Your labour and birth – Pre-labour and labour
According to the medical textbooks, labour has three distinct stages. The first stage of labour involves the full dilation – or opening – of the cervix, the muscle between the uterus and the birth canal. In the second stage of labour (delivery), the baby is pushed out of the womb, through the cervix and birth canal and is born. In the third stage, the placenta is delivered.
But these three medical stages don’t usually reflect women’s personal experiences of labour; pre-labour and the long first stage generally takes far longer than the intense experience of second stage, while third stage is often a blur, with most of your focus on your new baby rather than what is happening with your own body.
In the final weeks of your pregnancy, before your baby is ready to be born, hormones will trigger your body to start preparing to give birth.
Every woman’s experience of labour and pre-labour will be different, but here are some of the signs that labour may begin in the next few days or weeks. These can occur in any order over a few weeks, days or even hours and you may not notice them happening.
Engagement (also called ‘lightening’)
Before labour starts, "your baby will settle deep into your pelvis. This can give you relief from heartburn and take some of the pressure off your lungs, making it easier to breathe.
However, the baby will be pressing against your bladder, so you’ll probably feel that you need to urinate even more frequently; and the increased pressure against nearby nerves and blood vessels often causes leg cramps and swelling of feet and ankles. Keep your legs elevated as much as possible and rest on your left side to help reduce foot swelling.
Medical staff assess the amount that the baby’s head has ‘engaged’ by the location of the top of the baby’s head in relation to two bony projections in the middle of your pelvis, a ‘level’ or plane within the pelvis that is called ‘zero station.’ When the baby’s head is above this level by two centimetres, it’s called ‘zero station minus two,’ while one centimetre below this level (for example) is referred to as “zero station plus one.”
What happens when the baby is in a breech position? Find out about External Cephalic Version.
Nesting / burst of energy
Towards the end of pregnancy you are often feeling so cumbersome and elephant-like that you can’t imagine wanting to get off the lounge for any reason; but quite often, you will wake up one morning with a strong desire to rush around cleaning, cooking and shining silverware. Try to be kind to your body, you’ll need all that extra energy for labour so don’t wear yourself out scrubbing floors just before you have a baby.
Some women might find they lose up to 500g a day or so before labour starts, as hormone changes reduce their fluid retention.
Lower back ache
Some women report a rhythmic, dull ache in their back which makes them feel irritable and restless.
Similar feelings to those that you might experience shortly before menstruation are common just before labour, such as irritability, headaches, tiredness. Some women also experience diarrhoea.
The cervix is sealed in pregnancy with a plug of sticky mucus which can dislodge as the cervix starts to soften and dilate. This can happen a week or more before labour starts – or may not happen until during labour. The mucus plug is usually tinged with pink or brown blood and is called the ‘show.’
‘Practice’ Contractions (also called Braxton Hicks)
In the weeks before labour, your uterus will go into training for the marathon ahead, by starting a series of weak contractions that you might not even feel. These often last for about 30 seconds and come and go at irregular intervals. They may feel a little like period pain and you may feel a ‘tightening’ across your abdomen at the time.
For some women, these contractions can be quite painful and they may even keep you awake at night. This is a great chance to start practicing those relaxation techniques you learned in pre-natal classes so that you’re ready for the real thing!
As you approach the time your baby will be born (and unfortunately it seems very unusual that anyone ever has their baby on their so-called ‘due date!’), the practice contractions might occur more often and feel stronger until you think – hang on, is this the real thing?
This is often called ‘false labour’ – and many a pregnant woman (me included) has shown up at their hospital in the middle of the night thinking they are in labour only to be sent home, back to the waiting game.
If you are not sure whether you are in labour, print out our Timing your Contractions sheet, grab a pencil and a clock with a second hand and start timing the contractions – how far apart are they, and how long do they last?
Practice contractions don’t generally settle into a regular pattern and if you stand up and move around, they will often disappear. ‘Real’ contractions will get progressively stronger and start to form a regular pattern.
If you’re not sure – phone your caregiver or local hospital for advice. It could be a false alarm – or you may be in early labour.
For more information see Childbirth.
By Fran Molloy – journalist and mum of 4