How does labour pains start

Contractions and signs of labor

Learning the signs of labor before your due date can help you feel ready for your baby’s birth.

Signs of labor include strong and regular contractions, pain in your belly and lower back, a bloody mucus discharge and your water breaking.

If you think you’re in labor, call your health care provider.

Not all contractions mean you're in true labor. Learning the difference between true and false labor can help you know when it’s the real thing.

What is labor?

Labor (also called childbirth) is the process of your baby leaving the uterus (womb). You’re in labor when you have regular contractions that cause your cervix to change. Contractions are when the muscles of your uterus get tight and then relax. Contractions help push your baby out of your uterus. Your cervix is the opening to the uterus that sits at the top of the vagina. When labor starts, your cervix dilates (opens up).

As you get closer to your due date, learning the signs of labor can help you feel ready for labor and birth. If you have any signs of labor, call your health care provider.

What are the signs of labor?

You know you’re in true labor when:

You have strong and regular contractions. A contraction is when the muscles of your uterus tighten up like a fist and then relax. Contractions help push your baby out. When you’re in true labor, your contractions last about 30 to 70 seconds and come about 5 to 10 minutes apart. They’re so strong that you can’t walk or talk during them. They get stronger and closer together over time.
You feel pain in your belly and lower back. This pain doesn't go away when you move or change positions.
You have an increase in vaginal discharge that can be clear, pink or slightly bloody (brownish or reddish). This is called bloody show. It can happen a few days before labor or at the beginning of labor. If you have bright red bleeding or if the bleeding is heavy, tell your provider right away.
Your water breaks. Your baby has been growing in amniotic fluid (the bag of waters) in your uterus. When the bag of waters breaks, you may feel a big rush of water. Or you may feel just a trickle.

If you think you’re in labor, call your health care provider, no matter what time of day or night. Your provider can tell you if it’s time to head for the hospital. To see for sure that you’re in labor, your health care provider measures your cervix.

What are signs that you may be close to starting labor?

You may be close to starting labor if:

Your baby drops or moves lower into your pelvis. This is called lightening. It means that your baby is getting ready to move into position for birth. It can happen a few weeks or even just a few hours before your labor begins.
You have an increase in vaginal discharge that’s clear, pink or slightly bloody. This is called show or bloody show. It can happen a few days before labor starts or at the beginning of labor.
At a prenatal checkup, your health care provider tells you that your cervix has begun to efface (thin) and dilate (open). Before labor, your cervix is about 3.5 to 4 centimeters long. When it’s fully dilated (open) for labor, it’s 10 centimeters. Once labor starts, contractions help open your cervix.
You have the nesting instinct. This is when you want to get things organized in your home to get ready for your baby. You may want to do things like cook meals or get the baby’s clothes and room ready. Doing these things is fine as long as you’re careful not to overdo it. You need your energy for labor and birth.

If you have any of these signs, you may start labor soon. Learn the signs of labor so you know when to call your provider.

What are false labor and Braxton-Hicks contractions?

Not all contractions mean you’re in labor. You may have contractions on and off before true labor starts. These contractions are called false labor or Braxton-Hicks contractions. They soften and thin the cervix to help your body get ready for labor and birth. You may feel them in the weeks right before your due date. Learning the differences between true labor contractions and false labor contractions can help you know when you’re really in labor.

It can be hard to tell the difference between true labor and false labor. When you first feel contractions, time them. Write down how much time it takes from the start of one contraction to the start of the next. Make a note of how strong the contractions feel. Keep a record of your contractions for 1 hour. Walk or move around to see if the contractions stop when you change positions.

What is preterm labor?

Preterm labor is labor that begins too early, before 37 weeks of pregnancy. Premature babies (born before 37 weeks of pregnancy) can have health problems at birth and later in life. If you’re not to 37 weeks of pregnancy and you have signs or symptoms of preterm labor, call your provider. Getting help quickly is the best thing you can do. Learn about risk factors for preterm labor and what you can do to help reduce your risk.

What are stages of labor?

