Pregnancy Article:

Pregnancy: What to Expect at the Time of Labour

By: Connie Limon

As your due date approaches you may become anxious and want to know about what to expect as signs of labour. I know this was on my mind a lot. I often wondered how I will know "when" to go to the hospital. In my case, I got there well in advance. I arrived at the hospital around 11:00 p.m. and my daughter appeared the next day around 2:00 p.m. Every woman is different and unique, as can be each pregnancy of the same woman.

As every woman's labour and delivery experience is unique, no one knows exactly how it will be. You can gain an understanding of the "typical" signs of labour that will help you to know and be a little more prepared for the big event. Some of the signs of labour include:

• Lightening or adjusting the pressure
• Effacement or ripening of the cervix
• Dilation or opening of the cervix
• Bloody show or loss of mucus plug
• Nesting or spurt of energy
• Rupture of membranes or breaking of water
• Contractions or when labour begins

Lightening or adjusting the pressure is one of the first signs of labour. It may be a sensation that the baby is settling deeper into your pelvis. You may begin to breathe a little easier as the baby's new position gives your lungs more room to expand. Or, you may experience pelvic discomfort and increased pressure on your bladder that sends you to the bathroom more.

If this is your first pregnancy, lightening may occur weeks or days before labour begins. After the first pregnancy, it may not even happen. Some women notice these changes while others do not.

Effacement or ripening of the cervix is your cervix preparing for the birth. It softens and thins. This is not a sign of labour you will be able to feel happening. Your doctor will check for this sign with vaginal exams. Your cervix will be 100 percent effaced or completely thinned out before a vaginal delivery.

Dilation or opening of the cervix is measured by the doctor in centimeters from zero to 10.

These cervical changes may occur very slowly. Some women dilate 2 to 3 centimeters for days or weeks before actual labour begins. Progress of cervical dilation is a general sign you are getting ready for labour. Once labour actually occurs you can expect to dilate more quickly.

Bloody show or loss of mucus plug occurs when your cervix begins to thin and open. At this time, the plug may be discharged. All during your pregnancy a thick plug of mucus blocks the cervical opening to prevent bacteria from entering the uterus. When the mucus plug is discharged you may notice stringy mucus or a thick discharge that is typically brown and may be tinged with blood. You may discharge the mucus plug and still not start into labour for a week or more.

Nesting is something I see my female Shih Tzu do just before they go into labour. Some women also go through nesting behaviors shortly before going into labour. Signs of nesting might be sudden spurts of energy to clean and organize your surroundings. The urge to clean and organize is commonly known as nesting. Nesting may begin months before your due date, but may be the strongest just before delivery.

Rupture of membranes or water breaking is a very common sign that not too far off is a baby. The amniotic sac is a fluid-filled membrane that cushions your baby in the uterus. When it breaks you may notice a trickle of fluid or a more obvious gush of water. If this happens at home, call your doctor right away. Timing becomes very important if the amniotic sac is no longer intact. The longer the membranes are ruptured, the greater the risk of an infection. If labour does not begin on its own at this point, your doctor may need to induce labour. During this time be careful about introducing bacteria into your vagina. Sex is not a good idea if you are leaking amniotic fluid.

Contractions are when labour pains begin. To know true labour pains review the following:

• 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 stronger and closer together. Real contractions are most likely those that come about every five minutes.
• How long do they last? Measure the length of each contraction by timing when it begins and when it ends. A true contraction last more than 30 seconds at first and gets progressively longer, up to 75 seconds, and stronger. If you are in a false labour, the contractions vary in length and intensity.
• Can you stop the contractions?  True contractions continue regardless of what you are doing, or which position you turn to. They often grow stronger with increased activity. In false labour, you may be able to stop the contractions by changing your activity or position, lying down or even taking a walk.
• When do you feel the contractions? True contractions tend to begin high in the abdomen, radiate throughout the abdomen and lower back. False labour pains are often concentrated in the lower abdomen.

Do not hesitate to call your doctor if you wonder whether or not you are in labour. If you experience symptoms of labour before 36 weeks and especially if the symptoms are accompanied by vaginal spotting, see your doctor for an exam.

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