What To Do When Labour Starts? What Mums-to-Be Need to Know

My due date is approaching. What are the signs of labour that I should look out for?

Labour is a unique, exciting, and somehow a terrifying experience for most pregnant women. It can be over in a matter of hours, but in some cases, the process of labour test's a mother's physical and emotional endurance.

To know more about labour, we will talk about the signs and what to do in this most awaited moment of every soon-to-be mother's life.

What is Labour

Labour, also known as childbirth, is the process through which a baby makes its way from the womb into the outside world. It's like the grand finale of pregnancy, where all the hard work and anticipation finally pay off. The journey through labour consists of three main stages, each with its own unique quirks and challenges.

Stage 1: Early Labour and Active Labour

• Early labour involves the cervix dilating and effacing, with mild, irregular contractions. A clear pink or slightly bloody discharge may indicate the mucus plug passing.
• Active labour follows, with stronger, more regular contractions. The cervix dilates from 6 cm to 10 cm, and contractions intensify. Nausea and leg cramps might occur.
• Duration: Early labour varies, while active labour typically lasts 4 to 8 hours or more, with the cervix dilating at approximately 1 cm per hour.

Stage 2: The Birth of Your Baby

• This stage involves pushing the baby through the birth canal. The duration can vary from minutes to hours, especially for first-time moms or those with epidurals

Stage 3: Delivery of the Placenta

• After the baby is born, you'll deliver the placenta. It usually takes around 30 minutes, but it can take up to an hour.

Each stage has its ups and downs, but remember, you've got a whole team of medical professionals and support people cheering you on every step of the way. So take a deep breath, mama, you've got this!

Signs of Labour

So, what are the telltale signs that labour is starting and it's the real deal? Here's what you should certainly look out for:

• Tightening or contractions

Contractions are the powerhouse of labour, driving the journey of bringing new life into the world. These waves of sensation are like a dance between your body and your baby, working together to bring them closer to meeting you.

When it's go-time, your uterus, one of the strongest muscles in the body, tightens and applies pressure on the cervix, causing it to open or dilate.

What do contractions feel like?

Contractions can be likened to a series of squeezing surges that gradually build, peak, and then release. They may feel like intense tightening and pressure in your abdomen, with some women comparing them to stronger versions of period cramps.

Contractions often start with a gentle tightening, but as labour progresses, they become more intense, lasting longer and coming closer together. You may feel them radiating from your back to the front of your core, making your belly rock hard, and even experiencing a dull backache. 

You can feel the muscles tighten up and then, relax. These real contractions may start regularly and then, gets stronger. Since these contractions will last from 30 to 70 seconds and come in waves at about 5 to 10 minutes apart. They will be very strong that you can't walk or talk during the occurrence.

As your delivery draws closer, they will get stronger and the time will be closer together until you already feel the urge to push.

• There might be a "show," or when the plug of mucus from your cervix (entrance of your womb or uterus) comes away

This natural occurrence happens when a small amount of blood and mucus is released from the vagina. The bloody show marks the exciting phase when the cervix starts to soften, thin, and widen in preparation for labour.

As the cervix dilates to create room for the baby's passage, it can bleed easily due to its rich blood vessel supply. The blood mixes with the mucus from the mucus plug, giving the discharge a distinctive appearance.

The bloody show can vary in colour, from red to brown or pink, and may contain all or parts of the mucus plug. It has a jelly-like, stringy texture, and some women experience it all at once, while others may notice it gradually.

The amount of blood should not exceed a tablespoon or two of discharge, and severe bleeding should always be reported to a healthcare provider as it could indicate a complication. The appearance of a bloody show is a positive indication that your body is gearing up for labour, and your little one's arrival is imminent.

• Backache

When you're in labour, you will feel pain in your lower back. And it's a distinct kind of pain that, try as you might, there is nothing that you can do to avoid, even in any position.

Lower back pain tends to intensify during contractions and doesn't subside in between. Back pain during labour can be severe and sharp, persisting throughout the entire process, as the baby's head exerts pressure on the lower back, particularly when facing forward and positioned down.

• Having an urge to go to the bathroom

Experiencing an increased urge to go to the bathroom, particularly with loose and frequent bowel movements, could be a sign that labour is approaching. As the body prepares for childbirth, the bowels empty to allow the uterus to contract effectively. This phenomenon is the body's way of preparing for the upcoming labour and delivery process.

• Your water breaking

Water breaking, also known as the rupture of the amniotic sac, is a significant sign of labour approaching.