Stages of labor include the whole process of labor, from your first contractions (stage 1) to pushing (stage 2) to delivery of the placenta (stage 3) after your baby is born. Learning about the stages of labor can help you know what to expect during labor and birth.

Last reviewed: December, 2018

Stages of labor | March of Dimes

Every woman’s labor is different. And it may be different each time you have a baby.

Learning about stages of labor before your due date can help you know what to expect so you can feel ready for your baby’s birth.

Use a birth plan so your health care provider and hospital staff know what your plans are for labor and after birth.

Having a professional support person, like a doula, during labor can help you have a better experience with labor and birth.

Try to stay comfortable and relaxed through labor. Move around and try different positions to find what works best for you.

What are stages of labor?

Labor (also called childbirth) is the process of your baby leaving the uterus (womb). Labor is divided into three stages:

Labor
Pushing and birth
Delivery of the placenta

Every woman’s labor is different. And your labor may be different each time you have a baby. But there are patterns to labor that are true for most women. Learning about the stages of labor and what happens during each one can help you know what to expect once labor begins.

What is a birth plan?

A birth plan is a set of instructions you make about your baby’s birth. It includes things like:

Where you want to have your baby
Who you want to be with you during labor and birth
If you want medicine to help with labor pain
If there are cultural traditions you’d like to follow during labor and birth
If you plan to breastfeed

Before your due date, use the March of Dimes birth plan to help you think about how you want your labor to be. Share the completed plan with your partner, your health care provider and the staff at the hospital where you plan to give birth.

What is a doula?

You may want to have a professional support person help you through labor and childbirth. A doula is a professional labor assistant. This is someone who is trained to give physical and emotional care and support to women and their families before, during and after childbirth. For example, a doula can:

Help you stay comfortable
Explain what’s happening during labor and birth and any procedures you may have
Encourage you and give you confidence
Support your family and friends who are with you during labor
Let hospital staff know what you need
Help you get started breastfeeding

Having a support person like a doula can be good for you, your baby and your family. It can help you feel good about your birth experience. Having a doula can help:

Shorten your labor
Reduce your need for pain medicine during labor
Reduce your risk of needing a cesarean birth or the need for your provider to use forceps or suction with a vaginal birth
Your baby get a good Apgar score at birth. Your baby gets an Apgar test right after birth to check his overall health. The test checks his heart rate, breathing, muscle tone, reflexes and skin color.

To find a certified doula, ask your provider or go to DONA International.

You also may want to have your partner, a friend or a family member be a support person to help you through labor. They can go to childbirth education classes with you to learn ways to help, like timing your contractions, helping you relax and helping you move around to find a comfortable position. Ask your provider about childbirth education classes in your area.

If you decide to have a doula or another support person help you with labor and birth, put their names and contact information in your birth plan. Share your plan with your provider and with hospital staff.

What happens in the first stage of labor?

The first stage of labor is the longest stage. For first-time moms, it can last from 12 to 19 hours. It may be shorter (about 14 hours) for moms who’ve already had children. It’s when contractions become strong and regular enough to cause your cervix to dilate (open) and thin out (efface). This lets your baby move lower into your pelvis and into your birth canal (vagina). This stage of labor ends when you are 10 centimeters dilated. The first stage is divided into three parts: early labor, active labor and transition to stage 2 of labor.

Early labor

For most first-time moms, early labor lasts about 6 to 12 hours. You can spend this time at home or wherever you’re most comfortable. During early labor:

You may feel mild contractions that come every 5 to 15 minutes and last 60 to 90 seconds.
You may have a bloody show. This is a pink, red or bloody vaginal discharge. If you have heavy bleeding or bleeding like your period, call your provider right away.

What you can do in early labor:

This is a great time for you to rely on your doula or labor support person. Try the methods you learned about in childbirth education classes about how to relax and cope with pain. During early labor:

Rest and relax as much as you can.
Take a shower or bath.
Go for a walk.
Change positions often.
Make sure you’re ready to go to the hospital.
Take slow, relaxing breaths during contractions.

