Bleeding during labor pains cause. Bloody discharge during childbirth

Date: 03.11.2019

During the entire pregnancy, a woman had to deal with a change in the nature of vaginal discharge more than once. Firstly, it is strongly influenced by the hormonal background of a pregnant woman, which constantly changes over time. Secondly, very often it is during this period that thrush becomes aggravated or for the first time manifests itself, annoying with cheesy discharge with a characteristic sour smell. Thirdly, it is likely that it was not without the threat of a breakdown, which is indicated. And it is these secretions that expectant mothers are most afraid of.

Now, at the end of the term, it is almost possible to breathe calmly: the release of blood before childbirth in the vast majority of cases will mean their early onset. But it is still too early to completely relax: even on the eve of the baby's birth, premature placental abruption may begin.

Bloody discharge before childbirth is a sign of their onset

One of the most reliable signs of incipient labor is, which is always accompanied by secretions. The cork can move away already in childbirth (then the woman will not notice it) or come out all at once with the whole clot, for example, while taking a shower, which can also be ignored.

But also often the mucous plug comes off in parts, gradually, and at the same time the woman notices mucous discharge of white-yellow color on the linen, which may contain streaks of blood - pinkish, brown or brown. This is a sure sign that it will not be long before the meeting with the most desirable creature. From the moment the mucous plug begins to drain, the mother should stop any actions that may entail the penetration of infection into the womb (sexual intercourse, taking a bath and bathing in stagnant bodies of water).

Almost all women who discuss bloody discharge before childbirth on the forums confirm that within a day or two after the discovery of small volumes of bloody mucus on their underwear, they were in labor. At the same time, obstetricians note that the darker the blood, the less it remains to walk with a belly. Please note that it can take from several hours to 2 weeks before delivery.

Other safe causes of bleeding before childbirth

The discharge of the mucous plug is the most likely cause of the appearance of bloody discharge before childbirth, which is an absolute physiological norm. But there may be other safe reasons for the phenomenon that is alarming you.

A pregnant woman can observe a slight discharge of blood from the vagina after being examined on a gynecological chair, and it is not at all necessary immediately after an appointment with a doctor, and possibly even for several hours after that.

Likewise, after intercourse, and it is quite normal - for two days after sex. The reason for the appearance of bloody discharge in both of these cases is mechanical irritation of the cervix, which is already preparing for the beginning of its disclosure.

When to go to the hospital

We pay special attention to the fact that spotting before childbirth in all the cases described above should not be profuse. Normally, these are scanty smearing marks or small blotches, usually brownish, but they can also be red. If bleeding has begun, then you need to go to the hospital without delay, without wasting a second! It is also necessary to see a doctor if, after the mucous plug begins to drain, blood secretion begins to increase or the baby has changed his motor activity.

Bloody discharge before childbirth, observed 2 weeks before their expected onset and earlier, also cannot be ignored: be sure to notify your doctor about this.

Especially for Elena Kichak

Bleeding can complicate the course of childbirth, the postpartum period, and lead to severe endocrine pathology. Every year 140,000 women die from bleeding during childbirth. Half of them arise against the background of gestosis, pathology of vital organs. Underestimation of the severity of the patient's condition, insufficient examination, inadequate and untimely therapy lead to a fatal outcome. What are the causes of obstetric bleeding, is there any prevention, what should be the therapy.

What is physiological blood loss

Most cases of pathological blood loss occur in the postpartum period, after placenta separation. The volume programmed by nature up to 0.5% of a woman's body weight does not exceed three hundred milliliters. From one hundred to one hundred and fifty of them are spent on the formation of blood clots in the placental site after the separation of the placenta. Two hundred milliliters are secreted from the genital tract. This blood loss is called physiological - provided by nature without harm to health.

Why arises

Obstetric bleeding is usually divided into those that begin with the onset of labor, in the subsequent and early postpartum periods. Bleeding in the first stage of labor and in the second can be triggered by premature detachment of the normally located placenta. In the third period, there are many more reasons.

After the birth of the fetus, during the normal course of labor, the placenta is separated and the placenta is excreted. At this time, an open placental site appears, which contains up to two hundred spiral arteries. The end sections of these vessels do not have a muscular membrane, blood loss is prevented only due to uterine contractions and activation of the hemostasis system. The following happens:

After the expulsion of the fetus, the uterus is significantly reduced in size.
There is a powerful contraction and shortening of muscle fibers, which pull in the spiral arteries, compressing them by the force of contractions of the myometrium.
At the same time, the veins are compressed, twisted and folded, and blood clots are intensively formed.

In the area of the placental site (the place of the former attachment of the placenta) in healthy women, blood clotting processes are accelerated ten times compared to the time of thrombus formation in the vascular bed. In the normal course of the postpartum period, the first is the contraction of the uterus, which triggers the thrombosis mechanism, which requires a decrease in the lumen of blood vessels, a decrease in blood pressure.

