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Signs of labor: Know what to expect
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/signs-of-labor/PR00083
Labor and delivery (18)
- Episiotomy: When it's needed, when it's not
- Signs of labor: Know what to expect
- Water breaking: Understand this sign of labor
- see all in Labor and delivery
Postpartum care (14)
- Exercise after pregnancy: How to get started
- Maternity leave: Tips for returning to work
- C-section recovery: What to expect
- see all in Postpartum care
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Signs of labor: Know what to expect
Do you know the typical signs of labor? Understand the changes your body will go through as you prepare to give birth.
By Mayo Clinic staffOn television, babies are often born with a rush of emotion and swift action. The mother doubles over from the pain of a single contraction, and the baby appears before the commercial break. In reality, however, labor usually begins less dramatically. Find out common signs of labor and what they mean for you and your baby.
Effacement: Ripening of the cervix
One of the first signs of labor is your cervix softening and thinning, or effacing. Most of the effacing happens in the last weeks before delivery and you won't feel this preparation for labor happening. Instead, your health care provider might check for signs of cervical change with vaginal exams.
Effacement is often expressed in percentages. The cervix starts out about 4 centimeters (cm) long. When you're 50 percent effaced, your cervix is half its original thickness, or 2 cm. Your cervix must be 100 percent effaced, or completely thinned out, before a vaginal delivery.
Dilation: Opening of the cervix
Another of the early signs of labor is your cervix beginning to open, or dilate. For most women, some dilation occurs before labor. Your health care provider will measure the dilation in centimeters from zero to 10.
At first, these cervical changes can be very slow. In fact, some women are dilated 2 to 3 cm for days or even weeks before labor actually begins. Dilation isn't a good indicator of when labor will begin, but rather a general sign that you're getting ready for labor. Once you're in active labor, expect to dilate more quickly.
Bloody show: Loss of mucous plug
During pregnancy, a thick plug of mucus blocks the cervical opening to prevent bacteria from entering the uterus. When your cervix begins to thin and open, this plug may fall out. You might notice stringy mucus or a thick discharge. It's typically brown and sometimes tinged with blood.
Losing the mucous plug is among the telltale signs of labor, but it's not a guarantee. Labor may still be days or weeks away.
Nesting: Spurt of energy
You might wake up one morning feeling energetic, raring to attack dust bunnies under the couch, set up the crib and arrange your baby's outfits according to color. This urge to clean and organize is commonly known as nesting. No one knows for sure, but it could be a primal instinct that hearkens back to a time when physical preparation was necessary for a safer childbirth.
Nesting might begin months before your due date, but the instinct is usually strongest just before delivery. Do what you must, but don't wear yourself out. Save your energy for the harder work of labor ahead.
Rupture of membranes: Your water breaks
The amniotic sac is a fluid-filled membrane that cushions your baby in the uterus. Sometimes the sac leaks or breaks before labor begins. If this happens, you might notice a slow trickle of fluid or a more obvious gush.
If your water breaks at home — or if you're uncertain whether the fluid is amniotic fluid, urine or something else — consult your health care provider right away. He or she will evaluate you and your baby to determine the next steps.
If the amniotic sac is no longer intact, timing becomes important. The longer it takes for labor to start after your water breaks, the greater the risk of developing an infection. If labor doesn't begin on its own, your health care provider might need to induce your labor. In the meantime, avoid doing anything that could introduce bacteria into your vagina, such as having sex.
Contractions: When labor pains begin
During the last few months of pregnancy, you might experience occasional, sometimes painful contractions — a sensation that your uterus is tightening and relaxing. These are called Braxton Hicks contractions. They're your body's way of warming up for labor.
Eventually, Braxton Hicks contractions will be replaced by the real thing. To tell the difference, consider these questions:
- Are the contractions regular? Time your contractions from the beginning of one to the beginning of the next. Look for a regular pattern of contractions that get progressively stronger and closer together. False labor contractions will remain irregular.
- How long do they last? True contractions last more than 30 seconds at first and get progressively longer — up to 90 seconds. The contractions of false labor vary in length.
- Can you stop the contractions? True contractions continue regardless of your activity level or position. In fact, they often grow stronger with increased activity, such as walking. With false labor, you might be able to stop the contractions by changing your activity or position, lying down or taking a walk.
Expect false alarms
The boundary between your body's preparation for labor and the actual process of labor isn't always clear. Some women have painful contractions for days with no cervical changes, while others might feel only a backache — or nothing at all.
Remember, no one knows for sure what triggers labor, and every woman's experience is unique. Sometimes it's hard to tell when labor begins. Don't hesitate to call your health care provider if you're confused about whether you're in labor. Preterm labor can be especially sneaky. If you have any signs of labor before 36 weeks — especially if you also experience vaginal spotting — consult your health care provider.
At term, labor will nearly always make itself apparent. If you arrive at the hospital in false labor, don't feel embarrassed or frustrated. Think of it as a practice run. The real thing is sure to be on its way!
- Labor and birth. The National Women's Health Information Center. http://www.womenshealth.gov/pregnancy/childbirth-beyond/labor-birth.cfm. Accessed Dec. 2, 2010.
- Kilpatrick S, et al. Normal labor and delivery. In: Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa.: Churchill Livingstone/Elsevier; 2007. http://www.mdconsult.com/das/book/body/113939576-5/783944298/1528/125.html#4-u1.0-B978-0-443-06930-7..50014-1--cesec14_618. Accessed Dec. 2, 2010.
- How to tell when labor begins. American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp004.cfm. Accessed Dec. 2, 2010.
- Herbst A, et al. Time between membrane rupture and delivery and septicemia in term neonates. Obstetrics & Gynecology. 2007;110:612.
- You and your baby: Prenatal care, labor and delivery, and postpartum care. American Congress of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/ab005.cfm. Accessed Dec. 2, 2010.
- Johnston J. The nesting instinct. Midwifery Today with International Midwife. 2004;71:36.
- Murry MM (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 6, 2010.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 7, 2010.
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