Precursors of labor in first-time mothers: what is it, the first signs of imminent delivery in the last weeks, when do they begin, how long do they last

The first pregnancy is a joyful and welcome event for every woman, and a repeat pregnancy is doubly pleasant, because now happy parents will be able to give their love to two little people at once. And if for the first time the process of bearing a child is unknown to the expectant mother, she just has to learn all its intricacies and learn a lot, then a second pregnancy is no longer so scary.
It is almost no different from the first one, and does not represent anything new. We already have experience in solving problems associated with pregnancy, and the second time they will not come as a surprise. But you can’t relax, especially at the end of the term. As a rule, in multiparous women, signs of incipient contractions appear earlier, sometimes as early as 36 weeks. Although they are weak, they are noticeable. That is why in recent weeks it is necessary to carefully monitor all changes. And not only in order to determine the onset of contractions in time, but also to respond in a timely manner to possible pathologies associated with these processes. Multiparous women should also know that early warning signs are in no way a reason for concern or preparation for premature birth. This is a completely natural situation, and there is no reason to panic here.

Not all multiparous mothers recognize the approaching birth in time, since everything happens faster the second time. This means that a woman planning to become a mother again should pay special attention to the warning signs of childbirth. What are they and how do they manifest themselves in multiparous women?

Reasons for the onset of labor in different periods

By the end of the third trimester, complex processes occur in the body of the expectant mother, which together cause the onset of a reflex act - labor. The main reason for the onset of labor is the maturity of the fetus and the readiness of the uterus to expel it.

The uterus, ready for childbirth, has the necessary mass and size, capable of full contraction of the neuromuscular system and a fully mature placenta. About 2-3 weeks before the baby is born, the muscle organ is freed from some of the nerve fibers: this makes it less sensitive to pain and increases contractility.

The main reason for natural childbirth is the maturity of the fetus and the readiness of the uterus to expel it.

In general, the process of onset of labor is provoked by the following factors:

Hormonal. Towards the end of pregnancy, the production of progesterone decreases and the synthesis of estrogen increases, which stimulates the onset of labor.
Nervous reflex. The muscle fibers of the uterus become more sensitive to the hormone oxytocin, due to which the contractile activity of the organ increases.
Neurohumoral. In the female body, in turn, oxytocin, prostaglandins, serotonin and other substances that cause uterine contractions are intensively synthesized.
Bioenergy. The production of glycogen, phosphorus compounds, electrolytes, which also affect the contractility of the uterus.
Mechanical. A mature uterus loses its ability to stretch.
Trophic and metabolic. Waste products accumulate in the fetal body. In the mature placenta, degenerative processes begin at this time.

The state of the nervous system of a pregnant woman is of key importance in the mechanism of the onset of labor. It is she who prepares the uterus for natural childbirth.

Pregnancy is considered full-term from 38 weeks. If labor does not occur after a full 41 weeks, then we are talking about postmaturity. Thus, labor can normally begin at any time within four weeks.

The situation is slightly different with premature birth.

Premature birth in Russia and a number of other countries means birth between 22 and 37 obstetric weeks. The weight of the fetus is over 500 g.

Most often, premature birth is caused by the following factors:

Isthmic-cervical insufficiency. With this pathology, the cervix is too weak to support the fetus, which becomes increasingly heavier. As a result, under its pressure, the organ begins to open, which causes premature labor. Isthmic-cervical insufficiency is mainly a consequence of abortions, miscarriages, which were accompanied by scraping out the uterine cavity, while the cervix is artificially dilated with special instruments.
Infectious diseases and pathologies of the uterus. This is the infantilism of the organ, its bicornuate or saddle-shaped form.
Multiple pregnancy.
Polyhydramnios.
Endocrine diseases, in particular diabetes mellitus, malfunction of the thyroid gland.
Bad habits of a woman during pregnancy: smoking, drinking alcohol and drugs.
Intense physical activity during pregnancy.
Stress factor.
Unfavorable social situation (poor nutrition, etc.).

Multiple pregnancies often end in premature birth

Changes in a pregnant woman's body weight before childbirth

A sign of imminent labor in first-time mothers is a decrease in a woman’s body weight by a couple of kilograms just before childbirth. The child and his mother are no longer gaining weight.

This happens due to the fact that the hormonal background changes before childbirth, the level of estrogen increases and excess fluid is removed from the body. The first-time mother will be able to see the change in weight when she visits the doctor during weighing.

Precursors of the onset of labor in a woman and fetus

The female body gradually begins to prepare for childbirth from the middle of the third trimester. It is at this time that the first harbingers of a long-awaited and exciting event often appear.

