As the big day approaches, you may wonder whether you'll know when you're in labour. Don't worry: A woman's body almost always gives her the signals she needs and the inner wisdom to recognise them.
There are a number of different signs that may indicate the start of labour is not too far away. These can occur as much as a week or more before labour begins and include:
- Increased flow of mucus from your vagina
- A surge of energy
- More frequent and intense Braxton Hicks contractions
- Mood swings
These early contractions help your cervix to go through the changes if needs to before it starts to dilate. These may be short and irregular and unlike the contractions in ‘real’ labour they may not get stronger, longer or closer together.
During Pre-labour and early labour you may experience some or all of the following.
1. Waters breaking: Rupture of membranes (amniotic sac)
The amount of clear amniotic fluid that escapes from the sac and flows out of the vagina differs from woman to woman. For some it's just a little trickle; for others it can be a gush. Surprisingly, this precursor to labour is a first symptom in fewer than 25 per cent of women; it may actually occur during labour instead of before it. But when it happens prior to labour, there's a good chance that labour will start within 24 hours. If your water breaks, notify your doctor or midwife immediately. Note the time it breaks, the colour and amount of fluid, and whether there is any foul odour. Report all of this information to your healthcare provider.
2. Bloody show
A day or two before contractions begin; you may notice a pinkish or blood-streaked mucus discharge. This 'bloody show' is actually the mucus plug that has sealed the cervix during pregnancy. Not all women notice this discharge, and some women begin contractions before the mucus plug is discharged. Also, keep in mind that the bloody show is not the same as the brownish, bloody discharge you might experience after a vaginal exam at a pre-natal appointment, which is no cause for concern.
Early signs of labour: Contractions
The big tip-off that you're in labour is the start of regular uterine contractions. At first, these early contractions feel like period pains or a low backache that comes and goes at 20- to 30-minute intervals and lasting 10 - 40 seconds. Gradually, the aching or cramping becomes stronger and lasts longer. The contractions also get more frequent, until they come every five minutes. To time your contractions, write down the exact time that each one begins and how long it lasts.
Real Labour or False Labour? Always reach out to your health care professional if unsure what the signs are
Contractions are regular and follow a predictable pattern (such as every eight or less minutes).
Contractions are irregular and unpredictable, occurring, for example, in intervals of ten minutes, then six minutes, two minutes, eight minutes, etc.
You experience three types of progression: Contractions become a) progressively closer, b) progressively longer and c) progressively stronger.
No progression is seen over time.
Each contraction is felt starting in the low back and then radiating around to the front, low in the groin.
Contractions are felt as a generalised abdominal tightening.
A change in activity or position will not slow down or stop contractions.
A change in activity or position may cause contractions to slow down or stop.
There may be bloody show.
There is usually no bloody show.
Membranes may rupture.
Membranes will not rupture.
Your doctor or midwife will notice cervical changes, such as ripening (softening), effacement (thinning) or dilation.
No cervical changes occur.
Making the Call
You should phone your healthcare provider if you think you are in labour. Have your notes with you when you make the call so you can give accurate information about your symptoms. Don't be afraid to call at any time, day or night. Your provider knows that labour doesn't always start between the hours of nine and five, and when doctors or midwives are on call, they expect the phone to ring – at any hour.
Also, keep in mind that you may not need to go to hospital immediately. In fact, if this is your first baby, most GPs or midwives suggest that you stay in the comfort of your home until the contractions have reached five-minute intervals. If you've had a previous labour and birth, you may be asked to come to hospital sooner, because your labour may move along more quickly.
Realising that you're in labour will bring a mixture of feelings, including excitement, disbelief and apprehension. Try to stay calm and focused. Arrange to have your partner or a friend with you to help you record your symptoms, keep you company and get you to hospital when the time comes. Above all, know that you can do the job that lies ahead: bringing your baby into the world!