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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

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 - 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. This state is quite understandable - you need to gather strength to prepare for childbirth. Often, just before giving birth, a woman wants to retire, looking for a secluded place where you can hide and focus on yourself and your experiences. nine0003

What should I do if there are any signs of childbirth? Usually you don’t need to do anything, because the harbingers are completely natural, they just say that the body is rebuilding and preparing for the birth of a child. Therefore, you should not worry and go to the hospital as soon as, for example, training contractions have begun or the mucous plug has come off. We must wait for real labor pains or outpouring of water.

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01/26/2018

IVF failures: embryological stage
Wrestler Maria Vladimirovna

Stages of labor | Canpolbabies.com

Childbirth is one of the most important and perhaps the most beautiful, albeit difficult, moments in every woman's life. The emotions that arise when you first meet your child are difficult to describe. It seems that everything is simple - you went to the hospital and gave birth to a child. However, before the little man is born, the expectant mother will have to go through several successive stages of childbirth. nine0003

Remember: a positive attitude is a must!

You already know that childbirth is difficult. Especially after hearing horror stories from friends, aunts, women in stores and at your gynecologist's waiting room, or having studied all the information on online pregnancy forums. But often women, especially those who have recently given birth, exaggerate. Because of all this, you may have a fear of childbirth, but you will cope with this fear if you know what awaits you and in what sequence, how the different stages of childbirth differ and what you should do at each of them. The most important thing is to use common sense and stay positive and have confidence in the hospital where you want to give birth. nine0003

There are three stages in normal childbirth.

The first period is divided into three phases: hidden, active and transitional.

During the first latent phase:

- the cervix shortens and dilates to three or four centimeters. Sometimes during the latent phase, when changes affect only the vaginal part of the uterus, women do not feel anything. The cervix begins to prepare for childbirth a few weeks before this event, and the woman does not experience any discomfort. However, it is difficult to call the "hidden" period when the cervix dilates to three or four centimeters, because most women remember this time as the worst. This is the longest phase in childbirth, after which everything goes much easier. nine0003

- You may feel weak contractions lasting 30-45 seconds, pain in the lower abdomen similar to that of menstruation, or contractions. Then you will feel a strong urge to empty your bowels.

- A dark brown liquid, sometimes slightly red, may come out of your vagina.

- Mucus plug may come off at this stage. This usually happens a day or two before giving birth, but according to research, the cork can come off even two weeks before giving birth. It all depends on the size and thickness of the cork, and this is individual for each woman. nine0003

Mucus plug is a pink or brown jelly-like discharge (possibly yellowish if you have used vaginal tablets before), which forms a clot of mucus and thus closes the entrance to the uterus during pregnancy. This is a kind of barrier between the child and the outside world, protecting the child from bacteria and viruses.

- At this stage, you can safely stay at home, as it lasts several hours. However, if you want to use an epidural during childbirth, you must go to the hospital. This type of anesthesia is administered when the cervix is ​​dilated to three to four centimeters. If the opening has reached eight centimeters, it is too late to administer anesthesia. nine0003

- It is best to walk at this stage, as it brings relief. I especially recommend walking or, if possible, a relaxing bath. The bath water should not be too hot. Do not take a bath if you have vaginal bleeding. To relax, watch a movie or read a book.

You must go to the hospital immediately if:

- You have had strong, painful and regular contractions for at least half an hour, which occur every ten minutes. Contractions every ten minutes may, however, weaken, but at this moment women begin to worry that they will not have time to get to the hospital (especially if this is not the first birth). Most of the women arrive too early, but they are understandable and no one has anything against it. nine0003

- Your amniotic fluid is breaking and you feel as if you have urinary incontinence. There may or may not be fights. The waters must be clear. Any other color (pink, streaked with blood) should be taken into account by the doctor. Green waters indicate a slight hypoxia in a child, the result of which is the release of meconium. In this case, a CTG sensor must be used during childbirth. It may also require constant or more frequent monitoring of the child's condition. The decision on such control is made by the medical team conducting the birth. nine0003

During the second - active - phase:

- The cervix dilates up to seven centimeters.

- The contractions of the uterus become more intense and prolonged, they last for 45-60 seconds and occur every three to four minutes. But you must remember that each pregnancy must be approached individually, and therefore this time may be slightly shifted up or down.

- The contractions are so strong that you cannot talk normally while you are having a contraction. nine0003

- Pain in the legs and in the sacrum increases, and bloody discharge comes out of the vagina.

- You may feel a little tired, restless or agitated due to the approaching moment of your baby's birth.

- If there are no contraindications, you can drink some water or eat something light and in small quantities, but most doctors forbid eating or drinking. In this case, you can moisten your mouth with water. Intravenous fluids are allowed.

- During this phase, you can walk around the room or at least around the bed. Change your position often to make contractions easier. nine0003

During the third transitional phase:

- The last three centimeters open fairly quickly. Usually, it takes from 15 minutes to one hour to complete - 10 centimeters - the opening of the cervix. However, for some women, this process can take up to two hours.