In general, the precursors of labor are a set of signs indicating the imminent onset of labor. These include the following:

Abdominal prolapse. This symptom is especially noticeable in primiparous women; it appears 2-4 weeks before birth (in multiparous women, this usually occurs only a few days before an important event, or even immediately before it). The fetal head descends into the pelvis, and the upper part of the uterus also moves down. The organ stops putting pressure on the stomach and lungs. This is why it becomes easier for the expectant mother to breathe and heartburn disappears. Simultaneously with the prolapse of the abdomen, many people note greater tension of the skin in this area and protrusion of the navel. During this final period of pregnancy, it is important to maintain physical activity: constant rest while lying on the sofa can delay the due date.
Changes in posture and gait. After the abdomen drops, the gait naturally changes, because the center of gravity of the body changes. It resembles a “duck”, the woman begins to waddle, while slightly throwing her head back. A characteristic proud posture appears.
Frequent urination. A descending uterus puts more strain on the bladder: a woman more often feels the urge to go to the toilet. Sometimes (especially at night) urine may even leak involuntarily.
Loose stools. This phenomenon is associated with a hormonal factor: an increase in estrogen concentration causes stool liquefaction. The body cleanses itself in this way, preparing for childbirth. Although it is worth noting that in some cases, constipation may occur due to the pressure of the uterus on the intestines: it all depends on individual characteristics.
Decreased appetite up to its complete absence. This happens about a couple of weeks before giving birth. Doctors associate this phenomenon mainly with the woman’s emotional experiences - she begins to worry more and more about the upcoming event. In addition, the uterus still puts pressure on the stomach, so less food is required to feel full.
Reducing body weight in pregnant women. A few days before giving birth, a woman usually finds that she has become 1–2 kg lighter. This is explained by the removal of excess fluid from the body (edema disappears) under the influence, again, of a hormonal factor. Also affected is a decrease in appetite and a physiological decrease in the volume of amniotic fluid.
Changes in the nature of vaginal discharge. Under the influence of hormones they become more fluid and abundant.
Removal of the mucus plug. It can happen either a couple of weeks before labor (usually in first-time mothers) or several hours before it begins. The cork may come out entirely or in small parts. A woman notices a lump of thick mucus on her underwear, sometimes mixed with blood. It must be borne in mind that after the mucus plug has passed through the vagina, various bacteria and microorganisms can easily penetrate into the uterus, so it is better to avoid sexual intercourse and swimming in open water at the final stage before childbirth.
Changes in the cervix. This can only be recorded by a gynecologist after an examination on the chair. Around week 38, under the influence of estrogen, the cervix becomes shorter and more elastic.
Colostrum release. Some expectant mothers note the appearance of transparent droplets from their nipples at the end of pregnancy (although there are women for whom this occurs much earlier). This is colostrum: it will be the first food for a newborn. The liquid should be wiped off with a cloth, and if necessary, use special breast pads. It is unacceptable to squeeze out colostrum: this can injure the delicate skin and cause infection.
Training (or false) contractions. Closer to the time of birth, the uterus gradually becomes more toned. And about 6-7 weeks before an important event, a woman feels periodic pain in the lower abdomen, reminiscent of the sensations during menstruation. The uterus thus prepares for the upcoming labor. False contractions last a short time (from 5 seconds to 1 minute), have different durations, occur chaotically during the day, disappear spontaneously when changing position or taking a bath, and do not cause the expectant mother much discomfort (for some, they may be completely absent).
Decreased number of fetal movements. A few weeks before giving birth, many babies reduce their physical activity. This is due to the fact that the fetus becomes cramped in the uterus: there is simply not enough room for it to move. However, the expectant mother must be vigilant, because a decrease in the child’s activity is sometimes a sign of hypoxia. Therefore, it is necessary to count movements: in any case, there should be at least ten of them per day.
Psychological precursors of childbirth: frequent mood swings and awakened “nesting instinct.” Shortly before an exciting event (for some a month, for others a few days), a woman’s emotional state can change dramatically: some pregnant women become too excitable, literally on the verge of a nervous breakdown. Others, on the contrary, become too calm and peaceful. In many expectant mothers, the “nesting” instinct awakens (especially if the pregnancy is very desired): the woman begins active preparations for the arrival of a new family member - she cleans the apartment, irons children’s clothes and linen, washes the floors, washes curtains, and in some cases even starts renovations. Again, there is another option - the pregnant woman seeks to hide from others, to retire. In any case, relatives should not interfere with the wishes of the expectant mother, but, on the contrary, help her.

Photo gallery: harbingers of a joyful event

Shortly before giving birth, a pregnant woman’s “nesting” instinct awakens when she strives to prepare her home for the birth of a child.

Shortly before giving birth, a woman’s weight decreases by 1–2 kg

The fetus, together with the uterus, moves to the pelvis, and therefore the abdomen visually becomes lower

At the end of pregnancy, many women notice the release of colostrum from the breasts.