For the final formation of a thrombus, it takes about two hours, which explains the observation time due to the risk of the described complication. Therefore, the causes of bleeding during childbirth can be:

conditions that violate the contractility of the myometrium;
pathology of the blood coagulation system;
birth canal injuries;
premature, violation of the processes of its separation and excretion.

Bleeding can begin after the birth of the fetus with a decrease in the tone of the myometrium, anomalies in the location of the placenta, violation of its attachment and incomplete separation from the walls in the third stage of labor. The likelihood of pathology is higher with the development of the following complications:

abnormalities of labor;
inadequate use of uterotonics;
rough management of the third period.

The risk group includes women with previous gynecological diseases, operations on the genitals, abortions, and infantilism. In the subsequent period, due to pathologies of the placenta, the force of contractions of the myometrium may be disrupted, and the operation for manual separation of the placenta disrupts the process of thrombus formation in the placental site.

Additional provoking factors are the violation of the integrity of the birth canal. In the first hours after childbirth, bleeding can be provoked by a low content of fibrinogen in the blood, atony and hypotension of the uterus, retention of parts of the placental tissue, fetal membranes.

How does it manifest

Bleeding is the most severe complication of childbirth. Blood loss of 400-500 milliliters is pathological, and one liter is massive. Pathology accompanies anomalies of placenta attachment, retention of a detached placenta, rupture of the soft tissues of the genital tract.

Premature detachment of a normally located placenta

If the measures carried out remain ineffective, they decide on the use of surgical treatment. When the uterus ruptures, internal bleeding develops. This condition is an indication for urgent extirpation or amputation of the organ.

Manifestations in the early postpartum period

Bleeding in the first two hours after birth occurs in five percent of all births. Predisposing factors can be inflammatory processes during pregnancy, endometritis, abortion, history of miscarriage, and the presence of a scar on the uterus. The main reasons for the occurrence are:

delay of parts of the placenta;
violation of the contractility of the myometrium;
birth canal injuries;
disorders of the blood coagulation system.

Read more about bleeding after childbirth in.

Retention of parts of the placenta, fetal membranes

Prevents contraction, clamping of uterine vessels. Pathology can arise in connection with the forcing of the birth of the placenta by obstetricians, when its complete separation has not yet occurred, with the true attachment of one or more lobules. They remain on the wall at a time when the bulk of the baby's place is born from the genital tract.

Pathology is diagnosed when examining the placenta, finding a defect in its lobules, membranes. The presence of defects is an indication for a mandatory revision of the uterine cavity, during which the search and separation of the retained parts are carried out.

Hypotension and uterine atony

Damage to the neuromuscular apparatus of the uterus, dysregulation of muscle fiber contractions, malnutrition, oxygen starvation of myometrial cells lead to a significant decrease or complete loss (respectively) of the tone of the uterus. Hypotonic bleeding during childbirth is a reversible condition, the first manifestations of which begin immediately after the separation of the placenta, can be combined with a violation of the processes of its separation.

Large organ sizes, flabby consistency, indistinct contours, profuse spotting from the birth canal, which are accompanied by additional release of blood and clots during external massage of the uterus, are symptoms of hypotension. This condition is a direct indication for manual examination of the cavity, massage on the fist, administration of uterotonics, and infusion therapy. In case of ineffectiveness of the measures taken and blood loss of 1 liter, they decide on the removal of the organ.

There are two options for the development of a pathological condition - undulating and massive blood loss. With atony of the uterus, bleeding is continuous, quickly leading to hemorrhagic shock. In this condition, emergency care is provided from the first seconds, with the simultaneous preparation of the operating room. Consists of several stages:

Restoration of the volume of lost blood.
Achieve adequate oxygen levels.
Timely use of supportive therapy - steroid hormones, cardiovascular drugs.
Correction of biochemical, clotting, vascular disorders.

The level of organization of the work of the maternity hospital, a well-developed scheme of personnel actions is the basis for successful therapy. Prevention of bleeding during childbirth involves the early identification of pregnant women in the appropriate risk group.

These measures make it possible to anticipate a serious complication, to prepare for it in advance. With the first contractions, install an intravenous catheter, determine the main indicators of hemostasis, introduce Methylergometrine during the eruption of the fetal head, prepare a supply of medicines. All activities are carried out against the background of intravenous administration of the necessary drugs.

The infusion therapy protocol provides for the administration of Infukol in an amount equal to the volume of blood lost. In addition, crystalloids, fresh frozen plasma, erythromass are used.

Indications for the introduction of erythrocyte mass can also be a decrease in the level of hemoglobin to 80 g / l of hematocrit to 25%. Platelet mass is prescribed when the platelet count drops to seventy. The volume of blood loss recovery is determined by its value.

Preventive measures include the fight against abortion, adherence to the protocol of women management at the stage of antenatal clinics, during childbirth, and the postpartum period. A competent assessment of the obstetric situation, prophylactic administration of uterotonics, timely operative delivery make bleeding preventable.

