As soon as the pregnancy approaches completion, many expectant mothers begin to worry: when should they go to the maternity hospital? And most importantly, how do you understand that the time for this has already come? In fact, everything is simple: there are several main points that you need to focus on.

Are these contractions?

Contractions are the main sign of the onset of labor. Even before they begin, you can feel that heaviness has appeared, a slight pain in the lower back, lower abdomen, the uterus has tensed and has become very dense to the touch. But it is important to recognize true contractions, and not “training” ones, which can occur in the second trimester of pregnancy. Real labor pains are repeated at regular intervals, which are gradually shortened, and the duration of the contraction itself increases; training contractions are irregular in time, and their intensity is almost always the same. Real contractions, unlike training contractions, are very painful; they do not go away after changing body position or a warm shower.

Counting the interval between contractions

If contractions have definitely begun, you should not immediately go to the maternity hospital. After all, the first stage of labor lasts quite a long time, and it is much more comfortable to spend it in a familiar home environment. So first, count how often contractions occur and how long they last. It is usually recommended to go to the maternity hospital if the interval between contractions is approximately 10 minutes. usually pass faster than the first ones, so if you are expecting a second child, then the dilatation of the cervix will pass much faster and you need to go to the maternity hospital as soon as the contractions become regular and rhythmic.

You need to prepare for the trip to the maternity hospital. Find out what you are allowed to take into the maternity ward in the particular maternity hospital where you plan to give birth. Make a list of what you need and, closer to your due date, collect the main things included in it.

The road to the maternity hospital

The maternity hospital may be located next to the house, or it may be located at the other end of the city, regional center, or region. That's why calculate the time it will take to travel. If the maternity hospital is located nearby and you can get to it quickly, then you can safely wait for the recommended interval between contractions - 10 minutes. If you have to drive through the entire city and traffic jams are possible on the streets, then it is better to leave the house early, for example, when the interval between contractions is another 15-20 minutes.

If your water breaks

If the laundry becomes unusually wet, and even more so if liquid runs down your legs, this is a sign that water broke. It doesn’t matter how much fluid comes out - a little or all 1-1.5 liters, whether there are contractions or not, you don’t have to wait for the start of regular labor (it will start a little later). Go straight to the maternity hospital. After all, if the water has spilled out or is leaking slightly, this means that the integrity of the membranes has been compromised and the child is no longer protected from the influences of the external environment, primarily from infectious agents. In addition, if contractions are already regular, the rupture of water indicates that the birth of the baby is just around the corner. But if the mucous plug (a clot of jelly-like substance) comes off, this is simply a harbinger of labor and there is no need to go to the maternity hospital right away.

Immediately to the maternity hospital!

Rarely, but There may be situations in which you need to go to the maternity hospital immediately and without thinking. This must be done if:

• emerged from the genital tract bloody issues, especially if they are significant;
• the uterus does not relax between contractions, the pain is very strong;
• the child has changed: they have become either very weak, or, on the contrary, strengthened;
• severe headache, increased blood pressure, vision changes (became blurry, “spots” flash before the eyes);
• if labor began before 38 weeks of pregnancy or labor began during a multiple pregnancy.

Be sure to keep in a visible place all the documents necessary for childbirth: exchange card, passport, compulsory medical insurance policy. If an assisted birth is planned, then the partner will also need documents: a passport; if the birth is without a contract, then permission to accompany you during childbirth (this is taken in advance from the head physician of the maternity hospital or his deputy); results of examinations of the partner during childbirth (the list must be clarified in advance at the maternity hospital).

To the maternity hospital by ambulance or on your own

There are two ways to get to the maternity hospital: on your own or by calling an ambulance. Today, if you have a compulsory medical insurance policy, any maternity hospital is obliged to admit a woman in labor - of course, if it has free places. It is desirable that the trip to the maternity hospital be comfortable for the expectant mother.

In addition, in every locality (city, regional center) there is specialized obstetric ambulance, whose telephone number can be found in the antenatal clinic or simply by dialing “03”. A car with a midwife will come for the expectant mother and take her to the maternity hospital. True, this maternity hospital will be the closest, and if the woman chose another institution, then this will need to be taken into account. Often, if the expectant mother has entered into a contract with the maternity hospital, then it also includes such a service as delivery to the birth (regardless of how far away the mother’s home is located).