Due to increased estrogen production, a pregnant woman experiences loose stools.

Shortly before birth, there is a decrease in the number of fetal movements, because it is already cramped in the uterus

Video: a doctor talks about the warning signs of labor in late pregnancy

Signs of labor by week

Week 36

At 36 weeks, firstborns may experience the first symptoms of impending labor. The child becomes much calmer, the activity of the fetus decreases. This is explained by the fact that the position of the fetus has changed and its head has dropped. Due to pressure on the vagina, the discharge becomes more abundant, but if it does not have a distinct color or smell, there is no need to worry. If the discharge becomes bloody, you should immediately consult a doctor.

Some begin to have training contractions - in order not to go to the maternity hospital in vain, you need to learn in advance how to distinguish real ones from false ones.

Important! If bleeding occurs during pregnancy, you must urgently call an ambulance.

If you have any bleeding, you should tell your doctor immediately.

Week 37

If the baby was born at 37 weeks or more, it is considered full-term, so you should not be afraid of giving birth during this period. Signs of labor beginning are:

Decrease in the height of the uterine fundus. The fetal head moves into the pelvis, and the woman’s abdomen descends. The baby begins to behave much calmer in the stomach. My mother is experiencing unpleasant symptoms such as heartburn and difficulty breathing.
Frequent trips to the toilet, as the prolapsed uterus compresses the intestines and bladder.
A pregnant woman's weight decreases as fluid leaves the body in greater quantities due to global changes in the hormonal system.
The pelvic bones move apart, which creates a feeling of pain in the area of the pelvic bones and pubis. The pain is especially severe at night.

Week 38

Signs of impending labor in first-time mothers at 38 weeks are similar to those at 39 weeks. The pregnant woman's belly drops, the fetal head begins to press on the fundus of the uterus and pelvic bones. The woman’s gait becomes measured and awkward and somewhat reminiscent of the “gait of penguins.” Sitting now is also difficult. From time to time, firstborns may experience pain and tugging in their stomach.

At the same moment, the mucus plug may come off. Usually, after its separation, contractions begin 3-6 days later, but if the plug comes out in one go, this may be a sign of imminent labor. The removal of the plug may not be noticed, for example, if it comes off when visiting the toilet. It happens that the plug comes off in parts in the form of light, yellowish or brown mucus - this can happen over the course of several days.

A woman's mammary glands enlarge and colostrum may be released. Some people start having training contractions, so that they do not cause severe pain, the doctor may recommend drinking Noshpa.

Week 39

The harbingers of labor at 39 weeks in first-time mothers are impossible not to notice. The expectant mother begins to carefully prepare for the baby's arrival, ironing and washing things, cleaning and arranging the room. This moment is called the “nesting period.”

As birth approaches, expectant mothers have a great desire to create comfort in their home.

You can also observe the following signs of early labor:

False contractions. To make them less painful, it is recommended to take a warm bath and rest. If the woman was able to fall asleep and the uterine contractions stopped, the contractions were training.
Separation of the mucus plug.
Vaginal discharge becomes more abundant and liquid-like. They can have a transparent, milky or brownish tint. Sometimes you can see bloody streaks in them. To exclude leakage of amniotic fluid, you can do a special test.
The stool stabilizes and constipation goes away.

40 week

The first signs of labor in primiparous girls at 40 weeks:

Loss of appetite. The girl's weight can decrease by 1.5-2 kg.
Reduced fetal movements. By 40 weeks, the baby becomes cramped in its shell, and movements become quieter. But it happens that the child begins to behave more violently in order to break out of the discomfort zone.
The cervix softens and shortens. This ensures a smooth passage of the baby through the birth canal. If the doctor notices that the cervix is dilated by 1-2 fingers, it means that after a few days the baby will be born.
The stool becomes liquid, possible attacks of nausea - usually cleansing the body naturally occurs 2-3 days before birth.
The plug should come out. Under no circumstances should you swim after it has been removed - this could lead to an infection.
Contractions, which are characterized by regularity and quite severe pain, after which amniotic fluid is discharged.

Important! The presence of the child in the womb after the rupture of amniotic fluid should not last more than 6 hours, otherwise it can lead to serious complications.

The main signs of the onset of labor

If there can be a lot of precursors of childbirth, then there are only two reliable signs of the beginning of this event. These are contractions (true, not training) and rupture of amniotic fluid.

Birth pains

Labor contractions are contractions of the muscle fibers of the uterus that occur at regular intervals. A woman cannot control this process in any way. The first contractions cause slight pain (it can be compared to the sensations during menstruation), which is localized in the lower abdomen or radiates to the lower back. Some pregnant women about the uterus: if you put your hand on your stomach, you can feel a hard, tense organ. In addition, pain in the lower back, rectum, legs (calves and thighs) is often added, and chills also occur.

