Sunday, 14 December 2014
Am I in labour?
Your cervix lies at the top of your vagina, and must open, or fully dilate in order for your baby to come out. Throughout labour your uterus will tense and relax and cause a contraction, which forces the cervix to gradually get softer and thinner, and start to dilate in preparation for the birth. Labour usually starts when the cervix has started to widen and mild contractions will start.
The latent stage of labour, or Pre-labour
Many women will have regular contractions as the cervix gets softer, and these can vary between mild contractions where you can carry on chatting or having lunch, and can last for hours, even days. For some women these contractions are strong and painful. Most women describe early labour pains as being like heavy menstrual cramps. It’s important to note the length and strength of your contractions, rather than the time between them. If they last 30-40 seconds and you are able to have a cup of tea in between, you are unlikely to be in established labour. If you are having regular contractions which intensify over time with the space between them getting shorter you are in labour.
Weeks before your baby is due, you’ll probably start to notice signs that your body is getting ready for labour:
Engagement is one of the physical signs that labour is imminent. In order for your baby’s journey through the birth canal to begin, he will move himself deeper into your pelvis. If this is your first pregnancy, the baby will move down roughly two to three weeks before labour starts, but with subsequent pregnancies, your uterine muscles will have stretched so that the baby doesn’t have to move so far down.
A nesting instinct is when pregnant women feel an uncontrollable urge to clean their house and everything around them. Females in the animal kingdom exhibit the same behaviour just before their offspring arrive. You may want to clean everything you see, or throw out anything old and grubby, or you may retreat into familiar company and the comfort of your own home. The nesting instinct can appear around the fifth month, but if you are close to being 40 weeks pregnant, it may indicate the onset of labour.
Braxton Hicks contractions are when your uterus practises for the stronger contractions of labour with weaker irregular contractions, and are named after the man who first identified them. They are normally painless, but uncomfortable, and can become frequent, intense and painful. They start with a tightening feeling in your uterus and spread downwards before relaxing. They can last from 15-20 seconds but some women experience them for much longer. If you find them painful, it may be a good idea to keep active, change positions or lie down when you are having them. Read our feature on Braxton Hicks contractions for more information.
The show is one of the more obvious signs that labour is on its way. The show is a plug of mucus that seals your cervix and protects it from any infection. If your cervix dilates wide enough, the mucus plug may become dislodged, and will appear as a sticky, brown/pink substance. Even though labour itself may be hours, or even days away you must inform the hospital if you have a show because once the mucus plug is gone, the baby is vulnerable to infections.
Vaginal discharge Some women notice increased vaginal discharge as their cervix softens. It can often look like egg white, but can also have a pinkish appearance.
Membrane rupture, or waters breaking is when the amniotic sac which contains your baby ruptures, and the amniotic fluid leaks out. Most women go into labour 24 hours after their waters break, because the rupture signals the release of prostaglandins, which stimulate contractions. Once your waters break, be careful not to put anything into your vagina, and have showers rather than baths as infections can now get to your baby. Once your waters have broken, call your midwife or maternity unit to let them know. They will probably ask how much fluid leaked out and what the consistency was like so make a note of this. They will advise you whether to wait at home, or come in to the hospital.
Regular contractions. When your irregular contractions are replaced by more consistent contractions, which get stronger, come every five minutes, and last roughly 45-60 seconds, you are in established labour, and you should phone the hospital or your midwife. You are not in established labour if your contractions are irregular (so sometimes they are every three minutes, and sometimes 5-10 minutes), or if they don’t intensify with time and they calm down if you walk about or lie down. The general rule of thumb seems to be, if you can't speak during a contraction you are in labour and should phone your hospital (or get someone to phone for you!) Most women know instantly that they are in labour.
If you are still in doubt to whether you are in labour or not, phone your midwife who can help put your mind at rest or will ask you to come into the maternity unit to be examined.