How long do training contractions last for 40. Training contractions - sensations and signs. What are Braxton Hicks contractions?

Pregnancy is an amazing time when a woman becomes more sensitive to her feelings. The sensations can be very diverse, but today we will talk about those that raise the most questions - about training (false) contractions. From this material you will know how and why this phenomenon occurs, how to distinguish such contractions from the real ones, and how to behave during training contractions.

A little theory - what is it?

Contractions in general concept- These are involuntary contractions of the smooth muscles of the uterus. In childbirth without contractions, it would be impossible for a child to be born. Muscle contractions seem to push the fetus out of the womb when the time comes.

Training contractions are not associated with labor, they never lead to dilatation of the cervix and the onset of labor. They are called training because for a long time it was believed that it was precisely with such short-term attacks of tension in the uterine muscles during pregnancy that the body of the expectant mother prepares for the real stress of childbirth.

The question of why false (aka training) contractions appear is still open and very controversial. If we take into account the theory of training activity, it becomes not entirely clear how women who have not had a single training contraction during the entire period of bearing a baby give birth. Believe me, there are many such women, and they give birth without any peculiarities, just like women who felt false contractions throughout their pregnancy.

It turns out that training the uterine muscles does not have such of great importance for subsequent births.

Medicine knows another theory of the occurrence of training contractions (synonym - Braxton-Hicks contractions). It is believed that these sensations are “phantom”, not real, and they are associated with increased excitability of the uterus itself, because with the onset of pregnancy and the growth of this reproductive organ, the nerve endings begin to perceive certain neurosignals differently. As a result, the brain is “deceived” and makes the muscles of the uterus ready (a feeling of tone arises). If this is not childbirth, then quite quickly the brain “puts two and two together” and cancels the “order” of high alert. Thus, according to this theory, contractions are "tricks" nervous system pregnant woman.

Women often ask who Braxton and Hicks are, who wrote the first description of strange contractions that do not lead to labor. In fact, this is one person - the English doctor John Braxton-Hicks, who, back in the 19th century, observed pregnant women and described a mysterious phenomenon. Since that time, his colleagues and followers have not advanced one step towards establishing the truth - the nature of the occurrence of false contractions remains a big mystery.

Speaking about training contractions, a woman should clearly distinguish between several of their types. Those that appear long before birth are called false, training. And those that start a couple of weeks before birth are preliminary contractions. They are also known as precursors. They, like early false ones, do not lead to the opening of the cervix and the beginning of the expulsion of the fetus from the womb, but they occur more often. Preliminary contractions can rightfully be called training contractions, since it is before childbirth that the muscles and ligaments begin to relax under the influence of a special hormone - relaxin. It is its action that becomes the beginning of the preparatory period for all organs involved in childbirth.

Should I be afraid of training bouts? The answer to this question lies in the very definition of the phenomenon. They do not lead to dilatation of the cervix, do not stimulate or bring the day of birth closer, and do not in any way affect the condition of the fetus. Therefore, there is no need to worry, the main thing is to know how to behave during false contraction-like activity, as well as how to distinguish such contractions from real ones. Let's talk about this in more detail.

When do they start?

The timing of the appearance of false contractions is another complex and controversial issue. Officially, medical sources indicate that a woman can theoretically begin to feel Braxton-Hicks contractions after the 20th week of gestation. In practice, these periods may well turn out to be different from theory - for some they begin before 20 weeks, for some they appear only at 30 weeks, and for some only precursor contractions occur, which begin a couple of weeks before the baby " will gather" into our world. There are women who do not feel any training tension in the muscles of the uterus at all, and this, too, is completely normal.

Experienced obstetricians and gynecologists have long noticed a certain pattern in the appearance of Braxton-Hicks contractions depending on the number of previous births. Thus, in primiparous women, such sensations may appear much earlier. And in multiparous women, such contractions usually appear immediately closer to the expected date of birth. This can be explained by the difference in the state of the smooth muscles of a woman who has given birth and a woman who has not previously given birth. In those who have already given birth, the smooth muscles are more elastic and stretched, the growth of the uterus and its intensive filling with blood proceed more “softly”, as usual.

The opinion that the early appearance of training contractions increases the likelihood of premature birth is not true. Be that as it may, such sensations only look threatening at first glance, if you look at the phenomenon more closely, you can understand that the presence or absence of training activity of the uterine muscles does not affect the date of birth. Often, those who began to feel false contractions at week 20 carry the pregnancy to term and give birth only after 42 weeks, and those who have not had such contractions are sent to the maternity hospital much earlier than their due date.

Symptoms and sensations

Many official medical sources authoritatively state that false or training contractions are completely painless. In practice, and reviews from women are clear proof of this, much depends on the individual degree of sensitivity. One pregnant woman may indeed not feel anything disturbing, but another will feel quite unpleasant.

The contraction is manifested by tension in the muscles of the uterus. Many pregnant women describe that their “stomach turns to stone” and becomes tougher. A pulling sensation may occur in the very lower abdomen (due to tension in the ligamentous apparatus that holds the uterus). A pulling sensation may appear in the lumbar region (for the same reason). Often women claim that the sensations are very similar to how menstruation feels.

Tension in the uterus may persist for several seconds or several minutes. After this, it disappears and does not appear, or appears, but not at certain cyclical intervals. It is the fact that training contractions are irregular that allows us to understand what is really happening. Regular contractions are a sign of the onset of labor. Spontaneous episodes of increased tone are false contractions.

Even if the contraction repeats several more times within an hour, it will not become more noticeable. Painful sensations intensify only during real labor contractions, and during false ones they always weaken and decrease.

