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When labour begins

In this video, Julie talks about how labour begins.
Before we start, I want you to imagine what you expect the start of labour will be like. What will you do if your waters break? What do you think the contractions will feel like? If you have had a baby before, do you think it will be different? What were the signs that labour was starting on your last baby? Many women are worried that they will not know when labour is starting. How long should you stay at home if you are planning to give birth in a unit or hospital? This is a common worry, especially if it is your first time to birth a baby. As we have mentioned before, every labour and birth is different and individual.
You may only have one of the indications that labour is starting, or you may have all of them. Also, labour can begin at any stage of your pregnancy. Let’s start with contractions. Contractions generally do not start without warning, and you may have been experiencing cramping pains like mild period pains in the buildup to them. Some women can experience cramping pains in their back, abdomen, or both, that may come and go for a week and then stop. For others, you may experience these cramps for a few days before the contractions start. Many women who are in early labour, before 3 centimetres dilated, or open, will say, I haven’t slept for days, because the cramps have kept them awake at night.
Therefore, it is important to try and do normal daily activities in between those cramps and rest when you can.
Once your contractions are regular and three to five minutes apart, you are hopefully close to being in labour. Again, this can be different for each woman. We would like you to start timing your contractions when you feel they are becoming regular, approximately 5 to 10 minutes apart, lasting approximately 40 seconds, and causing you to stop what you are doing and breathe through them.
The length of time you wait at home is dependent on where you live, your medical and surgical history, and who you have nearby to support you. Ask your midwife or doctor when you should call them or visit the maternity unit, as they will be aware of your personal situation and will be able to guide you. Contractions should come and go like a wave that rises up to a peak. So at the start, you feel cramping like a period pain, which is your cue to start breathing gently in and out and relaxing on every out breath. As the contraction gets stronger, you need to relax more and more until you feel the strongest part of the contraction, the peak.
Then you know that the contraction will start easing off, and you can relax completely again. You should always feel that you are getting a break between the peaks of your contractions. Your tummy will be hard during a contraction and soften in between. You may feel the contraction in your back, your tummy, or both. Your midwife or obstetrician will usually consider that you are in labour once your cervix, or the neck of the womb, has opened to 3 centimetres dilated.
Keep drinking and eating as you feel like, usually light foods such as soup, toast, and jam. You may feel nauseated and have vomiting, particularly as the contractions intensify. If this is the case, sip on water or isotonic drinks or suck on ice cubes or an apple juice ice pop, and have lighter, dry snacks such as crackers, nuts, or cereal bars. You may also experience diarrhoea or loose bowel motions. This can be normal, nature’s way of making more room for the baby to move down. But make sure that you are drinking enough fluids.
Secondly, if your waters break, are you in labour? What will this feel like? And what colour will it be? Well, if your waters break, you may not be in labour. To be in labour, you will need contractions. If your waters break, it can be a sign that you may go into labour sometime soon. Women say that when their waters break, it feels like a pop, or sometimes women notice a trickle of water down their legs. It will be at your body temperature. Your waters will be a number of colours, clear, slightly straw coloured, pinkish, blood stained, or green. Clear and pinkish are normal. Blood stained is something that may mean you require monitoring and observation.
Green waters can be an indication that your baby has passed its first bowel motion called meconium. In other words, he or she has been to the toilet inside of you. This would mean that your baby will need close monitoring and observation. So you will need to go into the maternity unit or hospital straight away, or call your midwife if you are birthing at home.
What should you do if your waters break? Look at the clock to make a note of the time that your waters went. This will be important for your midwife and obstetrician to know to plan your care. Put a fresh pad on, or you may need two, as there can be about 800 mils of water that will leak from this point on until your baby is born. Look at the colour of your waters. If the waters are clear or pink, maybe have a shower before you call your midwife or you go to your birthing centre or hospital. They may send you home again for a period of time once you are assessed.
If your waters are bloodstained or green, don’t bother with the shower. Make your way into the assessment unit or your birthing centre or hospital. Other things to consider if your waters break– what position is your baby in, head down or bum down? If your baby was coming bottom or feet first the last time you were checked, you may need to tell your midwife or obstetrician straight away that your waters have gone. Also, is there any other indication that you would be required to return to hospital if your waters broke– antibiotics, antiretrovirals? Ask your midwife or obstetrician at your next visit.
A show on its own does not mean that labour has started. A show is a sticky, mucousy consistency. It may have blood running through it. It may occur with or without contractions. Not every woman has a show, and some women will experience many shows at the end of their pregnancy before they finally go into labour.
Also, be mindful of your baby’s movements through your labour. Previously in the course, we discussed the importance of your baby’s movements. Ask yourself, is this normally the time of day that your baby would be quiet or more active? I hope you have a better understanding of when labour begins and how you will know that you were in labour.

Julie explains in this video what to expect when labour begins. She explores the signs that labour is starting, what you can expect to happen and when to attend your birthing unit, maternity hospital or phone your home birthing midwife – whichever plan of care you’ve chosen.

Remember, labour can happen any time from 37 weeks of pregnancy. If any of these indications occur before 37 weeks, you should attend and inform your midwife or maternity unit.

Reflecting on this video:

  • What do you think you can do to prepare yourself for when labour begins?
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Journey to birth

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