Am I in labour?

The signs of the onset of labour

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“The baby, it’s coming!”

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It must be the most over-used line in TV script writing. A more likely scenario involves a rather less certain pregnant woman telling her questioning partner “It might be coming”, or even more likely wondering whether she should wake anyone up in the middle of the night or disturb her partner at work in case it’s just a false alarm. Is the pain in your abdomen real labour or more Braxton Hicks contractions?

No-one wants the embarrassment of rushing off to hospital just to be sent home a few hours later after being told they’re not in real labour, but if you wait too long before making a call to the midwife and support, you could be in for a surprise in-transit birth or home delivery. To help you decide when to get people involved, here are signs you should look out for that labour is imminent.

Contractions 
The most common sign that labour is beginning is strong, painful and regular contractions. You may have felt Braxton Hicks contractions in the weeks leading up to labour, but these would have been irregular and most probably not painful. In the hours or even days before the onset of real labour you will probably experience much stronger contractions, initially about half and hour or twenty minutes apart and lasting between thirty seconds and a minute.

If the contractions seem to ease up when you move around then it may be false labour – real contractions won’t be relieved by activity, although moving around may distract you from the pain.

Over time, real contractions will become closer together as they begin to dilate the cervix, and they might come in waves, with times of calm in-between. Experience of pre-labour contractions vary enormously: You may find the early contractions quite intrusive, or you may be able to go calmly about your usual tasks: some women find the contractions very painful and draining, while others may hardly notice until they are several centimetres dilated, particularly if it’s not their first baby.

Timing contractions will help you work out whether they are regular or not – don’t expect all the contractions to come at evenly spaced intervals though, contractions are still likely to come in waves. When you think the contractions are regular call your midwife for advice. Depending on how you’re doing she might recommend you go to hospital quite soon, or may prefer that you stay at home until the contractions are closer together.

Breaking waters 
The scenario of your waters breaking in the middle of the supermarket or on a crowded bus is one that many mums-to-be worry about, but as fewer than 15% of women experience their waters breaking as the onset of labour then chances are you’ll be already well aware of being in labour when they do break, and in fact your midwife may rupture your membranes for you in hospital to move things along a bit.

If your waters do break early on then you won’t necessarily feel a sudden gush of fluid as the baby’s head may block the neck of the womb, particularly if you’re standing up, in which case you’ll only experience a dribble.

It can be quite difficult to know whether your waters have broken or whether you’re just suffering a bout of incontinence. If in doubt, look at and smell the fluid to see if it smells or looks like urine.

If you do experience your waters breaking as the first sign of labour then you can usually expect the contractions to begin within 24 hours. You should call your doctor or midwife right away to let them know and also be sure to tell them immediately if the waters were a dark or greenish colour, as this may be a sign that your baby is distressed. Don’t worry that your baby will have no fluid left, your body will continue to produce fluid until birth.

Depending on the circumstances they might recommend that you stay at home and wait for contractions to begin, or that you make your way to hospital.

A show
Throughout the months of your pregnancy your womb has been sealed off at the cervix with a plug of mucous. As the cervix ripens and thins, this mucous plug may fall away and be discharged by the vagina. It will appear jelly-like and may be blood tinged, pink or brown. Having a show doesn’t necessarily mean that you’re in, or about to go into, labour, and for some it might even be another couple of weeks before labour, but it may also be a sign that it’s not too far away.

Not everyone has or notices a show, if you do then it’s nothing to worry about unless you also discharge blood clots or heavier bleeding – if this happens you should call your midwife or doctor immediately.

What to do 
If you think you are or may be in labour then the first thing to do is to stay calm and ring your midwife or hospital so you can describe what’s happening to them. It’s best to make this call yourself, even if you are in some pain, so that details don’t get lost in translation. If you’re speaking to the hospital or midwife don’t try to be a heroine when contractions strike as they’ll be judging the situation partly by how much pain you appear to be in.

Don’t be worried about calling with a false alarm, it’s far better to call just in case and to put your mind at rest than to end up at panic stations.

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If you’ve arranged for family or friends to come and help you then give them a call and, presuming you don’t have to dash off to hospital right away, try some of our suggestions for getting through the early stages of labour at home.

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