How to understand that labor has begun

In late pregnancy, time can drag on very slowly: it becomes difficult to sit and lie down, sleep is disturbed, and relatives constantly ask when the birth will occur. Let’s figure out whether there are any sure signs that labor will occur in the next 24-48 hours.

How does childbirth proceed?

You can mentally prepare for childbirth if you know the typical sequence of events. This process has three stages. The first period consists of latent and active phases and can last up to 18–20 hours. The latent phase begins with contractions every 8–10 minutes. Contractions are periods of contraction and relaxation of the uterus. They help move the baby along the birth canal. The fetus presses on the cervix, the cervix softens and as a result opens by 5 cm.

After this, the active phase of labor begins. Over the next 4-6 hours, the cervix opens completely, and the baby begins to descend into the pelvis. The woman experiences frequent and painful contractions – they bring sharp or dull pain in the lower abdomen and lower back, as well as pressure in the pelvic area. Some women in labor experience leg cramps and nausea. 

The intensity of pain depends on various factors: the size and position of the baby, the strength of contractions, individual sensitivity to pain. Here are some tips to help reduce discomfort: 

• Move more. You can walk calmly, stopping to breathe during contractions.
• Ride on a large exercise ball. This will help reduce the intensity of the pain.
• If possible, take a warm shower or bath.
• Try breathing techniques to reduce pain. For example, take a deep breath and exhale all the tension. Focus on any object and prepare for a new contraction. When the contraction gets more intense, speed up your breathing: take shallow, frequent breaths every second. Try to relax your neck and shoulders. Breathe through your mouth. Take a deep breath when the contraction ends.
• Ask your partner or midwife to give you a gentle massage between contractions.
• If you feel hungry, have a light snack. You shouldn’t overeat: when you need to have a cesarean section, food in the stomach can lead to complications. In this case, you can eat ice cream, drink some water or juice.

In the second, most difficult period of labor, the baby passes through the birth canal and is born. This can take from an hour to 4-5 hours.

In the third stage, the placenta with the fetal membranes is born. The woman still feels regular, but less painful contractions. The process can last from 5 minutes to an hour. 

How to understand that labor has begun

There are no reliable symptoms that guarantee the imminent onset of labor. However, there are several signs that may indirectly indicate the long-awaited event. And they are not always as spectacular as in the movies, when the pregnant heroine’s water breaks suddenly and quickly. 

• Contractions. In the early stages of labor, women feel contractions every 15 minutes. They can feel like pain in the lower back and lower abdomen, sometimes the sides and hips hurt.
• Cramps. Some women experience a mild, pulling sensation in the lower abdomen, similar to menstrual cramps. They can last from a few hours to a few days.
• Pelvic pressure. Before labor begins, the baby moves into the pelvic area. As a result, pressure on the bladder and vagina increases, and frequent urges to urinate and lower back pain occur.
• Mucus plug discharge. Sometimes expectant mothers notice the discharge of viscous pink or yellowish mucus clots from the vagina, which may indicate the discharge of the mucus plug. The mucus plug is a collection of mucus that forms a reliable barrier to protect the fetus from infections. Usually, the mucus plug comes off a few days or hours before labor, when the cervix is ​​preparing for labor. However, in the practice of obstetricians there are cases when the mucus plug comes off during labor.

Some women may experience less obvious symptoms , but there is no clear evidence that these are related to early labor.

• Fatigue. A completely normal feeling at the end of pregnancy: the size of the fetus makes it difficult to sit, walk, lie down. Pressure on the bladder leads to frequent urges to go to the toilet in the middle of the night. Constant anxiety, lack of sleep, and physical discomfort at the end of the third trimester of pregnancy exhaust the expectant mother.
• Sharp pain in the perineum. Some women report a shooting sharp pain in the perineum and in the pelvic area, which is caused by the position of the fetus.
• Diarrhea: A surge of hormones that control labor causes the smooth muscles of the intestine to relax.
• Nausea. Associated with the baby dropping into the pelvis or with pain during contractions.

What are practice contractions and how are they different from real ones?

Before labor begins, many women experience practice contractions, known as Braxton Hicks contractions. These are irregular contractions of the uterus that begin in the second or third trimester. These contractions are the pregnant woman’s body’s way of preparing for the upcoming birth. Many women report feeling cramps in their lower abdomen, similar to period pain. 

Unlike real contractions, the strength, frequency, and duration of practice contractions do not change over time. Practice contractions usually go away when you walk around, sit down, or take a break. Real labor contractions are regular and last from 30 seconds to 1.5 minutes, do not go away, and even get stronger when a woman walks, sits down, or takes a shower. During labor contractions, it is difficult to talk and walk, and the pain increases over time. 

When exactly is it time to go to the maternity hospital?

Usually, gynecologists recommend going to the maternity hospital already in the latent phase of the first stage of labor. In this case, contractions should be regular, with an interval of at least 8-10 minutes. In repeated births, the cervix opens faster, so it is worth hospitalizing as soon as contractions become rhythmic and regular. In addition, you need to see a doctor if the following symptoms appear:

• Vaginal bleeding. This can be a sign of placental abruption, where the baby suffers from lack of oxygen and the woman is at risk of losing a lot of blood.
• Breaking of waters. During pregnancy, the fetus develops in a fluid-filled amniotic sac. When the membranes of the sac rupture , the woman’s waters break: the fluid may flow copiously or in small streams. After the waters break, labor should begin within 24 hours. 
• Clear vaginal discharge. It is important to distinguish between normal water discharge and premature rupture of membranes, which can occur before the 37th week of pregnancy. In this case, the fluid does not flow in large quantities, but leaks – this can be noticed by damp underwear. With premature rupture of membranes, the risk of infections for the mother and child  increases .
• Decreased motor activity of the child. If less than 6-10 movements of the child are noticeable within an hour, this may indicate intrauterine hypoxia and requires medical intervention.