As you approach your due date, several big questions keep popping into your mind. What does labor feel like? Will it hurt? Will it go smoothly? How will I know I’m in labor? What if I have the baby in the car on the way to the hospital?! Many women begin to feel like they can’t do it, and they alternate between wishing that the baby would just come out already, and not wanting the baby to come out at all! When the time comes, there are many signs that you can spot to know that you are in labor, the most well known of which is your waters breaking. Other key signs are losing your mucous plug, and of course, contractions!
In the movies, the pregnant woman’s water breaks always at the most inconvenient time: at the supermarket, in the middle of an argument, or just after a plot-changing event occurs. In real life, however, this is usually not the case. The American Congress of Obstetricians and Gynecologists note that only 5-10% of pregnancies result in the waters breaking (also known as your membranes rupturing) prior to the onset of labor, and only 3% of women have this occur prior to 37 weeks gestation. For some women, the waters breaking will be enough to cause labor to begin, but in most cases, your water will break after labor is already established. For others, their water breaking does not trigger labor at all, so don’t rely on this one as a reliable sign that your baby is about to arrive! If your water breaks and labor does not follow soon after, you and your baby may be vulnerable to infection: in most cases if this occurs, your care provider will induce labor to bring your baby out safely. If you are nearly, or at term, and you feel a trickle of liquid, you may be unsure whether your water has broken or whether you have lost bladder control. In this situation call your care provider: they may ask you to come in and they will test the fluid to determine what it is. While this may seem embarrassing, it’s always better to be safe than sorry.
Another common sign of labor is losing your mucous plug. As labor progresses, your cervix dilates and effaces. A good way to think of dilation and effacement is imagining your cervix as a completely rolled-out condom with a hole in the tip: as your cervix effaces, imagine rolling the condom up so that it’s just a ring; when your cervix dilates, the ring is stretched to become wider. When your cervix is fully effaced and dilated to 10cm, the baby can descend and come through the cervix and through the vagina to be born. Your mucous plug blocks off the cervix during the pregnancy to prevent bacteria and infection from reaching the fetus. If your mucous plug is falling out, it usually means your cervix is beginning to dilate and efface! Unfortunately, once again, this is not always a reliable sign: some women are dilated to 3-4cm for weeks prior to the onset of contractions. Your mucous plug usually looks like a big blob of vaginal discharge, or ‘snot’, and may be tinged with brown or reddish blood. Be aware: Mayo Clinic advises that if you lose your mucous plug, labor may be already established, or may be as far as weeks or days away.
The most reliable sign that labor is in progress is regular contractions. Throughout your pregnancy you may have experienced Braxton Hicks (an irregular and infrequent tightening of your uterus). The main differences between Braxton Hicks and real contractions is that productive, labor contractions are regular, while Braxton Hicks are not. Time the length of your contractions, as well as the time in between each contraction. If they are occurring at regular intervals, such as every ten minutes, this may be the beginning of labor. If the time in between each contraction begins to shorten (e.g. shifting from every ten minutes to every eight minutes, then every five minutes) this is a strong indicator that you are in labor. The time between contractions can also tell you how far through your labor you are: as contractions become closer together, this is a sign that your labor is progressing and it may be time to head to the hospital. The easiest way to time contractions is with the Pregnancy View app Contraction Timer. It takes out the guesswork.
Another thing to look at is the length of your contractions. Mayo Clinic notes that true contractions last from 30 to 90 seconds. A complicating factor is that women sometimes experience what is known as false labor. This means that you may experience contractions for some time (a few hours, days, or even weeks) but the contractions may stop and start, or may not seem to grow longer or closer together. If you are unsure about whether or not you are in false labor, try changing positions, going for a short walk, taking a bath, or lying down for a rest: any of these things can stall false labor, while true labor should progress regardless.
Going into labor can be an exciting, but scary time, and knowing what to look for can help to reassure you that things are progressing normally. While many women say that they “just knew” they were in labor, if you are uncertain at all or have any doubts, call your care provider and let them know what your signs of labor are: in particular, make sure you mention any contractions, water breaking, or loss of mucous plug.
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