Every pregnant woman, from the first weeks of pregnancy, begins to worry about questions: where to give birth, what things to take with her, what method of delivery to choose. But now almost nine months of pregnancy are behind us, the woman chose the maternity hospital, she clearly knows what to take.

One important question remains - when should you go to the maternity hospital?

I don’t want to go too early, but I also don’t want to be late and then give birth in an ambulance or even at home. But, unfortunately, no doctor can accurately determine the date and time of birth.

Therefore, you should know a few things that will help you prepare for childbirth and arrive at the maternity hospital on time.

What every expectant mother needs to know?

The gestational age at which the baby is considered full-term varies significantly according to different experts and, on average, is in the range between 39 and 42 weeks.

The main harbinger are precursor contractions - painless contractions of the abdominal muscles. Such contractions appear at any time, are irregular, and pass quickly after taking antispasmodic drugs.

With the help of precursor contractions, a woman’s body begins to prepare for the upcoming labor.

Less commonly, a few days before giving birth, women notice a small amount of mucus appearing in the vagina. This plug serves as additional protection at the entrance to the cervix.

A little about the beginning of labor

When should you go to the maternity hospital? The answer is simple - at . However, there is emergency reasons when delaying admission to the maternity hospital threatens various complications.

Such reasons are the appearance of bloody discharge and antepartum effusion amniotic fluid.

Labor activity represents pain that is regular, painful and repeated at regular intervals.

Gradually, the frequency of contractions increases, while the contractions are not stopped by the use of conventional antispasmodic drugs, what distinguishes them from precursor contractions.

It can be difficult to distinguish between both of these types of contractions, in which case it is better to play it safe and go to the maternity hospital.

Appearance may accompany normal labor (cervical dilatation is accompanied by minor vascular damage), but most often the appearance of blood is a sign of placental abruption and other pathological conditions.

The development of placental abruption threatens the death of the fetus and mother, so if even a small amount of blood appears, it is better to call an ambulance.

Rush of amniotic fluid it is usually easy to determine - amniotic fluid often has a large volume, although, again, there may be little water, and there may be a gradual leakage.

The feeling of the appearance and discharge of water (not mucus) from the vagina is also an indication to call an ambulance.

In conclusion, it is worth saying that in the presence or complicated course of pregnancy, prenatal hospitalization in a hospital is planned in advance. All other cases are the responsibility of the woman herself.

So when is the best time to go to the maternity hospital? It's better to come to the maternity hospital earlier Why worry later - will the ambulance arrive in time?

Primiparas should also take precautions, because the first birth usually lasts a long time, until 10-13 o'clock, repeated births occur much faster.

First, you need to know the expected calendar date of birth. The length 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 your due date?

There are different ways to calculate your due date. Some try to determine the day of conception and count the days from it. However, the day on which sexual intercourse occurred and the day of conception itself may not coincide, since sperm are able to maintain their viability and “wait” for the egg in the woman’s genital tract for several days.

Determining the date of birth by menstruation

The most common way to calculate the date of birth 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 simpler - add another 7 days to the date of the first day of the last menstruation and count back three months. For example, the last menstruation began on September 5th. Then birth can be expected on June 12 (5 + 7 days = 12, 9th month September - 3 = 6th month June). But this method will be unreliable if a woman has irregular menstrual cycle or she does not remember the date of her period.

Our Due Date Calculator will help you calculate your due date based on menstruation.

Determining the date of birth by ultrasound

IN modern conditions the date of birth is determined quite accurately, based on the data ultrasound examination(ultrasound) performed before the 12th week of pregnancy. IN late dates During pregnancy, the error in determining the due date using ultrasound increases. This is due to the fact that the size of the fetus, which the doctor focuses on in his calculations, has large individual fluctuations at the end of pregnancy.

In the same way, calculations are made based on the date and duration of pregnancy established at the first visit to the doctor (the “first appearance at the antenatal clinic” method). The sooner your doctor determines your gestational age, the more accurate your future delivery date predictions will be.

Determining the date of birth by fetal movements

You can roughly calculate the date of birth by 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 baby’s first movement is not always clearly visible.

You can find out about the full-term pregnancy and impending birth by several signs. In about 1 - 2 weeks, the so-called “harbingers” of labor appear.