One of the signs of the onset of labor is true contractions

A stopwatch will help determine the truth of labor contractions. Initially, the pain occurs at intervals of approximately 15–30 minutes. Then the attacks become more and more prolonged, painful, and the time between them decreases. The pain does not disappear after changing body position, resting, or taking a warm bath, as happens during training contractions. The amniotic sac, together with the fetal head, puts more and more pressure on the fundus of the uterus, gradually causing the cervix to dilate.

Table: phases of labor contractions

Phase	Duration of contraction	Frequency of contractions	Opening of the uterus	Phase duration
Initial (or hidden)	20 seconds	15–30 minutes	up to 3 cm	7–8 hours
Active (usually amniotic fluid is released in this phase)	20–60 seconds	2–4 minutes	3–7 cm	3–5 hours
Transitional (transient)	60 seconds	2–3 minutes	7–10 cm	0.5–1.5 hours

Labor contractions occur during the first stage of labor, which is called the dilatation period. This is followed by a period of pushing, when the baby passes through the birth canal.

Rush of amniotic fluid

With the classic course of labor, in the active phase of contractions, the amniotic fluid ruptures. The baby's head presses on the amniotic sac, causing it to rupture and some of the fluid to come out. This process may remind the mother of involuntary urination. Sometimes the water does not recede immediately, but in small portions.

The second reliable sign of the onset of labor is the rupture of amniotic fluid.

The outpouring of water can be observed before the onset of contractions and dilatation of the cervix. In this case of childbirth, doctors usually prescribe stimulation of labor with the help of medications. Another scenario is when the water does not break even after the throat is fully dilated: here the woman in labor is already pierced through the amniotic sac. Both cases do not mean a pathology of childbirth, but simply require special tactics for their management.

From my experience, I remember that while already in the maternity hospital (where I waited for a natural birth for a week), I felt the rupture of amniotic fluid - the underwear became wet. I immediately reported this to my attending physician, and after an examination in the chair, he reported that the cervix was already quite dilated. Thus, I either did not notice the first contractions, or the waters broke before they began.

If a pregnant woman suspects water leakage even before contractions occur (the woman is still at home), the following test should be performed. A piece of cotton fabric should be folded in several layers and placed in the panties as a pad. The result is assessed in about half an hour: if there are watery, colorless spots on the material, then it’s time to call an ambulance and go to the maternity hospital. After all, if the integrity of the amniotic membrane is violated, there is always a risk of infection of the fetus.

Video: an obstetrician-gynecologist characterizes the main signs of the onset of labor

How to understand that labor has begun

In most cases, labor begins with contractions. At first, the woman does not attach much importance to this, because in recent weeks she has been bothered by training contractions. It is important to be able to distinguish training contractions from real ones.

Training contractions represent the hardening of the abdomen. It may be slightly painful, but does not occur very often. During real contractions, the pain resembles the sensations during menstruation, only several times stronger.

Spasmodic contractions during real contractions are repeated regularly, and the interval between them is constantly decreasing. They begin the first stage of labor and continue until the cervix is fully dilated, which is approximately 12 hours. Just before childbirth, the interval between contractions is less than the duration of the contraction itself.

The first stage of labor is quite long, so if the woman is not in danger and feels tolerable pain, she can safely prepare to go to the maternity hospital. During the contraction, it is better to lie down, calm down and massage your stomach. You can come to the maternity hospital in advance, but it is better when the contractions become quite intense, for example, every 5 minutes.

In addition, the release of amniotic fluid will help you understand that labor has begun. This is the most reliable sign of the onset of labor, which cannot be ignored. If amniotic fluid leaks, the pregnant woman should urgently go to the doctor, since the anhydrous period is very dangerous for the child.

Thus, the main sign of real labor is contractions that repeat at regular intervals. If labor begins with the rupture of amniotic fluid, contractions usually do not take long to occur and begin within a short time.

In addition, there are signs that are visible to the gynecologist and indicate the onset of labor. These include:

shortening the length of the cervix;
shortening and softening of the uterus;
opening of the cervix by one or two fingers;
reducing the patient's weight;
change in the position of the abdominal circumference;
reduction of swelling of the limbs.

Differences in precursors and signs in primiparous and multiparous women

In principle, the signs of labor in women who are preparing to become mothers for the first time and in multiparous women are the same. However, in the second case, the birth canal is already prepared for the birth of the baby, and the onset of labor proceeds much faster. Such pregnant women already know about the sensations that await them and easily notice them. They should go to the maternity hospital immediately, at the very beginning of labor.

