There isn’t a much more unique experience a human can have than labour during childbirth. It is a magical, otherworldly experience which many women find hard to put into words, and is unlike any other experience once can have in one’s own body.
For first time moms, this whole process can be downright terrifying. Here is a breakdown of what you can expect leading up to labour and how to prepare for it:
How will I know I’m in labour?
The first stage of labour and birth occurs when you begin to feel persistent contractions. These contractions become stronger, more regular and more frequent over time. They cause the cervix to open (dilate) and soften as well as shorten and thin (efface) to allow your baby to move into the birth canal.
Early labour
During early labour, your cervix dilates and effaces. You'll likely feel mild, irregular contractions.
As your cervix begins to open, you might notice a clear pink or slightly bloody discharge from your vagina. This is likely the mucus plug that blocks the cervical opening during pregnancy.
How long it lasts: Early labour is unpredictable. For first-time moms, the average length varies from hours to days. It's often shorter for subsequent deliveries.
What you can do: For many women, early labour isn't particularly uncomfortable, but contractions may be more intense for some. Try to stay relaxed.
To promote comfort during early labour:
Go for a walk
Take a shower or bath
Listen to relaxing music
Try breathing or relaxation techniques taught in childbirth class
Change positions
If you're having an uncomplicated pregnancy, you may spend most of your early labour at home until your contractions start to increase in frequency and intensity. Your health care provider will instruct you on when to leave for the hospital or birthing center. If your water breaks or you experience significant vaginal bleeding, call your health care provider right away.
Many women have several pre-labour signs that might hint that labour will start soon. These signs of labour include:
Backaches.
Diarrhoea.
Weight loss.
Nesting (cleaning and organizing your home).
No one knows for sure what causes labour to start, but several hormonal and physical changes may point to the beginning of labour.
What are Braxton Hicks contractions?
Often called practice contractions, Braxton Hicks are irregular contractions that don’t cause cervical change. Think of them as a test run for the real thing. They can start happening at the end of your pregnancy and can startle people into thinking they’re in labour. This is called false labour.
A Braxton Hicks contraction will feel like a sudden, sharp tightening of your abdominal muscles. Even though this is very similar to how a contraction feels, Braxton Hicks contractions don’t follow a pattern or progress over time. They may also stop when you lay down or relax. When you start to experience these practice contractions, keep track of them. Writing them down is the best way to tell the difference between true and false labour.
What is lightening?
Lightening is the process where your baby settles or lowers into your pelvis. This can happen a few weeks or a few hours before labour. When this happens, you may experience some increased lower pelvic pressure. Because your uterus rests on your bladder more after lightening, you might also feel the need to urinate more frequently. You might notice that you’re not as short of breath once your baby drops.
What’s the mucus plug and what does it mean when it falls out?
During pregnancy, a thick piece of mucus called a plug blocks the cervical opening. This plug keeps your uterus closed off from the birth canal and the outside of your body and prevents bacteria from traveling into your uterus. When your cervix begins to soften, thin, and open, the mucus is expelled into your vagina. Not every mucus plug will look the same. Possible colours of the mucus plug can include:
Clear.
Pink.
Slightly bloody.
Labour could start shortly after you lose your mucus plug or it could begin several weeks later.
How do I time my contractions?
Once you’re in labour, it’s important to keep track of your contractions. Your healthcare provider will need to know how long your contractions are lasting (duration), how often they’re happening (frequency) and how intense they are. When you’re timing your contractions, you will want to have a way to record each one – pen and paper or through an app on your phone – and a timer or clock. Make sure you keep track of each contraction from start to end, as well as the time between each contraction. This second measurement will help your provider know the frequency of your contractions.
It can be difficult to record the intensity of your contractions. This can really vary from person to person. Often, an easy way to keep track of the intensity of your contractions is to record when you cannot walk, talk or laugh during contractions.
Is there anything I can do to cope with contractions?
As you approach the end of your pregnancy, it’s a good idea to talk to your healthcare provider about different ways to deal with pain and discomfort during labour. There are several options your provider will discuss with you to relieve pain.
