Signs of Labour

Prelabor: Labor Day is Near

1. Dropping. Some time during the final few weeks you may notice that your baby has moved down lower in your abdomen. Most first-timers notice their babies dropping within two weeks of delivery, though some mothers "drop" as many as four weeks before D-day. Second-time mothers often find their babies do not drop lower until labor begins, because mom's pelvic muscles have already been stretched, and no warm-up is needed. Baby's head settling into the pelvis is also called "lightening" (because the lower-riding load seems smaller and lighter) or "engagement" (since baby's head engages the pelvic opening). Whether baby "drops," "lightens," or "engages," you will feel and look different. Your breasts probably no longer touch the top of your abdomen. You might be able to sense baby's head resting just beneath the middle of your pelvic bone.

2. Frequent urination. Now that baby's head lies closer to your bladder you may be going to the bathroom more often.

3. Low backache. As baby gets heavier and drops lower, count on some aches or pains in your lower back and pelvis as your uterine and pelvic ligaments are stretched even more.

4. Stronger Braxton-Hicks contractions. You may notice that your warm- up contractions go from feeling uncomfortable to being rather painful like menstrual cramps. Even though these prelabor contractions are not as strong as labor contractions, they are strong enough to be starting the work of thinning out, or effacing, your cervix from a thick-walled cone to a thin-walled cup. While these contractions will get even stronger just prior to labor, they can continue this way, on and off, for a week or two before labor starts. They become less intense when you change position or start walking.

5. Diarrhea. Birth hormones acting on your intestines may cause abdominal cramps and loose, frequent bowel movements -- nature's enema, emptying your intestines to make more room for baby's passage. Those same hormones can also make you feel nauseated.

6. Increased vaginal discharge. You may notice more egg white or pink- tinged vaginal discharge. This differs from the "bloody show."

7. Bloody show. The combination of baby's head descending into the pelvic cavity and the prelabor contractions thinning the cervix can "uncork" the mucus plug that previously sealed the cervix. The consistency of this mucus varies from stringy to thick and gooey. Some women notice the one-time passing of an obvious mucus plug; others simply notice increased blood-tinged vaginal discharge. Some of the tiny blood vessels in your cervix break as your cervix thins, so you may see anything from a pink to a brownish-red-tinged teaspoonful of bloody mucous. If your discharge shows more blood than mucus - like a menstrual period or a lot of bright-red blood -- report this to your practitioner immediately. Once you notice a bloody show, you are likely to begin labor within three days, but some mothers hang on for another week or two.

8. Bag of waters breaking. Only 1 in 10 mothers experience their bag of waters breaking prior to labor. For most mothers this doesn't happen until they are well into labor. If your water breaks before labor has started, plan on your labor starting intensely within the next few minutes or hours, or at least within the next day.

HOW TO TELL LABOR IS BEGINNING

You're officially in active labor when your cervix is four centimetres dilated. Some women can stay just shy of this stage of dilatation for days or a week or two before they experience consistently regular, hard contractions. So we will arbitrarily say your labor has begun when your contractions become regular and increasingly intense, and you are likely to see your baby within a day.

We do not find the terms "true" and "false" labor helpful, nor accurate, since there is no such thing as a "false" labor contraction. As discussed, all those prelabor Braxton-Hicks contractions you've had for weeks and months have been toning the uterus, adjusting baby's position, and effacing your cervix, all preparing for the day you're going to labor a baby out. Instead, we find it helpful to divide contractions into preparing-the-passage-for-baby contractions (prelabor contractions) and delivering-baby contractions (labor contractions). Many women, especially first-timers, can't pinpoint the exact moment labor contractions begin. Labor contractions can seem like prelabor ones at first. After the fact, of course, mothers can look back and say, "Oh yes, that was when they started." Once active labor is well underway, you'll no longer doubt that this will end except with the delivery of your baby. Here's how to tell the difference.

Prelabor contractions (also called "false" contractions):
- Are irregular, following no discernable pattern for more than a few hours.
- Are non-progressive: don't become stronger, longer, or more frequent.
- Are felt most in front, in the lower abdomen.
- Vary from painless to mildly uncomfortable; feel more like pressure than pain.
- Become less intense and less uncomfortable if you change position or walk, lie down, or take a hot bath or shower.
- Make your uterus feel like a hard ball.

Labor contractions (also called "real" or "true" contractions):
- Follow a regular pattern. (Timing is seldom precise to the minute.)
- Are progressive: become stronger, longer, and more frequent. The contractions get longer and the intervals between them shorter.
- Are felt most in the lower abdomen and radiate around to the lower back.
- Vary from uncomfortable pressure to a grabbing, pulling pain, which can usually be managed, even lessened, by conscious release of tension in the rest of your muscles.
- Don't change if you lie down or change position; may be intensified by walking.
- Are usually accompanied by a "bloody show."