Do I need to call in advance to the hospital. Do I need to go to the hospital in advance? We count the interval between contractions

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

What are the harbingers of childbirth?

Harbingers represent certain signs by which it is possible to assume that the onset of labor will soon occur.

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

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

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

What symptoms indicate an imminent onset of labor?

Among the main symptoms indicating the imminent onset of labor activity, one can single out:

1. Loose stools. In order to facilitate the upcoming birth and the passage of the baby through the birth canal, the body begins to remove all unnecessary from itself. As a result, diarrhea may occur. It can appear several times a day, but is accompanied by dehydration, as well as a change in the color and smell of stool. As a rule, this sign, unlike the others, appears almost before childbirth in 1-2 days. However, it may be absent if the woman is multiparous.
2. Weight loss. As a result of hormonal changes, excess fluid is eliminated before childbirth. It is the more, the stronger the edema was during pregnancy. The fluid was retained in the body under the action of progesterone, but its reduction leads to its release, which contributes to weight loss from 0.5 to 3 kg.
3. Isolation of the mucous plug. A mucous plug created from a special secretion of the cervical canal is necessary during pregnancy to protect the fetus. It is needed to prevent infection from the vagina from entering the uterine cavity. Estrogen softens the cervix, opens its canal, resulting in yellowish-brown discharge, transparent or jelly-like, but not having an unpleasant odor. The mucous plug can come out completely or in parts. As a rule, it is not accompanied by painful sensations, however, the presence of a pulling, mild pain as before menstruation is also a variant of the norm. As soon as the cork has come off the baby, nothing protects against bacteria, so it is not recommended to take a bath, you can only use a shower.
4. "Abdominal prolapse". As a rule, the child is in a cephalic presentation. Before giving birth, his head pulls the uterus downward, pressing against the entrance to the small pelvis and preparing to move along the birth canal. Thanks to these changes, the uterus ceases to press so hard on the diaphragm, as a result, a woman can feel the following improvements - shortness of breath disappears, heartburn and a feeling of heaviness stop. However, the pressure on the organs located in the pelvic region increases, as a result, the urge to use the toilet increases.
5. The discomfort. As a result of sprained ligaments, as well as a rush of blood to the pelvic organs, unpleasant sensations may appear in the lower abdomen, in the lumbar region or slightly below. The pain should not be severe, it resembles a pulling sensation before menstruation. Discomfort can manifest itself both when the mucous plug comes off or training fights, or for no apparent reason.
6. Training bouts. Harbinger contractions are contractions of the walls of the uterus within a few seconds. The expectant mother feels how the uterus strains, “stiffens,” and then relaxes, while the cervix does not open. It is not difficult to distinguish them - they are irregular, or the gap between them is very large. Moreover, they are weak and not accompanied by pain. Real contractions increase over time, they become more frequent and last longer.
7. Cervical changes. Only a doctor can determine them during the next examination. The neck is significantly shortened, from about 4 to 1 centimeter, and also softens.

In what cases do you need to go to the hospital:

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

- at the first birth

If the mucous plug has moved away or any of the above-mentioned precursors of childbirth have appeared, you should not go to the hospital, they simply will not accept you there, since there may be a few days or several weeks before the onset of labor. But when regular fights began (not to be confused with training ones), it's time to get ready. Since the first birth, as a rule, takes at least 12-20 hours, you should not go to the hospital or, moreover, call an ambulance immediately after the onset of contractions. Wait until the interval between contractions is about 10 minutes.

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

- with repeated childbirth

Repeated labor is usually faster because the cervix softens and opens much more easily than the first time. On average, the whole process of childbirth in the second and subsequent times takes about 6-7 hours. Therefore, so that the birth of a child does not take place in a completely inappropriate place for this, it is necessary to go to the hospital immediately after it became clear that the contractions are regular and the interval of contractions decreases.

When do you need emergency help?

