Signs of labour

How will I know when I'm in labour?

Every woman's experience of labour is different. You may only be able to work out when labour truly started after you've been through it! However, changes that take place in pre-labour and early labour may cause tell-tale signs and symptoms that labour is imminent.

In pre-labour or early labour (the latent phase), you may have: 

• Persistent lower back pain or abdominal pain, with a pre-menstrual feeling and cramps.
• Painful contractions or tightenings that may be irregular in strength and frequency and may stop and start.
• Broken waters. Your membranes may rupture with a gush or a trickle of amniotic fluid. Although this can happen long before labour starts, you should still, call your maternity unit to let them know.
• A brownish or blood-tinged mucus discharge (bloody show). If you pass the mucus plug that blocks the cervix, labour could start soon, or in a few days. It's a sign that things are moving along.
• An upset tummy or loose bowels.
• A period of feeling emotional, excited or moody. You might feel restless, anxious or impatient.
• Disrupted sleep.

As there can be overlap between pre-labour and the start of labour itself, it's possible to confuse the symptoms of the two . How you'll feel in the pre-labour or early labour phases depends on: 

• Whether you've had a baby before.
• How you perceive and respond to pain.
• How prepared you are for what going into labour may be like.

Can I tell if labour is about to happen soon?

Maybe. There's a lot of overlap between the symptoms of late pregnancy and pre-labour, which is the time just before you go into the early first stage of labour. Signs that the birth may be on its way include: 

• Lightening, when your baby's head drops into an engaged position in your pelvis. You may be able to breathe more deeply and eat more, but you'll also need to wee more frequently, and walking may be more difficult.
• Heavier vaginal discharge with more mucus.
• More frequent and, possibly, noticeably more intense Braxton Hicks contractions.
• Mood swings.
• A sudden urge to clean or bring order to your home!

What should I do in early labour?

The early phase of the first stage of labour is when your cervix dilates to 4cm. The best thing to do during this time will depend on what time of day it is, what you like doing, and how you're feeling. Keeping calm and relaxed will help your body to release the hormone, oxytocin, that you need for your labour to progress. It can help you to cope with the contractions or tightenings. Do whatever will help you to stay relaxed. 

This could mean watching your favourite film, going for a walk, pottering around at home, or asking a friend or relative over to keep you company. You could alternate between walking and resting, or try taking a warm bath or shower to ease any aches and pains. If you can, try to get some rest to prepare you for the work ahead. 

During early labour, you may feel hungry, so eat and drink if you feel like it . Nibble on small amounts of high-energy foods to keep you going. This will help to comfort you and may even help your labour to progress more smoothly.

Early labour is a good time to try out different positions, breathing techniques and visualisations to see if they help you to cope with contractions. If you've got a TENS machine, early labour is the time to use it. It’s unlikely to help if you wait until you’re in active labour before you start using it.

How will I know when I've moved into active labour?

If you're planning to have your baby in a hospital or birth centre, the active phase of the first stage of labour is the time to go. This is where your cervix dilates from 4cm to 10cm. For many women, the main sign is painful, regular contractions. These gradually become more frequent, longer, and stronger in intensity.

Your midwife may have told you what to expect, such as contractions coming at least every five minutes and lasting at least a minute. However, for some women, labour progresses well without following a "textbook" pattern.

Listen to your body and watch out for how you're feeling. As labour intensifies, you're likely to talk less. You'll find holding a conversation during a contraction more difficult. You may notice that you have to pause as each surge builds, leaning forward and rocking your pelvis to help you through it. 

As your labour progresses, you may start to turn your awareness inward, focusing in on each contraction and using your breath to help you to cope. You might start "sighing" out from the start of each contraction.

As your labour gets stronger, your appetite is likely to wane, and you may feel hot and anxious. You may also and start to feel less inhibited and care less about what you're doing. This may help you to demand exactly what you need to help you cope!

When should I call my midwife?

You've probably talked to your midwife about what to do when you think you're in active labour. But if you're not sure whether the time has come, don't be embarrassed to call. Midwives are used to getting calls from women who are uncertain if they're in early labour or active labour, and who need guidance. It's part of their job. 

