Onset of labor - How to tell when labor begins
As you approach the end of pregnancy, changes take place that may signal the approach of labor. You may or may not notice some of these changes prior to the actual onset of contractions. The changes and signs are as follows:
LIGHTENING – feeling as if the baby has dropped lower in the pelvis with the head settling deep into the pelvis. This may occur from a few weeks before your due date to only hours before labor begins.
SHOW – loss of a mucous plug or a significant increase in a mucousy thick vaginal discharge. This occurs when the cervix begins to open (dilate) and usually occurs several days before labor begins, although show is sometimes noticed only with the actual onset of labor. The mucousy "show" may be clear, pink, or slightly bloody.
RUPTURE OF MEMBRANES– leaking or breaking of the fluid-filled sac that surrounds the baby resulting in a gush or trickle of watery fluid (the amniotic fluid) from the vagina. This may occur several hours before labor begins or may occur any time during labor. Note the color of the fluid and time.
Contractions or labor pains will be your clear sign that labor has actually begun. It is sometimes very difficult, however, to determine if the sensations you are experiencing are real labor contractions or false labor contractions (Braxton-Hicks contractions). You may need an examination including a vaginal exam to tell if you really are in true labor. On the reverse side of this page is a chart with comparisons that may help you, at the onset, to differentiate between true and false labor contractions.
If you think you are in labor, time your contractions for an hour. With true labor, contractions last 30to70seconds, occur at regular intervals, and don't go away when you move around or change position. It is time to consider going to the hospital when your contractions are becoming moderately intense, lasting 45to60seconds, and are occurring every 5to7minutes. Your decision when to go to the hospital will also need to include such considerations as how far you live from the hospital, the weather and road conditions, the availability of your transportation, and whether or not you need to make special arrangements such as getting a baby sitter for your other children.
Call your physician directly, however, in the following circumstances:
• if you think you are in premature labor (labor pains or your water breaking/leaking before 37weeks gestation);
• if your "water breaks" or you suspect fluid is leaking and labor contractions have not begun within 2to3hours of the leakage of fluid;
• if you have a history of genital herpes or are group B strep positive and your "water breaks" or you suspect you are leaking amniotic fluid;
• if you have heavy vaginal bleeding;
if you have constant severe pain.
If you have none of the risk factors listed above and think you are in good labor, either check in with your physician or, if after hours, call Labor&Delivery at St. Joseph Hospital (direct telephone number is 738-6360) and plan to go directly into Labor & Delivery at St.Joseph Hospital. The nurses will assess your situation and notify your physician or midwife shortly after your arrival.
Above all, do NOT hesitate to call if you have any questions or concerns.
CHANGES |
TRUE LABOR |
FALSE LABOR |
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Timing or frequency of contractions....................... |
Occur at regular intervals and, as time goes on, get closer and closer together |
Often irregular and do not consistently and progressively get closer and closer together |
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Location of contractions..... |
Often felt in the back and radiate around to the front and involve the whole uterus |
Often felt in the abdomen and sometimes involve only part of the uterus |
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Change with movement..... |
Contractions continue despite movement or activity and often progress in frequency with activity |
Contractions tend to stop with activity or change in position. |