HOW LABOUR BEGINS
SIGNS THAT LABOUR HAS BEGUN
Know the signs
You’re likely to recognise the signs of labour when the time comes, but if you’re in any doubt, don’t hesitate to contact your midwife.
The main signs of labour starting are strong, regular contractions and a “show”. A show is when the plug of mucus from your cervix comes away.
Other signs that labour is beginning include your waters breaking (rupture of the membranes), backache and an urge to go to the toilet, which is caused by your baby’s head pressing on your bowel.
WHAT ARE CONTRACTIONS LIKE?
When you have a contraction, your womb (uterus) tightens and then relaxes, like a stronger version of period pains. You may have had contractions throughout your pregnancy, particularly towards the end. During pregnancy, these painless tightenings are called Braxton Hicks contractions.
When you are having regular, painful contractions that feel stronger and last more than 30 seconds, labour may have started. As labour gets going, your contractions tend to become longer, stronger and more frequent.
During a contraction, the muscles in your womb contract and the pain increases. If you put your hand on your abdomen, you will feel it getting harder. When the muscles relax, the pain fades and your hand will feel the hardness ease. The contractions are pushing your baby down and opening your cervix (entrance to the womb), ready for your baby to go through.
Your midwife will probably advise you to stay at home until your contractions become frequent. When your contractions last 30-60 seconds and occur every five minutes, call your midwife for guidance. If you’re planning to have your baby in a maternity ward, phone the hospital.
BACKACHE OFTEN COMES ON IN LABOUR
You may get backache or the aching, heavy feeling that some women experience with their monthly period.
A “show” signals the start of labour
While you are pregnant, a plug of mucus is present in your cervix. Just before labour starts, or in early labour, the plug comes away and you may pass this out of your vagina. This small amount of sticky, jelly-like pink mucus is called a show.
It may come away in one blob, or in several pieces. It is pink in colour because it’s bloodstained, and it’s normal to lose a small amount of blood mixed with mucus. If you’re losing more blood, it may be a sign that something is wrong, so telephone your hospital or midwife straight away.
A show indicates the cervix is starting to open and labour may follow quickly, or it may take a few days. Some women do not have a show.
WHAT HAPPENS WHEN YOUR WATERS BREAK?
Most women’s waters break during labour, but it can also happen before labour starts. Your unborn baby develops and grows inside a bag of fluid called the amniotic sac. When it’s time for your baby to be born, the sac breaks and the amniotic fluid drains out through your vagina. This is your waters breaking.
You may feel a slow trickle, or a sudden gush of water that you cannot control. To prepare for this, you could keep a sanitary towel (but not a tampon) handy if you are going out and put a protective sheet on your bed.
Amniotic fluid is clear and a pale straw colour. Sometimes it’s difficult to tell amniotic fluid from urine. When your waters break, the water may be a little blood-stained to begin with. Tell your midwife immediately if the waters are smelly or coloured, or if you are losing blood, as this could mean you and your baby require urgent attention.
If your waters break before labour starts, phone your midwife or the hospital for advice. Without amniotic fluid your baby is no longer protected and there is a risk of infection.
How to cope when labour begins
At the beginning of labour:
- You can be walking/moving about if you feel like it.
- You can drink fluids and may find isotonic drinks (sports drinks) help keep your energy levels up.
- You can have a snack, although many women don’t feel very hungry and some feel sick.
- As the contractions get stronger and more painful, you can try relaxation and breathing exercises – your birth partner can help by doing these with you.
- Your birth partner can rub your back as it can help relieve pain.
PRE-LABOR: ONE TO FOUR WEEKS BEFORE LABOR
- YOUR BABY “DROPS”
A few weeks before labor begins, your baby will start to descend into your pelvis (for first-time moms; in future births, this “lightening” doesn’t usually happen until you’re truly in labor). Your baby is getting into position to make his exit: head down and low. Yes, you might feel you’re waddling even more than you have been up until this point — and you may be back to taking very frequent bathroom breaks like you did way back in your first trimester, because baby’s head is pushing down on your bladder too. But the good news is you have a little more breathing room, since baby is moving away from your lungs.
- YOUR CERVIX DILATES
Your cervix, too, is starting to prepare for birth: It starts to dilate (open) and to efface (thin out) in the days or weeks before you deliver. At your weekly check-ups, your provider may measure and track dilation and effacement via an internal exam. But everyone progresses differently, so don’t be discouraged if you’re dilating slowly (or not at all yet).
- YOU FEEL MORE CRAMPS AND INCREASED BACK PAIN
Especially if this is not your first pregnancy, you may feel some crampiness and pain in your groin and lower back as labor nears. Your muscles and joints are stretching and shifting in preparation for birth.
- YOUR JOINTS FEEL LOOSER
Throughout your pregnancy, the hormone relaxin has made all of your ligaments soften and loosen (it’s also responsible for your bouts of clumsiness this past trimester). Before you go into labor, you may notice your joints all over your body feel a bit looser. Relax — it’s just nature’s way of opening up your pelvis for your little passenger to make his or her way into the world.