It is worth not rushing to send to the hospital only in those cases when labor begins without any complications. But there are certain symptoms, in the event of which, you should immediately call an ambulance, as they indicate a risk to the life and health of the child. It is necessary to seek emergency help when the following situations arise:

1. Discharge or leakage of amniotic fluid. It is important to understand that even a slight leakage of water indicates a violation of the integrity of the amniotic membrane, which means that the child is no longer protected from various infections and environmental influences. Ideally, no more than 10-12 hours should elapse between the moment the water leaves and the delivery itself. When in a hospital under the supervision of doctors and the timely administration of the necessary drugs, this period can be 24 hours or more (but this situation is considered undesirable).
2. You have gnarled discharge or bleeding (scarlet blood). Even a small amount of red discharge may indicate a detachment of the placenta or the development of other pathological conditions that threaten the child's life.
3. Sharp pain between contractions. When the contraction is released, the discomfort should also disappear. If sharp or aching pain persists all the time, this is an unconditional sign of complications.
4. Contractions occur more often than once every 5 minutes. If the interval between contractions is rapidly shrinking, it means that there is less and less time before childbirth. In this case, it is not recommended to get to the hospital on your own. Also, if there is already a rapid birth in the anamnesis, or it happened earlier in the next of kin, it is necessary to go to the hospital with the beginning of the first regular contractions.

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

Finally

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

Specially for- Olga Pavlova

Do I need to go to the hospital in advance?

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

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

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

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

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

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

An important role belongs to the doctors of antenatal clinics, who, being reinsured and fearing for the health of patients, hospitalize them in the maternity hospital even if minimal deviations in health are detected (sometimes without them): minor edema, a single detection of protein in the urine, fetal malnutrition of the 1st degree, rhesus negative blood without antibodies, slight oligohydramnios or polyhydramnios, premature aging of the placenta without disturbing the condition of the fetus according to CTG and dopplerometry, prevention of prolongation at 39-40 weeks of pregnancy, etc. Of course, in such a situation, patients without professional knowledge cannot take responsibility for their health. If you have doubts about whether it is worth going to the maternity hospital in the direction of an antenatal clinic, you can consult the advisory department of the maternity hospital to determine the appropriateness of hospitalization.

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

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

How to find out the due date?

There are various ways of calculating the due date. Some try to determine the day of conception and count the days from it. However, the day when sexual intercourse occurred and the day of conception itself may not coincide, since the sperm cells are able to maintain their viability and “wait” for an egg in a woman's genital tract for several days.

Determining the date of birth by menstruation

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

Calculate your due date by your period using our due date calculator

Determining the date of birth by ultrasound

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

Likewise, the calculation is made based on the date and duration of pregnancy established at the first visit to the doctor (method “at the first visit to the antenatal clinic”). The sooner your doctor determines the gestational age, the more accurate your future predictions of the due date will be.

Determining the date of birth by fetal movements

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

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

Harbingers of childbirth

Most women at the end of pregnancy notice that their belly “sank” and it became easier to breathe. This is because during a full-term pregnancy, the amount of amniotic fluid decreases slightly, and the fetal head is pressed against the entrance to the woman's small pelvis. The uterus becomes more excitable, she "trains", prepares for the great work ahead. Irregular painless tension of the uterus and a feeling of heaviness in the lower abdomen and lower back are called "contractions of pregnant women." Not always even a doctor can say with certainty whether this is the onset of labor or preparatory contractions occur. If such a state of increased irregular excitability of the uterus lasts 1 - 2 days, then it is better to contact maternity hospital, where they will be able to assess whether the child is suffering at the same time.

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

In many women, by the end of pregnancy, colostrum, the precursor of breast milk, is secreted from the nipples.

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

When is it time to go to the hospital?

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

Often, amniotic fluid can drain before the onset of labor. The normal water content in the uterus by the end of pregnancy is up to 1.5 liters. You may feel that a light, warm fluid is flowing out of the vagina (no connection with urination). A little liquid may spill out, or all 1.5 - 2 liters. Be that as it may, if you notice unusually wet laundry, this is a situation in which you need to go to maternity hospital... If the water is poured out completely or leaks slightly, this means that the integrity of the membranes is violated, and the child is no longer protected from the effects of the external environment, primarily from infectious agents. Time counts on the clock, it is advisable for a child in such a situation to be born no later than 12 hours after the outpouring of water. Doctor in maternity hospital must determine if you have a chance of having a vaginal birth, or whether it is better to have a caesarean section. In most cases, following the outpouring of water, normal contractions begin, and labor ends safely.

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

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

Water stained with blood leaks;

Painful sensations are very strong, the uterus is painful to the touch, does not relax between contractions;

Fetal movements become unusually strong, or weak, or painful;

worried about a headache, vision has become blurry ("flies flicker" in front of the eyes), there are pains in the epigastric region, blood pressure has increased, you cannot urinate.