Anatomically, the uterus of a woman who has already given birth is different from that of a woman who is pregnant for the first time. When a baby is born, his head stretches the cervix, and it becomes wider and more elastic. For this reason, the first stage of labor for such mothers lasts approximately 3–7 hours, and it is also less painful. In first-time mothers, the cervix dilates in 6–12 hours, accompanied by severe pain during contractions.

In multiparous women, labor develops much faster.
As for the precursors of childbirth, in multiparous women they are more distinct and appear closer to the beginning of an important event. Women who are about to become mothers for the first time, due to inexperience, may not recognize significant changes or may mistake them for a common ailment.

It is interesting that if the last birth took place more than ten years ago, then the harbingers may appear long before them. The fact is that over such a long period of time, the female body recovers, returning almost to its original state. And such a mother should not rely entirely on how the previous birth went. The same applies to planned caesarean section. In women who have undergone this operation in the past, the precursors proceed as in primigravidas.

Important differences

During a second pregnancy, the signs of impending labor are somewhat different from those experienced by the woman during the first. As already mentioned, they may appear earlier, since the body is already familiar with the procedure. In practice, there have been cases when the precursors became clearly noticeable already at the 35th week, but this did not lead to premature birth. Moreover, the body gradually got used to many of them, so by the end of pregnancy they even decreased.

The differences include the general condition (well-being) of multiparous women. In the last weeks of the term, they experience almost no physical discomfort. Primogenous women feel discomfort due to stretching of muscle tissue, while in multiparous women, the muscles and ligaments rarely return to tone, so they have practically no pain. Pain in the lower abdomen may appear immediately before contractions, and this is a reason to immediately go to the maternity hospital.

During the first birth, very little time passes between the release of amniotic fluid and the birth of the baby, but during the second, the water may break even the day before contractions. A woman must understand that at this moment her body becomes unprotected, extremely vulnerable to external attacks. This refers to microorganisms, cold and others. It is advisable to arrive at the maternity hospital before your water breaks, but if this happens at home, then you will have to call an ambulance.

Experts advise women planning to give birth to a second child to forget about charts and calculation tables, and instead listen to their body. He himself will tell you when to prepare for childbirth. How exactly will he let you know about this? We'll sort it out by time frame.

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

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

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

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

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

What to do if there are signs of impending labor

Many people want to end up in the hospital faster, but this is unnecessary worry. The appearance and intensification of the precursors of labor indicate that they will occur no later than in a week or two. From now on, you need to behave more correctly: get plenty of rest, don’t lift heavy things, spend time in the fresh air. Moderate physical activity and walking will be beneficial. When real contractions begin and their frequency decreases, you should go to the maternity hospital. If your water breaks, it is advisable to get to the maternity hospital as quickly as possible.

There is always a danger of premature birth, so you should immediately consult a doctor, regardless of your stage of pregnancy, if you notice that:

vaginal bleeding began;
the color of the waste water is not transparent or pinkish, but yellow, green or any other uncharacteristic;
the child has completely stopped moving in the stomach and does not respond to your touch;
attempts began;
vomiting lasts more than several hours;
unusually severe or acute pain appeared in the abdomen, back, or other parts of the body.

Absence of precursors and signs of labor: is there any danger?

In general, the precursors of childbirth rarely appear in a woman in their entirety. Basically, these are only 2-3 symptoms. In some cases, they may be completely absent. This is due to a lack of experience (when the first-time mother simply does not notice them), individual characteristics of the body and the course of pregnancy. Under no circumstances should a woman panic; she just needs to discuss this issue with her doctor.

If the expected due date has already approached, and signs do not appear, the doctor should prescribe the necessary tests for the pregnant woman to make sure that everything is fine with the baby. If signs of post-maturity are detected, the doctor will decide how the birth will take place (artificial stimulation or cesarean section will be required).

What are the harbingers of labor?

This is the name given to a number of sensations and symptoms that the firstborn experiences at different periods. Based on one or another precursor, a woman can approximately determine how soon labor will begin and decide whether to go to the hospital. It is worth noting that there are a large number of signs, but this does not mean that any first-time mother will necessarily experience all of them. Each week of gestation has its own precursors to childbirth.

38th week of pregnancy: harbingers of labor
Thirty-sixth week of pregnancy
Thirty-ninth week of pregnancy

Cervical ripening

We said earlier that the precursors of labor at the 38th week of pregnancy in primiparous and multiparous women include changes in the cervix. Let's look at this issue in more detail. This sign is the most informative, but readiness for labor based on the condition of the uterus can be determined directly by an obstetrician-gynecologist.

The cervix is a round muscle, the maturation of which consists of softening, which allows for the necessary degree of opening during contractions. Its reduction to one centimeter indicates the imminent completion of maturation. During the process of labor pains, the cervix will completely smooth out and open the fetus into the vast world where his mother is looking forward to meeting him.