The appearance of such tension can arise spontaneously at any moment, even where it is completely inappropriate - at work, in transport, during an important meeting.

There are also circumstances that indirectly or directly increase the frequency of such false episodes.

• Active intimate life. During sexual arousal and orgasm, small contractions of the smooth muscles of the uterus occur, so after sexual intercourse, Braxton-Hicks contractions may occur within an hour or two. This is not a reason to refuse intimate relationships if a woman has no other contraindications.
• Big physical activity future mother. Bending over, lifting weights, walking up stairs, rarely resting, constantly being on your feet - all this can provoke the appearance of false contraction-like muscle activity.
• Child activity. Overly active babies, who often and painfully “kick” the expectant mother from the inside, can also indirectly cause increased nervous excitability of the uterus.
• Stress. At the time of strong emotional experiences, a woman often feels tension in the uterus, but most often false contractions “visit” expectant mothers after stress, as soon as the woman relaxes a little.
• Full bladder. If the expectant mother does not have the opportunity to go to the toilet (she is in a public place where there is no toilet, she is traveling in transport), then the bladder filled with urine is strongly compressed by the uterus. But there is also counter pressure - on the uterus. This effect causes short-term tension in the muscles of the reproductive organ.

There is also an individual pattern in the appearance of contractions and certain actions of a pregnant woman. For example, for some, false uterine tension begins to appear after a woman gets out of bed in the morning and stretches, while for others, only after women get up from a sitting position. For others, after taking a shower. Therefore, you need to carefully observe in what situation Braxton-Hicks contractions most often develop in you in order to reduce such situations to a minimum or be psychologically prepared for them.

Over the years of monitoring pregnant women, doctors noticed that Training contractions most often occur in the mornings and evenings. After a hearty meal, the likelihood of feeling uterine tension is higher than after a moderate dinner or breakfast. On average, the period of false hypertonicity lasts from 15 minutes to 2-3 hours, but there are also isolated contractions, as well as longer periods - everything is very individual, no two identical symptomatic signs can be found.

Differences from the real ones

The question of how to distinguish training episodes of contractive activity from real labor contractions is asked very often, especially by first-time mothers. A woman who has no experience in childbirth is afraid of being confused, not being able to detect it in time, not recognizing real contractions and not being able to get to the maternity hospital on time. The question becomes especially relevant as the expected date of birth approaches - at 38-39 weeks, as well as a little earlier and a little later. Believe me, distinguishing one from the other will not be so difficult. When real contractions come, they will not at all resemble false ones. Here are the main differences.

• Painful sensations. Once labor begins, each subsequent contraction feels more painful than the previous one. This never happens with premonitory or early training episodes of tone. During true contractions, the cervix opens, which is why the pain will become more and more intense.
• Duration of the fight. If it’s a matter of training and preparation for childbirth, then each subsequent contraction does not increase in time. No need to worry. If the contractions are painful, and each subsequent one lasts a long time, no less than the previous one, we are talking about labor. You need to arm yourself with a stopwatch or a special counter program on your smartphone and simply measure the duration of two or three consecutive episodes of uterine tension.
• Frequency. Preparatory contractions are not regular. They can be repeated at random intervals, while the real ones will be very rhythmic (will occur at certain intervals). At first - at large intervals, then the contraction will become strong, long, and the episodes will become frequent. If periods of uterine tension become more frequent and occur at regular intervals, it’s time to go to the maternity hospital.
• Measures to reduce sensations. If a woman during a false contraction simply changes her body position, takes a shower, takes a pill, she will feel noticeable relief. True contractions cannot be numbed; they also will not respond to showers and changes in body position. It is impossible to stop labor that has started.

To accurately distinguish the type of contractions, you need to analyze other accompanying signs. If cyclical tensions of the uterine muscles arose after the passage of the mucus plug, after the discharge of water, or the discharge and discharge of amniotic fluid happened after the appearance of contractions, then you cannot hesitate - labor has begun, so it will be better for everyone if the woman ends up in a hospital as soon as possible under the supervision of a qualified medical personnel.

There is a joke among obstetricians: “If you're not sure you're in labor, you're not in labor yet.” Think about it and calm down. When the time comes, the question of the differences between the types of uterine contractions will not arise.

Are Braxton Hicks contractions dangerous?

This question comes from time to time to all women in an “interesting position” who feel such sensations. Expectant mothers who are at risk of premature birth and pregnancy pathologies are especially worried. Let us reassure everyone at the same time - Braxton Hicks contractions do not pose a danger to either the mother or the fetus.

There is one theory (it’s hard to say how scientific it is, but doctors often say this to their worried patients), which says that a training contraction increases blood supply to the reproductive organ, as a result of which, after relaxing the muscles, the child receives more nutrients and oxygen, and therefore false contractions can easily be classified as useful and productive.

If there is still a lot of time left before giving birth, and training contractions occur frequently, for example, they are present all night, then you should still visit a doctor to find out the causes of uterine hypertonicity. If even the next morning such contractions disappear, consult an obstetrician-gynecologist. This will make everyone calmer.

How to behave in case of false contractions?

If false contractions appear, the woman will have to come to terms with them. Even if uterine tension causes discomfort, there are many ways to alleviate the condition and live with these training episodes until childbirth in relative comfort. What should I do?