Active labor

This is when you head to the hospital! Active labor usually lasts about 4 to 8 hours. It starts when your contractions are regular and your cervix has dilated to 6 centimeters. In active labor:

Your contractions get stronger, longer and more painful. Each lasts about 45 seconds and they can be as close as 3 minutes apart.
You may feel pressure in your lower back, and your legs may cramp.
You may feel the urge to push.
Your cervix will dilate up to 10 centimeters.
If your water hasn’t broken, it may break now.
You may feel sick to your stomach.

What you can do in active labor:

Make sure the hospital staff has a copy of your birth plan.
Try to stay relaxed and not think too hard about the next contraction.
Move around or change positions. Walk the hallways in the hospital.
Drink water or other liquids. But don’t eat solid foods.
If you’re going to take medicine to help relieve labor pain, you can start taking it now. Your choice about pain relief is part of your birth plan.
Go to the bathroom often to empty your bladder. An empty bladder gives more room for your baby’s head to move down.
If you feel like you want to push, tell your provider. You don’t want to start pushing until your provider checks your cervix to see how dilated it is.

Transition to the second stage of labor

This can be the toughest and most painful part of labor. It can last 15 minutes to an hour. During the transition:

Contractions come closer together and can last 60 to 90 seconds. You may feel like you want to bear down.
You may feel a lot of pressure in your lower back and rectum. If you feel like you want to push, tell your provider.

What happens in the second stage of labor?

In the second stage of labor, your cervix is fully dilated and ready for childbirth. This stage is the most work for you because your provider wants you to start pushing your baby out. This stage can be as short as 20 minutes or as long as a few hours. It may be longer for first-time moms or if you’ve had an epidural. An epidural is pain medicine you get through a tube in your lower back that helps numb your lower body during labor. It's the most common kind of pain relief used during labor. The second stage ends when your baby is born.

During the second stage of labor:

Your contractions may slow down to come every 2 to 5 minutes apart. They last about 60 to 90 seconds.
You may get an episiotomy. This is a small cut made at the opening of the vagina to help let the baby out. Most women don't need an episiotomy.
Your baby’s head begins to show. This is called crowning.
Your provider guides your baby out of the birth canal. She may use special tools, like forceps or suction, to help your baby out.
Your baby is born, and the umbilical cord is cut. Instructions about who’s cutting the umbilical cord are in your birth plan.

What you can do:

Find a position that is comfortable for you. You can squat, sit, kneel or lie back.
Push during contractions and rest between them. Push when you feel the urge or when your provider tells you.
If you’re uncomfortable or pushing has stopped, try a new position.

What happens in the third stage of labor?

In the third stage of labor, the placenta is delivered. The placenta grows in your uterus and supplies your baby with food and oxygen through the umbilical cord. This stage is the shortest and usually doesn’t take more than 20 minutes.

During the third stage of labor:

You have contractions that are closer together and not as painful as earlier. These contractions help the placenta separate from the uterus and move into the birth canal. They begin 5 to 30 minutes after birth.
You continue to have contractions even after the placenta is delivered. You may get medicine to help with contractions and to prevent heavy bleeding.
Your provider squeezes and presses on your belly to make sure the uterus feels right.
If you had an episiotomy, your provider repairs it now.
If you’re storing your umbilical cord blood, your provider collects it now. Umbilical cord blood is blood left in the umbilical cord and placenta after your baby is born and the cord is cut. Some moms and families want to store or donate umbilical cord blood so it can be used later to treat certain diseases, like cancer. Your instructions about umbilical cord blood can be part of your birth plan.
You may have chills or feel shaky. Tell your provider if these are making you uncomfortable.

What happens after your baby is born?

Congratulations! It’s time to hold your baby! Right after birth your provider places your baby skin-to-skin on your chest and covers him with a blanket. Holding your baby skin-to-skin helps your baby stay warm as he gets used to being outside the womb. It’s also a great way to get started breastfeeding. You can start breastfeeding even within an hour of your baby’s birth. Even if you don’t plan to breastfeed, hold your baby skin-to-skin so you get to know each other right away. Your baby will welcome your gentle touch, and this closeness can help you and your baby bond.