As the cervix ripens, the discharge may increase and a tingling pain may appear inside. If maturation does not correspond to the gestational age, the expectant mother is hospitalized in a maternity hospital and stimulated with medications. If there is no proper effect from drug treatment, the woman will have a caesarean section.

Signs of the body's readiness for childbirth

The closer the date of birth, the stronger the transformations occurring in the body due to changes in hormonal levels. The body’s readiness for labor is indicated by:

Aging of the placenta. By the end of gestation, around the 36th week, structural changes occur in the placenta: deposits of calcium salts increase, its thickness decreases, and the placental lobules become denser. The volume of functions performed by the placenta decreases somewhat, the synthesis of progesterone decreases, and estrogen increases. It is estrogens that prepare the muscular layer of the uterus for stimulation and promote the production of prostaglandins, which trigger the synthesis of oxytocin in the woman’s pituitary gland. Prostaglandins also destroy the main pregnancy hormone, progesterone.
Generic dominant. During gestation, a “dominant pregnancy” is formed in a woman’s brain, which determines its calm course, normal growth and development of the embryo. On the eve of childbirth (about 14 days before the due date), the electrical activity of the areas responsible for the birth process increases in the pregnant woman’s brain. Thus, a “dominant of labor” is formed, which means the body is completely ready for contractions and stimulates the production of oxytocin in the pituitary gland.
Fruit maturity. Due to the rapid growth of the fetus, an increase in its weight to approximately 3 kg and a decrease in the volume of amniotic fluid, the walls of the uterus tightly envelop the fetus, which is a stress factor for it. In response to stress, the adrenal glands of the unborn child trigger the synthesis of cortisol, a stress hormone that stimulates the production of prostaglandins in the female body. Once a significant level of prostaglandins and oxytocin is reached in the mother’s body, labor begins.
Cervical ripening. The condition of the cervix determines the course of labor and its completion. At approximately 37–38 weeks, the ripening of the cervix begins, which is manifested by structural transformations of its main components: collagen, elastin, connective tissue. Due to the softening of the connective tissue, the hydrophilicity of the cervix increases and the muscle bundles diverge. In general, the cervix easily stretches upon examination, softens and shortens. The mature cervix is no more than 1.5 cm in length, centered (located along the longitudinal pelvic axis), the cervical canal is straightened, passes a finger through the internal os, which makes it possible to palpate the presenting part and its landmarks (sutures of the skull, anus).

First harbingers

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

How to find out that multiparous women are about to give birth:

training contractions;
weight loss;
the appearance of colostrum;
nesting syndrome;
change in gait;
change of mood.

Training contractions. In the third trimester of pregnancy, multiparous mothers experience false contractions; cramps appear from the 21st to the 39th week. The birth canals are prepared in advance for the release of the fetus, the muscles of the organs are developed. During such training, the cervix gradually shortens and prepares to open. There is no pain, a slight pulling sensation appears in the lower abdomen.

Differences from the real ones:

intermediate intervals up to 6 hours;
consecutively last a maximum of 3.5 hours;
the duration of one contraction is no more than 50 seconds;
no lumbago;
go away if you change your position;
painless.

85% of women pregnant for the second time calmly tolerate false contractions, as the body is ready for the onset of labor. Second mothers are admitted to maternity institutions only with the onset of true symptoms.

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

The appearance of colostrum. One of the most striking first signs of approaching labor in multiparous women. Colostrum is released from the beginning of the 3rd trimester, but when the uterus is ready for the birth 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 anxiety and changes in hormonal levels. The state of health before childbirth in multiparous women is not stable, they remember previous worries, and they are setting up a home for the baby. Linen, towels, hygiene supplies are purchased, and the mother sterilizes baby care items. Cleaning is easy, you don't feel your stomach.

Gait. The center of gravity is directed forward, due to the decrease in the height of the uterus, the abdomen moves downward. The distance between the chest and the upper abdomen increases, the shape changes to sloping. Therefore, in order to “hold the fruit” while walking, the shoulders are pulled back, in counterbalance.

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

Each manifestation does not always mean that labor is approaching. But, if a woman feels anxious, it’s time to prepare her bag for the maternity hospital.

At what stage does labor begin?

In obstetric practice, the indicator of a normal prenatal period is 38 weeks.
This is the period when the fetus has reached its final development.

The stage when the first signs of labor may begin includes 38 - 42 weeks

. The recommended period for delivery is considered to be 40 weeks.

If pregnancy exceeds 42 weeks, a detrimental effect on the child’s body is expected. Possible development of pathologies

and suppression of his life activity.

Experts do not give a definite answer as to what period primigravidas usually give birth.