• Change the position of the body in space. If a training contraction has begun, you need to try to change your position. If at this moment the woman was lying down, it is better to get up and walk around, if she was sitting, to lie down, and if she was standing, to sit down or take a horizontal position. The “cat pose” helps well - a knee-elbow position with a bend of the spine in the lower back. You can use it to avoid wasting time and practice proper breathing; this will come in handy when the time comes to give birth.
• Don't pay attention. If a false contraction is quite gentle and does not bother you much, it is best to ignore it - turn on your favorite movie, good music, open an unread book, or return to needlework that was put off for later. This will help you take your mind off things.
• Walk. The advice is simple and effective. During a leisurely and sedate walk in a park or square (away from city roads), a pregnant woman and her baby receive positive emotions and oxygen. Regular walks reduce the frequency and duration of false contractions several times.

• Water procedures. A warm shower helps relieve unpleasant symptoms. It is better to refrain from taking a bath. A shower for 5-10 minutes will help you completely relax and get rid of tension in the walls of the uterus. If a woman’s contractions occur frequently and bother her greatly, it makes sense to buy a subscription to the pool, to a special group for expectant mothers - swimming will help reduce the frequency and duration of Braxton-Hicks episodes.
• Medicines. Tablets and other medications should be used only in extreme cases, if the sensations are very disturbing. It would not be a bad idea to consult a doctor first. Most often, pregnant women are recommended to relieve increased uterine tone.

Update: October 2018

As the due date approaches, the expectant mother has more and more questions. Among the many topics of concern to pregnant women is the following: what are false contractions during pregnancy? Unfortunately, not every obstetrician considers it necessary to explain the essence of false contractions, how they differ from real contractions and whether this is normal. Most pregnant women experience false contractions and, as a rule, shortly before giving birth. In addition to such contractions, a number of other harbingers indicate the approaching birth, which are difficult not to notice.

Harbingers of childbirth

The gestation period for women lasts on average 280 days or 40 obstetric weeks. By the end of this period, about 2 weeks before, harbingers of labor appear, which inform about its imminent onset. Thanks to the harbingers, the woman understands that the long-awaited meeting with the baby will soon come. These signs appear in all women, in some they are well expressed, while others do not notice them at all. But childbirth rarely begins suddenly, “without warning,” and the period of harbingers is laid down by nature so that the woman has time to prepare and tune in to childbirth. The appearance of all the precursors of labor is not at all necessary; the occurrence of one or two should already alert the woman.

False contractions

The concept of false contractions was introduced by the English doctor Braxton-Hicks at the end of the 19th century, which is why they are also called Braxton-Hicks or training contractions. False contractions are periodic, spontaneous muscle contractions of the uterus. Their appearance is registered as early as 6 weeks of gestation, but in most pregnant women they are felt only after 20 weeks. By the end of pregnancy, at about 38 weeks, false or training contractions are felt by expectant mothers in 70% of cases. Such contractions are called false, since they do not lead to the start of labor and stop on their own.

Abdominal prolapse

The belly drops in expectant mothers a couple of weeks before birth in first-time mothers and a few hours in multiparous mothers. This is due to the fact that the presenting part of the baby, usually the head, is pressed against the entrance to the pelvis, pulling the uterus along with it. At the same time, its upper part (bottom) also descends, which relieves the pressure of the uterus on the chest and abdominal cavities. From that moment on, the woman notices easier breathing, shortness of breath disappears with little physical activity, but being in a sitting position or walking becomes more difficult. Since the uterus no longer lifts the stomach, heartburn and belching disappear. But the downward movement of the uterus increases pressure on the bladder, which is manifested by increased urination.

With prolapse of the uterus, a feeling of heaviness in the lower abdomen and discomfort in the area of ​​the inguinal ligaments may occur. It is also possible that tingling may occur in the legs and lower back. These symptoms are associated with irritation of the nerve endings located in the pelvis when the head is inserted into its entrance.

The mucus plug comes off

This sign is considered the most characteristic, it is difficult not to notice it. Cervical glands with early dates pregnancy begins to produce a thick secretion that fills the cervical canal and prevents the penetration of pathogenic microorganisms into the uterine cavity, thereby protecting the fetus and amniotic fluid from infection. On the eve of childbirth, the production of estrogen in a woman’s body increases, due to which the cervix begins to soften and open slightly, which facilitates the passage of the mucus plug. Characteristic signs of its discharge are jelly-like mucous clots that are visible on the underwear. The color of the mucus plug varies from white or transparent to yellowish or pinkish. Often, streaks of blood are visible in the plug, which is considered normal and indicates the imminent onset of labor (within 24 hours). The mucus plug is released either entirely at once, or in parts throughout the day. Removal of the plug is painless, but drawing pain in the lower abdomen may occur. The time it takes for the plug to come out varies. It can go away either 2 weeks before the onset of labor or immediately with the onset of contractions.

Weight loss

One to two weeks before the onset of contractions, the pregnant woman’s weight decreases (by about 500 grams - 2 kg). The effect of progesterone, which retains fluid in the body, decreases, and estrogens come into play. As a result, excess fluid is removed from the body, swelling is reduced, and it is much easier to put on shoes and put on gloves with rings.

Changes in urination and bowel movements

Most pregnant women notice the appearance of constipation before childbirth, which is associated with compression of the rectum by the presenting part of the child. But the opposite situation is also possible - the occurrence of diarrhea. Urination also becomes more frequent, as the fetal head puts pressure on the bladder, causing a frequent desire to urinate. Urinary incontinence is possible, especially during physical activity.

Change in fetal movement

Towards the end of pregnancy, the expectant mother notices a decrease in the child’s motor activity. This is due to rapid growth and increase in fetal weight. The baby becomes cramped in the uterus, which is reflected in his movements; they become fewer.