Harbingers of childbirth

Most women at the end of pregnancy notice that their stomach “sinks” and it becomes easier to breathe. This happens because during full-term pregnancy, the amount of amniotic fluid decreases slightly, and the fetal head is pressed against the entrance to the woman’s pelvis. The uterus becomes more excitable, it “trains”, prepares for the upcoming great job. Irregular, low-painful tension of the uterus and a feeling of heaviness in the lower abdomen and lower back are called “pregnant contractions.” Even a doctor cannot always say with certainty whether labor is beginning or preparatory contractions are occurring. If this state of increased irregular excitability of the uterus continues for 1 - 2 days, then it is better to contact maternity hospital, where they can assess whether the child is suffering.

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

Towards the end of pregnancy, many women release colostrum from their nipples, a precursor to mother's milk.

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

When is it time to go to the maternity hospital?

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

Often, amniotic fluid may leak before contractions begin. The normal water content in the uterus by the end of pregnancy is up to 1.5 liters. You may feel a light, warm fluid leaking from your vagina (not associated with urination). A little liquid may pour out, or even 1.5 - 2 liters. Be that as it may, if you notice unusually wet underwear, this is a situation in which you need to go to the maternity hospital. If the water has completely poured out or is leaking slightly, this means that the integrity of the membranes has been compromised, and the child is no longer protected from environmental influences, primarily from infectious agents. Time is counted by the clock; in such a situation, it is advisable for a child to be born no later than 12 hours after the water breaks. Doctor in maternity hospital should determine whether you have a chance of giving birth vaginally, or whether it is better to have C-section. In most cases, after the water breaks, normal contractions begin, and the birth ends safely.

The above described 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. Immediately call an ambulance and go to maternity hospital, If:

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

Blood-stained water leaks;

The pain is very strong, the uterus is painful to the touch, does not relax between contractions;

Fetal movements become unusually strong, weak, or painful;

you are worried about a headache, your vision has become blurry (“spots are flashing” before your eyes), pain has appeared in the epigastric region, your blood pressure has increased, you cannot urinate.

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

1. Decide in advance in which institution you will give birth. Many women prefer to have the same doctor manage their pregnancy and deliver the baby. In practice this is not always feasible. The state monitoring system for pregnant women is organized in such a way that the doctor is not necessarily present at the birth of his patient. And in non-governmental clinics, the obstetrician who observed you, due to various circumstances, may not be next to you at this very moment. However, you should not perceive as a tragedy the situation when you are given birth by an unfamiliar doctor. Choose a facility with a good reputation for delivery; if you are not “assigned” to it on a territorial basis (formal objections may arise during hospitalization), decide in advance for yourself whether you agree to paid services. It is advisable to undergo a set of examinations accepted in this institution and enter into a service agreement.

2. Keep your documents collected, namely:

An exchange card with the data of all tests and ultrasound examinations in the third trimester;

Passport;

Insurance policy.

IT'S BETTER TO ALWAYS HAVE THESE DOCUMENTS WITH YOU!

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

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

However, in the maternity ward itself, you won’t need anything other than slippers: usually the necessary linen and clothing are provided at the birth center. maternity hospital. Everything else, including things for the baby, will be brought to you by your relatives after the birth.

Our service will tell you what to take with you to the maternity hospital List of things to take to the maternity hospital

It will be more convenient for doctors, and for you too, if, when you feel the approach of labor, you do not put much strain on your stomach. While waiting for labor to begin at home, limit your diet to light crackers, a cup of broth, and tea.

Trim your nails; You can shave your pubic area yourself - these are mandatory procedures before giving birth.

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

Every pregnant woman, especially if she is expecting a child for the first time, sooner or later asks the question: How do you know when it’s time to go to the maternity hospital? In addition to the obvious “symptoms” of the onset of labor, such as contractions or the release of amniotic fluid, there are also so-called harbingers of labor, which allow you to prepare in advance and understand that the birth of the baby is just around the corner.

What are the harbingers of labor?

Precursors are certain signs that indicate that labor will soon begin.

The last weeks of gestation are characterized by changes in hormonal levels. As a result of the aging of the placenta, the level of progesterone produced by the body, which is responsible for the preservation and normal course of pregnancy throughout the nine months, is reduced. 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. depended on the amount of this hormone. Instead of progesterone, estrogen begins to be intensively produced, which is necessary to prepare the female body for the upcoming birth. It ensures elasticity and patency of the birth canal, as well as the speed of dilation 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.

Precursors of childbirth become an external response to the hormonal changes that occur before childbirth in the body of the expectant mother. Their appearance is absolutely normal, so you should not worry and immediately consult a doctor if a woman discovers one or several signs 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 that preparations for childbirth are not taking place. This only indicates that it passes unnoticed by the woman.

