The 7 signs of early labour to look out for.
By Dr Juliet McGrattan (MBChB)
If you’re in your third trimester of pregnancy, it’s normal to think every little twinge might be a sign that baby is about to arrive. Whether you are on tenterhooks and ready to meet your baby or you haven’t packed your hospital bag yet, either way it’s important to know what the first signs of labour are.
Only around five per cent of babies are born on their due date and normal labour can begin anywhere from 37 to 42 weeks of pregnancy, so it can easily catch you off guard.
Dr Juliet McGrattan takes us through the stages of labour including what happens during the latent phase, signs that might indicate labour has begun and what to do next:
The stages of labour
Labour is split into three stages. During the first stage, contractions begin and the cervix (neck of the womb) dilates in preparation for the baby to exit. This is typically the longest stage of labour. The second stage begins when the cervix is fully dilated (10 centimetres) and ends when baby is born. During the third and final stage, the womb shrinks in size and the placenta is delivered through the vagina.
How long labour takes varies hugely from woman to woman. It can last hours to several days but it is typically longer in first pregnancies.
What is early labour
The start of labour can be a bit vague and false alarms are common. Every woman experiences it differently and it can be different in every pregnancy too.
The first stage begins with the latent phase. During this, the cervix is beginning to soften, become thinner and open up. This latent phase lasts an average of 12 to 14 hours but it can last days.
The start of labour can be a bit vague and false alarms are common. Every woman experiences it differently.
When the cervix is 4cm dilated you are then in active or established labour. When you are assessed by a midwife they will perform an internal examination to see how dilated your cervix is. This will guide them as to how far into labour you are.
7 signs of early labour
You might get niggles and twinges and wonder if you’re going into labour. As your due date gets closer you can feel super aware of your body and notice all sorts of irrelevant sensations! It can all be quite confusing, frustrating and at times make you feel a bit worried or anxious.
Here are 7 early signs of labour that might indicate your baby wants to join you in the outside world, whether you are ready or not:
- Baby drops down
You might feel that you are waddling more than normal and that your bump has moved downwards. As your body prepares for labour, the baby’s head ‘engages’ and moves deeper into your pelvis. You might not be aware of this, especially in your first pregnancy.
- Mucous plug
As the cervix softens and begins to open up, the jelly-like mucous that was plugging it comes away. This is sometimes called ‘a show’. It might appear in your undies as a single blob or in smaller pieces over a day or two. You might just notice it as a change in your vaginal discharge. It’s usually pink in colour due to blood-staining. Labour will usually start within days of the mucous plug dislodging.
- Contractions
You will probably have experienced some tightenings of your bump during your pregnancy, perhaps when you’ve been on your feet for a while. These are called Braxton Hicks which are also known as practice contractions. Labour contractions are different. They are stronger, more painful and last longer. They don’t go away when you rest and although they can initially be haphazard in their frequency, length and intensity, they gradually settle into a regular pattern as you move into established labour. Contractions are a good sign that labour is beginning although it’s not unusual for there to be a false start and for contractions to fizzle out after a while.
- Back pain
Whether or not you have experienced it during your pregnancy, dull back pain is a common sign of early labour. Baby is moving south, your pelvis is opening up and your body is preparing for labour.
- Fluid leak
Contrary to how labour is often depicted in films, a big gush of fluid in a busy supermarket is not usually the first sign of labour. Waters normally break later on in the process once contractions are strong and regular and often just before baby’s head emerges. Some women however might experience their waters breaking as a sign of early labour. It could be a gush but it’s equally likely to be a trickle. This fluid is the amniotic fluid that the baby has been bathing in inside the uterus. It’s easy to confuse with a leak of urine so give it a sniff to check. Amniotic fluid is clear, pink or straw-coloured and either has no odour or smells sweet or metallic. Labour usually starts within 24 hours of your waters breaking.
- Needing to poo
Pressure from the baby’s head can irritate the bowel and make you want to sit on the toilet. It’s normal to have some diarrhoea in early labour. See it as your body having a good clear-out ahead of a lot of pushing to come.
- Restlessness
Psychological symptoms are as common as physical ones in early labour. A strong ‘nesting’ instinct may appear out of nowhere and you may find yourself washing down the paintwork or clearing out drawers. Equally you may feel very fatigued and just want to rest. Every woman is an individual but just feeling ‘different’ is normal.
What to do in early labour
Early labour can last days so the best place to be is at home. You stand more chance of relaxing, napping and being able to distract yourself with a TV show at home than in a busy maternity unit.
You can take some paracetamol, have a warm bath or a massage to ease your discomfort. Pottering about helps to get baby into a good position and to encourage labour to progress. Being on all fours, on your hands and knees can help too.
Start focusing on your breathing during contractions, making sure it is deep and relaxed. Getting into this practice now will help you when the contractions get more painful. Keep your energy levels up by eating and drinking, as you don’t know how long your labour will last.
When to call the midwife
If you are unsure about anything in pregnancy always ask your midwife for advice. You aren’t expected to be an expert, even if this isn’t your first pregnancy. You can call the maternity unit, or your home birth team just to get their opinion on how far into early labour you are and whether you need to be assessed by them.
You should contact your midwife if any of the following occurs:
- Your contractions are coming regularly, less than every five minutes, they are lasting about one minute and they are strong and painful.
- Your waters break or you think they have as you may be unsure.
- You are not copingwith the pain.
- You are worried or concerned about something.
Early labour warning signs
Trying to stay calm in early labour will help you to relax and manage the pain. Serious complications during labour are rare but it’s important to know when you should take immediate action. Get medical help if any of the following occurs:
- You have vaginal bleeding.
- You are less than 37 weeks pregnant and you think you are in labour.
- Your waters break and the fluid is green in colour or smelly.
- Your baby isn’t moving as much as normal.
- Your abdominal pain is constant with no breaks in between.
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