How will I know when I am in labour?

• How will I know when I am in labour?
• When will labour occur?
• What is labour?
• What are Braxton-Hicks contractions?
• What is false labour?
• When should I go to hospital?

How will I know when I am in labour?

The start of labour is identified by regular coordinated contractions (feeling of tightening with pain), which cause the cervix (neck of the womb) to become shorter (effacement), then dilate (open). There may be a ‘show’, when a small amount of blood stained mucous comes away from the cervix (though this may occur up to 72 hours before labour starts), or breaking of waters (ruptured membranes), with a gush of fluid from the vagina. In 90% of cases, contractions start before the waters break. In 10% of cases, the waters breaking is the first sign of labour.

When will labour occur?

Labour is considered ‘term’ if it occurs from 37 weeks of pregnancy to 41 weeks. Babies born before 37 weeks are known as ‘preterm’. Some women go into labour extremely early, and their baby will require care at a specialist centre. The earliest a baby could survive early delivery if they are in a specialist centre is at 23-24 weeks of pregnancy (gestation), however there may be some significant health problems due to the fact the baby is not well developed before birth.

More information on Premature Labour.

What is labour?

The criteria for labour are regular rhythmical contractions of the uterus (womb), causing cervical effacement (the progressive shortening and thinning of the cervix) and cervical dilation (the increase in cervical opening diameter). Contractions may last around 30-40 seconds. A doctor or midwife will confirm labour by doing a vaginal examination (inserting a gloved finger into the vagina) in order to check the dilation of the cervix, and whether the membranes have ruptured. The doctor or midwife will also feel the tummy to check how low the baby’s head is in the pelvis, what position it is lying in, and which part of the baby is coming out first (presentation – cephalic, breech, shoulder).

What are Braxton-Hicks contractions?

Some women may experience Braxton-Hicks contractions. These are feelings of tightening of the uterus, which usually last for around half a minute, may be uncomfortable, but don’t usually cause pain.

It is thought that Braxton-Hicks contractions may be the uterus ‘practicing’, or ‘toning up’ for true labour. They may also play a role in ‘effacement’ (thinning and flattening) of the cervix in preparation for labour.

Braxton-Hicks contractions may be felt from around 16 weeks into the pregnancy onwards and may occur as often as once or twice an hour, or a few times a day. These contractions may stop with a change of activity, such as a gentle walk around. They do not increase in intensity, and are not rhythmic. In contrast, labour contractions are longer, more regular, more painful, more frequent, and they become more intense as time passes.

What is false labour?

False labour is the term used when Braxton-Hicks contractions take place more regularly and rhythmically in late pregnancy. False labour may cause discomfort, contractions occur every 10-20 minutes, and is difficult to distinguish from early labour. The difference between false labour and early labour is that in false labour the cervix does not change. A midwife can work out if the cervix is changing by doing a vaginal examination.

When should I go to hospital?

Many women are more comfortable staying at home for the first few hours of their labour. Women who give birth in hospital have generally had antenatal appointments, and will have been advised by their hospital as to what to do when labour starts. Some hospitals have phone lines that a woman can ring to advise them how long to wait before coming into hospital.

A woman in labour should make her way into hospital when:

• Her contractions are strong and 5 minutes apart; or
• Her waters break. This means the barrier for infection reaching the baby is no longer intact, so a woman should immediately contact her doctor or midwife for further advice, even if contractions have not yet started.

A women at any stage of pregnancy should go to the hospital or seek review by a doctor or midwife immediately if:

• She is experiencing bleeding from the vagina;
• She is less than 37 weeks pregnant and experience cramping pain in their abdomen or lower back, or watery or bloody vaginal discharge (which may be signs of early labour);
• She feels particularly unwell;
• She has persistent abdominal pain;
• She has signs of high blood pressure, including significant and sudden swelling of the face and hands (note some swelling of hands and feet is normal during pregnancy), headaches, blurred vision or upper abdominal pain; or
• She thinks her baby’s movements have slowed down.

If in any doubt, a woman should phone her hospital, doctor or midwife, and be driven (by someone else!) into hospital to seek reassurance or receive treatment if it is required.

 

More information

For information on birthing statistics,stages of labour, various birthing types and other information related to giving birth, see Birth.

References

 

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