When labor is approaching your body undergoes
certain changes and provides you with signals to let you know
if this is the moment you've been waiting for over these past
months. In order to discern the differences between these signs
and phases we encourage you to read on. Knowing the differences
will help you wait through "false labor" without anxiety and
be prepared for "true labor" when it arrives.
What is labor?
Your Due Date
Plans to Call Your Health
Care Provider
Plans to Go to
the Hospital
What Happens
During Labor
How to Tell when
Labor is Approaching
True Labor Versus
False Labor
Other Reasons
to Call Your Health Care Provider
What is
Labor?
Labor
is the process by which contractions of a pregnant uterus cause
birth. During labor the cervix thins (effaces) and opens (dilation).
The baby moves down the birth canal and is born. Delivery of
the placenta is the last part of labor.
Every labor is different. How long it lasts and how it progresses
differ from woman to woman and from birth to birth. There are,
however, general guidelines for labor that a health care provider
uses to decide whether it is progressing normally. If it is
not progressing normally, you may need medical assistance or
a cesarean section.
No one knows exactly what starts the labor process. However,
we do know that certain hormones, such as oxytocin and prostaglandin,
causes uterine contractions and the thinning of the cervix.
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Your Due Date
The most important thing to remember about a due date is that
it is only an estimate--there is nothing "magic" about it that
will help labor begin. Women often don't give birth on
their due dates. In fact, you may not even want to tell
relatives and friends an exact date so that you do not feel
disappointed or upset by phone calls and questions if the date
comes and goes and labor has not yet started. The beginning
of labor is unpredictable and often happens a little early
or late. This is no cause for anxiety or alarm. In
fact, labor may begin as much as 2 weeks before or after your
due date and still be considered normal.
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Plans to Call Your Health Care Provider
As you plan for the birth, you should take steps to help preparations
for your delivery go smoothly. Be sure that you have
discussed these steps with your health care provider before
the time comes. Find out whether your health care provider
prefers any special procedures:
- When should you call your health care provider?
- How should you notify the health care provider? Should
you go directly to the hospital or call the health care provider's
office first?
- Are there any other steps your health care provider wants
you to take?
Now is the time to ask questions!
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Plans to
Go to the Hospital
There are also quite a few things to think about before it
is time to make the decision to go to the hospital. Some
of them are quite simple, but you may not have had time to
stop and think about them. They include some of the following:
- Distance. How far do you live from the hospital?
- Transportation. Is someone available to take you, or do
you have to call and find someone?
- Time of Day. Depending on where you live, it may
take longer during rush hours than at other times of the
day or night.
- Home Arrangements. Do you have other children to
take to a babysitter's home, or must other special arrangements
be made?
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What Happens During Labor
Although labor is different for each birth, the basic
process is the same. Labor occurs in three stages:
- Stage 1. The cervix (opening of the uterus)
thins out and opens up enough to permit the fetus to move
from the uterus into the vagina. This stage is divided into
early and active phases and usually lasts several hours.
By the end of the first stage, the cervix will have fully
dilated to 10 centimeters. Early labor is the period of time
when you are 0 to 3 centimeters dilated. When the cervix
is 3 to 4 centimeters dilated, active labor begins. The contractions
become more intense and more frequent, and the cervix dilates
faster. If this is your first pregnancy, you usually progress
faster.
- Stage 2. The mother bears down, or pushes,
while the muscles of the uterus contract to push the fetus
through the birth canal. This stage ends when the baby
is born. The second stage of labor may last 2 or 3 hours,
depending on several factors, such as the position of the
baby's head and the size of the baby and of the birth canal.
- Stage 3. The placenta, or afterbirth, comes
out of the uterus through the birth canal. This usually happens
within 30 minutes after the birth of the baby.
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How to Tell when Labor Is Approaching
Some changes take place that may signal the approach of labor. These
changes are listed in Table 1. Except for the contractions,
you may or may not notice some of these signs before labor
begins.
Table 1. Signs That You
Are Approaching Labor
|
Sign
|
What it is
|
When it happens
|
| Feeling as if the baby has dropped lower. |
Lightening. Commonly referred to as the "baby dropping." The
baby's head has settle deep into your pelvis |
From afew weeks to a few hours before labor begins |
| Discharging a thick plug of mucus or having an increase
of vaginal discharge (clear, pink or slightly bloody) |
Show. A thick mucus plug has accumulated at the cervix
during pregnancy. When the cervix begins to open
the plug is pushed into the vagina. |
Several days before labor begins or at the onset of
labor. |
| Discharging a continuous trickle or a gush of watery
fluid from your vagina. |
Rupture of the membranes. The fluid filled sac
that surrounded the baby during preganancy breaks (your "water
breaks"). |
From several hours before labor begins to any time
during labor. |
| Feeling a regular pattern of cramps or what may feel
like a bad back ache or menstrual cramps. |
Contractions. Your uterus is muscle that tightens
and relaxes. The hardness you feel is from your
uterus contracting. These contractions may cause
pain as the cervix opens and the baby moves through the
birth canal. |
Usually at the onset of labor (see Table
2, below, to compare contractions at labor to false
labor pains) |
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True Labor
Versus False Labor
In the last several weeks of pregnancy, you may notice
that your abdomen gets hard and then gets soft again. As
you get closer to your delivery date, you may find that this
becomes uncomfortable or even painful. These irregular
cramps are called Braxton-Hicks contractions, or false labor
pains. They may occur more frequently when you are physically
active.
False labor can occur just at the time when labor is expected
to start. Thus it is sometimes difficult to tell this
from true labor. Don't be upset or embarrassed if you
react by thinking labor is beginning. Sometimes the difference
can only be determined by a vaginal exam--changes in your cervix
signal the onset of true, active labor. Other times there
are ways that might help you to tell the difference between
true and false labor.
One good way to tell is to time the contractions. Time
how long each cramping period lasts and the length of time
in between each contraction. Keep a record for an hour. During
true labor ...
- the contractions last about 50-80 seconds
- they occur at regular intervals
- they don't go away when you move around
Call your health care provider when contractions reach the level
that you agreed upon earlier as the time to call.
Table 2 gives you easy reference to some of the differences between true, active
labor and false labor. Keep in mind, though, that it can be hard to time
labor pains accurately if the contractions are slight. It's best to be
cautious--don't wait too long to call your health care provider if you think
you are going into labor.
Table 2: Differences Between
False Labor and True Labor
|
Type of Change
|
False Labor
|
True Labor
|
| Timing of contractions. |
Often are irregular and do not consistently get closer together (called
Braxton-Hicks contractions) |
Come at regular intervals and, as time goes on, get closer and closer
together. |
| Change with movement |
Contractions may stop when you walk or rest, or even may stop with
a change of position. |
Contractions continue despite movement. |
| Location of contractions |
Often felt in the abdomen |
Usually felt in the back coming around to the front. |
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Other Reasons to Call
Your Health Care Provider
There are other signs that should prompt you to call your health care provider
and to think about going to the hospital. Call if:
- your membranes rupture (your "water breaks"), even if you are not having
any contractions
- you are bleeding from the vagina (but not if it is just the "show" mentioned
in Table 1)
- you have constant, severe pain--don't wait for a whole hour to pass
- you feel reduced fetal movement
Finally ...
You are approaching a special, exciting time. Although it is impossible
to know exactly when labor will begin, you can be ready by knowing what to
look for and what to expect and by having your questions answered. Being
prepared will help make your labor experience the best it can be for you.
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