Pre-labour and labour
Medically, labour is divided into three stages. In the first stage, your cervix opens fully to allow your baby to pass through; in the second stage, your baby descends through the vagina; in the third stage, the placenta is delivered. All these stages are discussed in detail in the following sections. As well as these stages, most women experience pre-labour.
Pre-labour
© Jupiter
Before real labour begins, hormones from your uterus and your baby prepare your body for birth in a number of ways. During the last few weeks, you'll probably notice signs of your coming labour. But just as each woman's experience of labour and birth is unique, so these pre-labour symptoms affect everyone in different ways. They do provide useful signals to warn you that labour is imminent.
Baby's engagement during pre-labour
To position himself for the journey through the birth canal, your baby will move lower down so that his presenting part, usually his head, settles into your bony pelvis. This is known as engagement and you'll experience it as a feeling of lightening.
If this is your first pregnancy, your baby will probably engage two to three weeks before the labour starts. If you've had previous babies, your baby's head may stay higher until just before labour starts, because your uterine muscles have stretched and so exert less pressure on your baby.
You'll know when your baby has engaged because there's less pressure on your diaphragm and breathing becomes easier. On the other hand, you'll probably find you have to pass urine more often, as your baby will now be pressing down on your bladder.
Braxton Hicks contractions
Your uterus practises for the strong contractions needed in labour with weak, irregular contractions, named after the doctor who first described them. Most women feel these during the last few months. If you place your hand on your abdomen, you may feel a hardening and tightening of your uterus, which lasts for approximately 25 seconds. Unlike real labour contractions, these are usually painless, although some women find them uncomfortable. If you do feel any discomfort, sit down quietly until the feeling eases. You may find you get more and stronger Braxton Hicks contractions as real labour approaches. This is your body's way of preparing the cervix to dilate and increasing the circulation of blood to the placenta.
When you feel a run of Braxton Hicks, practise the relaxation techniques you're going to use during labour; the tightening and relaxing of your uterus will give you a good idea of how a contraction feels as it waxes, and then wanes. Some mothers misinterpret Braxton Hicks for real labour pains and go to hospital, only to be told they can go home again (see A false labour?).
Nesting instinct
You may suddenly feel like making final preparations for the arrival of your baby. If you want to rush around cleaning or decorating the house, or cooking large meals, try to restrain yourself. Save this extra energy for coping with labour and delivery.
The show
A sign that labour is coming soon is the appearance of the show - a thick sticky discharge that occurs when the plug of mucus that seals your cervix in pregnancy, providing protection against infection, becomes dislodged. Although this often doesn't appear until labour is underway, the cervix may widen enough for the mucus plug to be dislodged up to 12 days before labour begins. The show may be slightly brown, pink, or blood-tinged from the capillaries that attached it to the cervix. The show signals dilation of the cervix.
Premenstrual feelings during pre-labour
You may notice some physical and emotional changes similar to those you have before a menstrual period. You may also feel crampy, with some pressure in your rectum, and feel the need to empty your bowels and pass urine more often than usual.
Your baby's descent
Your midwife will check your baby's progress down your birth canal by an internal examination. She measures the baby's position in “stations”, or lines, calculated in centimetres from -5 to +5 in relation to the level of your ischial spines (specific anatomical points on your pelvis) and the top of your baby's head.
Your mood changes during pre-labour and labour
As you wait for signs that your baby is ready to be born, you may feel a number of emotions.
Contentment
As your body changes in preparation for labour, you may find that you respond to the ripening of your womb in a sensual way. Particularly if this is your first baby, you may like to enjoy these last days on your own indulging your whims, sharing moments of intimacy with your partner, or spending the time just daydreaming.
Elation
You may feel a great sense of joy when your body alerts you to the moment that you've been waiting for with such excitement. Don't try to quench this feeling; share it with the people around you as it may help to release any pangs of nervous tension.
Anxiety
The signs of pre-labour can make you feel apprehensive. You may worry about the pain of labour and its effect on your baby and you may wonder if you'll be able to cope. You may feel nervous about your waters breaking in an embarrassing situation.
Impatience
If your expected date of delivery comes and goes, don't be depressed. Remember it's only an approximate date and that most babies arrive sooner or later than expected. This is particularly likely if you were born sooner or later than expected.
What your baby's doing
While no one actually knows for certain why labour starts, there's increasing evidence to suggest that your baby plays a major role.
Hormones
The start of labour is triggered by hormones - the levels of some pregnancy hormones drop, others rise. New hormones are secreted, one of which is produced by your baby.
Engagement
Throughout your pregnancy, your baby will be floating in his amniotic sac above your pelvic brim. As his birth approaches, his head, or his bottom if he is in a breech position, will descend lower down into your pelvis and become engaged.
Kicking less
You may notice that your baby becomes quieter than in previous months. From time to time you may feel a slight flurry of movement, but if his actions seem to stop completely, get in touch with your doctor or midwife.
Posted 16.11.2010
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