How will I know when labor begins?
It can be very difficult to tell the difference between true labor and “false” labor. When a woman experiences Braxton Hicks contractions they are often irregular and do not get closer together. They may stop when you walk, rest, or change position and they do not usually get stronger. During true labor the contractions usually start in the back and move to the front. True contractions will continue despite movement, come at regular intervals, get closer together, and increase steadily in strength as time goes on. Sometimes the only way to tell the difference is to have a vaginal exam to find out if your cervix has changed.
Prepare to time your contractions if you believe they may be coming at regular intervals, becoming more intense, lasting longer, or be coming closer together. Contractions are timed for both duration (the amount of time the contraction lasts) and frequency (the time from the start of one contraction to the start of the next contraction). If you have a gush or trickle of fluid from your vagina note the color, odor, and amount along with the time it occurred. This may be what is called rupture of membranes or your “water breaking”. If you believe this has occurred you should contact your healthcare provider or go to the labor and delivery unit of your hospital regardless of rather or not you are having contractions.
If you have bright red vaginal bleeding (other than bloody mucus or light spotting following a vaginal exam or intercourse), if you have severe pain with no relief between contractions or any time you notice the baby is moving less often you should contact your physician immediately or go to the labor and delivery unit of your hospital.
Dilation, Effacement, and Station
As your body prepares for the birth of your child many changes begin to take place. Hormones, called prostaglandins, soften and “ripen” your cervix to allow it to thin and open to allow your baby to pass through the birth canal. The opening of your cervix is measured in centimeters from zero to ten. 10 cm dilation indicates that your cervix is completely open. During a vaginal exam these factors are evaluated by the healthcare provider. The thinning out of your cervix is referred to as effacement and is measured from zero to one hundred percent. 0% effaced means there has been no change to your cervix while 100% effaced indicates that your cervix is completely thinned out. Station refers to the level of your baby’s head in relation to two bony prominences in your pelvis that can be felt by the healthcare provider during a vaginal exam. As labor progresses the contraction of your uterus help to move the baby’s head downward toward the birth canal. Determining rather you are in true labor is in part determined by the degree of change seen in these factors within a time frame of observation.
Stages of labor
The time from which true labor begins until your cervix is completely dilated is referred to as the first stage of labor. This is usually the longest stage and can be broken down into 3 phases. The early phase is the time between the start of labor and your cervix dilating to 3 cm. It is important to do your best to conserve your energy as much as possible during this stage. The excitement and anticipation may make this difficult to do. Many women feel very social during this stage but may also experience anxiety or fear knowing the time they’ve anticipated for so long is finally here.