As you approach the final days of your nine month pregnancy journey, you may begin to think about labour and experience some anxiety and uncertainties. Notably, many women have fears in regards to how they will know when they are in labour and should head to their birthing facility.
While determining if you are in labour is never a clear cut affair, there are some very distinct signs that the day your child will arrive is drawing near. There is no way to predict whether you will experience all of these signs, but rest assured your body will let you know that labour is imminent.
Always keep in mind that if you are unsure at all about how you are feeling and are uncertain how to proceed, your medical caregiver will be happy to have a call from you in order to give you reassurance and guidelines for the days or hours ahead.
Labour can be described as having three stages:
Early days of labour
In the days, and possibly weeks before you begin your active labour phase, you may notice signs that indicate your baby will soon be arriving.
- Your baby descends lower in the pelvis. This can bring a feeling of lightness as the weight you are bearing has shifted, allowing more room for your lungs to breathe. You can also feel added pressure in the pelvis due to the baby’s head pressing on your pelvic bone.
- There will be menstrual like cramping which may ease up with movement or a change of position.
- Your bowel movements may become much looser and more frequent. This is caused by the release of the substance prostaglandin, which plays a crucial role in softening the cervix for delivery. It is very important to remember to stay hydrated at this time.
- A nesting instinct often kicks in and you will have the urge to clean and prepare for the arrival of your new family member.
- You may experience a dull form of backache in virtue of the fact that your joints are becoming looser and your ligaments are stretching in preparation for labour. These are natural progressions that make the delivery process go smoothly.
- Because the baby may be resting on your bladder, causing you to feel full, you will possibly have the frequent need to urinate.
Pre labour phase
In the days preceding true labour, you will notice several more indications of your baby’s impending birth.
- The Braxton Hicks contractions that you have felt over the past few weeks will become more frequent. However, these contractions are not yet active labour. These pre labour pains will come and go, and while uncomfortable, they should not cause intense pain. Braxton Hicks contractions are part of the body’s preparation for delivery, aiding the cervix in the steps of effacement.
- Effacement is when the cervix begins to thin out in readiness for cervical dilation. In the pre labour stage, your cervix will begin a slow dilation which will be evaluated by your doctor close to your due date. Your medical practitioner, in a medical exam, can often give you a fairly accurate indication of how things are progressing in the days before your delivery.
- There is a mucous plug that has sealed the entrance to the cervix, which serves as a barrier to germs and a preventative against infection. The mucous plug will pass from the cervix as the thinning is taking place.
- You may begin to leak a small amount of amniotic fluid. This can be barely evident. If you see a large amount of fluid leaking from the vagina, active labour may be just around the corner.
Active labour stage
The active labour stage is, in most cases, a very obvious event. Your doctor or midwife will have discussed with you in the previous weeks, the guidelines for when to go to the hospital or birthing center. Guidelines can vary, depending on the position of your baby at the last prenatal exam, whether this is your first baby, or how far you live from the hospital.
- In the active labour stage, the rupture of membranes is a sure sign that your labour will now progress more quickly. If you feel the amniotic sac has broken, you should take note of the time of breakage, and any color or odor that may be present.
- At the very least, contact your medical practitioner who will instruct you as to what to do next. Otherwise, head straight to your delivery facility.
- For many women, the water breaks only after they are in the hospital with full contractions. It also may happen that the doctor has to rupture the sac for you through a procedure called an amniotomy.
- Contractions will become more frequent and intense, with no letting up. Your cervix is undergoing maximum effacement. Your uterus is tightening, helping to push the baby out. You may feel pain wrapping around your abdomen, from back to front. Some women experience intense pain in the back if the baby’s skull is putting pressure on the nerves in the back. You may also feel pain radiating through your thighs.
- If you have not had an obvious breaking of the amniotic sac and are still at home, and the intensity and frequency of your contractions is increasing, you should time them for an indication of when to head to the hospital. A common guideline is the 1-5-1 scenario. Intense contractions that last one minute, occur every five minutes, and have been happening for at least one hour indicate that you are in active labour.
- Go to the hospital before the 1-5-1 guideline if you are experiencing any vomiting with contractions, you have vaginal bleeding, or if you cannot walk or talk through your contractions.
Once you are in your birthing location, the rest will progress as it may under the care of your birthing team. It is natural to feel anxious about labour and delivery, and the unknowns of the entire process. Try to relax and focus on this incredible event. Your medical caregivers have trained extensively to be a comfort and a guide as you deliver your baby.