- Contractions very frequent and violent. They occur every minute or two and last 60-90 minutes. It may seem that they are not weakening at all, but still sometimes they are weaker and sometimes stronger. Hold on and don't give up! It will all be over soon. nine0003

- You may experience pain in the lower back and perineum. You may also feel intense pressure inside your rectum, possibly passing urine or stool involuntarily. For this reason, at an earlier stage of labor, it is recommended to do an enema and urinate more often. An enema is not required, but it should be borne in mind that involuntary excretion of feces in the presence of medical personnel can be uncomfortable and unpleasant for the woman in labor. Regular emptying of the bladder is necessary for better insertion of the baby's head into the birth canal, but if you have been given an epidural, you may not feel the need to urinate. In this case, it is required to insert a catheter into the urethra of the woman in labor. A full bladder is a serious problem during childbirth. nine0003

- Dizziness, nausea and even vomiting are possible. It's fairly common for women in labor at this stage of labor, although it doesn't happen to everyone. Vomiting is very difficult, but it speaks of progress in the birth process.

- During this phase you may have bouts of shivering, you may feel cold followed by hot flashes and sweating. This is completely normal and there is no cause for concern.

- Now you already feel exhausted and debilitated by the long process. This is a very difficult moment for a woman in labor, as it is difficult to concentrate and relax during painful contractions. nine0003

- The transitional phase is the most exhausting and difficult, so it's good if you have someone next to you who will help and support you at critical moments. It could be your husband or your best friend. It is important that the decision about a birth partner is thoughtful and mutually agreed, and not spontaneous or made to please fashion trends. This should be a person whom you completely trust and in front of whom you are not ashamed of your pain, a person with strong nerves, who will support you and will not panic. nine0003

- Try to relax between contractions. Breathe as slowly and rhythmically as possible. Use the breathing techniques you learned in childbirth preparation classes. You can also ask a midwife for help.

- Remember not to push until the cervix is ​​fully dilated, as this can lead to swelling and delay labor. You can start pushing only on a signal from the midwife.

The second stage of labor may last only a few minutes, but according to the recommendations of obstetrician-gynecologists, it should not exceed two hours. nine0003

- Contractions during the second period occur every two to five minutes and last 60-90 seconds. They are still very strong, but less painful, you can feel when one ends and the next begins.

- Sensation of pressure inside the rectum especially strong. You may feel the need to defecate. Report this to your midwife. Never go to the toilet without telling the midwife if you don't want to have your baby in the toilet.

- As the baby's head moves through the birth canal, you may experience tingling, itching, stinging or even sharp pain. nine0003

- You may involuntarily urinate or have a bowel movement while pushing. It's completely natural. Do not worry about it. In this case, everything is immediately removed so as not to cause discomfort to the woman in labor.

- Find the most comfortable position for you, for example half-sitting. You can also squat down. It all depends on your mood and strength.

- At this stage, you must listen to the obstetrician and follow the instructions of the birth doctor. Breathing properly will make the birth process easier and is very important for the baby. nine0003

- You should rest between contractions. Use these moments to relax your facial muscles and restore your breathing. As the contraction intensifies, breathe more rapidly until you feel a strong urge to push. At this point, draw air into the lungs and push the diaphragm towards the pubic symphysis. When the contraction eases, you will again have time to relax and catch your breath. If screaming brings you relief, you can scream at the end of the push and during the breaks between contractions. Yelling at the beginning or middle of a push can cause you to use up all the air you need for the push and make it ineffective. You will get tired and the baby will get stuck in the perineum. nine0003

- At some point the obstetrician may ask you not to push. This is usually done to prevent rupture of the perineum.

- After a series of such contractions, there comes a moment when the baby's head is shown, this is a turning point during the second stage of labor. If necessary, at this point, the obstetrician, using special scissors, makes an episiotomy to protect the skin of the perineum from tears.

- Shoulders, belly and legs follow the head. And then the newborn was born. You hear his first cry. The obstetrician places the baby on your stomach and cuts the umbilical cord. You can ask that your partner be allowed to cut the umbilical cord. Then the child is weighed, measured and evaluated on a ten-point Apgar scale. nine0003

At this point, you are entering the third stage of labor.

The third stage of labor lasts from a few minutes to half an hour.

- At this time, the uterus contracts, pushing the placenta out.

- Contractions are now much shorter, weaker and not as painful as they used to be. You may not feel them at all, being completely absorbed in your newborn baby.

- The obstetrician will take your temperature and blood pressure, the obstetrician-gynecologist will check the condition of your perineum, vagina and uterus, and evaluate the placenta. Sometimes it is partially damaged, and then scraping of the remaining part is required. It is very important that the entire placenta exits the uterus, as any leftover placenta can cause infections and bleeding.

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