Contrary to what most tv shows and movies would have you believe, the onset of labor is not typically marked by sudden, gripping and panicked contractions that require an immediate rush to the hospital. In fact, the portrayal of a typical woman’s uncomplicated labor and birth would not cause a network’s ratings to skyrocket. Labor is a process that is individual to each woman and is on her own timetable. While one of the most obvious signs you are in labor is the steady progression in length, intensity and frequency of contractions, there are a number of events that leads up to a baby’s birth day.
Dropping or Lightening
During the final weeks, you may wake up one day and notice you’re able to breathe more easily because your baby has moved down lower into the abdomen. While you may feel some relief in your lungs and a decrease in heartburn since your baby has engaged into the pelvic opening, you may also now feel more pressure on your bladder and bowels, along with an increase in constipation, hemorrhoids and the urge to urinate.
Cervical Changes and Loss of the Mucous Plug
A mucous “plug” forms at the entrance of the cervix shortly after a fertilized egg implants in the uterus. During pregnancy, the mucous plug protects the baby by preventing bacteria from entering the uterus. Before birth, hormonal changes begin to cause the cervix to soften, thin (efface), and open (dilate). As these changes occur, the mucous plug begins to detach and appear as discharge when you go to the bathroom. This may look like a glob of mucous, and it is sometimes tinged pink with blood. Sometimes, the plug falls away more slowly and its loss is not noticed.
You may be curious to know whether your cervix is effacing and dilating. Your doctor can tell you this information by doing a vaginal exam at a prenatal visit, but it is important to know that any cervical changes (or lack thereof) will not predict how long it will be until labor begins.
Aching Back and Pelvis
As your baby drops lower, you may experience discomfort in your lower back and pelvis. With the increased weight of the baby and the surge in hormones, your uterine and pelvic ligaments are looser and the baby is putting additional pressure on the pelvis and lower back.
The Nesting Instinct
Near the end of your pregnancy, you may suddenly feel a surge of energy and the motivation to prepare for your baby’s arrival. The need to organize, clean and get that to-do list done can be strong. Heed your urges, but be sure to rest frequently and nourish yourself during this time.
As labor nears, the increased hormone load often results in a natural enema, causing nausea, abdominal cramps and frequent, loose bowel movements.
Increased Practice Contractions
Braxton-Hicks contractions may increase in strength and frequency in the weeks leading to labor. These warm-up contractions help the softening and thinning of the cervix. The contractions may range in intensity from a feeling of tightening or pressure, to sensations similar to menstrual cramps. Although contractions like these may be called “false” labor, be assured that they do serve a purpose in helping your body prepare for birth.
The breaking of the amniotic sac (aka rupture of membranes), where amniotic fluid gushes out before labor starts, only happens to 1 in 10 women. Sometimes a leak forms and clear, odorless fluid begins to discharge. There are other times that the pressure of the baby on the bladder causes urine to trickle.
If you suspect your membranes have ruptured, do not introduce anything into the vagina, because that could introduce bacteria into the baby’s environment. Be comforted to know that your body continues to make more amniotic fluid during this time. Contact your doctor or midwife for further instructions on when to leave home. If the fluid is has an unpleasant odor and especially if it is green in color, you must let your care provider know, as that could be a sign of distress of the baby.
True Labor Contractions
You are really in labor if you are experiencing contractions that grow progressively longer, stronger, and are happening more frequently over time. They begin to follow a pattern, such as occurring every 10 minutes for 30 seconds. Contractions are typically felt first in the lower back and then radiate to the front, or it can happen from front to back. They may feel like menstrual cramps, and increase in intensity and discomfort over time.
You could use the “411 method” to know when to let your doctor know you are going to the hospital — when your contractions are four minutes apart, lasting for one minute in length, over the course of one hour, that is a good sign to know you are in active labor, and if you go to the hospital, your labor should continue to progress.
Labor is a unique experience for every woman, and actually, for every birth, as labor will differ for the same woman with different babies. One woman can be dilated to 5 cm for a few weeks, while another can have few to no effacement or dilation until labor begins. Some women have a very quick labor, while others have labor contractions for many hours. Occasionally, a woman’s water will break, while for another, the baby will be born “in the caul,” or within the amniotic sac. Trust in your body’s wisdom, and know that baby will be born when he or she is ready.