Looking Ahead: Signs and Symptoms of Labor

Are these contractions?Even though you've been anticipating the birth of your baby for several months, it may be difficult to tell when labor actually begins. People say, "you'll just know," but that's hardly reassuring. How can you interpret your body's changes as labor approaches? While every pregnancy is unique, these common signs and symptoms signal your body is getting ready for labor:

Symptoms of Approaching Labor

  • Increased vaginal discharge: Usually clear mucous, but sometimes streaked or tinged with brown or pink. This is sometimes referred to as "bloody show". This discharge may appear at the same time that contractions begin or a few days before. Your mucus plug, which has blocked the cervix throughout the pregnancy to protect your baby from infection, may loosen and be expelled. Any amount of vaginal bleeding should be reported to our doctors and nurses at once.
  • Engagement: The baby's movement into your pelvis in preparation for birth (also called "lightening" or "the baby dropping"). It can happen anywhere from a few weeks to a few hours before labor begins. You will find that it will be easier to breathe and heartburn may be lessened. But the additional pressure of your baby's head on your bladder may make you need to urinate more frequently.
  • Weight Loss: As a result of changes in your hormone levels, you may lose 1 to 3 pounds in the week before labor begins. This is mostly a loss of fluid that has been held in your tissues.
  • Backache: Dull, lower backache that may come and go.
  • Diarrhea, Indigestion, Nausea and Vomiting: You may experience one or more of these conditions before or at the beginning of labor, often accompanied by cramping. This is just your body's way of responding to the labor process.
  • Rupture of the Amniotic Membranes: The breaking of your "bag of water." This may happen several hours before labor begins, but in most cases, the fluid-filled sac that surrounds your baby during pregnancy doesn't rupture until later in the labor process. Discharge may be a continuous trickle or a gush of watery fluid from your vagina. If you are not already in the hospital when you rupture your membranes, notify your provider immediately to describe the time of rupture, the color and amount of fluid.
  • Contractions: The most obvious sign of labor, but often confusing because irregular cramps of false labor pains occur. You may have experienced these "Braxton Hicks" or "practice" contractions throughout your pregnancy, but you will notice an increase in frequency and intensity in these last weeks before delivery. Your abdomen may feel like it is tightening or hardening. Some women have compared it to strong menstrual or intestinal cramps.

Is This Really Labor

The following descriptions may help you to distinguish between true and false labor contractions:

True Labor Contractions

  • Occur at regular and frequent intervals.
  • Rest periods between contractions become shorter.
  • Gradually become stronger.
  • Felt in abdomen and back.
  • Your activity does not change the contractions.
  • Cervix dilates and effaces.

False Labor Contractions

  • Often occur at irregular intervals.
  • No change in rest periods between contractions.
  • Strength varies.
  • Felt mostly in lower abdomen.
  • May change depending on your activity, such as walking versus resting.
  • Cervix does not dilate or efface.

Changes as Labor Proceeds

Cervical Effacement and Dilation: The process of shortening and thinning of your cervix is called effacement. Dilation, or the stretching or opening, allows your baby's head to pass through at birth. Your cervix may thin out during pregnancy and even dilate a bit in these last weeks, but in true labor, effacement and dilation generally happen together.

Nesting: Many pregnant women develop a sudden burst of energy just before labor begins, and want to take care of household and personal tasks such as getting the baby's clothes and room ready or even scrubbing the kitchen floor. After feeling so fatigued for so many weeks, it's easy to give in to the impulse to tie up all those loose ends, but remember that it's more important to conserve all that energy for the labor and delivery process.

Grief: As birth becomes a near reality, some women may experience a sense of loss of the intimate connection they've had with their baby. There is also a natural anticipation of the loss of attention that comes with being pregnant.

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