Signs of Labor
It is natural to be perplexed, curious and even tensed
about what is going to happen when the date draws
close. If this is your first baby, fear of what to
expect, curious if you will recognize when labor has
actually started for you and other such related ideas
are going to preoccupy your thoughts increasingly.
Amidst all these feelings you will also feel a sense
of relief (it is all coming to an end), sadness (strange
but you are going to miss those pregnancy months),
and happiness (now that your baby will finally be
in your arms). Once labor begins you will experience
clear indications that tell you it is time; however
the signs are different for every woman.
The signs you can typically anticipate are
At the onset of true labor, the contractions will
feel like a tightening of abdominal muscles, a dull
ache or a pressure on the lower pelvis or back. At
about this time you may feel the baby drop down into
the pelvis; this is known as engagement because the
baby has settled into its position for birth. Another
term aptly used is lightening because the baby's new
position means the mother has now more space to breathe
and digest food. With time the contractions start
to come at a more regular pace and the pain intensifies.
The sensation is like a belt tightening around your
back which spreads round underneath the baby. As the
labor progresses the contractions last longer and
occur at decreasing intervals.
A plug of mucous which seals the top of the vagina
acts as a barrier against infection from invading
the uterus. Sometimes this plug dislodges itself before
the contractions commence and you will notice a 'show'
i.e. thick vaginal discharge mixed with blood in your
underwear. This however is no indication that you
are into proper labor; it may be several days before
the action commences. In other instances, the contractions
begin well before the expulsion of the mucous plug.
In about 20% of women, the pressure of the baby's
head can puncture the amniotic bag causing the fluids
to leak out before labor. Often it occurs in later
part of labor. There is no mistaking a rupture; the
leakage is clear and watery from the vagina and you
can lose as much as 2 pints of fluid. The water can
gush out or come in a slow trickle. Contact your hospital
immediately; you will probably be advised to go in
right away since baby is in risk of infection and
chance of umbilical cord's descent into the birth
canal is there. Water breaking can pose a risk to
your baby either in the form of infection or the oxygen
supply being affected.
You may experience other symptoms; nausea, diarrhea
and backache. Sometimes you even feel some tightening
the whole day before labor begins; this is indicative
of the cervix ripening and shortening at a gradual
pace or your baby could be probably lying with its
back to your back. In the case of the latter the tightening
occurs as the baby rotates round to assume the right
position before making its entry into the world.
True or False labor - how
can you tell
In the start, you might not know if you are in real
labor. The most distinguishing factor is true labor
pains are consistent and regular; they slowly increase
in frequency, duration and intensity. False labor
on the other hand, tends to disappear if you lie down
or walk around or a glass of drink cold water, and
do not increase in frequency or duration.
The three stages of Labor
no increase in frequency or duration
intervals which gradually become closely
||Stop and start
at irregular intervals
|| Back, then
travels to the front
||Weak and remains
|| Mucus plug
may dislodge; membrane rupture; bladder
you are tired, especially in the evenings
Labor has 3 distinct stages, each with its own characteristics.
The first stage
with the first contraction and ends
when the cervix is fully dilated. The cervix undergoes
many changes: it becomes softer, spongier, the cells
thin out and the cervix shortens. This shortening
and thinning is termed effacement. Before effacement
the cervix is 1.5 inches in length and after effacement
it somewhat disappears. Force from the contractions
combined with the pressure from baby's head slowly
compels the now 'thin' cervix opening to widen. This
is termed as dilation, which basically means the widening
of the opening. Full dilation is at 10cm, about the
width of a hand. When the cervix is beginning to dilate
most mothers will feel the contractions in the back.
You will be conscious of this ache but you can still
go about with your normal activities. If you do not
experience this, the mucous plug will soon dislodge
• The rate of dilation varies; tends to be slower
in first time mothers.
• On average it will take about 9 hours for
the cervix to dilate 2.5 cm (the latent phase). The
time varies; some women take longer, some with lesser
• Next comes the active phase which causes the
cervix to dilate from 3 - 10 cm; this phase lasts
between 2 - 4 hours. Again the time varies. The pain
is intense and the urge to bear down and push the
baby out starts now.
• On average one hour is taken up for every
centimeter that the cervix dilates
The second stage begins
at full dilation and
ends when the baby makes an entry into the world.
Uterine contractions are now even more pronounced;
they help in the dilation and force the baby down
and out. The contractions now occur every 2-3 minutes,
lasting between 1 to 1.5 minutes. As the baby makes
its descent, the mother works hard on the pushing.
In a typical, normal situation, first the head descends
followed by the rest of the body through the vagina.
• It takes a first baby close to an hour to
make its way down the birth canal, through the vagina
to the vulva
• The appearance of the baby's head at the mouth
of the vagina is called crowning.
• Following the crowning, the doctor may make
a small cut into the area between the vagina and the
rectum; this is called episiotomy. Many doctors feel
that this procedure should be performed only when
In the final stage,
the placenta dislodges from the uterus and is expelled.
After the baby is delivered, the uterus sheds the
placenta (placenta provided nourishment to baby during
the entire course). Contractions continue even after
baby is born. The uterus begins to get smaller and
its walls thicker. This reduces the surface the placenta
was attached. The placenta then separates and is pushed
down and out of the vagina. Blood clots form immediately
at the site of separation preventing any excessive
bleeding. Bleeding is also controlled by the uterus
contracting and closing the blood vessels that previously
supported the placenta.
stage - first contraction to full dilation of
stage - full dilation until delivery
stage - birth
1st contraction to 3-5 cm of cervix dilationContractions
every 5-15 minutesLasts for an average 8-10
hours for 1st pregnancy
|| Lasts for 2 hours
|| Begins with birth
of baby and ends with delivery of placenta
phase: 3-5 cm to full dilation of 10
cm Contractions 3-5 minutes apartLasts an average
4 hours for 1st pregnancy
|| pushing begins
with contractions and the urge to bear down
|| Lasts for about