Different women feel oncoming labor differently
Some feel no symptoms until they are right in the beginning of labor. Others have many symptoms such as cramping for weeks before labor actually begins. During labor four major changes occur:
- Ripening- the softening of the cervix.
- Effacement- the thinning out of the cervix.
- Dilatation- the opening of the cervix.
- Station- the movement of the baby’s head onto the ischial spines.
- Only five percent of women actually deliver on their due dates. The typical range for delivery is two weeks before to two weeks after the actual due date.
- The average length of a first labor is 14 to 17 hours. Subsequent labors generally last 6 to 8 hours.
- The position of the baby can effect the length of labor.
Prelude to Labor
Before labor actually begins, many women experience some of the following:
- Braxton Hicks contractions - These “practice” contractions (sometimes felt throughout the second half of pregnancy) tend to be irregular and are focused in the abdomen, as opposed to beginning in the back. They generally cause no changes in the cervix. Many women find that walking may give some relief.
- Lightening - Lightening, or “dropping,” occurs when the presenting part of the baby moves down into the pelvis. This often relieves shortness of breath, but can increase pelvic pressure and frequency of urination. In first time pregnancies, lightening may occur several weeks or just a few hours before the onset of labor. In subsequent pregnancies, lightening does not generally occur until just before labor begins.
- Weight loss - After all of those weeks and months of gaining weight, many women lose two or three pounds before labor even begins.
- Bursts of energy - Many women experience a burst of energy before the onset of labor. Often referred to as “nesting,” many women find themselves cleaning and preparing their homes for the arrival of the new baby.
- Activity of baby - The baby may become slightly less active as labor approaches. You should still feel the baby move several times an hour - if you don’t, call your health care provider immediately.
- Changes in the cervix - Particularly for women who have already had a baby, the cervix may begin to change weeks before labor begins.
- Increased vaginal discharge - Discharge may become thicker and may even be blood tinged.
Signs of Labor
- Contractions - In true labor, contractions will become very regular and will often start in the back and work their way toward the front. They will become progressively stronger and closer together. While walking often stops Braxton Hicks contractions, it will often make real contractions stronger. Time your contractions from the beginning of one to the beginning of the next.
- Rupture of membranes - Also known as “water breaking,” this may be experienced as either a gush of fluid or a slow trickle. Call your health care provider immediately, and be prepared to tell him/her the color of the fluid, the time of rupture, and the movement of the baby.
- Bloody show - As the cervix readies itself for labor, the mucous in the cervix will often emerge from the vagina.
- Effacement and Dilation - The cervix must thin out (effacement) and dilate (enlarge) in order to deliver the baby. The cervix must be 10 centimeters dilated in order for the woman to push.
Braxton Hicks Contractions
Before you go into true labor, you may experience what is known as Braxton Hicks contractions, or false labor. These are labor-like contractions, often felt for many weeks, that help to prepare your cervix for true labor by thinning, softening, and sometimes even opening your cervix slightly. The contractions often occur more frequently as you get closer to your due date and in the afternoon, evening, after you have exercised, or at other times when you are tired. These contractions can range from mild, when you can’t even feel them, to severe, where they can be quite painful.
Some ways to tell if you are feeling Braxton Hicks contractions are to:
- Time your contractions- False labor contractions are often irregular and don’t get close together as time goes on. True labor contractions come at regular intervals and get closer together. They last from 30 to 60 seconds.
- Try to move around. False labor contractions often stop when you walk, rest, or change position. Real labor contractions do not stop as you move around.
- Notice the strength of the contractions- False labor contractions do not increase in intensity. True labor contractions steadily get stronger.
- Note the place of the pain- Pain from false labor contractions are usually only felt in the front while true labor contractions often start in the back and move to the front.
If you begin to feel contractions, time them for one full hour and write down how they feel. Don’t hesitate to go to the hospital if you really can’t tell if you are in labor. It is better to be safe than sorry.
If you have any of these symptoms, call your doctor’s office or the hospital:
- You have symptoms of labor before you are 37 weeks.
- You feel your water break even though you have no contractions.
- You have vaginal bleeding.
- You have constant severe pain.
- You have a fever or chills.
- You feel your baby moving less.
What Should I Bring to the Hospital?
Some time around 33 to 36 weeks might be a good time to pack that overnight bag and leave it near the door, as you really could deliver at any time over the next month. Many women like to have some “comfort” items in the labor room, including:
- Watch or clock with second hand for timing contractions.
- Radio or CD/cassette player and your favorite tapes, if music soothes and relaxes you.
- Camera and/or video equipment if you want to capture the moment. Women & Infants does not allow the use of video and audio equipment while the birth or a medical procedure is in progress. However, this equipment is permitted during labor and after the birth of the baby or the completion of medical procedures. Still photography is permitted during the birth experience or at any time during your hospital stay. For the privacy of other patients, families are asked to refrain from filming other babies in the nursery.
- Lotions or oils you might like for massage.
- Tennis ball or plastic rolling pin for firm counter-massage if you are experiencing lower back pain.
At Women & Infants, the clothing that you wear on arrival is usually sent home and we will provide you with a “johnnie” (hospital gown) to wear during your stay. The following are some additional items that you may want to bring:
- Toothbrush and toothpaste.
- Shampoo and soap.
- Nightgowns and robe (if you plan to breastfeed, be sure that your nightgown has the appropriate openings).
- Shower shoes.
- Breast pads.
- Comfortable undergarments (bras and underpants).
- Additional toiletry items.
Clothing will be provided for your newborn infant as long as he or she stays in the nursery. It is recommended that you have clothing for yourself and your baby brought to the hospital the day before you are scheduled to return home.