On average, delivery occurs from 40 to 42 weeks. But there are cases of first-born births even after the 42-week period. This feature is associated with possible inaccuracy in determining the date of conception. Also, when the first children are born, the expectant mother’s body is not so worn out. There are no pathologies of the reproductive system caused by previous labor.

The topic at what stage primiparas usually give birth can be considered based on the gender of the fetus. A tendency for early birth of girls has been revealed,

compared to boys. The pattern is due to their earlier maturation and rapid development. As a result, girls are more likely to survive when they give birth prematurely than boys.

Heavy discharge

With repeated births, they come out in much larger quantities than with the first. The lower half of the amniotic sac surrounding the baby peels off from the “uterine” walls and indicates an imminent visit to the maternity hospital.

Such fluids exit through the genitourinary tract. This is the moment that scares many women in labor - they begin to worry that amniotic fluid is leaking.

Did you know? When a baby is born, the heart beats 120–160 beats per minute. For comparison

—
in adults, such numbers appear only during moments of increased activity (for example, after a game of tennis).
There is no need to panic: the discharge can be easily checked for the presence of amniotic fluid, which is determined by the results of a rapid test.

But if it is detected, then there is no more than an hour left before contractions (1.5 hours is already rare).

When to Call Emergency Help

All expectant mothers should be prepared for emergency admission to the maternity hospital, starting at 36 weeks . To do this, you need to have an “alarm suitcase” on hand, which should contain hygiene items, pads, and documents. On the eve of childbirth, it is recommended to remove hair from the perineum and wash off nail polish, including toenails.

An ambulance is called in the following cases:

breaking of water;
the occurrence of bleeding;
rise in blood pressure (above 140/90);
sudden sharp pain in the abdomen;
headache, dizziness, nasal congestion, flashing before the eyes (signs of preeclampsia);
absence of fetal movements for 6 or more hours;
regular contractions (2 – 3 every 10 minutes).

Sozinova Anna Vladimirovna, obstetrician-gynecologist

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Removal of the mucus plug before childbirth

The passage of the mucus plug before childbirth occurs due to the maturation and opening of the cervix (internal os). Sometimes there are cases when these phenomena are observed in the early stages due to isthmic-cervical insufficiency.

When a woman notices heavy mucus discharge, for example, at 28 weeks, she needs to consult a qualified specialist as soon as possible. In such a situation, the doctor is obliged to take measurements of the cervix. This sign of imminent labor in those giving birth never goes unnoticed by the gynecologist.

There are also cases when the mucous plug comes out 3 weeks before delivery, but this rarity is considered an exception to the rule.

Sign of imminent labor in first-time mothers	Departure time	Color	Consistency	Periodicity
Mucus plug	1-5 days before delivery	Beige, brown, pinkish, possibly streaked with blood	Liquid, mucous with lumps	In portions (usually in the morning), perhaps a couple of days in a row

The mucus that blocks the entrance to the uterus is released and comes out before the delivery process. When the described phenomenon occurs, the primigravida may see small transparent mucous clots on her underwear that are odorless.

Frequency of urination and loose stools

In the third trimester, especially towards its end, visits to the toilet become more frequent. This is logical - the uterus simply puts pressure on the bladder, causing a rapid release of fluid.

Now about the chair. Of course, in pregnant women it is far from ideal, but it can still be stable. A sudden upset bowel movement for no apparent reason is a sure sign that there are 1-2 days left before delivery.

For women in labor expecting their second child, such manifestations at 38–39 weeks are very unpleasant: diarrhea is often accompanied by severe nausea and frequent vomiting.

There is only one solution - run to the maternity hospital. Some, fearing poisoning, run to the “infectious diseases”, but this is not the case, and in such a situation, every minute counts.

What to do if there are no warning signs?

If at the onset of the 38th week there are no precursors of labor, and the expected due date has approached, you need to contact a gynecologist for additional examination. But most importantly, it is important to remember that childbirth is a unique process that can begin at any time.

That is why, starting from the 38th week, every woman should pay close attention to all changes in the body so as not to miss the onset of labor.

The process of childbirth in multiparous women

The onset of subsequent labor may occur at the 38th week of pregnancy, when the fetus in the uterus already occupies quite a large space. The first warning symptoms in experienced women in labor may appear shortly before the expected date of birth and lead to the rapid completion of pregnancy.

The process for women giving birth repeatedly can be very painful. The pain becomes very intense, but the process of childbirth usually ends faster than the first, since the cervix is already ready to open and accept the child. On average, the process of contractions during the second and subsequent births lasts from 6 to 8 hours, while first-time mothers can give birth for 12 hours. Well, the process of pushing out the fetus itself can take 15 minutes for women giving birth again, 30-40 minutes for women giving birth for the first time.

