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What happens when you lose your mucus plug during pregnancy

Photo credit: Ridofranz - Getty Images
Photo credit: Ridofranz - Getty Images

If you're preparing for the arrival of a new baby you might have lots of unanswered questions to consider, such as what is a mucus plug and what is a bloody show? And if you think you might have lost your mucus plug, should you head for the hospital?

Your mucus plug protects the cervical canal during pregnancy, and losing your mucus plug can be a early sign of labour, but not always. Dr Louise Wiseman answers your most common questions about the mucus plug, so you know when to relax and when to grab your birthing bag and hotfoot it to the maternity hospital:

What exactly is the mucus plug?

When a woman is pregnant, the cervix secretes a thick jelly-like substance to protect the labour canal and keep it moist. Because the cervix is closed, this fluid seals the area closed and forms what is called the mucus plug. The baby is protected in pregnancy by the amniotic sac and the plug provides an extra barrier of protection. It protects the baby from any infection or bacteria coming up the mother’s reproductive tract.

What is a show?

At the beginning of labour this mucus plug may come out. This is commonly then named a ‘show’ or sometimes ‘bloody show’. A midwife will commonly ask expectant mothers if they have ‘had a show’. This may be noticed by the mother when she goes to the toilet or seen in her underwear or as she wipes herself. This is completely normal at and beyond 37 weeks. It is also normal for some women to not have a show or simply not notice it.

⚠️ Call your midwife for advice if you think the mucus plug has come out and you are less than 37 weeks pregnant. This could be a sign of early labour so they might need to check you further.

What does the mucus plug look like?

The mucus plug is slightly different for every woman, but is generally a blob of jelly-like mucus that may come away in one piece at once or it can come out in several sized pieces over a few hours. Many women anecdotally describe about the size of two tablespoons of mucus but there is no arbitrary sizing.

The mucus plug can range from looking like a clear or pinkish jelly to a yellow or brown discharge. It is normal to have a streak of blood or be streaked with old brownish blood when it comes away and it may also have a sticky texture.

If any of the following occurs, call your midwife urgently:

  • If the mucus plug is green or smelly contact your doctor or midwife for advice as this may indicate a possible infection.

  • If there is a significant amount of blood call your maternity unit urgently. They might need to check you further to make sure there is not a problem with the placenta or pregnancy.

  • If you start losing fresh blood at any stage of pregnancy you should contact your maternity unit urgently.

  • If you are less than 37 weeks pregnant you should contact your maternity unit in case you are going into labour earlier than normal and they need to assess you. You won’t necessarily go into labour early but it is better to be safe so they can guide you.

Photo credit: Sirirat Noisapung / EyeEm - Getty Images
Photo credit: Sirirat Noisapung / EyeEm - Getty Images

What to do when you lose your mucus plug

Your mucus plug can be one of the early signs that labour is starting, but not necessarily. If you think you might have lost your mucus plug, it is sensible to now wear a sanitary pad in your underwear. This way you will feel more comfortable and you can easily monitor any fluid, blood or discharge lost from the vagina. This will help the midwife when assessing you.

If you are between 37 and 42 weeks pregnant losing the mucus plug is completely normal. It most likely heralds the exciting start of labour and your journey to see your baby. Your antenatal clinic is likely to have given you advice on who to contact and when.

If you think you are going into labour or are worried, contact your midwife who will happily guide you on the next stages of what to do. If you are classed as a ‘high risk pregnancy’ then let your maternity unit know as they may need to see you sooner.

⚠️ If the show is heavily blood stained or you are losing fresh blood call the maternity unit straight away.



Does losing the mucus plug mean labour is starting?

If you lose the mucus plug and have signs of early labour it is more likely that things are really starting, but it is also possible for things to still take a while.

Losing the plug can mean the latent stage of labour has arrived. This is when the cervix first softens and thins (becomes effaced – the old fashioned term was ripening). It also then stretches (dilates) in preparation for the baby coming down the birth canal. The effacement alone may mean the plug is not held in place and falls out. This latent phase can take hours or days and is usually longer in first pregnancies.

It is also possible for the plug to be dislodged during a vaginal examination by a doctor or midwife or after sexual intercourse. Sometimes a membrane sweep (a technique performed to encourage the start of labour) causes loss of the mucus plug. Let your midwife know about any vaginal loss after a sweep.



How long after losing your mucus plug do you go into labour?

After losing your mucus plug it can be anything between one to two weeks to a few hours before real contractions start.

For women who have previously had very rapid deliveries, the antenatal team have usually made a specific plan for when things like the show happens and other signs of labour come on.



What should you do if labour starts?

If you have lost your mucus plug and think you might be in early labour, call your midwife for advice. If everything is OK, she may advise that you do the following while early labour progresses:

  • Try to rest while you can.

  • Walk around and keep mobile between rest periods to encourage progress.

  • Keep well hydrated.

  • Have small regular snacks (some women have nausea and sickness in labour so little and often may be easier).

  • Use any techniques for relaxation taught at your antenatal or pregnancy yoga classes.

  • Warm baths or showers (not hot) may help any discomfort.

  • Use a TENs machine if you have one.

⚠️ If at any point you think baby’s movements have reduced contact the maternity unit urgently.



How long does the latent phase of labour last?

There is no general agreement amongst professionals as to exactly when the latent stage of labour ends and established active labour starts. The latent stage covers the time when the cervix goes from 0 to below 4 cm dilated.

Active labour is when the cervix dilates from 4 cm up to 10cm and contractions are stronger and more regular. For women the length of the latent phase can range from 6 to 8 hours until a few days or even longer.

The NHS advice is to call the midwife for advice when your contractions are:

  • Regular

  • Lasting a minute or more

  • Occurring every 5 minutes or less

Once an expectant mother is having contractions 3 times in ten minutes, most women are advised to attend the hospital as they are thought to be in the active labour stage.

Summary

Losing the mucus plug, especially when accompanied by other symptoms, may be a sign that your baby is coming soon. However if it happens on its own you may still have a while to wait. Be reassured that your maternity unit are used to reassuring and guiding women and that you can contact them for advice on what to expect and when to go into hospital.



Last updated: 24-02-2021

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