After birth, your body starts to change to help you heal. Your provider takes your temperature and checks your heart and blood pressure to make sure you’re doing well. If you had anesthesia during labor, your provider makes sure you’re recovering without any complications.

Last reviewed: March, 2019

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Contractions: false or real / “Waiting for a baby”

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Shortly before the birth, the expectant mother may be disturbed by training contractions, rhythmic contractions of the uterus, which quickly pass and appear occasionally. How to distinguish them from real contractions, and why they are needed, we will try to find out. nine0003

The phenomenon of temporary contractions was first described by the English doctor John Braxton Hicks. That is why they are called - Braxton Hicks contractions or false, training contractions, precursor contractions. In his scientific work of 1872, he argued that these contractions are short-term (from half a minute to 2 minutes) contractions of the muscles of the uterus, which are felt by a pregnant woman as an increase in the tone of the uterus. They appear after the 20th week of pregnancy. And during the day they happen often, but the expectant mother in the daytime may not even notice them. However, as time goes on, they intensify, becoming more and more obvious. nine0003

WHAT DO YOU NEED FALSE BROUGHT

The uterus is a muscular organ. And like any muscle that has to perform the work allotted to it in the body, it needs training. After all, if she hangs for all forty weeks like a bag, she will not cope with the load in childbirth. Thus, the purpose of training or false contractions is to prepare the uterus and cervix for childbirth. That is why one of the names of training bouts is contractions harbingers - harbingers of an approaching birth. nine0003

ARE FALSE PARTS PAINFUL?

As a rule, false contractions are painless, but with increasing duration they become more noticeable and bring more discomfort. However, in all women, they manifest themselves in different ways, someone does not feel them at all, and someone does not sleep at night, tossing and turning and trying to find a comfortable position for sleeping. It all depends on the pain threshold. The main thing in this situation is to stop being nervous about this and calm yourself with the thought that such training is necessary for the most important upcoming event - the birth of your crumbs. And to calm down a little and sleep better, ask your doctor to prescribe a sedative for you and get a special pillow for expectant and nursing mothers. With her, falling asleep and experiencing the discomfort of the last weeks of pregnancy will be much easier! nine0003

HOW TO LIVE WITH FREQUENT PARTS

Some expectant mothers complain that their Braxton Hicks contractions are frequent and cause significant discomfort, even when they are doing housework or other light physical activity. In such a situation, obstetricians are advised to lie down or vice versa, take an easy walk, in any case, change the type of activity. If training contractions bother you a lot, it is recommended to drink a glass of water, juice or herbal tea, calm down and get some rest. Ask someone close to give you a massage. Lie in silence. And to also benefit from training fights, try doing breathing exercises: practice breathing techniques in childbirth in practice. nine0003

HOW TO DIFFERENTIATE TRAINING FROM LIVING

The most important thing to understand is that real contractions are much more painful than Braxton Hicks contractions. You will understand it right away. In addition, the contractions that bring you closer to childbirth are more regular. The contractions begin in the lower back, spread to the front of the abdomen, and occur every 10 minutes (or more than 5 contractions per hour). Then they occur with an interval of about 30-70 seconds and over time the intervals between them are reduced. Some women describe the sensations of labor pains as severe menstrual cramps, or sensations during diarrhea, when the pain rolls in waves in the abdomen. These contractions, unlike false ones, continue even after a change in position and when walking, constantly intensifying. As soon as you feel all these symptoms, call your ob-gyn - hour X has arrived. If in doubt, also do not be afraid to disturb the doctor. The doctor will ask you a few questions that will help him determine the type of contractions and eliminate all your doubts and worries. After all, it is always better to consult a doctor and trust his professional experience. nine0003

You should seek help if:

• you have more than four contractions an hour and they happen regularly
• contractions are accompanied by pain in the lower spine
• contractions are accompanied by watery or bloody vaginal discharge
• the contractions are so strong that it is very difficult for you to endure them
• there is a marked change in the child's movement, or less than 10 movements every 2 hours nine0080 • you think your waters have started to break

Alla Misyutina, Consultant Physician, Independent Laboratory INVITRO

Dear women, during labor, the body needs a lot of oxygen, so proper breathing is very important. A large influx of oxygen into the blood of mother and baby alleviates the condition of the crumbs, which during childbirth experiences oxygen starvation. Special breathing techniques help to properly open the birth canal and make contractions and attempts as effective as possible. nine0003

Different types of breathing should be used at different stages of labor.