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

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

2. Keep your documents collected, namely:

Exchange card with data of all analyzes and ultrasound examination in the III trimester;

Passport;

Insurance policy.

IT IS BETTER TO ALWAYS HAVE THESE DOCUMENTS WITH YOURSELF!

In the absence of medical documents, childbirth should be carried out in the II obstetric (observational department) or even in a specialized infectious maternity hospital! If you do not have a passport or insurance policy with you, then problems may arise with the possibility of free childbirth (for compulsory health insurance). Be careful.

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

However, in the maternity ward itself, you will not need anything other than slippers: usually, for the time of childbirth, the necessary underwear and clothes are given out in maternity hospital... Relatives will bring you everything else, including things for the baby, after the birth.

What to take with you to the hospital will be suggested by our service List of things in the hospital

Doctors, and you too, will be more comfortable if, having felt the approach of labor, you will not overload your stomach. While waiting for labor at home, limit your diet to light crackers, a cup of broth, and tea.

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

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

Waiting for the first birth is an exciting and alarming time. Many women worry that they will miss the onset of contractions, and the baby will be born at home. However, in practice, it is quite difficult not to notice the onset of labor.

The beginning of labor

Labor usually begins between 38 and 42 weeks of gestation. In this case, they are considered normal and timely, and the baby is considered full-term.

When is it time to go to the hospital during the first pregnancy? Should I go to the hospital in advance?

Regardless of whether a woman is carrying the first or third child, there are no indications for hospitalization in a hospital before the onset of labor.

Although earlier this practice was widespread. If by forty weeks the expectant mother did not open her cervix, and regular contractions did not begin, she was sent for hospitalization in a hospital. In the maternity hospital, the woman was under constant medical supervision, if necessary, labor was stimulated.

To date, without indications in the form of complications of pregnancy, the obstetrician-gynecologist does not issue a referral for hospitalization. The expectant mother can stay at home for up to 42 weeks and lead a normal life.

However, the proximity of childbirth must be borne in mind in order to prepare everything you need for the hospital. It is also necessary to be aware of such changes in the body as precursors.

Harbingers

Harbingers signal the expectant mother that it is time for the child to be born. During the first pregnancy, between the onset of these symptoms and the onset of labor, usually 1-2 weeks pass, while during the second and subsequent ones, the baby may be born the next day. This is due to the faster reaction of the uterus to the processes taking place in the body.

Harbingers include the following symptoms:

• Change in the shape of the abdomen.
• Disappearance of heartburn and digestive problems, shortness of breath.
• Straightening the back and neck.

These manifestations are associated with the fact that the fetus sinks lower and fits tightly with the head to the entrance to the small pelvis. At the same time, the pressure on the upper abdomen, respectively, decreases, and the unpleasant symptoms associated with pressure on the diaphragm weaken or disappear.

Abdominal prolapse leads to a shift in the center of gravity, this causes straightening and deflection of the back and neck. Also, a woman may be bothered by pain in the lumbar region.

Closer to childbirth, a mucous plug may come off the genital tract. Usually it is a clot of secretions with bloody streaks and blotches. Sometimes the mucous plug comes off in parts, and this goes unnoticed, especially if the pregnancy is the first.

The appearance of mucous-bloody discharge can frighten the expectant mother. However, this harbinger is not a reason for emergency hospitalization in the hospital.

If the water does not leave and regular contractions of the uterus are not observed, even after the cork has come off, you can stay at home and wait for the birth.

Signs of labor

The mechanism of childbirth is quite complex. First of all, it is necessary for the cervix to open for the free movement of the child along the birth canal.

This occurs during the first stage of labor. This is followed by attempts, when the contractions of the uterus are combined with a strong tension of the muscles of the press, they push the child out. The third stage is the discharge of the placenta - the placenta, or "child's place".

The main signs of incipient labor:

• Regular uterine contractions.
• Discharge of amniotic fluid.

The expectant mother should know that, in addition to true contractions, there are also false, or training contractions. If a woman understands the difference, it will be easy for her to distinguish between them.

Training contractions

Training contractions are sometimes referred to as precursors of childbirth, especially if they are first observed at 37–38 weeks.