A woman giving birth to her second baby is already familiar with the process of childbirth and is much better prepared for it. She knows how to breathe correctly during contractions, how to push when pushing to avoid ruptures.

Stages of labor

Baby's behavior

Pay attention to the child's activity. Before their first “outing into the world,” even the wild little ones quiet down. But this calm is just a respite.

Important! Having noticed several signs from this list, get ready for the appearance of the baby in the next day
or two.
Longer delays are rare. If the baby has developed excessive activity in the womb, know that he is already preparing, looking for the best position for birth. The wait won't be long.

The appearance of “training” contractions

Expectant mothers are well aware that contractions are the precursor to childbirth.

It is extremely important that they are familiar with information about “training” contractions in the early stages of pregnancy. For the simple reason that pregnant women who have completed training courses will be more sensitive to the well-being and health of the baby.

Having acquired the necessary skills, women have the opportunity to independently determine when “training” contractions occur and how to behave correctly.

Primiparas begin to feel aching pain in the abdomen. The spasms that appear resemble real contractions, but the female body is only preparing for the process of childbirth. The difference is that the cervix does not open, but the uterus itself, when palpated, either hardens or relaxes.

The main signs of “training” manifestations include: a feeling of compression and the appearance of aching pain in the groin area, as well as in the lower abdomen.

The described pains are usually characterized by their inconsistency and irregular contractions. They appear only in one area of the abdomen, but the frequency of contractions can reach up to 5 times in 60 minutes.

During false contractions, there is no feeling of recoil in the back, as during prenatal contractions. They also do not cause severe pain and gradually disappear.

In many cases, expectant mothers can get away with “training” contractions. To do this, you need to drink a certain amount of fluid, not worry and remain calm until the birth itself.

To relieve training contractions, you can drink liquids

Medical professionals recommend adhering to these rules even if “training” contractions make themselves felt.

What happens in the body?

Shortly before giving birth, significant changes occur in a woman's body. In the blood of the expectant mother, the level of hormones that stimulate labor gradually increases. Relaxin is a hormone that helps soften ligaments and joints. With its significant increase, the pelvic bones become more pliable. Because of this, a woman may experience weak and nagging pain in the sacrum and lower back. Under the influence of estrogen and oxytocin, the cervix changes shape, which indicates preparation for childbirth. At this time, the sensations and frequency of false contractions may increase significantly. As a rule, such precursors of labor at the 38th week in primiparous women can begin much earlier than in multiparous women. Typically, in women expecting their first child, labor begins with weak contractions, the strength and frequency of which can increase over the course of a day or even more. In this case, you need to be patient and wait for constant contractions.

Precursors of labor at 37-38 weeks of pregnancy include abdominal prolapse. This is due to the fact that some time before the baby is born, its head fits more tightly to the pelvic floor. Prolapse occurs at different times for every mother. So, for one it may be a week before giving birth, while for another it may be a couple of days. Many women note that after the abdomen drops, breathing becomes easier and heartburn bothers them less. It often happens that the harbingers of labor at the 38th week of pregnancy in primiparous and multiparous women can be nausea, vomiting, and diarrhea.

Changes in hormonal levels affect not only the physical condition of a woman, but also the psychological one. For example, a mother may notice emotional instability and mood swings. It is worth noting that there are quite a lot of precursors to childbirth at the 38th week for primiparous and multiparous women, but it is not necessary for a woman to expect them in full. Sometimes the presence of one or more signs can indicate an imminent birth.

Signs of approach

Symptoms of approaching labor are divided into two groups: subjective and objective. The first option has an emotional overtone: insomnia, anxiety, mood swings, and pain of various types. From a medical point of view, the above cannot be a reason to believe that childbirth will take place soon.

The second group includes physiological changes in a pregnant woman, which have a more justified medical origin, which is why they are taken into account by doctors. Let's take a closer look at the precursors of childbirth at the 38th week in primiparous and multiparous women.

How to find out about the approaching birth so that you can prepare and get to the maternity hospital?

This question interests every expectant mother, especially first-time mothers. The body itself will tell you that labor will begin soon. All his changes will speak 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 symptoms before childbirth, harbingers that it will soon be time to give birth. At this time, training contractions appear. They are irregular and occur mainly when the body position changes. In first-time mothers, they appear 5 or more days before birth. They prepare the uterus for a future event, so don’t worry and go straight to the maternity hospital. How then do you know that you are giving birth? Real contractions are periodic and rhythmic. If their interval is 10-15 minutes, and they last at least a minute, then you can safely go to the maternity hospital.

What are the warning signs of labor for first-time mothers? Essentially, they are the same, no matter what the birth is. When preparing the body, loose stools may 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 first-time mothers is less intense and rapid. The harbingers of premature birth are the leakage of amniotic fluid or their rupture.