Soon you'll experience the amazing process of childbirth! But, how do you know when "its time?" This is probably the most common question for women at the end of their pregnancies. If you've never had a baby before, or even if you have, it's sometimes confusing as to when it's considered active labor or not.
As you approach your due date, you will be looking for any little sign that labor is about to start. But keep in mind that active labor itself is usually not based on one sign or symptom, but often a combination of several of them.
In the last month of pregnancy, it is normal to begin to feel changes that indicate you may be getting close to the time your body will begin active labor. You might notice that your baby has "dropped" or moved lower into your pelvis. This is called "lightening." If you have a pelvic exam during your prenatal visit, your provider might report changes in your cervix that you cannot feel, but that suggest your body is getting ready. An increase in vaginal discharge may occur. This discharge is not itchy or irritating, but is usually increased in amount. It can be somewhat thicker or mucousy as well. For some women, a flurry of energy and the impulse to cook or clean, called "nesting," is a sign that labor is approaching. These are all changes that can begin even a full month before active labor begins.
What are contractions?
For the majority of women, especially first-time mothers-to-be, they may think they are in labor when they're not. This is called false labor. "Practice" contractions called Braxton Hicks contractions are common in the last weeks of pregnancy or earlier.
Contractions are when the uterus, which a large muscle, tightens up. The uterus contracts actually quite frequently, even early on in pregnancy, although we generally don't notice it. It can happen when we move, when the baby moves, when the bladder is full, or just after the bladder is empty, and, one of the number one reasons the uterus will contract is dehydration. When the uterus stretches and gets larger throughout the pregnancy we can feel the contractions much more.
The tightening of your uterus might startle you. Some might even be painful or take your breath away. It's no wonder that many women mistake Braxton Hicks contractions for the real thing. So don't feel embarrassed if you go to the hospital thinking you're in labor, only to be sent home.
So, how can you tell if your contractions are true labor?
Time them. Use a watch or clock to keep track of the time one contraction starts to the time the next contraction starts, as well as how long each contraction lasts. With active or "true" labor, contractions become very regular, stronger, and more frequent hour by hour. Braxton Hicks contractions are not in a regular pattern, and they taper off and go away. Some women find that a change in activity, such as walking or lying down, makes Braxton Hicks contractions go away. This won't happen with true labor. Even with these guidelines, it can be hard to tell if labor is real. If you ever are unsure if contractions are true labor, you can call your provider.
So what are some other signs that true labor will begin very soon?
You have contractions that become stronger hour-by-hour, at regular and increasingly shorter intervals, such as every 3-5 minutes. These will be very consistent and after a period of 1-1/2 to 2 hours, are much more intense.
You have lower back pain and cramping that does not go away with drinking increased fluids, warm bath, warm heating pad, and changing positions and rest.
Your water breaks (can be a large gush or a continuous trickle).
You have a bloody (brownish or red-tinged) mucus discharge. This is probably the mucus plug that blocks the cervix. Losing your mucus plug usually means your cervix is changing -dilating (opening up) and becoming thinner and softer (effacing). Remember, this sign can begin even a couple weeks before going into labor, but if combined with any of the other signs/symptoms listed above, can indicate active labor.
How do I know if my water breaks?
It's not always easy to know. If your water breaks, it could be a gush or a slow trickle of amniotic fluid. Rupture of membranes is the medical term for your water breaking. Let your provider know the time your water breaks, the color of the fluid and if it has an odor. Usually the fluid is clear to straw colored, and will not smell bad. It is also uncontrollable- it's not like emptying the bladder where we can control the flow-somewhat! With amniotic fluid, it continues to leak and for most women, if they put an a peripad and walk around for about 30 minutes, the pad generally will be soaked with fluid in this amount of time. If you are unsure whether your water has broke, be sure to contact your provider. An easy test can tell your provider if the leaking fluid is urine (many pregnant women leak urine), increased normal discharge or amniotic fluid. Often a woman will go into labor soon after her water breaks. When this doesn't happen, her provider may want to induce (bring about) labor. This is because once your water breaks, your risk of getting an infection goes up as labor is delayed.
Knowing whether it's the "real thing" and you are in active labor is sometimes difficult. If you are unsure and have questions, call your provider- even if it's weeks before your due date — you might be going into preterm labor. Your provider will let you know if you need to go to the hospital or if you should be seen at the office first.
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