How will I know if I'm in Labour?

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This is a question I often get asked by mums-to-be as they prepare for the “big day”.

The stock answer that most people tell you is “Don’t worry you’ll know!” – Well that doesn’t really help does it??

So let’s look at the two signs of labour:

1) Contractions/tightenings or surges (Hypnobirthing word)

2) Waters breaking (not always – see below)

What are contractions?

Your womb (uterus) has a muscular layer within it so it contracts just like any other muscle in your body. During the third trimester of pregnancy you may notice your bump having brief episodes of tightness (If you place the palm on your hand on the top of your bump you’ll feel it go hard) – this is your womb practicing contracting in readiness for the big day. At the same time these short episodes of tightening will help nudge your baby into the optimal position for birth. These “practice contractions” are known as Braxton Hicks

and this new sensation may feel a bit weird but should be painless. (Some women don’t even notice them).

At the end of pregnancy as your body prepares to give birth your Braxton Hicks will become more frequent, last longer and you may start to notice them more – this is your body gearing up to start labour.

What’s the difference between Braxton Hicks and real contractions?

1) Braxton Hicks can be haphazard in their appearance whereas real contractions will get closer together until they are regular in the frequency, every so many minutes. So you could time your watch by them & as Midwives we do like you to time them! – We will ask you how many contractions you are having in a 10 minute space of time.

2) Braxton Hicks are unpredictable in length with each one lasting a different length of time. On the other hand real contractions will get longer in length until they are regularly lasting between 45-60 seconds (Get someone else to time them as you lose all sense of timing when you’re experiencing this).

3) Braxton Hicks will generally come to an end if you change position, have a bath or empty your bladder whereas real contractions will remain pretty much constant no matter what you do!

4) Braxton Hicks cause little to no discomfort, mostly just a feeling of tightness all over your bump. However real contractions come over you like a wave, commonly starting in the lower back and working their way around to the front of your lower bump. They can also give you a pressure feeling in your pelvis and vagina and period like cramping in your lower abdomen. The sensations of real contractions become more intense over time – (Just to mention the huge subject of if contractions are painful – there are so many factors that come into play in answer to this question I’ll cover it in a separate blog!)

When will my waters break?

We’ve all seen it on the soaps or in a film where a pregnant woman going about her business suddenly has a gush of water all over the floor – proceeds to dash to the hospital – two quick pushes later the baby is out!!

Well I’m sorry to tell you in reality that doesn’t happen!!

Your waters can break at any of these stages:

· Before contractions start

· At any point during labour

· As you push your baby out

· Sometimes the waters don’t break at all & your baby is born still in their bag of waters!! (Weird rare sight that I’ve seen twice - supposed to bring good luck & legend has it that Sailors bought the membranes from such births to keep themselves safe at sea!)

Your waters should be a clear liquid or straw like colour sometimes having white flecks in – they are often confused with urine because heavily pregnant ladies can sometimes leak a little bit of wee & then wonder if their waters have gone - but wee smells like wee & waters do not!!

You may feel an occasional uncontrollable trickle from your vagina or you may feel an internal “pop” sensation & more of a gush of fluid. Either way the best course of action is to grab a maternity pad to wear, check what colour the waters are & phone your midwife/hospital to let them know.

(If the waters are blood stained or a green/brown colour or have green/brown/black bits in this would be an indication for an immediate trip to the hospital (you must still phone first!) as your baby may have pooed as a sign of distress.)

What happens if my waters break but I’m not in labour?

As I already mentioned sometimes your waters can break before labour starts, (Urban myth has it that if they break in a well-known department store you get £250 voucher!) so if this is the case for you it is still important to inform your Midwife/hospital as they will still want to see you to double check for themselves and make sure that you and baby are fit and well.

If all is well you will be allowed home to try to encourage labour to begin, however they will book you a date to return to hospital for induction as a backup plan.

What’s an induction & why do I need one?

Once your waters have gone your baby has lost their sterile environment, because just as waters can leak out so can bacteria make their way into your womb. However 60% of women in this situation will go into labour within 24

hours. So whilst your health care provider will be happy to give Mother Nature a chance to get labour started naturally, if things aren’t happening within 24 hours they will encourage you to have an induction to reduce the risk of an infection to you and your baby.

An induction is a process where artificial hormones are introduced into your body to mimic those that are produced when you are in labour. By doing this your body reacts in the same way and contractions begin.

(There are many different reasons why an induction may be considered – I will be writing a blog on Induction & what’s involved soon!)

Thanks for reading

Jane – The Midwife

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