Signs of
Labor
It is natural to be perplexed, curious
and even tensed about what is going
to happen when the date draws close.
If this is your first baby, fear of
what to expect, curious if you will
recognize when labor has actually
started for you and other such related
ideas are going to preoccupy your
thoughts increasingly. Amidst all
these feelings you will also feel
a sense of relief (it is all coming
to an end), sadness (strange but you
are going to miss those pregnancy
months), and happiness (now that your
baby will finally be in your arms).
Once labor begins you will experience
clear indications that tell you it
is time; however the signs are different
for every woman.
The signs you can typically anticipate
are described below:
Regular
contractions:
At the onset of true labor, the contractions
will feel like a tightening of abdominal
muscles, a dull ache or a pressure
on the lower pelvis or back. At about
this time you may feel the baby drop
down into the pelvis; this is known
as engagement because the baby has
settled into its position for birth.
Another term aptly used is lightening
because the baby's new position means
the mother has now more space to breathe
and digest food. With time the contractions
start to come at a more regular pace
and the pain intensifies. The sensation
is like a belt tightening around your
back which spreads round underneath
the baby. As the labor progresses
the contractions last longer and occur
at decreasing intervals.
Bloody
show:
A plug of mucous which seals the top
of the vagina acts as a barrier against
infection from invading the uterus.
Sometimes this plug dislodges itself
before the contractions commence and
you will notice a 'show' i.e. thick
vaginal discharge mixed with blood
in your underwear. This however is
no indication that you are into proper
labor; it may be several days before
the action commences. In other instances,
the contractions begin well before
the expulsion of the mucous plug.
Water break:
In about 20% of women, the pressure
of the baby's head can puncture the
amniotic bag causing the fluids to
leak out before labor. Often it occurs
in later part of labor. There is no
mistaking a rupture; the leakage is
clear and watery from the vagina and
you can lose as much as 2 pints of
fluid. The water can gush out or come
in a slow trickle. Contact your hospital
immediately; you will probably be
advised to go in right away since
baby is in risk of infection and chance
of umbilical cord's descent into the
birth canal is there. Water breaking
can pose a risk to your baby either
in the form of infection or the oxygen
supply being affected.
Other signs:
You may experience other symptoms;
nausea, diarrhea and backache. Sometimes
you even feel some tightening the
whole day before labor begins; this
is indicative of the cervix ripening
and shortening at a gradual pace or
your baby could be probably lying
with its back to your back. In the
case of the latter the tightening
occurs as the baby rotates round to
assume the right position before making
its entry into the world.
True or
False labor - how can you tell
In the start, you might not know if
you are in real labor. The most distinguishing
factor is true labor pains are consistent
and regular; they slowly increase
in frequency, duration and intensity.
False labor on the other hand, tends
to disappear if you lie down or walk
around or a glass of drink cold water,
and do not increase in frequency or
duration.
| Contractions |
False
labor |
True
labor |
| Timing |
Irregular, no increase
in frequency or duration |
Regular intervals which
gradually become closely
spaced |
| Change
with motion |
Stop
and start at irregular
intervals |
Progress is continuous |
| Location |
Abdomen |
Back, then travels to
the front |
| Intensity |
Weak
and remains weak |
Intensifies with time |
| External
changes |
None |
Mucus plug may dislodge;
membrane rupture; bladder
pressure |
| Occurrence |
Happens
when you are tired, especially
in the evenings |
Anytime |
|
The three
stages of Labor
Labor has 3 distinct stages, each
with its own characteristics.
The
first stage begins with the
first contraction and ends when the
cervix is fully dilated. The cervix
undergoes many changes: it becomes
softer, spongier, the cells thin out
and the cervix shortens. This shortening
and thinning is termed effacement.
Before effacement the cervix is 1.5
inches in length and after effacement
it somewhat disappears. Force from
the contractions combined with the
pressure from baby's head slowly compels
the now 'thin' cervix opening to widen.
This is termed as dilation, which
basically means the widening of the
opening. Full dilation is at 10cm,
about the width of a hand. When the
cervix is beginning to dilate most
mothers will feel the contractions
in the back. You will be conscious
of this ache but you can still go
about with your normal activities.
If you do not experience this, the
mucous plug will soon dislodge instead.
• The rate of dilation varies;
tends to be slower in first time mothers.
• On average it will take about
9 hours for the cervix to dilate 2.5
cm (the latent phase). The time varies;
some women take longer, some with
lesser time.
• Next comes the active phase
which causes the cervix to dilate
from 3 - 10 cm; this phase lasts between
2 - 4 hours. Again the time varies.
The pain is intense and the urge to
bear down and push the baby out starts
now.
• On average one hour is taken
up for every centimeter that the cervix
dilates
The second stage begins at
full dilation and ends when the baby
makes an entry into the world. Uterine
contractions are now even more pronounced;
they help in the dilation and force
the baby down and out. The contractions
now occur every 2-3 minutes, lasting
between 1 to 1.5 minutes. As the baby
makes its descent, the mother works
hard on the pushing. In a typical,
normal situation, first the head descends
followed by the rest of the body through
the vagina.
• It takes a first baby close
to an hour to make its way down the
birth canal, through the vagina to
the vulva
• The appearance of the baby's
head at the mouth of the vagina is
called crowning.
• Following the crowning, the
doctor may make a small cut into the
area between the vagina and the rectum;
this is called episiotomy. Many doctors
feel that this procedure should be
performed only when necessary
In
the final stage, the placenta
dislodges from the uterus and is expelled.
After the baby is delivered, the uterus
sheds the placenta (placenta provided
nourishment to baby during the entire
course). Contractions continue even
after baby is born. The uterus begins
to get smaller and its walls thicker.
This reduces the surface the placenta
was attached. The placenta then separates
and is pushed down and out of the
vagina. Blood clots form immediately
at the site of separation preventing
any excessive bleeding. Bleeding is
also controlled by the uterus contracting
and closing the blood vessels that
previously supported the placenta.
| First
stage - first contraction to
full dilation of cervix |
Second
stage - full dilation until
delivery |
Third
stage - birth |
| Latent
phase: 1st contraction
to 3-5 cm of cervix dilationContractions
every 5-15 minutesLasts for
an average 8-10 hours for 1st
pregnancy |
Lasts for 2 hours or more |
Begins with birth of baby and
ends with delivery of placenta |
|
Active phase:
3-5 cm to full dilation of 10
cm Contractions 3-5 minutes
apartLasts an average 4 hours
for 1st pregnancy |
pushing begins with contractions
and the urge to bear down |
Lasts for about 20 minutes |
