Signs of Labour

Many women worry about false labour and showing up at the hospital too early, only to be sent back home. Others are concerned that they will wait too long, and end up having an unplanned delivery in the car or at home. Do you know what signs and symptoms to look out for? What are the differences between false labour and real labour? When is the right time to call your health care provider or proceed to the hospital? These are questions that almost every pregnant woman is concerned about.

The days leading up to labour

In the days before the contractions of labour begin, the uterus is “awakened” and prepared for labour. The cervix starts to soften and ripen. The body may go through a number of changes, such as the following:

• lightening and engagement, when the baby begins to descend down into the pelvis
• pressure on the pelvis and rectum, cramps and groin pain, and sometimes a persistent backache
• more fatigue, or alternatively, sudden spurts of energy
• thickening of the vaginal discharge
• diarrhea
• release of a small amount of blood-streaked mucus from the vagina, referred to as the “bloody show”

False or preparatory labour

If you have only the following symptoms, you probably are not yet in real labour:

• irregular contractions that do not get worse or more frequent over time; sometimes they ease with time
• contractions that are of low intensity or short in duration
• pain that is confined to the lower abdomen and groin, rather than the lower back

These contractions may help prepare your uterus and cervix for labour. Monitor the contractions to see if they start to increase in frequency and intensity, and watch out for signs of real labour. If you are not sure whether you are in real labour, call your health care provider or the hospital, and they will provide you with extra guidance.

Real labour

Real labour is characterized by forceful and painful contractions. Here are a few signs and symptoms of real labour:

• contractions that get progressively stronger, more regular, and more frequent over time
• pain in the abdomen and back, which may also spread to the legs
• release of the blood-streaked mucus from the vagina, referred to as the “bloody show,” if it has not already occurred
• rupture of the fetal membranes, causing a gush or trickle of amniotic fluid from the vagina

When to consult your health care provider

If you have any of the following signs or symptoms, call your health care provider right away or proceed to your hospital:

• regular contractions that are increasing in intensity and frequency
• pain that is worse than you anticipated
• rupture of the fetal membranes: If you feel a gush or trickle of clear fluid from your vagina, it means that your fetal membranes have ruptured. You should obtain medical help if this happens, whether or not you have started feeling labour pains yet. If your fetal membranes rupture before the onset of labour pains – a condition known as premature rupture of the fetal membranes – the baby could be at risk, and you may need to have labour induced.
• significant bleeding from your vagina: This is a medical emergency. If you have bleeding, not just spotting, at any time during your pregnancy or when labour begins, you should proceed to a hospital right away.

It is best to err on the side of caution. So if you think you might be in labour, call your health care provider.

	UTERUS An organ, also called the womb, where the fertilized egg cell implants and grows into the unborn baby during pregnancy.

	CERVIX The lower part of the uterus, extending from the narrowed end of the uterus into the vagina. The cervix is also called the “neck of the uterus.”

	LIGHTENING When the baby’s head will begin to settle downward, deep inside the pelvis, ready for birth.

	GROIN The area at the top of the thighs where the legs join the body.

	FATIGUE Tiredness.

	VAGINA A muscular tube that receives the penis during sex, through which sperm cells travel on their way to fertilize an egg cell, and through which a baby passes during childbirth.

	MUCUS A slimy, protective substance secreted by the mucous membranes.

	SYMPTOMS A person’s experience of a sensation or physical effect that could indicate a disease or physical problem.

	ABDOMEN The belly, the lower part of the body below the chest.

	MONITOR To watch or check regularly or continuously.