Frequent mood changes

On the eve of childbirth, a pregnant woman is characterized by frequent mood changes. Activity and efficiency suddenly gives way to tears, which is caused by neuroendocrine processes and fatigue by the woman. Often, expectant mothers become apathetic, drowsy and seek solitude. All these signs indicate the accumulation of energy before the upcoming birth.

Causes and characteristics of false contractions

What are false contractions for? First of all, they keep the uterus in good shape, “train” it before childbirth and create conditions for the “ripening” of the cervix. Secondly, thanks to training folds, blood flow to the child increases, which contributes to its better saturation with oxygen and nutrients. It becomes clear that false contractions are absolutely normal manifestations that you should not be afraid of. There are a number of factors that can cause false contractions to occur.

Provoking factors

Training contractions appear under the following conditions:

• excessive physical activity (housework, sports, prolonged standing, etc.);
• taking a hot shower/bath;
• increased motor activity of the fetus;
• drinking strong alcohol frequently (stimulates the nervous system and increases the tone of the uterus);
• emotional stress, stress;
• active sex and orgasm (the release of oxytocin, which promotes uterine contractions);
• smoking and drinking alcohol;
• fatigue, sleep disturbance;
• a full bladder (puts pressure on the uterus, forcing it to contract);
• (the volume of circulating blood decreases, the blood supply to the uterus deteriorates, which provokes its contractions);
• improper or insufficient nutrition;
• multiple pregnancy or large fetus (the space is too small for the child/children, any movement of them irritates the uterine walls);
• overeating or feeling hungry, drinking soda (causes the stomach to contract, the irritation of which is transmitted to the uterus);
• touching the stomach by a stranger.

Characteristics of false contractions

As indicated, false contractions occur in the second half of gestation, but usually on the eve of childbirth (at 38–39 weeks of pregnancy). As a rule, training contractions appear in the evening, when the woman is resting. These contractions do not cause pain and occur irregularly and infrequently. In addition, false contractions only prepare the cervix for dilatation, but do not cause it. Some expectant mothers may not feel false contractions, but this does not indicate abnormalities.

Symptoms and sensations

Since each body is individual, the symptoms of false labor may vary. Some feel them well due to the significant intensity and severity of the unpleasant sensations, while for others they pass almost unnoticed. Characteristic signs of training contractions include:

• contractions are irregular, it is impossible to catch the rhythm of their occurrence (they can occur every 5 - 6 hours (but less than 6 times per hour) and after 1 - 2 days;
• the duration of false contractions is short, a few seconds, no more than a minute;
• tension (compression) of the uterus;
• Vivid sensations during contractions do not cause pain, but bring discomfort;
• usually occur in the evening or at night, when the woman is resting (during the day, expectant mothers often do not pay attention to them);
• the intensity of contractions quickly decreases with changes in body position.

What does it feel like to have false contractions? In many cases, training contractions are painless, and expectant mothers tolerate them quite easily. But in the case of a low threshold of pain sensitivity, false contractions are very unpleasant and even require assistance. The sensations during false contractions are reminiscent of menstrual pain: they are of a pulling nature and occur in the lower abdomen. A woman can also feel the hardening of the uterus herself by placing her hand on her stomach.

Differences between real contractions and false ones

How to distinguish false contractions from real ones? Signs of training and true contractions are shown in the table:

How to deal with false contractions

To eliminate the discomfort caused by training contractions, following some recommendations will help:

Walk

A leisurely walk in a park or square will not only help eliminate discomfort, but will also enrich the mother’s blood with oxygen, which is beneficial for the baby.

Change body position

Sometimes it’s enough to change your body position and take the most comfortable position. If a pregnant woman is lying down, you can stand up and take a few steps, or sit down while standing for a long time.

Get distracted

Watching your favorite movie, listening to calm music or reading a book will help you unwind and relax.

Warm water

Taking a warm shower or bath with aromatic oil can help relieve Braxton Hicks contractions.

Correct breathing

The occurrence of false contractions is an excellent moment to practice proper breathing during childbirth, which was taught in classes at mothers’ school. Take deep breaths through your nose, trying to exhale slowly and smoothly through your mouth, with your lips pursed into a tube. You can try breathing like a dog - intermittent and frequent, but do not get carried away, otherwise you will feel dizzy.

Drink water or have a snack

If false contractions are caused by dehydration, drinking a glass of plain water is enough to relieve them. In case of hunger, even mild, which provoked uterine contractions, you should have a snack that is easily digestible and nutritious (for example, a banana).

When to call an ambulance

Sometimes situations arise when you urgently need to call an ambulance or contact your doctor:

• the gestational age at which uterine contractions appeared is less than 36 weeks (the threat of premature birth cannot be ruled out);
• the occurrence of moderate or heavy bleeding (suspicion of placental abruption);
• the appearance of watery discharge (possible leakage of amniotic fluid);
• discharge of the mucus plug before 36 weeks;
• pressing pain in the sacral and lumbar regions;
• feeling of pressure in the perineum;
• excessive physical activity of the child or its sharp decrease;
• the frequency of contractions is 3 or more in 10 minutes (the beginning of labor).

Preliminary period - what does it mean? The preliminary period is the period of time during which a woman’s body prepares for childbirth. That is, the preliminary period can be called the preparatory period, during which the harbingers of childbirth appear. A normal preliminary period is recorded in 30–33% of women at the end of gestation (38–40 weeks). The physiological preliminary period is characterized by:

• contractions that occur with varying frequency, duration and intensity, but lasting no more than 6 – 8 hours;
• contractions may disappear on their own and reappear after 24 hours;
• the pregnant woman’s sleep and general well-being are satisfactory;
• the expectant mother is fully ready for childbirth (“mature” cervix, positive mammary and oxytocin tests, etc.);
• the uterus is in normal tone, the fetus does not suffer in utero;
• in 70%, the normal preliminary period develops into adequate labor.

