Labor manifests itself differently for different women. Some women feel distinct symptoms of labor while others do not. Knowing what to expect can help ensure that the patient gets to the hospital well in time in order to minimize complications. Although there is no sure fire way of predicting the exact time labor pains will begin, there are several hormonal and physical changes that mark the onset of labor, and recognizing these changes can be critical. As labor time approaches many women report feeling a sudden burst of energy accompanied by a strong urge to get things in order and ready for the baby. This is called the nesting instinct, which typically kicks in a few weeks or days prior to delivery. The following signs of labor are a fairly reliable indicators that labor will commence in a few weeks or days:
Lightening
As labor time approaches the baby settles or lowers into the pelvis in a process called lightening. As that happens the pressure on the diaphragm decreases making breathing slightly easier, however, pressure on the bladder increases, and that may lead to an increase in frequency of urination.
Loss of Mucus Plug
Although not all women experience this sign, many do. During pregnancy a thick plug of mucus forms over the cervical opening to protect against intrusion of bacteria. As the cervix begins to thin and relax in preparation for delivery, this ‘plug’ will be expelled as stringy mucus that may or may not be tinged with blood. This bloody show is a sure sign that delivery is to be expected within a few days if not a few hours.
Rupture of Membranes
The amniotic fluid may burst forth in a sudden gush or it may begin to leak gradually. The fluid is odorless and that helps distinguish it from urine. Once the membranes are ruptured health officials need to be contacted immediately, and caution needs to be exercised to avoid getting any bacteria in the vagina. This means abstinence from intercourse and tampon use until a physician has been seen. If the discharge is greenish in color, or has a foul odor, the doctor needs to be notified as that may be an indicator of an infection in the uterus that requires immediate treatment.
Effacement
In preparation for delivery the cervix begins to thin and stretch. It is measured in percentages. Effacement can be evaluated by an exam by the health care official, typically conducted weekly once the last month of pregnancy begins.
Dilation of Cervix
The cervix begins to dilate to prepare for labor. Dilation is measured in centimeters and cannot be measured personally. It requires an exam by a healthcare official. 10 cm means fully dilated.
Uterine Contractions
Experiencing regular uterine contractions is the most obvious indication of the onset of labor. They can feel like menstrual cramps or intermittent lower back pain at regular intervals. They may start off at longer intervals up to 30 minutes apart, however frequency and intensity progressively increases as time goes on. Once contractions are experienced every five minutes it is time to get to a hospital.
Sources:
William’s Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 17.
http://www.emedicine.com/
“Signs of Labor.” American Pregnancy Association, 10 Aug. 2017, americanpregnancy.org/labor-and-birth/signs-of-labor/.
https://www.babycenter.com/0_signs-of-labor_181.bc