The midwife will want to hear about what you've been experiencing, particularly how close together your contractions are. She'll be able to tell a lot by the tone of your voice and how you respond to a contraction, so talking helps. 

It's not always possible for a midwife to accurately judge whether active labour has started over the phone. If you're using hypnosis or deep relaxation you may sound as though you're in an earlier stage than you are. That's why it's important to trust what your body is telling you as well as being guided by your midwife. 

If you're planning to have your baby in hospital or in a birth centre, you may not need to go in straight away. Instead, your midwife may give you some coping tips and advise you to stay at home until contractions become more frequent and stronger. Depending on what's available locally, she may arrange for a midwife to visit you at home, or ask you to come in so she canassess your labour.

Trust your instincts on when you think it's the right time to leave the house or call in the midwife. This may mean ignoring pressure from your partner, mum, or whoever else is with you, until you feel it's the right time to go. 

If you're going to hospital or a birth centre, always phone before setting off, as your chosen unit may be busy. If that's the case, the staff may ask you to stay home a bit longer or direct you to another unit. It's a good idea to prepare for this possibility so that it's not such a big disappointment if it happens to you. 

Ask your midwife how often your chosen unit has to divert women in labour and which unit they are usually sent to instead. Plan your route to your chosen unit and back up unit, perhaps even rehearsing the journey and checking out the parking at each one in the weeks leading up to your due date. This can take some of the anxiety out of the trip when you're in labour. 

When deciding when it’s time to leave, bear in mind that it can be harder to move as your contractions get longer, stronger and more frequent. Getting from your front door into your car may take a while as you pause for each contraction. 

Once your midwife sees you and can confirm you're in active labour, she will admit you to the labour ward, or stay with you if you're having a home birth. If she thinks you're in early labour, she's likely to encourage you to go home until you're in active labour. Her decision will depend on how you're coping and whether you've got a birth partner to give you good support. 

You should contact your midwife or doctor if: 

• Your baby's moving less than usual.
• Your waters break, or you suspect you're leaking amniotic fluid, so that you and your baby can be checked over.
• You have vaginal bleeding (unless it's just a small amount after a membrane sweep or the blood-tinged mucus of the show).
• You have a severe headache, changes in your vision, or sudden swelling of the face, hands or feet.

See our list of other pregnancy symptoms you shouldn't ignore, in case anything else is worrying you. 

You and your partner could also watch our video on how to help you understand pregnancy strains.

Can I have contractions and not be in labour?

Yes. You can have pre-labour contractions (Braxton Hicks). These help your cervix to go through the changes it needs to before it starts to dilate. Your cervix usually points towards your back, but as you start to dilate is will move forward. It will also be getting shorter and thinner (softening and effacing). 

These changes may take place over the last few weeks of your pregnancy without you noticing. Alternatively, you may experience hours or days of cramps or contractions. These may be helping the early changes in your cervix to progress, even though they may not be dilating your cervix yet. 

Your midwife can confirm whether your cervix has started to change by carrying out a vaginal examination. At your 40-week appointment your cervix may be firm and unyielding, while at the next appointment it may be "paper thin" and starting to open. 

If your baby has his head down but his back to your back (occipito-posterior position), it can take longer for his head to engage and for labour to start. Your contractions may be erratic and low in intensity, and you may have backache.

If your baby is back-to-back, getting onto all fours on your hands and knees, for half an hour or so now and again may help to relieve your backache. All-fours, forward leaning and lunge positions may also help your baby to turn to a better position for birth.

Your midwife will advise you about ways to cope at home until labour becomes stronger. You could take a dose of paracetamol, or try a warm bath or massage to relieve the pain. 

A long and uncomfortable pre-labour and early labour phase can be challenging. You may find that you need a different kind of support to the often-repeated advice to stay at home and use self-help. You may want to phone the labour ward again and go in for an assessment. The doctors there may prescribe you extra painkillers if you need them.



http://www.babycentre.co.uk/signs-for-how-I-will-know-I-am-in-labour#ixzz3ZGOXcmyx