During pregnancy, the baby is cushioned within the fluid-filled amniotic sac. When labour begins or is about to start, the membranes surrounding the baby will rupture, causing the water to break. This can result in a sensation of wetness in the vagina or perineum, a slow or constant leakage of watery fluid, or even a sudden gush of clear or pale yellow fluid.

What to do when you think your water has broken

If you're not sure whether the water has broken, it is best to contact your healthcare provider or head to the delivery facility immediately. A physical examination will be conducted to confirm if the amniotic fluid is leaking. Typically, after the water breaks at term, labour follows soon after.

During this time, you can rest, take slow walks, or find ways to relax. However, the longer your water is broken, the higher the risk of infection becomes. Healthcare professionals will typically recommend interventions if labour hasn't started within 24 hours of the water breaking.

If your water breaks before 37 weeks of pregnancy, it's considered preterm premature rupture of membranes (PPROM), which requires immediate medical attention. Follow your doctor's advice about when to head to the hospital, as different doctors may have different recommendations based on your specific situation.

Water breaking but no other signs of labour

If your water breaks, but you're not experiencing contractions, you should still call your doctor or midwife right away. They will evaluate your condition and determine if any medical intervention is necessary.

No matter what time, day or night, if you notice these signs of labour, call your healthcare provider instantly. They can help you assess the situation and tell if it's time now to head for the hospital.

What to Do When Labour Starts

So, it's finally happening, huh? Labour is starting, and it's time to meet your little bundle of joy. Don't worry; you got this! Here's what to do when those contractions kick in:

1. Stay Calm and Breathe: Take a deep breath, mama. It's totally normal to feel a mix of excitement and nerves. Just remember to stay calm and focus on your breathing. You've got the strength to do this!

2. Time Those Contractions: Grab your phone or a handy-dandy timer and start tracking those contractions. Are they coming at regular intervals? When they're about five minutes apart and lasting for about a minute, it's game time!

3. Call Your Support Squad: Get your partner, doula, or whoever is on your labour team on speed dial. It's time to rally the troops and let them know that the big moment is here.

4. Pack Your Bags: Hopefully, you've already packed that hospital bag. If not, toss in some comfy clothes, snacks (for you and your partner), and anything else that'll make you feel cosy.

5. Follow Your Birth Plan: If you have a birth plan, now's the time to refer to it. Let your healthcare provider know your preferences, but remember, flexibility is key.

6. Listen to Your Body: Your body knows what to do, mama. Trust your instincts and go with the flow. If you feel like changing positions, do it. Rock those contractions!

7. Relax and Stay Hydrated: Take deep breaths, relax your muscles, and stay hydrated. Sip on water or clear fluids to keep your energy up.

8. Head to the Hospital: Once those contractions are steady and strong, it's time to make your way to the hospital. Call ahead so they can be ready for your arrival.

9. Embrace the Journey: Labour can be unpredictable, but remember, every contraction is bringing you closer to meeting your baby. You're a warrior, mama!

10. Trust Your Healthcare Team: You're not in this alone. Trust your healthcare providers; they've got your back and will guide you through this incredible journey.

Remember, every labour is different, so don't compare yourself to anyone else's experience. You've got your unique story to tell, and it's going to be amazing!

What Happens During Labour

You're in labour - now what? Here's what you can expect to happen in the next hours. 

If you think you might already be in labour but aren't sure, get on the phone. Your doctor can explain what’s going on, talk you through what's going to happen in the next couple of hours and have you come in if there's any uncertainty.

Don’t feel embarrassed or worry about calling outside of office hours, either: Your doctor knows it comes with the job and is used to getting calls in the middle of the night.

The Waiting Game

Early labour, also called the latency phase, is the earliest stage of labour. It is often the longest part of labour, sometimes, lasting for days. Contractions can be infrequent at first and be up to 20 minutes apart. Since early labour may be very long, relaxation and distraction can be important aids during this period.

If you go into the hospital or your midwifery care unit before having established labour, they might recommend that you go home again, for a while.

Your doctor may ask you to stay at home and monitor your contractions until they're very close. But in some cases, especially if your water has already broken, you will be asked to head to the hospital right away.

Also, during the latent phase, it is a good idea that you have something to eat and drink. You will need the energy from what you ate and drank for the upcoming established labour.

Active Labour

Once your labour has commenced and you're already in the hospital, your midwife may check on you every time to see how you are progressing. They will also offer you support, including pain relief, if necessary to do so.

You can either walk around or get into a position that makes you feel comfortable doing the labour.

Additionally, your midwife may offer you regular vaginal checkups to observe how your labour is progressing. Your midwife will discuss what important checkups you need to have to monitor your baby's movement.

