The onset of labor signs marks the end of pregnancy and the beginning of labor and eventually delivery. No one knows what triggers it, but some research shows that baby hormonal changes may stimulate increased production of a hormone known as corticotropin-releasing hormone. This leads to changes in the mother’s hormones, a softening/thinning of the cervix and contractions. Knowing what to expect can help you prepare as your due date approaches.
Symptoms may include:
Lightening - Early signs
Baby drops or settles in lower pelvis
Mother is less short of breath; baby has moved and this gives more room for mother’s lungs to expand
Increased pressure in pelvis and urinary bladder leads to an increased urge to urinate
In the first pregnancy, lightening may start several weeks prior to the delivery; with subsequent pregnancies, it may happen hours before delivery or not all
Ripening of Cervix - Effacement
-Cervix lining begins to soften and thin
Opening of Cervix - Dilation
This is measured in centimeters from 0-10.
Opening may progress slowly, e.g. 2-3 centimeters for days or weeks before labor
Once labor has begun, you will dilate more frequently
Bloody Show Discharge
Cervix softens/thins and starts to dilate (open up) in anticipation of delivery. Small blood vessels burst and this causes a pink or brown vaginal discharge
Mucus plug dislodges from cervix
Bloody show may take place hours before delivery or up to several weeks before
Nesting Instinct
Burst of energy a few days prior to labor
Urge to clean house and to organize baby’s clothing, crib or room
May occur months before due date
Strongest sense just before delivery
Water Breaks - Rupture of membranes
Amniotic sac that cushions the baby breaks or leaks
Small amount of fluid or gush appears
Risk of developing bacterial infection
Nausea and diarrhea
-Increased hormone levels and changes may cause nausea, upset stomach, abdominal cramping and diarrhea
Contractions
Occur more regularly and frequently
Are stronger, more intense and closer together
Last more than 30 seconds at first; last longer and become stronger
Continue regardless of position changes or activity level
Increase with activity like walking
What your doctor can do:
Perform regular assessments during prenatal visits.
Create a plan for what to do when labor begins.
Recommend a childbirth class.
Provide educational materials regarding labor signs and symptoms.
Provide educational materials regarding false labor signs and symptoms.
Schedule delivery at birthing center or hospital
Examine cervix for signs of effacement (softening and thinning of lining) and dilation (opening) with a vaginal exam.
Recommend options for delivery including vaginal delivery or cesarean-section
What you can do:
Keep all regularly scheduled prenatal visits.
Review your labor and delivery plan with your doctor, spouse (significant other), birth partner, friend or family member that will be assisting you during this process
Attend a childbirth class.
Monitor your baby’s activity and movements; consider keeping a written journal.
Have a bag packed and readily available at home and in your car. Do not pack jewelry or other valuables.
Have a map, address, and phone number of the hospital or birthing center. Plan a route and alternate route; take into consideration traffic, time of day and transportation options (private car, taxi, etc…).
Get a baby car seat for the trip home
Schedule a babysitter for older siblings if necessary
Keep your doctor’s office phone number readily available
Get plenty of rest even if you feel that you have a burst of energy; save your energy for labor and delivery.
Contact your doctor’s office if you experience any loss of fluid, either leaking or gushing as this may be your water breaking
Go to the hospital if you suspect labor has begun.
What you can expect:
False labor consists of:
a. Contractions that are irregular, that decrease with activity like walking, that may ease by changing position, and/or that do not change in frequency or intensity.
b. Pain may only occur in the lower abdomen
False alarms are common, especially during first time pregnancies.
True labor consists of:
a. the rupture of membranes (water breaks)
b. contractions that are regular, stronger, and 5 minutes apart and do not respond to position changes or activity
c. a sudden increase or decrease in your baby’s movement and activity
d. a pain high in the abdomen that radiates throughout abdomen and lower back.
NOTE: If you have not had a rupture of membranes and you are experiencing any of the other True Labor symptoms listed above, please contact your doctor for advice.
100% effacement (cervix that is completely thinned out) indicates that you are ready for a vaginal delivery
Timing contractions can help to distinguish between True and False Labor.
a. Use a stopwatch or second hand of a watch.
b. Write down the time that each contraction starts and stops. This is known as the duration.
c. Write down the time between the stopping of one contraction and the beginning of another. This is known as the interval.
d. Generally, strong, regular contractions lasting about 45-60 seconds and occurring 3-4 minutes apart indicates that you are in active labor. Call your doctor or hospital for advice.
Consult with your doctor if you are pregnant and have begun to experience any of the labor signs and symptoms noted previously.
Seek immediate medical advice if you experience any signs of vaginal bleeding i.e. spotting or changes in your baby’s activity or movements.