Careful observation in the first two hours after childbirth, the application of ice to the lower abdomen after the release of the placenta, periodic gentle external massage of the uterus, registration of lost blood, assessment of the general condition of a woman can avoid complications.

Pregnancy is one of the most difficult and exciting stages in a woman's life. Active hormonal and psychological restructuring, anticipation of meeting a child and frightening uncertainty of the last trimester ... Here is an incomplete list of thoughts and processes that disturb a young mother. Having paid attention to thematic forums, we can conclude that one of the problems that frighten women at 8-9 months of pregnancy is discharge before childbirth.

Based on the statistics of the Ministry of Health, on average, 4 out of 10 women interviewed have secretions of varying intensity and color at the final stage of gestation.

Discharge during late pregnancy is considered a normal physiological phenomenon. Their nature, abundance and intensity will help the gynecologist not only establish the expected time of delivery, but also learn about the pathological processes occurring with the fetus. A similar phenomenon, depending on the condition of the woman in labor and the factors that caused them, differ in color and consistency.

A yellowish and white, flaky discharge in late pregnancy

Such secretion indicates leakage of amniotic fluid. The presence of flakes is a normal phenomenon, indicating the ingress of lubricant particles into the liquid substance that protects the fetus during the prenatal period.

Amniotic waters are the natural habitat of a child for 9 months. The processes of its formation, respiration, and movement are actively going on in it. The presence of amniotic fluid around the maturing embryo protects it from external influences on the abdomen (shock, push), acting as a shock absorber. The discharge of a substance is a physiological process that precedes the onset of contractions and foreshadows their frequency.

As a rule, the outflow of water is accompanied by the opening of the uterus by 2-4 cm. The amount of fluid can vary from a glass to 1.5 liters. The substance is transparent and odorless, but the presence of sweetish shades is the norm.

In the course of pregnancy, a woman can be diagnosed with both low water and high water. The presence of such pathologies requires observation in a hospital setting.

The outflow of water is provoked by the rupture of the amniotic bladder and indicates the imminent onset of labor. The presence of feces in the substance and the presence of an unpleasant odor indicates a threat to the life and health of the fetus. The child can swallow liquid, which will lead to the development of infections and pathologies of the respiratory tract.

An incomplete rupture is often diagnosed, which leads to the leakage of the substance. It is worth talking about a violation of the course of pregnancy only if the process has intensified long before the expected date of birth.

How to detect water leakage?

It is also possible to diagnose constant leakage of liquid secretion at home:

It is necessary to carry out hygiene of the intimate area. It is recommended to perform a similar procedure with baby soap or a special gel with a mild antimicrobial effect;
Treat the surface of the genitals with a towel or napkin;
Lie down on a dry white sheet;
Stay in a horizontal position for at least 15–20 minutes.

If, in the process of these manipulations, several wet spots appeared on the surface of the sheet, we can safely talk about water leakage.

Rich yellow or green discharge

Such secretion indicates the presence of a threat to the life of the fetus.

The deep processes that provoked such mucus can only be determined by the gynecologist who observes the woman in labor throughout the entire period. The most common causes of yellowish effusions are:

Hypoxia
Premature detachment of the placenta
Fetal presentation

Brown, brown, dark brown discharge at 37–41 weeks

Discharge before childbirth of brown or dark brown shades of low intensity and volume are not evidence of a violation of the natural course of pregnancy.

Such substances in small quantities indicate the readiness of the cervical muscle for the passage of the fetus.

In such a situation, you should listen to your own feelings. A sharp muscle tone in the lower abdomen, combined with abundant secretions of brown or dark brown shades, indicate a sharp contraction of the cervical muscle. This phenomenon is fraught with a single or multiple rupture of the amniotic fluid.

Spotting discharge late in gestation

Concern should be caused by the presence of a blood clot or small spotting bleeding. If a similar phenomenon has found a woman in labor at home, it is necessary to urgently call an ambulance and go to the maternity hospital. Bloody spotting before childbirth may indicate premature placental abruption and presentation.

These phenomena can cause bleeding, which directly threatens not only the safety of the fetus, but also the woman's life.

Bloody and pink mucous discharge before childbirth

This process is associated with the beginning of the discharge of the mucous plug, which protects the fetus from the penetration of infections throughout the entire period and the active preparation of the woman's body for childbirth. The color color is associated with getting into it during the formation of blood cells. Such a phenomenon does not indicate a violation of the natural course of pregnancy and the possibility of a threat to the life of the fetus.

Physiological plug is a thick mucous substance. Its departure is an individual phenomenon and can take from several minutes to days. The result of this process is the softening of the cartilaginous tissues in the small pelvis and the onset of active labor. By the way, it is the increased uterine contractions at this time that cause false contractions.