• During "false" contractions, breathing should be deep and slow. During the period when the contractions become more intense, it is necessary to use "pain-relieving breathing". This breathing is slow, deep, the inhalation is done through the nose, it should be longer than the exhalation through the mouth. More details: inhale is done at the expense of 1-2-3-4, and exhale - at the expense of 1-2-3-4-5-6. With the help of such breathing: mom relaxes, distracts from pain, focuses on the score; the baby receives as much as possible, so he needs oxygen. nine0080 • In breaks from contractions, you need to rest and breathe evenly without any effort, so that you can then easily follow the doctor's recommendations.
• During attempts, you need to exhale all the air from the lungs, then take a deep breath and push for up to 6-9 seconds. Quickly exhale all the air, quickly take a deep breath and again hold your breath for 6-9 seconds, and so on - about three times per attempt.
• In breaks from attempts to rest and breathe deeply, evenly and relaxed. nine0080 • It is very important to only push on the perineum and never push on the head. In this case, all efforts are wasted and will appear in the form of burst vessels in the eyes and on the face.
• In the period after the birth of the head, it is necessary to stop pushing and breathing shallowly, some call this breathing “dog-like”, deep breathing can harm both mom and baby. Then everything goes on as usual, the main thing is to obey the doctor.
• After the baby was born, within half an hour the last stage of labor begins - the birth of the placenta. Special breathing is no longer required, at the doctor's command, push a little into the perineum and EVERYTHING! Dear women, pain during childbirth is good, it means that your baby will be born soon. There is no need to resist the pain, this is a mistake that brings a woman and a child nothing but fatigue. On the contrary, it is necessary to concentrate and help in every possible way to give birth to a healthy baby. nine0003

BIRTH AGAIN

So, you have decided that this is no longer a “teaching”, but the beginning of childbirth. In addition to contractions, the onset of labor can be indicated by the outflow of amniotic fluid and the passage of a mucous plug that closes the lumen of the cervix. The mucous plug can also come off 2-3 days before delivery. However, her departure does not always mean that it is time to go to the hospital. During pregnancy, the cervix is tightly closed. With the onset of labor pains, its opening begins: the cervix of the uterus gradually expands to 10-12 cm in diameter (full disclosure). The birth canal is preparing to "release" the child from the womb. Intrauterine pressure increases during contractions as the uterus shrinks. And in the end, this leads to rupture of the fetal bladder and the outflow of part of the amniotic fluid. nine0003

The first, preparatory, period of labor for women giving birth for the first time takes an average of 12 hours, and 2-4 hours less for those who have second births. At the beginning of the second stage of labor, contractions join the contractions - contractions of the muscles of the abdominal wall and diaphragm. In addition to the fact that different muscle groups are involved in contractions and attempts, they have one more important difference: contractions are an involuntary and uncontrollable phenomenon, neither their strength nor frequency depend on the woman in labor, while attempts to a certain extent obey her will , it can delay or strengthen them. Therefore, at this stage of childbirth, a lot depends on the expectant mother and her ability to quickly and correctly follow the commands of the obstetrician taking delivery. And most importantly - to tune in correctly and not allow panic and thoughts about something bad. Obstetricians and gynecologists recommend that mothers perceive childbirth as a holiday, a baby's birthday. Then it will be easier to concentrate on the fact that now your main task is to help the baby be born. If, during childbirth, the expectant mother panics, the concentration of adrenaline in her blood will increase significantly. Which will not have a very good effect on the process of childbirth. Adrenaline affects the synthesis of oxytocin, which significantly weakens contractions and slows down the process of childbirth. In addition, adrenaline completely blocks the production of endorphins, which will increase the feeling of pain during contractions and attempts. That is why it is so important to properly tune in, concentrate and help the baby to be born as soon as possible. nine0003

Lilia Egorova

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Harbingers - childbirth is coming soon!

