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Dr Duncan

How do I know if I'm going into labour?

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Doctors will give you an estimated date of delivery – EDD – but when it gets down to being precise about when labour begins, the simple answer at this stage is that no one really knows! Some suggest that it’s the baby itself that triggers labour, but as yet we haven’t learned how to decipher the process!

During the course of pregnancy, your baby will have grown from a small cluster of cells to perhaps a 4kg infant, and all that time your body will have been feeding and nurturing the infant and protecting it from harmful infections. In fact, the baby lives in its own little universe, sealed off from the outside world in its sac of amniotic fluid. This sac sits inside your uterus, which is becoming progressively thicker and stronger as time goes on because at some point it will have to squeeze that 4kg package out through your birth canal, and that will take a mighty, muscular effort!

You might remember that the uterus is a muscular structure, at the lower end of which lies the cervix, and this is sealed and protected by a mucous plug that keeps bacteria away from the growing infant.

baby-in-womb

Baby in the womb

Towards the end of pregnancy, that tight cervix needs to be slowly stretched and thinned to allow the baby’s head through. This can take some weeks, and the doctors will talk of your cervix “effacing”, which means that it’s getting thinner and shorter.

The next thing that your cervix needs to do is to start opening and when this happens, the mucous plug that’s been there sealing off the contents of the uterus will fall out. This plug is often significant and usually brown or frankly bloody, and it’s presence means that labour is near – but that could mean days and not necessarily hours!

Whilst all this is going on your uterus will have “gone into training” in order to get fit for the real business of pushing that baby out through the narrow birth canal. These preparatory contractions are called Braxton Hicks contractions. They will be short and erratic, but can still stop you in your tracks with their intensity. Even the most experienced mum can be unsure as to whether they are the “real thing”, so if in doubt, always ask your doctor or midwife.

In the latter part of pregnancy, women will often experience the “nesting instinct” with zealous desires to clean things, empty cupboards or generally spring clean the house! While this is not a bad thing, if you are about to go into labour, it is probably wise to try and conserve some of that much needed energy for the real work of labour.

With the cervix thinned out and dilating, and having lost its mucous plug, the next step in the process is often when the waters break. This means that the sealed off universe that your baby has been floating in for the last 9 months has been breached and things should start to happen. It is important to take note of what time this occurs as now your baby is connected to the outside world with all its germs and challenges. The consequence of your membranes rupturing is that if labour is not progressing, then your doctor will artificially induce it, to help get the uterus to start contracting effectively.

Remember that as a general principle, your first labour will last about 20 hours and subsequent ones may well be swifter, but after 24 hours the risk of infection to the baby does increase, so knowing when your waters broke is important to your obstetric team. Obviously, during this period of time it is unwise to have anything un-sterile put in your vagina!

If things are progressing smoothly, then real labour begins. It is so difficult to explain to people the difference between Braxton Hicks contractions and the contractions that we call labour pains. Being a male makes it doubly difficult! But if someone is asking you if they think they are in labour because they are having a contraction, they are probably not in labour! Labour pains will definitely stop you in your tracks and make it impossible to hold a normal conversation. They will be:

  • Regular when timed from the beginning of one to the beginning of the next one.
  • Lasting more than 30 seconds and getting progressively longer – up to 90 seconds.
  • You can’t stop them! With Braxton Hicks contractions you can sometimes ease them by doing something else, or perhaps changing your position.
But no one, not even the most experienced obstetrician can diagnose true labour with 100% accuracy every time, so be prepared for false alarms. As I said above, if you’re not sure, ask someone with more experience than you and be patient, I promise you that the baby will come out eventually!

Baby in the womb image: www.molarpregnancy.co.uk

Article written by Dr. Duncan Jefferson. More articles here. For more information on health care and private health cover, visit HBF Insurance at www.hbf.com.au.

The content of these articles is not tailored for any particular individual's circumstances. The author does not take into account your physical condition, medical history or any medication you may be taking. Any advice or information provided by the author cannot replace the advice of your health care professional. The views expressed in this article are those of the author and do not represent those of HBF unless clearly indicated.

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