There are also ways to deal with the discomforts of labour at home or without medication, including:
Distract yourself by taking a walk, going shopping or watching a movie.
Soak in a warm tub or take a warm shower. Make sure to ask your healthcare provider if you should take a tub bath if your bag of water has broken.
Sit on a birth ball.
Listen to music.
Dim the lights.
Use aromatherapy.
Get a massage.
Stay in an upright position. This can help with the descent and rotation of your baby.
Try to sleep if it’s evening. You’ll want to store up your energy before active labour and delivery.
How will I know when my water breaks?
You may be familiar with the common phrase “my water broke.” This is actually the rupturing of your amniotic membrane. During pregnancy, your baby is inside a fluid-filled sac, also called your bag of water. When this membrane breaks, you might feel a sudden gush or trickle of fluid. Like many parts of labour and childbirth, this experience can be different for each person. The fluid is usually odourless and may look clear or straw-coloured.
Unlike urine leakage that some pregnant women experience, this won’t stop. The amniotic fluid will often continue to leak.
If your water breaks, call your healthcare provider. Let your provider know what time your water broke, the amount (trickle or gush), the color of the fluid and the odour. Don't use tampons if your water has broken. Your labour might start right after your water breaks. Some women are already in labour when their water breaks while others don’t experience the first stage of labour for a while after their water breaks.
When should I call my healthcare provider or go to the hospital?
If you ever have any questions, it’s always a good idea to call your healthcare provider. Your provider can answer any questions you have about true labour versus false labour and discuss how you’re feeling. When you start to notice that you’re having regular contractions, call your provider to talk about when you should go to the hospital. Some women are able to stay home throughout early labour, while others may need to come in sooner.
You should also call your healthcare provider if you:
Think your water has broken. This could be a sudden gush of fluid or a trickle of fluid that leaks steadily.
Are bleeding (more than spotting).
Experience contractions that are very uncomfortable and have been coming every five minutes, lasting for one minute and have been like this for one hour.
What happens when I get to the hospital?
When you get to the hospital, you will check in at the labour and delivery desk. Most people will be seen in a triage room first. This is part of the admission process. It’s usually recommended that you only bring one person with you to the triage room.
From the triage room, you will be taken to the labour, delivery and recovery (LDR) room. You’ll be asked to wear a hospital gown. Your pulse, blood pressure and temperature will be checked. An external fetal monitor will be placed on your abdomen for a short time to check for uterine contractions and measure your baby’s heart rate. Your healthcare provider will also examine your cervix to see how far labour has progressed. An intravenous (IV) line might be placed into a vein in your arm to deliver fluids and medications.
What does it mean to have labour induced?
Labour doesn’t always start naturally or progress as it should. In these cases, your provider might talk to you about inducing labour. This is a medical procedure where labour is started by your healthcare provider. This could happen if you:
Are past your due date.
Have health complications like high blood pressure, preeclampsia, infection or diabetes.
Had your water break but labour didn’t start.
Have low levels of amniotic fluid.
Your labour can be advanced or induced in several ways. Your provider will advise you about the best and safest option depending on your health. Inducing labour can be done by using:
Medications (oxytocin) given through an IV (directly into your vein).
Breaking your amniotic sac (water).
Separating the amniotic membrane (the sac of fluid the baby is inside within your uterus) from your uterine wall. This is also called sweeping the membrane.
Softening your cervix and encouraging it to open with a medication that can be placed directly in your vagina.
Labour induction can take longer than spontaneous labour because the cervical ripening process takes time.
Fun Fact:
It is a common myth that women forget the pain of childbirth as an evolutionary survival tool. However, various studies have shown that women do not in fact forget the pain during childbirth, and that rather they are able to recall the pain although perhaps not always accurately. Another study also found that women who received an epidural rated higher levels of labour pain than those who did not have an epidural, indicating that these women mostly remembered the peak pain of their birth experience before the pain relief of the epidural.