death

Clinical death is a reversible process that appears suddenly or after a serious illness and requires urgent medical attention. Signs of clinical death, manifested in the first minutes:

If a person is in a coma, attached to a ventilator, and the pupils are dilated due to the action medications, then clinical death can only be determined by ECG results.

With the provision of timely assistance, within the first 5 minutes, you can bring a person back to life. If you provide artificial support for blood circulation and respiration later, then you can return the heart rate, but the person will never regain consciousness. This is due to the fact that brain cells die earlier than the neurons responsible for the vital activity of the body.

A dying bedridden patient may not have symptoms before death, but clinical death will be recorded.

Biological or true death is the irreversible cessation of the functioning of the body. Biological death occurs after clinical death, so all primary symptoms are similar. Secondary symptoms appear within 24 hours:

• cooling and rigidity of the body;
• drying out of the mucous membranes;
• the appearance of cadaveric spots;
• decomposition of tissues.

Behavior of a dying patient

In the last days of their lives, dying people often recall their past, tell the brightest moments of their lives in all colors and little things. Thus, a person wants to leave as much good as possible in the memory of loved ones. Positive changes in consciousness lead to the fact that a lying person is trying to do something, wants to go somewhere, indignant at the same time that he has very little time left.

Such positive mood swings are rare, most often dying people fall into deep depression, show aggressiveness. Doctors explain that mood changes can be associated with the use of narcotic painkillers of strong action, the rapid development of the disease, the appearance of metastases and irregularities.

A lying patient before death, being bedridden for a long time, but in a healthy mind, ponders his life and actions, evaluates what he and his loved ones will have to go through. Such reflections lead to a change in the emotional background and mental balance. Some of these people lose interest in what is happening around them and in life in general, others become withdrawn, others lose their sanity and the ability to think sanely. The constant deterioration of the state of health leads to the fact that the patient constantly thinks about death, asks to alleviate his situation by euthanasia.

How to ease the suffering of a dying person

Lying patients, people after, trauma or with cancer, most often experience severe pain. To block these, strong pain relievers are prescribed by the attending physician. Many pain relievers are only available with a prescription (such as morphine). In order to prevent the emergence of dependence on these funds, it is necessary to constantly monitor the patient's condition and change the dosage or stop taking the drug when an improvement appears.

How long can a bedridden patient live? No doctor will give an exact answer to this question. A relative or caregiver caring for a bedridden patient needs to be around the clock. For more and alleviating the suffering of the patient, you should use special means - beds,. To distract the patient, you can put a TV, radio or laptop next to his bed, and you should also have a pet (cat, fish).

Most often, relatives, having learned that their relative needs them, refuse him. Such bedridden patients also end up in hospitals, where everything falls on the shoulders of the workers of these institutions. Such an attitude towards a dying person not only leads to his apathy, aggression and isolation, but also aggravates his health. In medical institutions and boarding houses, there are certain standards of care, for example, a certain amount of disposable means (diapers, diapers) is allocated for each patient, and bedridden patients are practically deprived of communication.

When caring for a lying relative, it is important to choose an effective method of alleviating suffering, provide him with everything he needs and constantly worry about his well-being. This is the only way to reduce his mental and physical torment, as well as prepare for his inevitable death. You cannot decide everything for a person, it is important to ask his opinion about what is happening, to provide a choice in certain actions. In some cases, when there are only a few days left to live, you can cancel a number of heavy drugs that cause inconvenience to the bedridden patient (antibiotics, diuretics, complex vitamin complexes, and hormonal agents). It is necessary to leave only those medications and tranquilizers that relieve pain, prevent convulsions and vomiting.

Brain reaction before death

In the last hours of a person's life, his brain activity is disrupted, numerous irreversible changes appear as a result of oxygen starvation, hypoxia and the death of neurons. A person may see hallucinations, hear something, or feel as if someone is touching him. Brain processes take a few minutes, so the patient in the last hours of life often falls into a stupor or loses consciousness. The so-called "visions" of people before death are often associated with past life, religion, or unfulfilled dreams. To date, there is no exact scientific answer about the nature of the appearance of such hallucinations.

What are the predictors of death according to scientists

How does a sick person die? According to numerous observations of dying patients, scientists have drawn a number of conclusions:

1. Not all patients develop physiological changes. Every third person who dies has no obvious symptoms of death.
2. 60-72 hours before death, most patients lose their reaction to verbal stimuli. They do not respond to a smile, do not respond to gestures and facial expressions of the guardian. There is a change in voice.
3. Two days before death, there is an increased relaxation of the cervical muscles, i.e., it is difficult for the patient to keep his head in an elevated position.
4. Slow, also the patient cannot close the eyelids tightly, close his eyes.
5. You can also observe obvious disturbances in the work of the gastrointestinal tract, bleeding in its upper sections.

Signs of imminent death in a lying patient manifest themselves in different ways. According to the observations of doctors, it is possible to notice obvious manifestations of symptoms at a certain period of time, and at the same time determine the approximate date of death of a person.

	Development time
Change of daily routine	A few months
Swelling of the extremities	3-4 weeks
Perceptual impairment	3-4 weeks
General weakness, refusal to eat	3-4 weeks
Impaired brain activity	10 days
Predagonia	Short-term manifestation
Agony	From a few minutes to an hour
Coma, clinical death	Without assistance, a person dies in 5-7 minutes.

Video

016

---