Pathological preliminary period

A pathological preliminary period is spoken of when the preparatory period is prolonged, characterized by irregular but painful contractions that do not contribute to structural changes in the cervix. It is diagnosed in 10–17% of pregnant women and, as a rule, develops into labor anomalies (weakness of contractions or incoordination of contractions). IN foreign literature This pathology is called “fake childbirth.”

Reasons

The pathological nature of the preliminary period can be provoked by:

• emotional lability and neuroses;
• endocrine pathology (obesity or underweight, disorders menstrual cycle, genital infantilism and others);
• somatic pathology (heart defects, arrhythmias, hypertension, kidney and liver diseases);
• chronic inflammatory processes of the uterus and cervix;
• large fruit;
• (dystrophic processes);
• fear of childbirth, unwanted pregnancy;
• first births in women under 17 and over 30;
• little-and;
• incorrect position of the fetus and placenta;
• and so on.

How it manifests itself

The clinical picture of the pathological preliminary period is characterized by painful contractions that occur not only at night, but also during the day. Contractions are irregular and do not become true for a long time. The pathological preliminary period can last from one to ten days, which disrupts the pregnant woman’s sleep and contributes to her fatigue.

The cervix does not undergo structural changes, that is, it does not “ripe.” It is long, located anteriorly or posteriorly, dense, and the outer and inner pharynx are closed. Also, the lower segment of the uterus does not unfold, and the uterus itself is easily excitable and has increased tone.

The presenting part of the child does not press against the entrance to the pelvis for a long time, despite the absence of any discrepancy between the sizes of the baby and the mother’s pelvis. The presence of hypertonicity of the uterus makes it difficult to palpate the head and small parts of the child.

Uterine contractions are monotonous for a long time, the intervals between them do not shorten and the intensity of contractions does not increase. The psycho-emotional status of the expectant mother also suffers. She is irritable and whiny, aggressive and afraid of childbirth, doubting its successful completion.

The long course of the pathological preliminary period is often complicated by premature rupture of water and. Due to energy consumption, this pathology often develops into weakness of the birth forces.

Autonomic disorders are often observed (neurocirculatory dystonia, increased sweating), the woman complains of pain in the lumbar and sacral regions, palpitations and shortness of breath, painful movements of the baby.

Question - answer

Question:
I am about to give birth for the first time and I am afraid that I will not be able to distinguish false contractions from true ones. What should I do?

Many first-time women are afraid to miss real contractions, mistaking them for false ones. Doctors recommend: if there is any doubt about false contractions, especially if they are painful and last a minute or more, you should go to the maternity hospital. The obstetrician will conduct an internal vaginal examination and evaluate maturity and. If the alarm is false, the woman will be sent home with a recommendation to report to the antenatal clinic in 2 to 3 days.

Question:
When I gave birth for the first time, the doctors told me about some incorrect preparatory contractions and after a while they opened the amniotic sac, after which I gave birth myself. What was it and is there a high probability of this situation repeating in the second birth?

During your first birth, you experienced a pathological preliminary period. The likelihood of its development in the second birth depends on many reasons, but first of all on the mood for the successful completion of childbirth. Attend mothers' school, practice self-hypnosis and breathing exercises, try to get rid of the fear of childbirth and follow the doctor's recommendations. Competent psychoprophylactic preparation for childbirth will significantly reduce the chances of a pathological course of the preparatory period.

Question:
I am 41–42 weeks (recalculated at the antenatal clinic), but there are no false contractions or other precursors of labor. What to do?

You may be postterm pregnant. To stimulate labor, use natural methods (long walks, sex, certain foods, etc.).

Question:
How is the pathological preliminary period treated?

The tactics for managing a woman depend on the duration of the pathological preparatory period, the condition of the cervix, the intensity of pain, and the condition of the mother and child. If the cervix is ​​“mature” and the duration of this pathology is less than 6 hours, the amniotic sac is opened to stimulate contractions. If the cervix is ​​“immature”, but this period lasts 6 hours or less, sedatives (Relanium) are prescribed and the cervix is ​​prepared (prepidil-gel intracervically). In the case of a prolonged course (more than 10 hours) of the pathological preparatory period, medicinal sleep-rest is prescribed, after which the pregnant woman wakes up in the active phase of contractions.

Training contractions are tension in the muscles of the uterus during pregnancy, which does not lead to the onset of labor. Normally, they are safe for the mother and fetus and are aimed at preparing the reproductive organs for the birth of a child.

Training contractions during pregnancy were first described by the English scientist, obstetrician-gynecologist John Braxton Hicks, in the 19th century. By observing expectant mothers, he was able to explain the reason for the appearance of false uterine contractions and their benefits for future births.

If you prefer to receive information through audio and video formats, we suggest listening to this article about contractions in our video.

The mechanism of training contractions

The uterus consists of three layers of muscles that extend into different directions. During natural childbirth, hormonal changes and the functioning of the nervous system are synchronized, which stimulate the contraction of all myometrial fibers simultaneously.

With false contractions, the woman’s body is not yet ready for the birth of a child. The concentration of estrogen has not reached the required level, there is not a sufficient level of prostaglandins, and the “generic dominant” has not been formed. The fetus also has not undergone the necessary changes; it stimulates the mother’s body by increasing the activity of its own adrenal glands.

