Early signs and symptoms of labour.
The one question you’ll want the answer to is: How do I know when labour is starting?
The truth is, there is no definitive answer to this, it varies a great deal – sometimes it’s a slow build up of contractions and other times it’s a dramatic event like your waters breaking.
1. A ‘Labor show’
This is a pinkish/red mucus ‘blob’ of discharge from the vagina. It’s a plug of gel that has been protecting your uterus from infection during your pregnancy.
A show is usually a sign that labour is imminent and will happen in the next few days, although it can become dislodged a few weeks before labour starts.
If there is a lot of blood, you should contact your GP or maternity unit, as this could be a sign that something is wrong.
2. Lower back pain
You may notice a dull aching pain in your lower back. You don’t need to contact your doctor or midwife though, this is just a warning sign that everything is about to start.
3. Your waters may break
This could be with a gush or a trickle, it depends how much amniotic fluid you have and whether it is the ‘fore-waters’ (the large volume of fluids in front of the baby’s head), or a leak of the ‘hind-waters’ (the smaller amount of fluid behind the baby’s head).
The medical term for waters breaking is spontaneous rupture of the membranes (SROM).
This can happen before contractions start, but it’s more usual for it to happen during established labour, although it can be delayed to right before your baby’s head appears.
If it’s your hind waters that have leaked, contractions may not follow right away because your baby’s head may not be applying enough pressure to the cervix.
Normal amniotic fluid is straw-coloured and you may be able to distinguish it from urine because it is sweeter smelling.
You should phone your midwife or hospital for advice when your waters break, but you should go straight to hospital if the fluid is tinged with blood or is greenish-black in colour.
Blood can be a sign of placenta abruption where the placenta detaches itself from the uterine wall, which can be very dangerous for your baby.
The greenish colour in amniotic fluid can be an indication that your baby has passed meconium, her first waste products, and may be in distress. Once your waters have broken, there is a risk of infection, so if your contractions don’t start naturally within 24 to 48 hours, labour may need to be induced.
4. An urge to empty your bowels
Some women get diarrhoea-like bowel movements in early labour, as the body clears out the digestive system ready for the job ahead.
5. Regular contractions
You’ll be able to tell these are real contractions rather than Braxton Hicks because they hurt and they build up – becoming longer, stronger and more frequent. Women describe the early pain as feeling like a period cramp that reaches a peak, eases off and returns at regular intervals.
They may only last about 20 seconds and occur 15 to 20 minutes apart when they first start, or they could start off much stronger and closer together.
First labours usually last between 12 and 16 hours so it’s best not to go to hospital too soon.
Try to time the contractions from when you begin to feel the pain to when it eases off, and then the space between them. This will tell you how your labour is progressing.
As a general rule, you don’t need to contact the hospital/maternity unit until your contractions are lasting at least 45 seconds and coming five to ten minutes apart.
You should call the contact number you’ve been given for your midwife at this point. Taking into account how far away you live, you will be told when you should come in.
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