It is more difficult than you might think to pinpoint exactly when labour starts …

When you’re close to your due date, you’re aware of every twinge or suggestion of abdominal discomfort, wondering if this will be the start of something. The exact trigger for labour is unknown, but it’s thought that hormones produced by your baby’s adrenal gland encourage your placenta to release further hormones that cause your uterus to contract. Other signals are involved too, including the release of prostaglandins, which are also used to induce labour artificially. When your uterus begins to contract, your cervix (neck of your womb) starts to open, or dilate, and labour begins in earnest.

False Labour

In the late stages of pregnancy, you may have Braxton Hicks contractions, the practise contractions that prepare your uterus for action. In the days and hours prior to labour, these can be more uncomfortable and occur closer together, sometimes carrying on for hours. However, if the uterus is contracting but there is no dilation of the cervix, this is known as “false labour”. Braxton Hicks do encourage the baby’s head to move down in the pelvis, but until contractions are strong, regular, and develop a pattern, occurring closer together, you’re unlikely to be in labour.

Approaching Labour

The experience of labour varies between women, but as labour approaches, there are several signs and symptoms you may experience that tell you your body is preparing itself for the task ahead.

Waters Breaking Very few women find that their waters break (when the amniotic sac breaks and leaks its fluid) before labour. The fluid can either gush or drip out, which can be confused with leaking urine. Usually the sac doesn’t break until labour is established, and sometimes not until just before the birth. If your waters break, it is a sign that labour is imminent and your should visit the hospital or call your midwife. If labour doesn’t begin within 24 hours, there is a risk of developing an infection, so it’s important that your take instructions from your midwife or doctor and go in for an assessment when asked.

Amniotic fluid should be clear. If it is smelly or blood stained, contact your doctor or midwife at once. Contact them too if it is green, as this suggests that your baby has passed meconium, a sign that she may be distressed.

Other Signs And Symptoms You may lose the mucus plug ( a collection of mucus that plugs the cervix, which can be blood stained and is known as a “show”), as well as experience back and/or abdominal pain and feel queasy. Some women suffer diarrhoea, and even vomiting. This stage can take several days, so don’t ring the hospital yet.

Engagement of the Head You may experience “lightening”, which describes how you feel when your baby drops down in the pelvis, or engages, and the pressure of the diaphragm, which may have made you breathless before, is alleviated. This can happen days or weeks before the birth, but some women feel this just before contractions start. You may need to visit the loo more often, as your baby puts pressure on the bladder.

First Contractions As you approach early labour, contractions become uncomfortable and occur increasingly close together, although still irregularly. These differ from Braxton Hicks as they build up and begin to prepare the cervix for labour.

Symptoms You Shouldn’t Ignore

Call your midwife or doctor if your waters break; your baby moves less than usual; you have vaginal bleeding that is not associated with losing your mucus plug; you have a fever, changes in your vision, severe headaches, or abdominal pain; you feel an urge to push; or a sensation that your baby’s head is emerging.



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