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

What symptoms indicate the imminent onset of labor?

Among the main symptoms indicating the imminent onset of labor are:

1. Loose stool. In order to facilitate the upcoming birth and the passage of the baby through the birth canal, the body begins to remove everything unnecessary. As a result, diarrhea may occur. It can occur several times a day, but is accompanied by dehydration, as well as changes in the color and smell of stool. As a rule, this sign, unlike the others, appears almost before birth in 1-2 days. However, it may be absent if the woman is multiparous.
2. Loss of body weight. As a result hormonal changes, excess fluid is removed before childbirth. The greater the swelling during pregnancy, the greater the swelling. Fluid was retained in the body under the influence of progesterone, but its reduction leads to its release, which helps to reduce weight from 0.5 to 3 kg.
3. Discharge of mucus plug. Created from a special secretion of the cervical canal, the mucus plug 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 slightly, resulting in yellowish-brown discharge that is transparent or jelly-like, but has no unpleasant odor. The mucus plug may come out completely or in parts. As a rule, it is not accompanied by painful sensations, however, the presence of a nagging, mild pain like before menstruation is also a normal option. Once the plug has come off, nothing protects the baby from bacteria, so it is not recommended to take a bath, you can only use a shower.
4. "Dropping of the abdomen." As a rule, the baby is in a cephalic position. Before birth, its head pulls the uterus downward, pressing against the entrance to the pelvis and preparing to move along the birth canal. Thanks to these changes, the uterus stops putting so much pressure on the diaphragm, as a result, the 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 area increases, and as a result, the urge to go to the toilet increases.
5. 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 just below. The pain should not be severe, it resembles a pulling sensation before menstruation. Discomfort can occur either during the release of a mucus plug or during training contractions, or for no apparent reason.
6. Training contractions. Premonitory contractions are contractions of the uterine walls for several seconds. The expectant mother feels how the uterus tenses, “turns to stone,” 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. In addition, 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 should you go to the maternity hospital:

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

- at the first birth

If the mucus plug has come away or any of the above-mentioned precursors of labor have appeared, you should not go to the maternity hospital, they simply will not accept you, since there may still be several days or several weeks before the onset of labor. But when regular contractions begin (not to be confused with training contractions), 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 maternity hospital or, especially, call an ambulance immediately after the onset of contractions. It is necessary to 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 malpresentation of the fetus or premature passage amniotic fluid.

- during repeated births

Repeated births tend to proceed faster, as the cervix softens and dilates much more easily than the first time. On average, the entire process of childbirth for the second and subsequent times takes about 6-7 hours. Therefore, to prevent the birth of a child in a completely unsuitable place, it is necessary to go to the maternity hospital immediately after it has become clear that contractions are regular and the contraction interval is decreasing.

When is emergency help needed?

There is no need to rush into going to the maternity hospital only in cases where labor begins without any complications. But there are certain symptoms, if they occur, you should immediately call an ambulance, as they indicate a risk to the life and health of the child. You should seek emergency help if the following situations occur:

1. Discharge or leakage of amniotic fluid. It is important to understand that even 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 pass between the moment the water breaks and the birth itself. If you are in a hospital under the supervision of doctors and the necessary medications are administered in a timely manner, this period can be 24 hours or more (but such a situation is considered undesirable).
2. Rough discharge or bleeding (scarlet blood) appears. Even a small amount of red discharge may indicate placental abruption or the development of other pathological conditions that threaten the child’s life.
3. Sharp pain between contractions. When the contraction releases, the discomfort should also disappear. If acute or aching pain persists all the time, this is an unconditional sign of the presence of complications.
4. Contractions occur more often than once every 5 minutes. If the interval between contractions is rapidly decreasing, it means that there is less and less time left before giving birth. In this case, it is not recommended to get to the maternity hospital on your own. Also, if you already have a history of rapid labor, or it has previously occurred among close relatives, you must go to the maternity hospital with the onset of the first regular contractions.

It is important to understand that at the first signs of illness or deterioration in health ambulance should 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 time, the second or the third. Precursors of labor are not a reliable guide, since in some cases they may simply not be there. Therefore, after contractions begin, it is important to remain calm, make sure that the contractions are the beginning of labor (and not training contractions), and go to the maternity hospital when the intervals between them are reduced to 10 minutes (first birth) or 15-20 minutes (subsequent ones).

Especially for- Olga Pavlova