The assessment of the risks to the health of the fetus and the woman in labor should be carried out by a practicing gynecologist. If no threats are identified, it is worth adhering to simple recommendations in order to protect yourself from unwanted consequences:

Regardless of the amount and intensity of the discharge, the use of tampons is strictly prohibited! Their surface is a fertile environment for the development of microorganisms.
Refrain from visiting public pools, baths and saunas.
Refuse to take a bath. Use a shower for personal hygiene.
To get rid of secretion, it is strictly forbidden to use solutions and syringes.
Refrain from active sex life. After the release of protective mucus, the uterine cavity, and therefore the child, is easily infected.
When choosing underwear, try to focus on seamless patterns made from natural, hypoallergenic, breathable fabrics.

White cheesy discharge in the last weeks of pregnancy

This phenomenon indicates the onset of thrush. This disease is often detected in the last months of pregnancy and, as a rule, it is provoked by the unstable emotional state of the expectant mother. It is worth considering that the symptomatology intensifies along with labor and is expressed in itching in the labia and in painful, burning, urination. In this regard, when diagnosing such symptoms in yourself, you should immediately consult a doctor!

Discharge after examination by a gynecologist and after sex in the third trimester

Most often, late discharge that does not have a physiological background, is provoked from the outside. Mechanical effects on the internal mucous membrane of the uterus entail the appearance of substances, both yellowish and bloody.

Examination by a gynecologist

Any woman who is registered for the management of pregnancy in a maternity hospital or perinatal center is examined in a specialized chair in the interval from 36-40 weeks. Practice shows that most often such procedures are carried out at 38–39 weeks, but the interval 39–40 is considered a period of silence, in which, in the absence of fetal pathologies, the expectant mother can calm down and gain strength before the upcoming birth.

The internal cavity of the uterus is covered with a thin softened mucous membrane, which is easily injured during examination on a gynecological chair. Often, after such an intervention, microtrauma remains on the surface, which can bleed for 1-2 days and be accompanied by a dull, aching pain in the lower abdomen. Anxiety should be caused either by those that did not subside after a few days, but began to increase sharply. Such a manifestation is a serious reason for an emergency hospitalization of a woman in labor in the maternity ward.

Sex

An intimate life at the final stage of pregnancy is not a contraindication. But if a woman is diagnosed with fetal developmental pathologies, then it is better to abstain from sexual activity. The reason for such an asceticism for the benefit of the child may be:

Increased tone of the uterus.
Placenta previa, diagnosed by ultrasound examination of the woman in labor (ultrasound).
Multiple pregnancy (pregnancy with two or more children at once).
Dilution of the uterus diagnosed well before the expected date of delivery.
Discharge of the mucous plug.
Failure identified in the cervical region.
Thrush.
The presence of yellowish, pink, brown discharge or the presence of blood streaks in the structure of whitish discharge.
False contractions or the existing threat to activate preterm labor.

If a woman in labor has not been diagnosed with such deviations during pregnancy, then sexual intercourse is not only not prohibited, but also indicated. Sexual activity provokes the release of hormones into the bloodstream, which will have a positive effect on the fetus. But it is worth taking precautions. First of all, choose a position that is comfortable for the woman in labor and use barrier contraception (condoms). The semen has a relaxing effect on the walls of the uterus. Such an impact is fraught with provoking the onset of premature birth. Remember that during pregnancy it is worth giving up non-standard and traumatic types of sexual activity.

Signs of pathological abnormalities

Often, the release of a specific color and odor may indicate violations during the course of pregnancy and risks to the fetus and the woman in labor. Signs indicating deviations include:

Strong unpleasant odor.
Profuse bloody discharge with clots.
Itching and burning while urinating.
Swelling in the labia.
The presence of a rash or other skin rash in the perineal area.

When diagnosing such symptoms in a woman in labor, you should immediately contact a specialist!

Discharge during labor

Discharge that bothers a woman in labor in the last months of pregnancy may appear directly during labor and accompany childbirth. Such a phenomenon should not cause alarm in a woman.

Such discharge, often, has a smearing mucous consistency and a brown and brown tint. Sometimes a woman in labor can notice bloody blotches, more like streaks, in light yellow clots rejected by the body. To eliminate unnecessary anxiety, it is worth understanding the physiological processes of this stage.

Contractions are a sharp contraction of the muscles of the uterus, starting at the top point and spreading along the walls. It is accompanied by a sharp, throbbing pain radiating to the lumbar spine and groin. Contractions not only contribute to the advancement of the fetus, but also prepare the birth canal for this. The contractions of the first period are less intense and contribute to the opening of the cervix.

With the onset of labor, the lining of the uterus and blood vessels are under intense pressure. Injury to them during childbirth provokes the appearance of bloody spotting. It is on the basis of the presence of such clots, rejected by the uterus, that obstetricians-gynecologists establish the estimated time interval in which the child will be born.

Small amounts of brownish discharge with bright bloody streaks indicate possible delivery in a few hours.

Attention! The volume of physiological secretions that do not indicate abnormalities in the development and presentation of the fetus does not exceed 2-3 tablespoons!