Wrestler Maria Vladimirovna

Obstetrician-gynecologist

MD GROUP Clinical Hospital, Mother and Child Clinic Savelovskaya

False contractions

They may appear after the 38th week of pregnancy. False contractions are similar to Braxton-Hicks contractions, which a woman could already feel starting from the second trimester of pregnancy (the uterus seems to stiffen for a few seconds - a couple of minutes, then the tension in it subsides). False contractions train the uterus before childbirth, they are irregular and painless, the intervals between them are not reduced. Real labor pains, on the contrary, are regular, their strength gradually increases, they become longer and more painful, and the intervals between them are reduced. That's when you can already say that the birth began for real. In the meantime, false contractions are going on, it is not necessary to go to the maternity hospital - you can easily survive them at home. nine0003

Abdominal prolapse

Approximately two to three weeks before birth, the baby, in preparation for birth, presses the presenting part (usually the head) against the lower part of the uterus and pulls it down. As a result, the uterus moves lower into the pelvic region, its upper part ceases to put pressure on the internal organs of the chest and abdominal cavity. In the people it is called - the stomach dropped. As soon as the stomach drops, the expectant mother notices that it has become easier for her to breathe, but, on the contrary, it becomes more difficult to sit and walk. Heartburn and belching also disappear (after all, the uterus no longer presses on the diaphragm and stomach). But, having dropped down, the uterus begins to put pressure on the bladder - naturally, urination becomes more frequent. nine0003

For some, uterine prolapse causes a feeling of heaviness in the lower abdomen and even slight pain in the area of the inguinal ligaments. These sensations arise due to the fact that the child's head, moving down, irritates the nerve endings of the pelvic organs.

During the second and subsequent births, the belly drops later - right before the birth. It happens that this harbinger of childbirth is not at all.

Removal of the mucous plug

This is one of the main and obvious harbingers of childbirth. During pregnancy, the glands in the cervix produce a secret (it looks like a thick jelly and forms the so-called cork), which prevents various microorganisms from entering the uterine cavity. Before childbirth, under the influence of estrogens, the cervix softens, the cervical canal opens slightly and the cork can come out - the woman will see that there are mucus clots on the linen that look like jelly. Cork can be of different colors - white, transparent, yellowish-brown or pink-red. Often it is stained with blood - this is completely normal and may indicate that childbirth will occur within the next day. The mucus plug can come out all at once (at once) or come out piecemeal throughout the day. nine0003

Weight loss

Approximately two weeks before delivery, weight loss may occur, usually by 0.5–2 kg. This happens because excess fluid is removed from the body and swelling decreases. If earlier during pregnancy, under the influence of the hormone progesterone, fluid in the body of a pregnant woman accumulated, now, before childbirth, the effect of progesterone decreases, but other female sex hormones - estrogens - begin to work hard, they remove excess fluid from the body of the expectant mother. nine0003

In addition, the expectant mother often notices that at the end of pregnancy it became easier for her to put on rings, gloves, shoes - this means that swelling on the hands and feet has decreased.

Change of stool

Right before childbirth, hormones often act on the intestines too – they relax its muscles, as a result, stool disorder begins. Sometimes such frequent (up to 2-3 times a day) and even loose stools are mistaken for an intestinal infection. But if there is no nausea, vomiting, discoloration and smell of feces, or any other symptoms of intoxication, you should not worry: this is one of the harbingers of the upcoming birth. nine0003

And on the eve of childbirth, you often don't feel like eating at all. All this is also the preparation of the body for natural childbirth.

Mood changes

Many women experience mood changes a few days before giving birth. The expectant mother gets tired quickly, she wants to have more rest, sleep, even some kind of apathy appears.

The Masterpiece Mom