- YOU HAVE DIARRHEA
Just as the muscles in your uterus are relaxing in preparation for birth, so are other muscles in your body — including those in our rectum. That can lead to loose bowel movements. Though annoying, this is normal; stay hydrated and remember it’s a good sign!
- YOU STOP GAINING WEIGHT (OR LOSE POUNDS)
Weight gain tends to level off at the very end of pregnancy. Some moms-to-be even lose a couple of pounds! This is normal and won’t affect your baby’s birthweight. He’s still gaining, but you’re losing due to lower levels of amniotic fluid, more potty breaks (see #1 and #8 on this list), and even increased activity (see #7).
- YOU FEEL EXTRA-TIRED…OR YOU HAVE AN URGE TO NEST
Wait a minute, is this the third trimester or the first? Between the active bladder and the exhaustion, sometimes you can feel like you’ve traveled backwards in time. That super-size belly, along with the smooshed bladder, can make it hard (even impossible) to get a good night’s sleep during the last days and weeks of pregnancy. Pile on those pillows and take naps during the day if you possibly can! That is, unless you’re feeling the opposite of fatigued: Some moms get a burst of energy as birth-day nears, and can’t resist the compelling urge to clean and organize everything in sight. That’s okay, as long as you don’t overdo it!
EARLY LABOR: THE HOURS BEFORE LABOR STARTS
- YOUR VAGINAL DISCHARGE CHANGES COLOR AND CONSISTENCY
In the last days before labor you’ll notice an increased and/or thickened vaginal discharge. You may also notice the loss of your mucous plug — the cork sealing off your uterus from the outside world. It can come out in one large piece (it looks similar to the mucous you have in your nose, but with faint streaks of blood) or lots of little ones (though you may not notice it at all if you’re the flush-and-run type). This thickened, pinkish discharge is also called the bloody show and is a good indication that labor is imminent (though without labor contractions or dilation of three to four centimeters, labor could still be a few days away!).
2. YOU FEEL STRONGER, MORE FREQUENT CONTRACTIONS
Contractions are an early sign of active labor — except when they aren’t. You can experience Braxton-Hicks contractions for weeks and even months before delivery. You’ll feel their pinch as the muscles in your uterus tighten in preparation for their big moment (pushing that baby out!). How can you tell the difference between real and false labor contractions? Look for these signs of real labor:
If you’re active, contractions get stronger instead of easing up
If you change position, contractions don’t go away
The contraction pain starts in your lower back and moves to your lower abdomen, and possibly your legs
Contractions progress: They get more frequent and more painful, and sometimes fall into a regular pattern
3. YOUR WATER BREAKS
While movies would have you think you’ll learn you’re in labor only when your water breaks (of course in the middle of a romantic dinner date at a busy restaurant), that’s a very unlikely scenario. It’s actually one of the final signs of labor most women notice — and it happens in less than 15% of births. So don’t count on it as your only labor sign!
Still feel like you won’t know when to announce “It’s time!” and get ready to meet your baby? Try not to stress about it. You’ll be seeing your doctor or midwife frequently now, and she’ll help you spot all the important signs.
AM I GOING INTO LABOR? SHOULD I CALL THE DOCTOR?
If you think you’re going into labor, your practitioner should have advised you on what to do when your contractions become regular: “Call me when they’re coming about five minutes apart for at least an hour,” for example. Contractions won’t all be exactly spaced, but if they are becoming pretty consistent, it’s time to check in with your doc. If you think you might be in labor but aren’t sure, get on the phone; your provider can advise you on what’s going on. Don’t feel embarrassed or worry about calling outside of office hours (your doctor or midwife knew this would happen when she got into the baby-catching business!).
You should always call if:
- You experience any bleeding or bright-red discharge (not brown or pinkish).
- Your water breaks — especially if the fluid looks green or brown; this could be a sign that meconium is present (which is your newborn’s first stool; it can be dangerous if your baby inhales or ingests it during birth).
- You experience vision changes, a headache, or sudden or severe swelling. These can be symptoms of preeclampsia, or pregnancy-induced hypertension.
EARLY SIGNS OF LABOUR
Giving birth will be different for every woman, but the main signs that you are starting labour will be strong, regular contractions, and a ‘show’.
During your pregnancy, a plug of mucus sits in your cervix. A show is when that plug of mucus comes away, indicating that the cervix is starting to open.
Other signs that you are going into labour can include:
- your waters breaking (rupture of the membranes)
- an urge to go to the toilet caused by your baby’s head pressing in your bowel.
- Stages of labour
THERE ARE THREE STAGES TO LABOUR.
- The first stage is when your contractions make your cervix gradually open up (dilate). This is usually the longest stage.
- The second stage of labour is when your cervix is fully open. This is the part of labour where you help your baby move through your vagina by pushing with your contractions.
- The third stage is after the birth of your baby, when your womb contracts and causes the placenta to come out through the vagina.