What are Braxton Hicks contractions from an obstetrics perspective? This is a spasm of individual muscles of the uterus, which prepares the myometrium for childbirth.

During false contractions, uterine and placental blood flow is stimulated, and the fetus receives more oxygen and nutrients. In the later stages, under the influence of uterine contractions, the membranes peel off from the walls of the uterus, stimulating the synthesis of prostaglandins necessary for cervical ripening.

When to expect training contractions to appear

Braxton Hicks contractions may occur with... It is impossible to predict the exact date. It is believed that during the first pregnancy they become noticeable later than during the second pregnancy.

The optimal time for false contractions to appear is after 36–38 weeks. By this time, the fetus has matured, its adrenal glands begin to function, and surfactant is produced in the lungs. Therefore, the gradual maturation of the cervix and the approach of labor are not dangerous and are physiological.

But some pregnant women experience Braxton Hicks contractions after 20–22 weeks.

The exact causes of this condition have not been established, but suggest the influence of the following factors:

• Dehydration – insufficient fluid intake and its active loss in hot weather, with gestosis, gestational diabetes.
• Stressful situations – severe emotional experiences, nervous tension at home and at work increases the release of norepinephrine, adrenaline, and increases the likelihood of uterine contractions.
• Overwork – women who do not reduce physical activity and spend a lot of time on their feet have a risk of false contractions.
• Full bladder – due to pressure on the lower segment of the uterus, reflex contractions may occur.

Training contractions can appear in primigravidas and when carrying a child again. A direct relationship with birth rate or parity has not been established.

How Braxton Hicks Contractions Feel

Each pregnant woman has her own level of pain threshold, and therefore tolerates it differently. Training uterine contractions during pregnancy vary in intensity, but depending on individual sensitivity, women may not feel them or complain of abdominal pain. But they do not cause significant discomfort and do not impair the ability to move.

Symptoms of Braxton Hicks contractions are more likely to appear late in the day or at night. The sensation is reminiscent of cramps during menstruation. Sometimes, with a high pain threshold, there is no discomfort, but the uterus is hard to the touch. Its tension decreases after a few seconds or minutes.

Training contractions are sudden, but irregular. The time intervals between them are different. It is recommended for a pregnant woman to note the time after which the uterus becomes toned. If the breaks are long, varied in duration and are not shortened, there is no reason to worry.

Due to the peculiarities of the mechanism of occurrence of false contractions, pregnant women may feel them differently. Not all layers of the myometrium are involved in the process, but only some bundles. A woman experiences a feeling of tension in the front of her abdomen. But reflex pain in the lumbar region may bother you.

The peculiarity of this condition is that it is normally tolerated. The sensations do not force a woman to stop her work, stop, or immediately freeze. During the daytime, up to 30–34 weeks, some pregnant women do not notice that sometimes the uterus becomes toned. But closer to the time of birth, false contractions become more noticeable.

Differences between training contractions and labor contractions

To accurately recognize training contractions, you need to compare them with the real ones that a woman experiences during childbirth. The table shows the features of each condition.

How to Reduce Discomfort from Braxton Hicks Contractions

Training contractions during pregnancy are usually well tolerated, but closer to the time of birth they can begin to cause significant discomfort. To make it easier, you can use simple techniques:

• Go to the toilet. A full bladder can stimulate uterine contractions. To relieve the condition, you can have a bowel movement.
• Relax . If Braxton Hicks contractions occur after a trip on public transport or psychological stress, you can lie down in silence, with the lights dimmed, or take a short nap.
• Change body position . When contractions occur at night, it is often enough to turn over to the other side. Some women prefer to get out of bed and walk around a bit.
• Take a walk . In good, cool weather, a pregnant woman can go for a walk. This will help ease contractions and oxygenate the blood. But you need to avoid roads along highways and near industrial enterprises, optimal place– coniferous park.
• Eliminate fluid deficiency . You can drink a glass of water at room temperature, which will be absorbed faster than cold liquid. Warm tea, compote or fruit juice helps a lot. It is allowed to use soothing tea.
• Perform breathing exercises. It will help distract you from unpleasant sensations and saturate your blood with oxygen.
• Take a warm shower. Water will help relieve tension, relax muscles and reduce contractions.

When to see a doctor

Sometimes training contractions before childbirth occur with additional symptoms that reflect a threat to the condition of the pregnant woman or fetus. To ensure timely medical care, you must consult a doctor in the following situations:

• Liquid discharge appears from the genital tract – after 22 weeks, when the tone of the uterus increases, amniotic fluid may come out if the membranes are ruptured.
• Bloody discharge – up to 38 weeks, even scanty mucous-bloody spots on underwear should be alarming; later it may be a mucus plug.
• Bleeding – dangerous at any time, most common reason– which threatens the life of the fetus and the pregnant woman.
• Absence of fetal movements or too active kicks - a reason to urgently consult a doctor.
• Sharp abdominal pain after a short-term increase in tone - one of the signs of uterine rupture along a scar, which in rare cases occurs in women who have undergone other operations.

If training contractions gradually become regular and the interval between them shortens, there is a possibility that labor will begin. Therefore, the expectant mother needs to check her bag and documents required for the maternity hospital.

What to do if the term is long, but there are no training contractions

Training uterine contractions are not a mandatory symptom for pregnant women, and some do not even notice their occurrence. If you haven't experienced Braxton Hicks contractions after 38 weeks, don't panic. For the doctor who is managing the pregnancy, what is more important is the appearance of signs of ripening of the cervix, its shortening, softening and expansion of the canal.

