main banner

shutterstock_104963819_FI

It’s Labour Time!

If you are a first-time mother-to-be, this section will answer all your burning questions as to how to identify the onset of labour. 

This article spells out the classic signs of what to look out for and expect during the onset of labour, what to do when the contractions start and your waters break, and other important signs to look out for.

Classic signs of labour

Labour varies a great deal among women in terms of when it starts, the indications that it has started, and how long it actually lasts. In some cases, labour can start as early as 24 weeks of pregnancy, so it’s best to familiarise yourself with the main signs of the onset of labour so that when your time comes, you’ll be prepared.

If you’ve any doubts whatsoever about what to look out for with regards the onset of labour, or if your labour has started, then don’t hesitate to call your doctor or midwife.

Although knowing exactly when labour has started (when you have gone into labour) is often difficult, certain classic signs may suggest that actual labour (which is also called real or true labour) is underway. This initial phase of labour (going into labour) is also often referred to as the onset or start of labour, or early labour.

Contractions and labour

During the final trimester of pregnancy, the muscles of your uterus start to contract (relax and tighten) in preparation for delivery. These contractions are known as Braxton Hicks contractions and are practice runs by your uterus for real labour. If you’ve already had a baby, you may get these contractions as early as week 20 of your pregnancy.

Braxton Hicks are usually painless (although they can be uncomfortable), weak and irregular, and last for less than 30 seconds. Some women confuse these very early contractions or false labour as the start of the real contractions of actual labour. This is understandable because, as real labour approaches, Braxton Hicks contractions can become more intense and occur closer together.

Contractions associated with the onset of labour may start off as cramp-type pains (similar to period pains), and you may notice them in your stomach, back or thighs. Later, it feels more and more like a belt that gets tighter and tighter and then relaxes again. If actual contractions start at night-time, it will be impossible to relax and go back to sleep. The contractions will increase steadily, reach a peak and then decrease again. In between, there should be a phase without any pain. Another sign of genuine labour contractions might be that they don’t improve if you have a warm, relaxing bath, but instead get stronger.

If you find that your contractions have become progressively stronger, more painful and more frequent with shorter intervals (longer contractions), then labour has probably started. Contractions of early labour, however, can be mild and infrequent and may equally be mistaken for Braxton Hicks. Real labour is usually established when your contractions last for more than 20 seconds (and up to 60 seconds), occur every 5-7 minutes over an hour, and are beginning to become painful. This is when you should contact your healthcare professional. It will help to keep a mental note of how often they arise and how far apart they are, as they may give an indication of how close you are to delivery.

Discharge and labour

Another indication that the onset of labour may be imminent is the release of your protective mucus plug, which forms in the cervix at the start of pregnancy to seal the uterus. Expulsion of this plug from your vagina is commonly referred to as a “show” and indicates that the cervix has started to dilate (stretch). It’s usually sticky and mucus- or jelly-like and streaked with blood to produce a pinkish/brownish bloody discharge. It’s not, however, usual to lose a lot of blood with a show, which is normally just mucus tinged with blood; if you find that you’ve lost quite a lot of blood, you must call your pregnancy healthcare professional, your midwife or hospital immediately.

Your mucus plug can come away any time up to 12 days before labour begins, but it’s usually not released until a day or so before labour begins. If you have a show around the time of your due date, without regular contractions, frank bleeding or fluid loss, then there is no need to contact your healthcare professional. However, it would be worth making sure you have your bag packed if you are having a hospital birth, as labour is likely to start in the next day or two. Also, remember that in some women, labour will start without them noticing a show.

Waters breaking during labour

Rupture of the membranes that surround the amniotic fluid in which your baby floats is another main sign of labour starting. It usually occurs after the mucus discharge. This process, commonly referred to as your “waters breaking”, is painless and is recognised by a slow leak or trickle, or a sudden gush or flood, of fluid from your vagina. The fluid is normally clear, but if you notice that it is yellowish, greenish or brown, call your healthcare professional without delay, as it may indicate that your baby is in distress.

Your membranes can rupture any time during the first stage of labour (the time it takes for your cervix to become fully dilated), although they usually do so towards the end of this initial stage (near the point of delivery). In around 20% of women near their due date, they rupture before the onset of labour. If you find that your waters have broken while you’re at home or without your healthcare professional being there, then contact him/her at once, as it’s now time to check the baby’s heart rate and, if labour doesn’t follow, there is an increased chance of infection. There is an increased risk of having a prolapse of the umbilical cord if a considerable amount of fluid is lost. In some cases, the membranes don’t rupture even during the second stage of labour and have to be ruptured artificially by the midwife or the obstetrician to bring on labour contractions.

If your waters break before you have reached 37 weeks of pregnancy (ie full term), you’ll need to go into hospital, at least initially, because there’s a risk of premature labour and, rarely, of an infection developing inside the womb.

Other symptoms of labour

In some cases, women may experience other events or symptoms when labour is about to, or has, started.

Energy burst: Just before labour sets in, you may have a sudden burst of energy and the desire to do something fairly active, such as clean or decorate the house. Giving birth can be extremely exhausting, so it’s best to try to resist this pre-labour urge and conserve as much energy as you can for your labour.

Backache: When contractions start and when you go into labour, some women experience a strange mild or heavy pain in their lower back. This may feel similar to the pain that you have when you have a menstrual period.

Nausea: Some women feel sick and/or actually vomit when their labour starts. This is more likely in advanced labour. Fatigue can also be a sign of labour onset. Both are caused by the hormonal changes that induce labour.

Restlessness: For some, restlessness can lead to difficulty sleeping in the last few days before birth. Sensations like shuddering or trembling (which may last for a few minutes) are quite usual before the onset of labour and are the body’s way of getting rid of tension. A warm bath and/or a massage will make you feel more comfortable.

Diarrhoea: Contractions of the uterus, as well as hormones from the uterine wall (prostaglandins), may affect the bowel, and because of this, some women also have diarrhoea when they go into labour. Again, this is more likely in advanced labour.

What to do at the signs of labour

When you have regular and frequent contractions in labour or your waters break during labour, then you should contact your healthcare professional for advice.

As a very general rule, the contractions should be about 10 minutes apart if this is your first pregnancy; in subsequent pregnancies, they should at least arrive at regular intervals.

If this is your first baby, things may take some time to get going before actual labour sets in (and your baby may not arrive until 12 hours or more after labour starts), so your healthcare professional will advise you how best to proceed.

Depending on certain factors, you’ll be told either to stay at home or go straight to hospital.

About the Author

eumom team 

Comments

Please login to leave a comment.