At the end of my first pregnancy with Nahla, I remember laying in bed googling if being tired was a sign of labour. Looking back, it was probably more a sign that I should be sleeping instead of searching the internet all through the night for early signs of labour. To save you the same stress and make sure you're sleeping instead of googling the night away, I've checked the research and created this blog post for you to refer back to when you're unsure.
Early stages of labour: The latent-phase of labour
Early labour is referred to as the 'latent-phase of labour'. It's that time when your cervix is roughly less than 4cm, and your contractions are still irregular. For most mamas, it will always happen before active labour. The latent phase is a time when you should make sure you're ready to go [pack the hospital bag and petrol in the car if not already done], rest, eat, stay hydrated and try to relax. It often comes with typical 'signs', which can indicate that labour is approaching, which you can check out below.
When is considered early labour?
Early labour is when your cervix is less than 4cm dilated, and your contractions are more than 2-3 minutes apart and are still coming and going at random and unpredictable intervals. Your contractions might be described as uncomfortable rather than painful during early labour, but this can be influenced by many things such as bub's position and a mama's pain tolerance and perception of pain. During early labour, most mamas are still able to talk or breathe through contractions and go about normal activities between them.
Signs & symptoms of early labour:
Sign 1: Losing your mucous plug
One of the first signs of early labour can be losing your mucous plug. The mucous plug is a sticky, jelly-like mucous, which is usually yellow or brown but can also be blood-streaked. It can come out all in one, or small amounts. It doesn't always mean that you're going to go into labour as you can actually lose it weeks before labour begins. On the other hand, some mamas report losing their mucous plug days, or even hours before labour begins. You can also lose your mucous plug many times as it can regenerate. In the hospital, you might hear doctors or midwives refer to this as a 'show'. If you lose your mucous plug before 37 weeks, give your health providers a call because it may indicate changes in the cervix.
Sign 2: Lower back pain and early labour contractions
Lower back pain is a common complaint of mamas in early labour. Sometimes it can be contractions, or bubs position putting pressure on mamas back. For other mamas, back pain can signal their belly babe moving down. Some research also tells us that mamas who have back pain during their period are more likely to have back pain during labour. If your back pain is accompanied by any bleeding or a hard tummy that doesn't soften, call your birthing team.
Period pains that come and go
For some mamas, mild contractions feel like period pain. Take notice of these cramps; are they getting stronger? Are they lasting longer? Are they getting closer together? Can you feel your whole bump go hard with them? Do they stop when you change position or do something different? Are you constipated? Do you have gas? Does paracetamol help? Are they coming with Braxton Hicks?
How far apart are contractions in early labour?
There's no hard and fast answer for this one. Contractions in early labour could be 20 mins apart, 10 mins apart, or even 5 mins apart.
Are early labour contractions painful?
This one depends on the position of bub, and the perception of pain and pain tolerance of a mama. Some say yes, while others say no, just more uncomfortable.
Sign 3: Your cervix is opening, softening and thinning out
During pregnancy, some mamas will require speculum assessments; for example, if a mama thinks she is in preterm labour. A doctor or midwife will be able to see if the cervix is open or shortening, which can indicate labour may be near. Also at an ultrasound, a mama might be told her cervix is 'funnelling'. This means that it's opening on the inside, which if preterm, needs obstetric management. Once a low-risk mama is at least full-term, they may be offered a vaginal assessment before booking an induction, or a stretch and sweep. During this assessment, your health provider will assess many aspects of your cervix. These include position [does the opening face the front, middle or back], consistency [soft, medium or hard], dilation [how open it is from closed-10], effacement [how long it is from 0-4cm] and how low your bub's head is [from -3 to +2]. You'll then receive a 'Bishop's score'. As your score gets higher, your cervix is becoming more favourable, and you're moving closer and closer to labour.
Sign 4: Your waters break
Your waters could break in a big gush during early labour, or you might have a constant trickle. Some mamas will feel constantly wet. These are all hints that you might have broken your waters. And yes, it can happen before any other signs of labour. Around 1 in 12 pregnant mamas will experience their waters breaking before labour begins. Approximately 70% of pregnant mamas whose waters break before labour goes into spontaneous labour within 24 hours of their waters breaking. The liquor [waters] should be clear or pink. If it's green, yellow, brown, bloody, smells unpleasant, you are group B strep positive or you have been instructed to, contact your birthing team straight away.
Sign 5: You have loose bowel motions [not caused by food poisoning or gastro]
As your labour begins, your hormones, particularly prostaglandins, might cause diarrhoea. The diarrhoea may also be caused by bub's head moving down in the pelvis. Some people say that it's natures way of emptying the bowel to make sure your baby has enough room to come through the birth canal. Either way, it can be unpleasant. Keep your fluids up, and call your pregnancy team if you become dehydrated.