Another possible reason for the appearance of specific brown discharge during labor is the withdrawal of the mucous plug immediately at the time of the onset of delivery. This protective secret, in the process of clogging, can get blood cells that have arisen as a result of injury or the approach of the menstrual period. In case of rejection, before the active onset of the generic process, the "cork" can lose its structure and the released particles, interacting with air, acquire a brown tint.

The appearance of bloody scarlet discharge shortly or directly in the process of contractions, indicates a situation that requires urgent medical intervention! The presence of large blood clots in the mucus may indicate the onset of internal bleeding or premature placental abruption. Such deviations require immediate medical intervention in the labor process.

Briefly about the main

Month 9 is the most stressful and exciting time for a mother-to-be. The sharp appearance of various secretions can provoke "prenatal jitters" and seriously alarm the woman in labor. But, it is worth remembering that liquids of various colors and consistencies not only signal danger, but also portend an early delivery, being natural female guide-assistants.

For example, brown spotting in small quantities indicates the onset of active labor in 2-5 days from the appearance of the first "smears" . Colorless watery mucus makes it clear to the expectant mother that there are several days left before meeting the baby, but the abundant dark mucous substances that come out in parallel with frequent contractions are considered harbingers of the appearance of a child in a few hours.

Discharge that appears shortly before labor should not scare a woman, since their presence is a normal physiological process, indicating that the moment of delivery is already quite close.

Most often, abundant discharge before childbirth begins to be observed from week 36, especially in the morning. The main thing is to be able to correctly determine the nature of their occurrence in time in order to figure out if they pose a danger to the baby.

Brown, pink and bloody shades

The entire period of gestation, the cervix is closed with a mucous plug, necessary to protect the fetus from the ingress of harmful microorganisms from the external environment. A few days before childbirth, another hormonal change takes place in the body, which gradually prepares the cervix for opening. It is during this period that discharge appears.

In order for the child to pass through the birth canal, the cervix needs to get rid of the plug. As the secretions increase, the cervical cartilage tissue softens, contractions of the uterine muscles begin, under the influence of which the cork is pushed out. Its release most often occurs gradually, the process can last from two weeks to several days.

All these days, there is an increase in the tone of the uterus, so pregnant women often feel mild pain in the lower abdomen. In addition, in some women, when the mucous plug comes out, pink discharge is observed before childbirth, and sometimes yellow.

Also, a few days before delivery, bleeding may appear. Their presence requires immediate medical attention, since the discharge of fluid with blood before childbirth indicates the occurrence of complications.

In addition, brown discharge is often observed in women in labor. They can also develop due to the presence of pathology, therefore, medical assistance in this case is mandatory, especially if there is an unpleasant odor.

However, this kind of discharge can appear for such reasons as:

carrying out a gynecological examination;
having sex on days when the plug is rejected;
discharge of the mucous plug.

Examination by a gynecologist

Throughout pregnancy, the cervix is elongated, tight and closed. When the body begins to prepare for childbirth, the neck becomes shorter, softer and begins to open. To determine how the process is going, an obstetrician-gynecologist, at about 38–39 weeks, conducts a mandatory examination of a woman on a chair.

During such an examination, the softened and half-open uterus can easily be injured, as a result of which brown or reddish discharge appears. Unlike a pathological complication, this kind of discharge is characterized by an insignificant amount. They usually appear within 3-4 hours after examination and do not pose any danger for further gestation.

Intercourse

You can have sex in the late gestation period. However, it should be borne in mind that an incorrectly chosen posture can harm the cervix. Against this background, after 1–2 days, a brown daub may appear.

Sexual intercourse in the last weeks before childbirth is not recommended if:

there is a threat of premature contractions;
there is placenta previa;
the pregnancy is multiple;
there is a leakage of amniotic fluid;
bloody issues;
insufficiency of the cervix.

Mucous plug

Brown discharge before childbirth often occurs against the background of the discharge of the mucous plug. Its rejection can occur at absolutely different times, for example, a few weeks before labor or, in a couple of days. In some cases, there is an instant exit of the plug, after which the first contractions begin immediately (after 2–3 hours).

Discharge when the cork comes off can be of different consistency and different colors: mucus streaked with blood, transparent discharge, pinkish, light and brown. The latter indicate that there is little time left before the onset of labor.

Profuse white discharge

Throughout pregnancy, the child actively moves, changing position and posture. This is due to the amniotic fluid in which it floats inside the uterus. In addition to helping the baby to move, they also protect him from various negative external influences, such as punches or pushes in the stomach.

The discharge of amniotic fluid is also a natural physiological process, indicating that the child is ready to be born. Liquid is poured out after the rupture of the amniotic bladder, usually this process occurs instantly, but there are times when, due to incomplete rupture of the water, they begin to leak.

In a normal process, the amniotic fluid is colorless and odorless. It resembles ordinary water. Sometimes there may be a sweetish aroma and a touch of white flakes, but this is quite normal. Do not worry about the presence of mucus, as it appears in the waters after they pass through the vagina.

