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How to know when you are in labour, and what to do next!

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labour

The onset of labour can be a very daunting prospect for any expectant parent. One factor that contributes largely to the nervousness and apprehension that women can feel is the fear of the unknown. Below is a guide on what to look out for, signs that you may be going in to labour and what to do about it.

Contractions

Unlike you may see in the movies or on television, contractions very rarely come on strong and fast without a gradual build-up beforehand, particularly with your first baby. Contractions often start as lower abdominal period-like discomfort or backache. At the same time you may notice your abdomen has gone very hard. The pain progress from a dull ache to period pain to strong period pain and then will be felt across your entire abdomen. It is not uncommon for the backache to remain throughout the labour. Having said that, many women experience no backache at all.

Rupture of the Membranes (Waters breaking)

Sometimes it is not entirely obvious that the waters have broken. Women can experience anything in the range of a large dramatic gush of water from the vagina to a small trickle only. If you think you waters have broken or if you are unsure, it is important to put a maternity pad on and contact your caregiver straight away. They will ask you some questions including the colour and amount of fluid. Clear and pink are normal. Tell your health professional if the fluid is yellow or green. You may or may not already be having contractions when your waters break however most women will go into labour within 24hrs of your waters breaking.

Pre-labour

Pre-labour or the latent phase of labour can last anything from an hour or two to several days. Contractions are often irregular and uncomfortable but not distressing. This can be exhausting more than anything else. As long as the waters are not broken and your baby is moving normally and you are feeling otherwise well, the most important thing is to make yourself as comfortable as possible and be patient for established labour to commence. Remember that although labour is not established, these contractions are moving your baby down and making your cervix favourable for labour.

Established Labour

Established labour is defined as strong, regular and painful contractions. Contractions in established labour should be 3-5 minutes apart, lasting 40-60 seconds and be very painful. You often will not need clarification that you are in established labour, you will know without being told!

What to do next…

  1. If you think your labour has begun, you should inform your midwife/labour ward/obstetrician.
  2. Paracetamol is safe and effective in the early stages of labour.
  3. Try to ignore the contractions for as long as possible and get on with your day or try to sleep. It can be very exhausting to time the contractions from the moment they start. They can stop and start several times before labour really establishes.
  4. Relax! This is important. Stress hormones counteract the work of the contractions. The more relaxed you are, the more blood flow is directed to the uterus to allow regular effective contractions thus progressing labour.
  5. Water immersion. The bath allows you to relax. A shower may do the same. Having a shower is also an optimal position for allowing baby’s head to descend.
  6. Have your bag packed and ready to go to hospital.
  7. There are no rules about when to come to hospital. Ideally contractions should be 3-5 minutes apart however if you are not coping at home then you should discuss with your health professional about coming to hospital. If you are happy at home then you are probably safe to stay at home longer.
  8. AND MOST IMPORTANTLY… BE EXCITED!! YOUR BABY IS ON THE WAY!

Remember that if you have had any pregnancy complications or concerns then this standard advice may not be appropriate for you. If this is the case or if you are less than 37 weeks then it is important to let your caregiver know if you are experiencing any pain.

This advice is not aimed at replacing advice given to you by your health professional. If you have any questions or concerns it is important to discuss them with your main caregiver during pregnancy.

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