In my thorough research, there were also a few anecdotal early signs of labour. These are signs based on common personal experiences rather than studies or research.
Sign 6: Your bump drops
Many mamas say they were told their bump appears to look lower or 'drop' right before labour. This could be because of bub moving down into the pelvis.
Sign 7: Increased pressure down below
Lots of mamas report feeling heavy or having increased pressure in their vaginal or rectal area shortly before labour. Some mamas will experience 'lightening crutch', which feels like a shooting pain in the vagina. All of this is from your little person moving down towards the exit.
Sign 8: You can breathe easier but have to pee more often
This is another anecdotal sign related to bub moving down into the pelvis, which will make more room around your diaphragm and lungs, but leave less room around your bladder.
Sign 9: Nesting
We've all heard this wives tale. Some say it's a mamas instinct to get everything done before the new arrival
Sign 10: A big burst of energy
Like above, this wives tale says it's to make sure everything is ready to go.
When to call your doctor or midwife
It's time to call your Doctor or Midwife when:
- You break your waters, particularly if it's green, yellow or blood-stained [put a pad on before coming into hospital too].
- Bub's movements are reduced [it's a myth that they'll slow down towards the end of pregnancy + in labour].
- You're getting painful, regular contractions every 3-5 minutes that last at least 45-60 seconds, and this has been occurring for at least an hour.
- You're getting contractions and are less than 37 weeks or have had a previous c-section.
- You're bleeding.
- Severe abdo pain that doesn't stop or lessen in intensity.
- You're not coping at home, despite trying your pain relief options.
- You're feeling unwell, have a fever or can't keep fluids down.
- You've got a headache that doesn't go away, visual disturbances like spots in your vision or excessive swelling, particularly in unusual areas like your face.
- You're concerned.
What are the signs that something is wrong?
- A change in bub's movements. Your bub's movements are the only way they can tell you that they are ok. If there's a change in their normal movement pattern, it's time to call your Doctor or Midwife.
- Bleeding, but not always. Bleeding is tricky because it really depends on the amount, the colour, and where it's coming from. Sometimes the bleeding can come from the placenta if a part of it has sheered off the wall of a mama's uterus, while other times, it may be coming from something as simple as a cervical ectropion, which is a harmless condition.
- Severe abdo pain that doesn't stop or lessen in intensity. That's because this can sometimes indicate that part of the placenta has sheered away from the wall of a mama's uterus. Uncommon, but it is serious.
- You've got a headache that doesn't go away, visual disturbances like spots in your vision or excessive swelling, particularly in unusual areas like your face, because these may be subtle signs of a very serious pregnancy-related condition called Pre-Eclampsia.
FAQs
Is fatigue a sign of early labour?
Some say it's your body's way of telling you to slow down and rest to conserve energy before labour.
One myth I've heard that I want to bust right now is that a baby's movements will slow down towards the end of pregnancy, or leading up to labour. Some say that bub is running out of room, while others say it's to save energy before birth. Let's put a stop to this right now. This myth is entirely FALSE!! If there is any change in your bub's movements, whether that be an increase or decrease, or change in strength or frequency, please contact your health provider immediately. Don't wait. Your baby's movements are the best indication that they are okay.
How long can early labour last?
For some mamas, early labour may last just a few hours, while for others, it can go on for days.
Can stress bring on early labour
Sudden, short-lived stress is unlikely to trigger early labour. But the research suggests that stress in pregnancy that is ongoing, long-term and not well managed is linked to an increase in Cortisol [stress hormone], Adrenaline and Cytokines [inflammation proteins] in the blood. The raised level of these hormones and proteins is what is linked to things like pre-term labour, miscarriage, diabetes and bub being born very small. So to put it simply, ongoing, long-term, uncontrolled stress may trigger early labour, but short-term and sudden stress is unlikely to trigger early labour.
How to bring on early labour
As the due date approaches or has been and gone, lots of mamas try to bring on labour naturally. It's such as popular topic that we've written a whole blog post on how to naturally induce labour. But in a nutshell, you can try to bring on labour by trying these methods, keeping in mind some of them have some evidence supporting them, while others are based on word of mouth:
- Stretch + sweeps
- Antenatal expressing + nipple stimulation
- Sexual intercourse
- Curb walking + doing the stairs
- Eating dates, spicy foods + pineapple
- Castor oil
How to avoid early labour
Unfortunately, there's no way to avoid early labour, as it's a part of the labour process. Some mamas may experience a short period of early labour, while others will be in early labour for days on end. There's no way to prevent or avoid it, but it's definitely time to try all of those pain relief techniques, rest as much as possible and stay home for as long as possible if safe to do so.
