But first, what is labour, and how do you know you're in it? Labour is the process mamas go through to birth their bub vaginally. The uterus contracts, causing the cervix to open [dilate], which allows bub to move lower in the pelvis. Once the cervix is fully dilated, a mama may begin pushing to birth bub vaginally.
Signs that it's time to call your midwife:
- You're getting contractions every 2-3 minutes
- Contractions last between 45-60 seconds
- Your contractions have been doing that for at least an hour
- Contractions are painful, so much so you can't talk through them
- You're no longer coping with the pain at home despite taking panadol, having a shower, using heat packs, breathing through etc.
- You're concerned about bub's movements
- You've broken your waters, and it's green/ yellow or bloody
- You've got fresh bleeding
- You've had a caesarean previously or are having a planned c-section this time around and think you're in labour
- You're concerned in general
Signs Labour May Be Approaching
1. Cramping or Lower Back Pain
Cramping or lower back pain is generally one of the first signs people experience in early labour. Some describe it as feeling like mild period cramps or a dull lower backache. Some even get pain in the hips that radiates down the legs. Where you feel pain may depend on bub's position. If bub's back is facing toward your back, you might experience back or hip pain, while if bub's back is facing outward toward your belly, you might get those lower period like abdo pains. In saying that, cramps or lower back pain may not always indicate early labour. Sometimes it may be that you're carrying a full-term bub, have pushed yourself to do too much that day, or are just feeling generally uncomfortable. Watch the pattern of the pain; is it constant, and coming and going? Does panadol help/ stop it? What if you change activities or positions? If it's starting to get regular, more painful and doesn't stop no matter what you do, that might be a good sign that active labour isn't far away.
2. Diarrohea
Before labour begins, there's a huge hormonal shift in your body, which can affect the cervix, uterus and rectum. As a result, you may experience diarrhoea in the days or hours before labour begins. Some say this is nature's way of making room for bub to be able to drop down into the pelvis before labour begins. While it is common, diarrhoea isn't a pleasant experience for anyone, so try to:
- Keep hydrated by drinking plenty of fluids
- Eat small amounts of food to keep your energy up
- Rest where you can, particularly if you're going to go into labour in the coming hours/ days
- Stay close by a toilet; you know why 😂
3. Your Belly Goes Tight
Many mamas I've met have experienced intermittent "tightness" of their belly as their first sign labour is beginning. And most of them have all put it down to Braxton Hicks rather than true labour. It can be confusing, but there are a few key differences:
- True contractions become regular, while Braxton Hicks don't
- True contractions become painful as well as cause the tight belly, while Braxton Hicks aren't painful
- True contractions won't stop with position changes, while Braxton Hicks most likely will
- True contractions will come closer together, while Braxton Hicks will remain all over the place
- True contractions will begin to last longer, while Braxton Hicks are usually quick
4. Bloody Show
Leading up to labour, you might notice a bloody show when you go to the bathroom. A bloody show is your mucous plug mixed with small amounts of blood. It could be pink, red or brown in colour too. But why does it happen? The mucous plug is the seal that sits inside the cervix and helps seal the uterus to protect it and bub from infection during pregnancy. As the cervix starts to open, parts of the mucous plug may loosen and come away in parts, or sometimes all at once. Sometimes as the cervix opens, small amounts of bleeding [more like spotting] can occur, causing the blood streaks you see mixed with the mucous plug. It's very common to have a bloody show after a stretch and sweep too, but this is different from fresh bleeding. Fresh bleeding is like the bleeding that occurs when you cut your hand [not mucousy]. If you notice any fresh bleeding or change in bub's movements, it's time to call your Midwife or OB. Although it's a good sign, a bloody show is not always a guarantee that labour is near. It could still be days or weeks before labour begins.
5. Fatigue or Burst of Energy
This one is a bit of an old wives' tale; however, many mamas feel it's true. In the days before labour begins, you might experience fatigue, feel tired and want to do nothing more than put your feet up on the couch and rest. On the other hand, some mamas find they get a big burst of energy and clean every inch of the house. People say it's the body's way of making a mama rest and reserve her energy before the marathon of labour, or nature's way of making sure everything is ready in preparation for bub's arrival. Either way, the best advice is to listen to what your body is telling you to do.
6. Your Waters Break
Around 1 in 12 pregnant mamas will break their waters before labour begins. Around 70% of pregnant mamas will go into labour within 24 hours after their waters break. So chances are that if your first sign of labour is your waters breaking, you can expect that you'll most likely go into labour within the next 24 hours. When some mamas break their waters, it might be a big gush, a constant flow or a slow leak. When your waters do break, give your Midwife or OB a call. They'll invite you into the hospital, check you and bub, check the colour of the waters [clear or pink is normal, green/yellow or bloody is not] and make a plan. If you're low risk, both well and GBS negative/ unknown, you'll be offered a choice about what to do;
- Go home, wait for spontaneous labour to begin and come back the next day for further monitoring/ induction if labour hasn't begun yet.
- Commence an induction on the spot to bring on labour.
If bub isn't born by 18 hours since your waters break, you may be recommended antibiotics in labour to reduce the risk of infection to bub. Once you reach 24 hours since you broke your waters, your OB may also recommend commencing the induction process if you're not already in labour, again to reduce the risk of infection to bub. If you decline, your OB will recommend increased monitoring until you go into, and during labour.
7. Your Bump Drops
Again, this one is anecdotal, meaning it's based on what people experience rather than scientific evidence. It's true that as labour begins and progresses, most bubs engage [drop down in the pelvis]. But generally, it's not something you can see from the outside and is usually measured during a vaginal examination by feeling how far down in the pelvis bub's head is. So if people tell you that you look like you've dropped, great! But again, it's not a guarantee.
