As you approach your baby’s due date, you may begin to wonder how to recognize the first signs of labor. Every labor is different for every woman even if you have had babies before, but as your body prepares to give birth there are some sure pre-labor symptoms that will let you know your baby is on his or her way!
Cervix Dilation and Effacement
During the last few weeks of your pregnancy, your doctor may perform a pelvic exam to check for any signs of early labor. Your healthcare provider will typically measure cervical dilation (in centimeters from 0 to 10), effacement (how thin or shortened the cervix is), and station (how low the baby’s head is). The rate at which your cervix dilates and effaces depends on many factors, including the number of previous pregnancies, if you have had a previous vaginal delivery, and whether you are having many contractions.
The cervix changes its shape and structure to allow the baby to pass through the birth canal. It is usually long, tight, and narrow but as your body prepares to give birth the cervix begins to soften, shorten, and stretch open. This process is called “dilation.” Your baby will also drop down further into the pelvis which puts pressure on the cervix and causes it to thin out. This is referred to as “effacement,” and it is measured in percentages. For example, if your doctor says you are 50% effaced, it means your cervix is half of its normal thickness.
As the cervix dilates, it is common for women to have vaginal mucous or discharge. This is called “bloody show” and it can be thick or thin with some blood streaks in it. This is not a cause for concern, rather it is a sign that your labor is approaching and the birth of your baby is imminent.
Contractions refer to the periodic tightening of the muscles of the uterus. As your body prepares to give birth the initial contractions may be so subtle that you are unaware of them. These contractions often occur as a cramping or tightening of the belly and/or lower back. As they progress, they can become increasingly uncomfortable, enough to cause you to have to stop, sit down, and catch your breath.
Individual contractions usually last between 30 to 60 seconds, and may or may not have a pattern. It is possible to have one or two isolated contractions, or your contractions can come six to eight times in an hour or more. However, you are not in “hard labor” until your contractions have established a rhythm of coming every two to three minutes with very little break in between.
As you get closer to delivery, your contractions will build in both frequency and intensity. You may also feel pressure and pain deep in your pelvis, vagina, rectum, or back. Back labor is usually caused by the weight of baby’s head on the back or by its position within the birth canal. Back pain is often most significant during contractions, but it can persist in between them as well.
Your water breaking is a good sign that you are either in labor, or will be soon. Sometimes, a woman’s water breaks definitively with a large gush of watery fluid, but it can also occur as a subtler trickle. If you are leaking fluid, check it if it smells like urine, since it is common in pregnancy to experience some incontinence.You should also check the color. If the liquid is anything other than clear, you will need to inform your healthcare provider promptly.
Once your water breaks you should contact your doctor and/or delivery center. If you are full term (within three weeks of your assigned due date), you will most likely be instructed to go to the hospital. However, it is possible to go into active labor without your water breaking. Effective contractions and the dilation of the cervix can take place without the breaking of the water but this is not a cause for concern. If your water does not break on its own, your doctor may rupture the membranes in order to progress your labor.
Going Into Premature Labor
If you are more than three weeks from your due date and are experiencing any early signs of labor, it is absolutely crucial to contact your health care provider immediately in case you are in pre-term labor. Premature labor and delivery can cause complications for you and your baby, but if treated early it can sometimes be avoided. Likewise, if your baby is not moving normally or if you are experiencing vaginal bleeding, you should consult your care provider since these issues could indicate other problems that require prompt evaluation.
Contact Us If You Think You’re in Labor
Do not hesitate to contact your health care provider if you are unsure whether or not you are exhibiting pre-labor signs or especially if you have any questions or concerns. Every labor is unique and your care providers are best equipped to support you, provide information and let you know when it is time to come to the hospital and have your baby!