False uterine contractions are one of the signs of the imminent onset of labor; normally they occur 1–2 weeks before the baby is born. This condition is not accompanied by severe discomfort and is not dangerous for the fetus or the pregnant woman. But if additional symptoms appear, it is recommended to consult a doctor.

Useful video about training contractions

List of sources:

• Obstetrics: national guidelines. Ed. E.K. Ailamazyan, V.I. Kulakova, V.E. Radzinsky, G.M. Savelyeva. Ed. "GEOTAR-Media" - 2009.
• Premature birth: educational manual / V. N. Sidorenko, E. N. Kirillova, S. A. Pavlyukova. – Minsk: BSMU, 2018.
• John Braxton Hicks (1823–97) and painless uterine contractions. Peter M Dunn. Arch Dis Child Fetal Neonatal Ed 1999.

I like!

The first training contractions of Braxton Hicks appear, because... The woman’s body begins to prepare for the birth of a child.

Let's look at a number of questions on this topic:

• What sensations do they evoke?
• How to distinguish them from the true ones that accompany the onset of labor.

• Do false painful contractions necessarily begin before childbirth?
• How long (how long) do they last?

What's happened

In order to imagine what preliminary contractions are, it is necessary to understand what happens to the uterus during gestation and before childbirth.

As pregnancy progresses, the walls of the uterus become stretched and, as a result, tone decreases. But in order for the process of giving birth to a baby to be successful and safe, the uterus must contract strongly at the time of birth.

False contractions during pregnancy simulate labor, creating the conditions for a little training before childbirth.

They serve as a preliminary test of the body’s readiness for the end of pregnancy. A woman should not be afraid of false uterine contractions.

However, you should carefully monitor the condition of your body so that training contractions do not turn into real uterine contractions before childbirth.

How to understand and distinguish from real ones

Having asked such a question, first-time mothers will probably hear the same answer: “ When the real contractions begin, it won’t be confused with anything!».

That's right.

But how can a woman who doesn't know how to distinguish between true and false contractions know what they look like?

There are certain signs based on sensations.

So, what are Hicks false contractions?

• Irregular

The main feature that distinguishes Hicks' training contractions from real ones.

Before childbirth, contractions become regular and the intervals between them become shorter. Sometimes this happens quickly, and sometimes very slowly. But the dynamics still remain.

If you notice small contractions of the uterus and they do not occur regularly, then you should not worry.

Try to record how many times the symptoms occur within an hour.

In the case when contractions are repeated more than four times per hour, you should be patient and start counting the time between them.

It is possible that contractions of the muscular layer of the uterus begin immediately before childbirth. Of course, we are talking about a period of more than .

Are the intervals getting shorter? Training contractions!

• Painless (relatively)

When contractions of the uterine muscles begin before childbirth, they are really painful. And, over time, this pain only increases, and frequent contractions are also noted.

If the contractions are irregular and painless, then most likely the body is simply checking your readiness for the birth process and these are false symptoms.

• Appears in the evening or at night

The woman relaxes, all the worries of the day recede into the background. The most opportune time is coming, since the pregnant woman carefully listens to her body and the child’s behavior.

Therefore, new sensations are much easier to notice. And the likelihood of noticing Hicks' training contractions is higher.

• Short-term

A very characteristic sign.

False (training) contractions last on average from 30 seconds to a minute and a half.

Real contractions, indicating the onset of labor, take a significantly longer period of time.

• Stops after changing position

If, having felt the contractions of the uterus, you decided to change your position and everything went away, then it was false contractions.

In order to alleviate your condition and diagnose Braxton Hicks training contractions, experts recommend changing your position or taking a short walk.

This does not mean that you need to leave the house alone and go for a walk in the nearest park. Just walk around the apartment, change your position. Move from the sofa to the armchair, go to the kitchen, put the kettle on the stove.

If all the unpleasant sensations disappeared, then the symptoms were definitely false. When true uterine contractions begin before childbirth, you should call an ambulance or go to the maternity hospital yourself.

During labor pains, no change in position or attempts to walk will alleviate the woman’s condition.

Should you see a doctor?

There are Braxton Hicks symptoms when you should see a doctor. What points should a pregnant woman be wary of?

“I started having contractions, hurry to the maternity hospital!” - the wife screams early Saturday morning. The sleep-deprived husband drives the car through the city streets, and... at the next traffic light it turns out that everything has passed. Happy, but a little dazed married couple stops at a nearby cafe to have breakfast. Similar situations happen quite often, and training contractions are to blame. Let's figure out what they are and how to distinguish them from the real ones.

What are training contractions?

As you can easily guess from the name, they are not real. These uterine contractions are not aimed at starting the labor process. They are usually irregular, rare, and do not cause significant pain 1 .

This phenomenon has other names. Sometimes they are called even more obviously - false, as opposed to true labor pains. In the specialized literature you can find the term “Braxton-Hicks contractions” after the name of the English obstetrician-gynecologist 2, who first drew attention to them and described them.

Why do they happen?

Medicine does not have an exact answer to this question. There is not even a consensus on whether they are part of the normal pregnancy process or a deviation from it. Most experts adhere to the first version, considering them to be a warm-up for the body before real childbirth 3 .

It is assumed that false contractions are needed to maintain the tone of the uterus - it, like any other muscular organ, requires periodic exercise. On the other hand, the arrival time and frequency of training contractions differ greatly among different women, and some mothers who have successfully given birth are not familiar with these sensations at all.

What week do training contractions begin?