However, often a woman can notice their appearance much earlier - in the second trimester. From 16-18 weeks, irregular uterine contractions are normal.

The main purpose of this process is to prepare the uterus for the upcoming birth. Such contractions have been described for a long time and are better known in the medical literature as "Braxton-Hicks contractions."

They are painless and irregular, and go away quickly on their own. To reduce training contractions, you need to rest more, change your body position. Deep, rhythmic breathing sometimes helps.

Regular contractions

If a woman is constantly experiencing training contractions, she may miss the moment when they become regular. However, very quickly the differences become apparent.

True fights are characterized by:

• Regularity and rhythm.
• Reducing the intervals between uterine contractions.
• Increase in intensity.
• Painful sensations are moderate to severe.

In order to understand whether these contractions are true or false, you need to use the clock. Regular contractions indicate that labor has finally begun. In addition, they do not diminish during rest or sleep, when changing position. When moving, true contractions can get stronger and more painful. Also, they are not affected by the intake of antispasmodic drugs - No-shpy, Papaverine, Viburkola.

However, if the hospital is far away or difficult to reach, it is best to go as soon as the contractions are regular. It is not worth delaying if in the family along the female line - the mother or sister of the patient - there was a rapid birth. For a daughter, the birth of a baby may follow the same scenario.

Amniotic fluid discharge

During pregnancy, the baby is in a dense shell - a bubble that is filled with liquid. It is called amniotic fluid, or amniotic fluid.

They perform an important task - they protect the child from injury during sudden movements, they serve as a shock absorber. In addition, they are involved in some metabolic processes. Also, thanks to the amniotic fluid, it is possible to maintain the optimal temperature of the environment for the fetus.

At the beginning of labor, the membranes rupture, and the water is poured out. This process, as a rule, is sudden, without any precursors and painful sensations. Most often, women confuse the discharge of amniotic fluid with involuntary urination.

Sometimes a small amount of liquid is poured out, in parts. But the volume can reach 1.5–2 liters.

If this happens, it is advisable to go to the hospital as soon as possible, even if regular labor has not yet been observed. Most likely, the contractions are simply too weak, and the woman in labor does not yet feel them.

A long anhydrous interval threatens the baby with an infection, so you should not postpone going to the hospital. The sooner a woman is examined by a doctor, the lower the risk of complications.

Pathology

Sometimes labor starts early. This happens during the first and subsequent pregnancies.

Premature labor is considered if it starts before 38 weeks. In this case, the child or the woman in labor does not always suffer; in the period of 36–37 weeks, most often everything ends well.

Today, doctors are caring for babies starting from a weight of 500 grams. Of course, in this case, the risk of damage to the central nervous system and other complications is quite high.

That is why you need to strive with all your might to convey pregnancy. Premature labor may start as usual, but several weeks earlier. With this option, it is necessary to call the ambulance team as soon as the woman noticed the regularity of contractions or the discharge of amniotic fluid.

Sometimes delivery is forced - for example, with premature detachment of a normally located placenta, eclampsia.

A pregnant woman needs emergency hospitalization if the following symptoms appear:

• Regular contractions.
• The discharge of amniotic fluid.
• Sudden, sharp pain in the abdomen, lower back.
• Bloody discharge from the genital tract or signs of internal bleeding (loss of consciousness, a sharp drop in blood pressure, tachycardia, dizziness, sudden severe weakness and pallor).

How to know when it is time to go to the hospital? During the first pregnancy, this issue worries all women, without exception. However, almost no one gives birth at home due to the fact that they missed the onset of labor. Their signs are so obvious and tangible that mistakes are extremely rare.

The closer the end of pregnancy, the stronger the woman's anxiety about the upcoming birth. This period is especially exciting and alarming for those who become a mother for the first time. There are a lot of questions about when to go to the hospital, what to take with you and how the birth will take place.

A few days, and sometimes weeks before the birth of a child, there are some changes in the woman's well-being. During this period, it is worth worrying about collecting the bag at the maternity hospital, the necessary documents, and also informing loved ones. The birth itself takes place in several stages. In some cases, early hospitalization is recommended.