Your cervix needs to open about 4 to 10 cm for your baby to get through it. This is the phase of what we call being fully dilated. This is also the part where you might have established labour or also called active labour.

In the 1st hour of labour, the time from the commencement of established labour to being fully diluted is usually 8 to 12 hours. It is often quicker, at around 5 hours, in your future 2nd or 3rd pregnancy.

When you reach the end of the 1st stage of your labour, you will feel an urge to push.

Time to Push

Push with all your might, mama. Your baby's head will appear first, and shortly after, the rest of the little cutie will follow.

After delivery, your healthcare provider may wait a bit before cutting the umbilical cord. This helps transfer important nutrients to your baby and reduces the risk of anaemia.

The baby's here, but there's still more work to do. You'll deliver the placenta. Don't worry; it usually takes about 30 minutes.

Signs That Labour Is Coming Soon

So we've talked about what happens on D-day. But how do you know when that day is just around the corner? 

As you approach the grand finale of your pregnancy, there are some telltale signs that labour is on the horizon. Here's what to keep an eye out for:

1. Baby Dropping: You might notice that your baby's head starts to move down into your pelvis. Get ready for that little one to take their position!

2. Cervix Dilation: As labour nears, your cervix may begin to open up. But remember, dilation alone doesn't always mean labour is imminent.

3. Cramps: Those mild, menstrual-like cramps could be a sign that your body is getting ready for the big day.

4. Increased Back Pain: Ah, the joys of pregnancy backaches! But if you feel your back pain intensifying, it could be a signal that labour is coming.

5. Loose Joints: You might notice your joints feeling a bit more wobbly. It's your body's way of preparing for childbirth.

6. Diarrhoea: Yep, your body is cleaning the pipes, so to speak. Diarrhoea can be a pre-labour signal.

7. Weight Gain Stops: If you've been gaining steadily, but suddenly your scale takes a break, it could be a sign that labour is around the corner.

8. Fatigue: As your body gears up for the main event, you might find yourself extra tired. Rest up, mama!

9. Nesting Instinct: Suddenly have an urge to clean, organize, and prepare? That's the nesting instinct, and it's a sign that your baby's arrival is near.

Remember, every pregnancy is unique, so not all of these signs may apply to you. But if you notice a combination of these signals, it's time to get excited—the big day is coming!

Can I Be in Labour and Not Know It

Every labour experience is unique, and sometimes it's not as obvious as the movies make it seem. You might already be in labour without even realising it.

Some mums-to-be experience mild or irregular contractions that they may mistake for Braxton Hicks contractions, especially if it's their first pregnancy. Additionally, other early signs of labour, like baby dropping, cervix dilation, and increased back pain, can be subtle and easily overlooked.

On the days nearing your due date, it is crucial to stay in tune with your body and pay attention to any changes you notice. If you're unsure or suspect that you might be in labour, don't hesitate to reach out to your healthcare provider. 

Signs of Preterm Labour

Labour is considered preterm when it begins before the full gestation weeks or by week 37 of pregnancy. Premature or preterm babies are at risk for any health defects at birth and even later in life.

If you have signs of preterm labour or labour before 37 weeks of pregnancy, call your health care unit to get help immediately. It is also important to learn about the risks of preterm labour and how you may take preventive steps to reduce that risk.

If you have any of these signs or symptoms before your 37th week of pregnancy, you might be experiencing preterm labour:

• Change in your vaginal discharge (could be watery, mucus, or bloody) or having an increase in vaginal discharge than usual
• Pressure in your pelvis or lower belly, like your baby, is pushing down
• Constant low or dull backache
• Belly cramps with or without diarrhoea
• Regular or frequent contractions that make your belly become tighter, like a fist
• Your water breaks

What to do during preterm labour

If you think you have at least one of the signs of preterm labour, call your healthcare provider without delay. If you have preterm labour, getting help is the best thing you can do.

When you get to the hospital, your health provider may ask you to have a pelvic test or a transvaginal ultrasound to see if your cervix has started to thin and open.

A transvaginal ultrasound scans from the inside of your vagina instead of on the outside of your lower belly. Like a regular ultrasound, it uses sound waves and a computer to project a picture of your baby inside.

Additionally, if you are having preterm labour, your doctor may give you treatment to help stop it or to optimise your baby's health. Talk to your gynaecologist about the treatment that is appropriate for you.

It is always important to look out for different signs before the start of your labour. Essentially, it is also needed to know what to do when having these signs and symptoms and to always ask for guidance from your trusted doctor.

This article was written by Nathanielle Torre and republished with permission from theAsianparent Philippines.

Updates from Camille Eusebio

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