If you’re expecting, you’re likely eager to learn the early signs of labour, so that you can be prepped (well, as much as possible since, despite our pleas, babies don’t tend to work to a schedule) to call your midwife or head to the hospital.
There are three stages of labour and birth. The first, and often longest, is known as the latent phase, where the cervix starts to soften and open, and you begin to experience contractions. The latent phase can last hours or even days before you actually give birth.
The second stage of labour starts when the cervix is fully dilated and ends when the baby is born, which generally takes 2-3 hours, depending on whether you have had a baby before or not. The third and final stage of labour is delivering the placenta.
It goes without saying that every pregnancy is individual, and so too will be any early signs of labour.
But, what are the early signs of labour? And how do you know when you’re ready to give birth? WH asked the experts…
7 early signs of labour (and what to do when you experience them)
1. Your baby “drops”
‘This usually happens in the last few weeks before actual labour commences and often earlier in first-time mums,’ says Dr. Sadia Bhatti, Consultant Obstetrician at The Harley Street Centre For Women. It occurs when the baby’s head is getting engaged into the pelvic inlet (entrance of the pelvic cavity) and generally happens at around 36 or 37 weeks. It tends to be one of the first early signs that your body is preparing for labour.
‘With the baby descending lower into the pelvis, you’ll notice your bump will have dropped lower down your abdomen,’ says Dr. Bhatti. ‘When there is engagement of the head, or engagement of the presenting part (as it can be the bottom in breached babies), the mum may start to feel more pressure in the pelvis and on the bladder which will result in more frequent visits to the toilet. It is a positive sign of labour that things are progressing.’
Pregnant people needn’t do anything at this stage – just make themselves as comfortable as possible.
2. Increased back pain and cramps
Back pain and cramps can ramp up in the latent phase of labour and, according to Dr. Bhatti, start to feel more out of proportion compared to any back pain or cramps experienced in the antenatal period of the pregnancy (such as Braxton Hicks contractions, which are often painless).
‘You will feel cramps in the tummy area and pain or an achy feeling usually in the lower part of the back which will be getting much more frequent and with greater intensity,’ says Dr. Bhatti. ‘The activity in the uterus causes pressure on the nerve endings and the way the nerves are distributed, which results in the pain experienced – similar to the pain felt during menstruation.’
If your baby is positioned back-to-back (where their head is down but their back is against your spine), you might experience greater pain.
‘If the pain is too much, it’s advisable to call the labour ward to talk through how strong and frequent the contractions are and they will advise whether to come in. It’s fine to take paracetamol to help ease the pain,’ Dr. Bhatti advises.
3. Your joints feel more relaxed
‘Some women start to get more pain in the pubic bone because the ligaments are relaxing to make space for the baby to pass through the pelvic cavity,’ says Dr. Bhatti.
‘Relaxing of the ligaments causes your joints to be more mobile and that’s where the discomfort comes from – often leading to pelvic and lower back pain. It’s the effect of the progesterone hormone on the ligaments that cause ligaments to start to relax and some women may experience it much earlier on in their pregnancy.’
Movements, such as walking and getting out of bed, can cause significant discomfort for those experiencing pain in the pubic bone, as increased mobility from relaxed ligaments can result in overextension (opening your leg much more widely when getting out of bed, for example), causing pain.
‘Wearing a pelvic support belt can help to reduce joint mobility, and resting for short periods of time, and not standing or walking for long periods, is advised,’ says Dr. Bhatti.
4. Your cervix dilates
In first-time pregnancies, the cervix usually starts to dilate (where it becomes soft and begins opening to birth the baby) in the latent phase of labour. However, in those who have had previous births, it’s common for the cervix to be dilated 1-2cm throughout the pregnancy.
‘The cervix dilating and opening up is the body getting ready for the event of the birth and it’s how the progress of labour is assessed, so starting slowly at 1-2cm and as the labour advances the cervix dilates more until it is fully dilated at 10cm,’ says Dr. Bhatti.
‘An examination would be required to know that the cervix had started to dilate, it wouldn’t be something that the pregnant person would be aware of or could feel.’
As with all aspects of pregnancy, cervical dilation and contraction intensity vary from person to person, so some women might experience very strong contractions without any cervical dilation, whilst others might have mild contractions and be 5-6cms dilated.
‘Clinically, we differentiate someone who is in active labour by their cervix dilation – with 1-4cm being the latent phase and 4cm and above being active labour.’
5. You lose the mucus plug
Losing the mucus plug – the protective mucus in the cervix that seals the cervical canal – is a definite sign that labour is imminent, and could start within days (or less).
‘When the mucus plug presents itself, it means the cervix has started to shorten or open up and lumps of mucus (a thick, jelly-like substance) will start to come out,’ says Dr. Bhatti.
‘You may feel some wetness in your underwear or notice it when you go to the toilet. It is not something you need to go to the hospital about, just be more vigilant and prepare yourself for contractions and your water breaking.’
6. Your water breaks
For some pregnant people, water breaks during the latent phase of labour, whilst for others, it breaks during the active phase. Generally speaking, labour often starts within 24 hours of your water breaking.
‘Women will usually know it’s their water that has broken as it will feel like a trickle down their leg that they can’t control, and it will keep trickling again and again after the initial gush,’ says Dr. Bhatti.
‘It is advised to go to hospital even when you have a slight suspicion that they may have broken. The hospital will then be able to conduct a simple test and confirm whether it was indeed fluid from the baby.’
7. You’re experiencing stronger, more frequent contractions
‘Experiencing more regular and strong contractions is most likely to be when women are in active labour and the labour is really progressing well,’ says Dr. Bhatti.
‘It is the effects of the hormone oxytocin being released that stimulates the uterine contractions and this is what causes the intensity and frequency, and helps the cervix dilate fully and prepare for a vaginal delivery.’
At this stage, Dr. Bhatti advises discusses pain relief option with your midwife or obstetrician, if you choose to.
How do you tell the difference between genuine and false labour?
Truth is: it’s difficult to tell the difference between true labour contractions and false labour contractions.
However, the closer you are to your due date, the more likely you are to be experiencing genuine, as opposed to false, contractions or Braxton Hicks.
‘Contractions that become progressively more frequent and stronger and don’t go away will be genuine contractions,’ says Dr. Bhatti. ‘With false labour, you may get relief from taking paracetamol and a warm bath and the pain can pass.’
So, at what point during labour should you call your midwife?
Dr. Bhatti recommends calling a midwife or going to the hospital if or when:
You suspect your waters have broken – it’s best to get checked over, even if you aren’t sure
Contractions become stronger and more frequent (around 3 in every 10-minute period, according to the NHS)
You’re concerned about your baby’s movements (if, for example, they haven’t been moving as usual in recent days and weeks)
You experience any fresh blood (not presenting as the mucus plug)
How can you help labour along?
Turns out, there’s evidence to suggest that sex (specifically vaginal intercourse and, also, nipple stimulation) can help to encourage labour along, though it’s not the most efficient method, according to Dr. Bhatti.
‘The best way to help labour along is to have a membrane sweep [in which a midwife or obstetrician puts a finger in your cervix and makes a sweeping motion with their fingers] which naturally releases prostaglandins (chemicals that help relax tissues), although, this will only be effective if the cervix is already becoming favourable,’ she says.
‘There are prostaglandins in semen, which are is why sex is often spoken about as something that might trigger labour, but again the cervix would need to already be soft.'
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