A few days before the birth of the child, the woman's body begins to prepare. Observing her condition, a pregnant woman can detect the following signs:

• decrease, and sometimes some weight loss;
• omission of the abdomen by moving the child closer to the birth canal;
• reduction of heartburn and shortness of breath;
• increased urge to urinate;
• a feeling of heaviness and squeezing in the lumbar region;
• leg cramps;
• changes in intestinal motility: diarrhea, nausea, retching;
• decreased child activity;
• the manifestation of the "nesting instinct" (the desire to prepare the house for the appearance of a child, wash everything, clean it, organize a child's place in the bedroom);
• the development of false contractions - contractions that train the body and prepare the cervix for childbirth;
• the appearance of slight mucous discharge, odorless, transparent or slightly pinkish;
• discharge of a mucous plug (a clot that looks like a jellyfish).

If such signs are found, there is no need to immediately contact the hospital. It can take from several weeks to 1-2 days before the baby appears, it is impossible to determine the date of birth more precisely. The most important thing is to be on the lookout for medical attention at the first sign of labor.

When to go to the hospital?

You need to go to the hospital at the first signs of the onset of labor. These symptoms need to be known and closely monitored for changes in the condition:

1. The amniotic fluid is gone. In the normal course of labor, this occurs during the period of cervical dilatation. Often, the amniotic fluid ruptures before the onset of labor and cramping. In such a situation, you must immediately contact the maternity hospital, a child without amniotic fluid should not be more than 10-12 hours. It is dangerous to discharge amniotic fluid before the 37th week, in this case, doctors will need time to prepare the child's lungs for functioning.
2. The first contractions appeared - periodic contractile attacks, which occur along with pulling pains in the lower abdomen. Thanks to them, the cervix softens and opens. During the first birth, minor, but prolonged (up to 24 hours or more) contractions often develop. At first, the contractions do not cause much pain and last 15 seconds. During breaks, the muscles relax and the pregnant woman has the opportunity to rest. Labor activity gradually intensifies, contractions become more frequent, prolonged and painful. Breaks are shortened to 15-20 minutes, and during childbirth - up to 2-3. The pain extends to the lower back, rectum, thighs and calves, sometimes accompanied by chills. When contractions last a minute or more, and the breaks between them are reduced to 10-15 minutes, you need to go to the hospital. This frequency is the main sign of the imminent birth of a child.

The difference between the first stage of childbirth in multiparous women is that it passes more rapidly. Also, more often there is a discharge of amniotic fluid before the onset of contractions.

Situations in which early hospitalization is needed

A woman can go to the hospital in advance of her own free will, having received a referral from the doctor who supervised her. Some women in labor feel calmer under the supervision of the medical staff, even though there are no close people around. Especially often those who have had complications in previous childbirth ask for early hospitalization.

The indications for going to the hospital in advance are the following situations:

1. Postterm pregnancy. At the 42nd week, it is better to go to the hospital, even if there are no signs of labor yet. In the hospital, special procedures are carried out that prepare the body, soften the cervix and facilitate its disclosure.
2. Gestosis. This condition itself requires hospitalization. One of its complications can be premature birth, and in case of a severe form of pathology, an emergency delivery by a surgical method will be required.
3. Planned cesarean section. Early hospitalization allows the woman and the staff to prepare for the upcoming surgery: perform blood and urine tests, choose anesthesia and other medications. The procedure is performed one week before the expected due date (PDD).

These are just the most common reasons to go to the hospital in advance. The issue of an early referral to hospitalization is decided by the leading obstetrician-gynecologist leading the pregnancy based on the woman's condition, her health, and the characteristics of the gestation process (the presence of complications).

When do you need emergency help?

An immediate call for an ambulance is required in the following situations:

• contractions have become regular, repeated every 5 minutes or more;
• the amniotic fluid has departed;
• vaginal discharge becomes bloody or bleeding (scarlet blood) has developed;
• pains do not arise periodically, but torment constantly, by nature - aching or cramping.

Rapid childbirth is a separate case. They can not always be foreseen, a distinctive feature is the rapid opening of the cervix. At the same time, the rest periods are constantly shortened and soon last 2-3 minutes.

Therefore, if the previous birth was rapid or there is a hereditary factor, then an ambulance should be called at the first contractions.

In all of the above cases, it is worth seeking emergency help. It is unsafe to get to the maternity hospital on your own transport, since childbirth can move to the next stage and the woman's condition will worsen. The ambulance car has the necessary equipment for such situations.