They can begin already in the middle of pregnancy - from the 20th week 1, in rare cases even earlier. 2–3 weeks before the planned date, their frequency often increases. In this period they are called precursor, emphasizing that there is not long left before childbirth. However, even in the later stages, training contractions do not cause dilation of the cervix and continue to remain only the body’s preparation for the main event.

Contractions last several seconds, rarely up to 1 minute, and end as suddenly as they come 1. Then the expectant mother begins to listen to her feelings and wait for new ones, but they do not repeat themselves. When the woman has completely calmed down, contractions may return after a considerable time - 4-5 hours.

After several unexpected cases, false contractions become familiar, and the expectant mother ceases to be afraid of them. However, in the last weeks until hour X, they may surprise you again - often training contractions before childbirth become longer and more intense.

How do you feel during training contractions?

False contractions are not painful, but, unfortunately, if this is your first pregnancy, you have nothing to compare with. But there is another sure sign: all the muscles of the uterus are involved in labor contractions, and during training pain sensations are localized only in one area 4.

Frequency and localization of training contractions of the second and early third trimester, precursor contractions, labor contractions. Example.

False contractions usually appear as muscle spasms in the back, front, or top of the uterus. The intervals between them are irregular, and it is impossible to predict where the attack will move next time. A few weeks before giving birth, training contractions, which are now called precursor contractions, will become more frequent, but will retain their character - an attack localized in one area of ​​the uterus. During labor contractions, all the muscles of the uterus contract simultaneously.

Are training contractions dangerous?

There is no evidence that training contractions have any effect on fetal development. Their only danger is psychological. Some women, feeling unexpected contractions of the uterus, panic, and in this state they can do stupid things.

Remember that the onset of any contractions, even labor, does not mean that you will give birth in the next few minutes. There is time, so you need to calm down, take a deep breath and listen to your feelings. If you can't tell whether these are practice contractions or real contractions, call your doctor and describe your symptoms. After listening to your answers, he will tell you what to do - go to the maternity hospital or stay at home.

How to distinguish training contractions from contractions before childbirth?

Expectant mothers can almost accurately identify training contractions during their second and subsequent pregnancies. While you do not have experience yet, we recommend paying attention to the following 5 signs:

Training contractions are rarely painful, rather unexpected. The same cannot be said about labor - many women compare these sensations with very severe pain during menstruation.

Training contractions can usually be stopped. Leisurely walking around the room, breathing exercises and other calming exercises can completely eliminate discomfort in the uterine area.

They are not regular and have no obvious dynamics. In real contractions, on the contrary, there is regularity, a gradual increase in duration and a decrease in the interval between them.

For simplicity, we have collected the distinguishing features of false and true contractions in a table:

Is it possible to calculate training contractions somehow easier?

It just won't work. You will still have to listen to your feelings and record them. But you can get yourself an assistant - a special one mobile application to calculate the duration and intervals between contractions. All such applications work intuitively - you just need to press a large button every time an attack begins or ends.

In addition to recording and visualizing contractions, the application has useful additional features. It tracks the dynamics of the seizures and will tell you if it is similar to labor. And it will even show how much time you have left to get to the maternity hospital.

What to do?

You don’t have to do anything - after a while the training contractions will go away on their own. However, there are several proven methods 5 that help reduce discomfort during false contractions and make them disappear quickly. Here are some of them:

• Walk around the house.
• Lie down and relax.

  If you're not in the mood for a walk right now, lie down on the sofa or bed, find a comfortable position and think about something positive. It has been noticed that the best results are obtained by lying on your left side.

• Take a bath or shower.

  Water relaxes, and during training contractions this is just what you need. Fill the bathtub with water or stand in the shower and wait for the contractions to end there - most likely, this will happen very soon. But remember: only warm water, no hot baths or contrast showers!

• Drink some water.

  Dehydration can cause muscle spasms, so it is also considered a factor in causing false contractions. Pour a glass of water and drink it slowly, alternating sips, inhalations and exhalations. Water can be replaced with some other drink, but only healthy, for example, berry juice or rose hip decoction.

• Do breathing exercises.

  Proper breathing techniques are useful not only during training contractions. Before childbirth, they help to calm down, during childbirth - to relieve pain and better control your body. While the body is training the uterus, you train your breathing.

• Go to the toilet.
• Walk around the house.

  Calm, slow walking in most cases allows you to get rid of unexpected uterine contractions. If the weather is good outside and there is a suitable place for exercise nearby, you can also take a breath of fresh air - this will not be amiss.

• Go to the toilet.

  A full bladder is considered one of the culprits of false contractions: it puts pressure on the uterus, provoking its contractions. So before you settle into bed or go for a walk, don't forget to visit the toilet.

Leah Hennen; Murray, Linda; Jim Scott (2005). The BabyCenter Essential Guide to Pregnancy and Birth: Expert Advice and Real-World Wisdom from the Top Pregnancy and Parenting Resource. Emmaus, Pa: Rodale Books. ISBN 1-59486-211-7. Link: https://books.google.ru/​books?id=AK60Xmnrm_AC&​pg=PA294&dq=%22Braxton+Hicks+contractions%22&​;redir_esc=y&hl=ru#v=onepage&​q=%22Braxton%20Hicks% 20contractions%22&​f=false

John Braxton Hicks (1823-97) and painless uterine contractions. Link: https://web.archive.org/​web/20041031192937/​http://fn.bmjjournals.com/​cgi/content/full/81/2/F157

Bhattacharya, Deepamala. Braxton Hicks Contracts. Link: https://www.pregmed.org/braxton-hicks-contractions.htm

The Physiological Difference Between Braxton Hicks and Labor Contracts. Link: