What do contractions feel like?
Different types of contractions occur during pregnancy, each serving a specific purpose and manifesting themselves differently. A contraction is not always associated with pain. Some contractions are so weak that they can only be detected with a contraction recorder, known as a cardiotocograph (CTG). A slight pulling in the abdomen, back pain, menstrual-like cramps or a hard abdomen – these can all be signs of a contraction. However, this does not always mean that labor has begun. Only regular contractions indicate that labor is about to begin.
What contractions are there?
Five types of labor pains
Labor pains can be divided into the following five groups:
- opening labor
- expulsive labor
- pushing labor
- Postpartum labor
- Postpartum labor
Opening contractions: Here we go!
The birth begins as soon as you feel regular contractions – the opening contractions. Initially, the intervals between contractions are longer – there is a new contraction every 20 minutes or so, which usually only lasts a few seconds. Over time, the contractions follow each other more quickly (about every five minutes) and last up to one minute each. The intensity of the pain also increases. At the beginning, the pain is mainly felt in the coccyx and lower back. Later, the pain radiates to the lower abdomen and thighs.
If it is your first birth, the opening period can last up to twelve hours. With a subsequent birth, on the other hand, the second phase – the expulsion period – often begins after around two to eight hours.
Pushing out contractions: It gets exhausting
The opening contractions are followed by the so-called expulsive contractions. They begin when the cervix is fully dilated. The hormone oxytocin is now increasingly released. The contractions become somewhat stronger and more frequent – the uterus contracts every four minutes or so. You are now in the most strenuous part of the birth, which ends with the contractions. If this is your first birth, it will take about 50 minutes until your baby is born. If you have already given birth at least once, it will be quicker – it will then take up to 20 minutes.
Pushing contractions: The finale
When the contractions start, you and your baby have almost made it. The baby’s head now presses on the rectum and automatically triggers an urge to push. Your bowels will usually also empty, which is completely normal. If you find this unpleasant, you can ask for an enema to empty your bowels before the birth.
Initially, the baby’s head becomes visible during a pushing contraction and disappears again during the pause in labor (“cutting in”). If the head emerges through the perineum during another pushing contraction, doctors refer to this as “cutting through”. Sometimes the skin on the perineum (perineal tear) or labia tears slightly during this phase. The doctor may also make an episiotomy beforehand to prevent uncontrolled tearing of the tissue.
As soon as the baby’s head emerges, usually only one contraction is necessary and the rest of the body appears: your child is born!
It’s not over after the birth
But even when the baby is born, it’s not quite over yet. The so-called afterbirth contractions are still missing. They are significantly weaker than the previous pushing contractions and ensure that the placenta detaches and is expelled. This happens when the placenta releases a large amount of the hormone prostaglandin. The hormone causes the uterus to contract strongly so that the placenta detaches.
Labor pains in the postpartum period
About one to three days after the birth (also after a caesarean section), it becomes painful again, especially after the second or third child: the so-called postpartum or breastfeeding contractions begin. The baby’s sucking on the nipples stimulates the production of oxytocin again. The hormone not only promotes milk production, but also the contractions and involution of the uterus. A uterus that has grown to around 1,000 grams during pregnancy now shrinks back to its original size (around 50 to 70 grams). The contractions also help to stop the bleeding and stimulate the menstrual flow.
But what do contractions feel like? If you gave birth to your first child, you may experience a pulling sensation or slight menstrual-like pain in the lower abdomen. In subsequent births, the uterus has stretched further and now has to contract more than it did the first time. The muscles contract more strongly, which makes the afterpains much more painful and unpleasant. It is particularly unpleasant that this pain occurs during breastfeeding. However, these contractions are also over after three days at the latest.
What relieves the pain?
Labor pains are particularly painful. The following promises relief:
- Breathing technique (“breathe away”)
- Relaxation exercise (autogenic training)
- Warmth: hot water bottle in the back
- Change position: Follow your instinct and change your position if necessary: supine, sideways, quadrupedal position, squatting position (birthing stool).
- Medication: Painkillers (suppositories, tablets), epidural anesthesia (epidural)
40th week of pregnancy: No contractions
If the calculated due date is exceeded, you will need to have regular check-ups. The doctor will check at short intervals whether the baby is doing well. If your body is ready for the birth – and only then – a few things can help to induce labor. These include
- Stimulation of the nipples
- Sexual intercourse (semen contains prostaglandin)
- exercise
- hot bath
If there are still no or too weak contractions ten to 14 days after the calculated due date, the doctor must provide artificial help:
- instrumental rupture of the amniotic sac (amniotomy)
- Prostaglandin as a gel, tablet or suppository
- Oxytocin infusion
- Castor oil cocktail
If this does not induce labor within 48 hours, sometimes only a caesarean section can help.