Pregnancy - Labor

Is this your symptom?

• Regular contractions or other signs of labor

Signs of Labor

The symptoms of labor include:

• Water breaks (gush of fluid from your vagina)
• Contractions
• Bloody show (mucus streaked with blood)
• Dropping. Pressure in your pelvis as contractions push the baby toward your birth canal.

Stages of Labor

• First Stage:
  • Contractions start. They may not be regular at first, but they start to happen closer together, feel stronger and last longer.
  • You may see a bloody show. Mucus streaked with blood may pass from the neck of the womb through the vagina.
  • Your water may break. You'll feel a gush of fluid (which used to surround the baby) flow out the vagina.
  • Contractions push the baby down toward the birth canal. This will feel like pressure in your pelvis. You may have to pee or move your bowels urgently.
  • The cervix, or neck of the womb, starts to dilate (open up).
  • Your care team (doctor, nurse, midwife) will monitor your blood pressure, pulse, temperature and also the baby's heart rate. This gives them a better sense of how quickly your labor is progressing.
  • You may be given a monitor to check your baby's heart rate.
  • The time spent in this phase differs from mother to mother and with each pregnancy. 8 to 12 hours is common.
• Second Stage:
  • This phase starts once your cervix is dilated to 10 centimeters.
  • You may feel a strong urge to push or your care team may tell you that you can start to push.
  • The baby should be born within 2-3 hours of the start of pushing. Your baby will be monitored through this stage.
  • To protect your vagina from tearing, the care team may make a small cut at the entrance of the vagina. This will be stitched after the baby is born.
  • Once the baby's head is delivered, it often takes one more push to deliver the baby's body.
• Third Stage:
  • The placenta (afterbirth) is delivered. This normally happens within an hour of the baby being born.
  • If you have decided to breast feed, this is a good time to try while you are waiting for the placenta to pass. Breastfeeding makes the uterus contract and may help release the placenta.

What are the Symptoms of False Labor (Braxton-Hicks Contractions)?

Contractions felt during false labor:

• are Not regular.
• are strong enough to stop your activity, but may just feel uncomfortable rather than painful
• do Not get stronger and more frequent over time.

Labor Not Progressing

• Sometimes labor does not start, or it may not progress, even though there has been a bloody show and some regular contractions.
• This can happen for a number or reasons:
  • the baby not lying in the best position to be delivered
  • large babies or small diameter of the pelvis
  • exhaustion of the mother
  • others
• If your waters break and you don't go into labor, there is a risk of infection getting into the womb. You may need the help of IV medicine to get your labor started and antibiotics may be prescribed.
• If labor does not progress, depending on the stage at which it fails or stops, you may be offered an assisted delivery or a cesarian section to make sure you and your baby remain safe.

Premature Labor (Preterm Labor)

• This is labor which starts before 37 weeks with regular painful contractions which start the cervix dilating.
• In most cases this happens at between 34 and 37 weeks, but sometimes can be much earlier.
• If you think you are in premature labor, you should contact your doctor or midwife. It is sometimes possible to stop premature labor, allowing the baby a more time to mature.
• Premature labor is more common in multiple pregnancies (twins, triplets).
• Premature labor can be started on purpose with drugs, if there are concerns about the health of the mother or the baby. Sometimes the baby(babies) are delivered early by Cesarian section.

If you go into labor prematurely, the care you are offered will depend on how many weeks pregnant you are. 

• If you are more than 34 weeks pregnant, your baby will be mature enough to allow labor to go ahead. You will likely be advised to have the baby in hospital just in case the baby has any unexpected problems.
• The concern with babies who are born at less than 34 weeks is that their lungs may not be developed enough for them to breath for themselves. Those born even earlier may have other organs/systems which are not fully developed. They may need to spend some weeks in a neonatal (new baby) special care unit.