by Sarah Das
It’s very important that you can recognize signs that the big day has arrived and how you do so is a question so commonly asked. It would appear that despite all the information available on the subject and birth preparation classes, it remains a source of anxiety for many women – especially those expecting their first baby. You may find it reassuring to think about pre-labour and established labour as two separate phases.
What is Pre-labour?
Lets talk about pre-labour or the latent phase of labour first. During this phase of labour your cervix is usually shortening and softening or `effacing` – preparing to dilate (open).
This is typically the phase when you are unsure whether you are in labour. It can present as backache radiating to the lower abdomen, very similar to painful menstruation. You may feel nauseous, have loose bowel motions, feel emotionally unsettled and generally a bit out of sorts. You may or may not have a mucousy discharge or ‘show’ from your vagina. Sometimes your membranes or waters will break, causing an initial gush and then a steady trickling of amniotic fluid. If this happens you should call your midwife know and she will tell you what to do.
Pre-labour can last quite a while with a first baby and is a good time to try and rest or even sleep if you can, thus storing up energy for the later active stage of labour.
It`s possible of course that you may not be aware of your pre-labour stage as the first time you know something has changed is when established labour starts. I mention this because it can be very demoralizing for women who labour in this way to assume that established labour is pre-labour. It could naturally cause alarm about how much worse established labour could get.
What is established labour?
The definition of established labour is when you are experiencing regular contractions – one every five minutes, lasting at least 30 seconds or more. In addition, your cervix should be starting to dilate. It`s very unlikely that you will be able to assess dilatation of your own cervix, so you will have to rely on the nature of your contractions to guide you. This is not very difficult because apart from contractions coming and going in a rhythmical wave like fashion now, they are painful and you are likely to start noting how often you are being subjected to this discomfort.
You may continue to lose mucousy discharge from your vagina or you membranes may rupture with the steady, regular pressure on the cervix created by your contractions. You may even vomit at this time as your body is going through a momentous change and vomiting is a normal reaction to such change. If vomiting becomes very frequent inform your midwife, as it is counter-productive to become dehydrated in labour. The biggest muscle, which happens to be your uterus at this time, needs nourishment to help it to contract. Remember NO CONTRACTIONS = NO DILATATION. Contractions are GOOD. And with each contraction, you are one step closer to meeting your baby!
What are contractions like?
When you have a contraction, your uterus tightens and then relaxes, like a stronger version of period cramping. The feeling is meant to increase as labour progresses . If you put your hand on your abdomen, you will feel it getting harder. When the muscles relax (the contraction goes away), the sensation fades and you will feel the hardness ease. The contractions are pushing your baby down and opening your cervix (entrance to the womb), ready for your baby to go through. This cycle will continue until you baby is born.
When is a good time to go into hospital once labour has started?
This is a very difficult question to answer as every woman deals with pain in a different way. It`s usually safe to stay at home with a first baby until your contractions are coming every 3-5 minutes as long as you live within 30 minutes of your hospital and are coping with the sensations. If, like many women, you want to keep an open mind in labour about pain relief, you will no doubt try and stay at home until you need the safety net of the hospital environment. However, if you already know that an epidural is a definite for you, then you may as well go to hospital sooner rather than wait, thus gaining maximum benefit from the relief an epidural provides.
Labour can often be faster when it is your second plus baby, so it’s a good idea to leave for hospital when your contractions are no more than 5 minutes apart.
If your waters break, or you have any fresh bright red bleeding (like when you cut your finger) call the labour ward and discuss this with a midwife and she will advise you accordingly. Similarly if you are really unsure about when it’s a good time to head for the hospital, discuss what you are experiencing with a midwife and you can make the decision together. It`s helpful to have a second opinion at this time, so do pick up the phone rather than worrying at home with your partner. Anxiety won`t help your labour progress.
Before you leave for hospital
If you have not already made a call to your hospital make sure that you do so before you set off, so that the labour ward can plan for your arrival. And remember to take your notes with you.