A profuse, white, flake-like discharge may appear from leaking amniotic fluid. They are necessary to protect the child, so you shouldn't worry. But if this kind of discharge appears when it is still early before childbirth, then you need to consult a doctor to eliminate leakage.

Pathology or mucous plug

In the normal course of pregnancy, there should be no discharge before childbirth, except for the discharge of the mucous plug and the outpouring of amniotic fluid. Both of these processes are not pathological, if the gestation period has come to an end, and they began at 38 weeks. Otherwise, we can talk about premature birth.

It is possible to determine that the discharge refers to the rejection of the mucous plug by the following signs:

lack of acute pain in the lower abdomen;
no smell;
slight presence of blood streaks;
discharge has a slimy consistency.

The outpouring of amniotic fluid cannot be confused with anything. They are watery, immediately flow out in large quantities (from 0.5 to 1.5 ml) and transparent. We can talk about a pathological process if there is blood in the waters, there is a greenish tint and an unpleasant odor. In this case, the woman in labor needs immediate hospitalization.

Also, the presence of pathology is indicated by this kind of discharge:

Curd. Often in pregnant women, shortly before childbirth, against the background of experiences, thrush appears. The ailment intensifies just before delivery and is accompanied by severe itching, burning, especially during urination, curd discharge and a sour smell.
Leakage of amniotic fluid. The process is accompanied by constantly wet underwear. You can determine the leakage by this test: hygiene of the genital perineum, wipe dry, lie down on a clean, dry and white sheet. If, after 15–20 minutes, several wet spots appear, then amniotic fluid is leaking.
Bloody, greenish, and other discharge. Any suspicious color discharge can be a sign of the onset of complications, as well as pathological changes in the birth canal or uterus.

When to see a doctor

You should visit a doctor immediately after the excretory processes have begun. After all, it is difficult to independently figure out whether they are normal or pathological, it is better to entrust this matter to a specialist in order to protect yourself from unnecessary worries.

In addition, it is necessary to immediately consult a gynecologist in case of bleeding. Blood is especially dangerous before childbirth in large quantities and has a bright red color. If measures are not taken in a timely manner, then profuse bleeding may begin, which is dangerous not only for the life of the baby, but also for the mother.

The reason for visiting the clinic is also the appearance of discharge with an unpleasant odor. This can be a sign of an infectious process in the genitourinary system, which is very dangerous for the baby, especially at the end of pregnancy, when the cervix began to open and harmful microorganisms can easily enter the uterine cavity.

Also, you need to consult a doctor with discharge, accompanied by malaise or pain in the lower abdomen, having a cramping character. First of all, this symptomatology may indicate the onset of labor.

What most often scares a young woman preparing to become a mother for the first time (or what is most often scaring her)? The answer is obvious - contractions. The anticipation of pain can cause more panic than the pain itself. And the closer the cherished date, the more obsessive this fear haunts. The surest way to get rid of fear is to stop hiding from it and hiding it from yourself, to meet it face to face, to “talk” with it. Are you afraid of contractions? So let's figure out what it is.

WHAT IS A BATTLE?

In medical terms, labor pains are involuntary regular contractions of the uterus, along with attempts, related to the birth forces expelling the fetus.

Contractions indicate that childbirth has begun. (In addition to contractions, the onset of labor may be indicated by symptoms such as the outpouring of amniotic fluid and the discharge of a mucous plug that closes the lumen of the cervix; the mucous plug can come off 2-3 days before giving birth, so its discharge does not always mean that it is time to go in the hospital). Many works have been written about what, in fact, provokes the onset of childbirth. Diverging in particulars, all researchers agree on the main thing: the organisms of the mother and the child, being in close interaction, as if "agree", transmit the necessary impulses to each other.

Shortly before the onset of labor, the woman's placenta and the baby's pituitary gland begin to produce specific substances (in particular prostaglandins and the hormone oxytocin), which cause contractions of the muscles of the uterus, called contractions. During pregnancy, the cervix is tightly closed. With the onset of labor pains, its opening begins: the pharynx of the uterus gradually expands to 10-12 cm in diameter (full disclosure). The birth canal is preparing to "release" the child from the mother's womb.

Intrauterine pressure increases during labor as the uterus itself contracts in volume. Ultimately, this leads to rupture of the fetal bladder and the outpouring of part of the amniotic fluid. If this coincides in time with the complete opening of the uterine pharynx, they speak of the timely outpouring of water, but if the uterine pharynx did not open enough at the time of rupture of the fetal bladder, such an outpouring is called early.

The first, preparatory period of childbirth takes, on average, 12 hours if a woman gives birth for the first time, and 2-4 hours less for those who have not given birth for the first time. At the beginning of the second stage of labor (the period of expulsion of the fetus), attempts are added to the contractions - contractions of the muscles of the abdominal wall and diaphragm. In addition to the fact that different muscle groups are involved in contractions and attempts, they have another important difference: contractions are an involuntary and uncontrollable phenomenon, neither their strength nor frequency depend on the woman in labor, while attempts to a certain extent obey her will , she can delay or strengthen them.

WHAT TO EXPECT FROM THE BATTLE?

Feelings during contractions are individual. Sometimes the first tremors are felt in the lumbar region, then spread to the abdomen, become encircling. Pulling sensations can occur in the uterus itself, and not in the lumbar region. Pain during labor (if you cannot relax or find a comfortable position) resembles the pain that often accompanies menstrual bleeding.

However, you should not be afraid of contractions in panic. You can often hear from women giving birth that the contractions were either completely painless, or the pain was quite bearable. First, during contractions, the body releases its own pain relievers. In addition, the techniques of relaxation and proper breathing learned during pregnancy help to get rid of painful sensations. And finally, there are medication methods of pain relief, but they are recommended to be used only in extreme cases, since they all, to one degree or another, affect the baby.

Real (and not false - see below) "banishing forces" come at regular intervals. At first, the intervals between contractions are about half an hour, and sometimes more, the contraction of the uterus itself lasts 5-10 seconds. Gradually, the frequency, intensity and duration of contractions increase. The most intense and prolonged (and sometimes - although not always - painful) are the last contractions preceding the attempts. When to go to the hospital? In the case of the first birth (and if it is not far from the hospital), you can wait until the interval between contractions is reduced to 5-7 minutes. If a clear interval between contractions has not yet been established, but the pain intensifies and becomes more and more prolonged, then it's still time to go to the hospital. If childbirth is repeated, then with the onset of regular contractions, it is better to immediately go to the hospital (often repeated childbirth is rapid, so it is better not to hesitate).

With the onset of contractions, mucous discharge with a slight admixture of blood may appear - this is the very mucous plug that "clogged" the entrance to the uterus. Blood (in small amounts) enters the mucus due to the smoothing and dilation of the cervix. This is a natural process that should not be intimidated, but if there is profuse bleeding, immediate examination is necessary.

TRUE OR FALSE?

It should be borne in mind that after 20 weeks of pregnancy, some (not all) women develop so-called false contractions, or Braxton Hicks contractions, and 2-3 weeks before childbirth, women begin to feel the precursor contractions. Neither one nor the other, unlike true contractions, does not lead to the opening of the cervix. There are pulling sensations in the lower abdomen or in the lower back, the uterus, as it were, turns to stone - if you put your hand to the stomach, you can clearly feel it. The same, in fact, happens during labor pains, which is why Braxton Hicks and the harbingers often confuse women giving birth for the first time. How to understand if labor is really starting and it's time to go to the hospital, or is it just false contractions?

Braxton Hicks contractions, as opposed to true labor pains, rare and irregular ... Contractions last up to a minute, can be repeated after 4-5 hours.
False contractions painless ... Walking or taking a warm bath most often helps to completely relieve the discomfort.

The role of false contractions has not yet been fully elucidated. Their appearance is associated with an increase in the excitability of the uterus, it is believed that they, shortly before childbirth, precursor contractions contribute to the softening and shortening of its neck.

WHAT TO DO WHEN BREAKING?

It is noticed that the more a pregnant woman is scared, the less she knows about what is happening to her and what she is facing, the more difficult, longer and more painful her childbirth is. Even in the very recent past, the phrase "preparation for childbirth" seemed to be complete nonsense in Russia. Fortunately, over the past decade, there have been qualitative changes in this area - many courses and schools for preparing for childbirth have been opened, where not only future mothers, but also future fathers are preparing for this important event. Enough books have been published. And most importantly, psychology has changed. Now, if not all, then most women understand that they need to prepare for childbirth, as for any difficult and important work. And the main goal of such training is to get rid of fear and pain.

What do experts usually recommend to make contractions as easy and painless as possible? As already mentioned, you will not be able to control the frequency and strength of contractions, it does not depend on you. But you can quite help yourself and your child to survive these contractions.

At first, when the contractions have just begun, it is better not to lie down, but to move: this will speed up the process of opening the uterine pharynx, which means it will shorten the time of childbirth.
Concentrate calmly and try to find the position of your body in which you are most comfortable. Do not hesitate if you feel like standing on all fours, lying on a large inflatable ball, or even ... dancing. Believe me, no one would ever think of condemning you for being extravagant. Circling and swinging your pelvis can help relieve tension and relieve pain.
If possible, try to sleep between contractions or at least "pretend to be asleep" (this will help to relax the body).
You can lie down for about ten minutes in a bath with warm water - of course, if you are not alone in the apartment and, if necessary, they can help you.
Lightly stroking the skin of the lower abdomen with the pads of the fingers eases the contractions at the beginning of the path. With the beginning of the fight, you need to inhale and direct the movement of the hands from the midline to the sides, while exhaling, the arms move in the opposite direction.
When contractions intensify, strong and frequent pressure with thumbs on points in the region of the anterior-superior spines of the iliac bones (these are the most protruding parts of the pelvis) helps to relieve pain. It is convenient to place your hands with your palms along the hips.
Massage of the sacral area of the spine is very useful. It is effective not only at the beginning of labor, but as long as the expelling forces are at work in your body.

As the contractions intensify, correct breathing becomes more and more important. But the most important thing is to tune in, listen to your own feelings and ... remember the child. You both have a difficult job ahead of you, but the result will be a meeting!

Tatiana Kipriyanova

I hardly recognized the first contractions. The fact is that they were very similar to "training" contractions - the so-called "Braxton-Hicks contractions", which followed me from the 7th month almost every evening. And at first I could not understand - is it still they or already the beginning of labor. Feels like - as if the belly freezes below, then "lets go". The intervals between contractions were uneven: now after 20 minutes, then after 5; but still they walked regularly (longer than two hours) - this influenced the decision to go to the hospital.

The first contractions were quite bearable - just a little bit of discomfort. There were significant gaps between them, which made it possible to relax, and I even began to doubt that I was really giving birth. Upon arrival at the maternity hospital, the examination showed an opening of the cervix of 1 cm.When the bladder was pierced (by the way, it did not hurt at all), the contractions were already more effective, the pain became quite noticeable, the intervals were about 5-10 minutes (opening 4 cm). I used to have quite painful periods, and this pain seemed to me similar to menstrual pain. Over the next hours (the child moved towards the exit), the pain became more and more intense. It was hard. The massage of the lower back, which my husband did, and breathing, which I read about in books, helped me a little (the medical staff also suggested how to breathe better). When the pain became simply unbearable, attempts began (by the way, I have heard more than once from others that when you feel that the limit has come and there is no more urine to endure the pain, it means that everything will be over soon). Attempts are easy to recognize - you involuntarily begin to push (I could compare this process to the urge to go to the toilet). Attempts are also painful, but the cardiography machine began to listen poorly to the baby's heart, and I had to give birth as quickly as possible. Therefore, from about the fifth attempt, I already gave birth to my boy (not without an episitomy). The whole process took us 12 hours (this was my first birth).

Anna Goncharova

The contractions were like a very violent and painful period. At first they were very weak and I didn't even feel discomfort. It looked like a very mild (not painful) spasm inside the abdomen. Painful contractions became only four hours later. And it most resembled painful menstruation. But it only hurt for about an hour. It was possible to endure, but with difficulty. My husband helped a lot. Even in the most intense moment, the pain was not constant. Everything went on with a frequency of 5 minutes. At first, the pain grew rapidly, reached its maximum, and then disappeared just as quickly. Each fight took about two minutes. For about three minutes there was no pain at all! The worst thing for me was at the moment of the beginning of a new fight - when it didn't hurt yet, but you understand that everything started from the beginning. Unpleasant, but bearable. And only one hour. As soon as I was allowed to push, the pain stopped. I didn't have any more pains, which are sometimes written about (in the lower back, or somewhere else).

By the time the contractions began, I was already in the hospital, so I immediately went to the doctor, and the doctor confirmed that labor had begun. The doctor and midwife said when to start pushing. It didn't hurt at all, and it didn't hurt at all to give birth. Although they made an incision, I did not notice it at all.

In general, I remember childbirth very well, but the pain is forgotten very quickly. I remember more with pleasure - and first of all all sorts of funny moments. The feeling of horror and "never again" was not there at all. Maybe because there was a good maternity hospital and I gave birth with my husband!

Elizaveta Samoletova

Unfortunately, I was psychologically completely unprepared for childbirth. Therefore, already being in the delivery room (I was in the maternity hospital on preservation), I felt that my stomach ached very badly, and was frightened. Of course, "theoretically" I knew that I was going to have contractions, but I had little idea of what it was. Of course, there was no question of counting the intervals between contractions (this was suggested by the midwife, who was sitting next to the table and writing something). It seemed to me that I was dying, and in a weakening voice I asked for a cesarean section. The midwife laughed cheerfully for some reason. I ask: "What are you laughing at?" And she told me: "According to my calculations, every second woman in labor asks to do her caesarean."

I suffered for about an hour. I was very offended that the people who were around (nurses, midwives, head of the department and even some trainees who showed me as an example of an "old primiparous woman with a slightly narrowed pelvis") took my suffering for granted and like nothing sometimes they tried to talk to me about some boring everyday topics (they asked where I work, where did I get such a strange surname and how I would call my unborn child). And when my stomach started to hurt especially badly, the midwife came up and mockingly (as it seemed to me then) told me how I should breathe.

When the attempts began, it became easier and even, I would say, more interesting, because the "result of labor" was about to appear. He appeared. It contained 3 kg 600 g.

Then I apologized to the doctors, but they laughed again and said that almost everyone behaves like me. And I decided that I would prepare for the next birth for a long time and seriously.