labour

Dr Asma Khalil, consultant obstetrician and fetal medicine specialist at The Portland Hospital, reveals the signs of labour to look out for

There are many questions I’m asked by first-time mothers, but one of the most popular is, ‘How will I know when I’ve gone into labour?’ During our pregnancies we all feel a number of different changes and, for a woman who has never had a baby before, the prospect of going into labour can sometimes feel a bit scary.

Broken waters

The most obvious sign of labour is ruptured membranes – or broken waters, as it is more commonly known. This is when some of the amniotic fluid surrounding the baby leaks out. It is not always as dramatic as shown in the movies – it’s often just a small amount. And this doesn’t necessarily mean you are in labour either – it can sometimes happen before any contractions start, or even during labour after you’ve had contractions for several hours, but you should always report it to your midwife or consultant. In many cases, women aren’t surprised by their waters breaking as they would have been experiencing a number of other signs of labour beforehand.

Contractions

Another common sign of labour is contractions. Labour contractions feel different for everyone, but will cause pain in your abdomen and perhaps your lower back, starting at the top of the uterus and ending at the bottom of it. These will intensify throughout your labour, becoming more frequent and regular as time passes. However, you should be able to relax between each wave of discomfort.

Many women experience ‘false’ contractions, known as Braxton Hicks contractions. These differ from contractions experienced in labour, so it is important to understand the differences so you don’t worry unnecessarily! These may start around halfway through your pregnancy and are caused by a tightening of the muscles in your uterus.

Braxton Hicks contractions are sometimes called ‘practice contractions’. They can start
as early as 20 weeks of pregnancy in women who have had babies before, but usually only in the last few weeks in women having their first baby. They are relatively painless – your whole uterus goes very hard and tight; sometimes uncomfortable because it’s so tight, but they’re not intensely painful. After a minute or two, it passes, and your uterus relaxes again. On the other hand, labour contractions are painful; initially like mild period pains, then they grow in intensity and will occur more frequently.

Lightening

Some women feel their baby ‘drop’, which is when it settles much lower in your abdomen, or ‘engages’. This process we often term ‘lightening’. The baby’s head will fall lower into the pelvis, and sit on your pubic bone. This can be accompanied by an increased urge to urinate due to increased pressure on your bladder, as well as other symptoms such as a reduction of your heartburn and breathing difficulties. While this can happen up to a few weeks before you give birth, it is a sign that your pregnancy is reaching an end and your body is getting ready for labour, though this doesn’t necessarily mean your labour is imminent.

Anything else?

There are a few more vague symptoms that labour may be coming, including poor sleeping patterns, tummy problems and drastic mood changes. If you start to notice these as you approach your due date it might be time to pack your hospital bag. Having said that, these symptoms aren’t unusual throughout pregnancy, so don’t hold your breath!

Most of the signs of labour can last anywhere from a few weeks to a few hours before, which is important to keep in mind before you rush to the hospital a week early!

What next?

Once labour has started, you should have enough time to get to your chosen hospital – it very rarely lasts less than a few hours. If you’re a first time mum, the average time for your baby to be born is 12 hours after labour has become fully established, that is, your contractions are coming every three minutes or so, and your cervix has started to dilate. This average time is usually much shorter for mums who have had a baby before.

What’s important to note is when you are in labour, it’s essential you stay calm. Staying relaxed will help you to deal with pain and contractions. Hypnobirthing classes can help you prepare for this. I advise you have a birth plan prepared well ahead of your due date, including your plan for getting to the hospital and your preferences in case something was to go unexpectedly.

Labour can be a stressful time, but it’s also one of the most important days of your life so I always advise women to ask any questions they have before their due date so they know exactly what to expect in the run up to the special day.

Want more? What to expect in your third trimester

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