Every woman experiences labour differently. You may only start to realise some of the symptoms you were experiencing were labour related after you’ve actually been through it! There are however a number of tell tale signs and symptoms that happen before labour begins and during early labour.
During the pre-labour and early labour phase (also known as the latent phase) you may experience lower back pain or abdominal pain which feels similar to period pains or cramps. You may start to experience contractions of tightenings which will be irregular in strength and frequency and may stop and start. You waters may break with either a gush os just a trickle of fluid, although this can happen before labour starts (if it does then you need to call your maternity unit). You may have a show, which is a brownish or blood-tinged mucus discharge, this is the mucus plug which blocks the cervix and will be lost when changes start to happen within the cervix and is a sign things may be starting. Manu women also experience an upset tummy or loose bowels, disrupted sleep and feel emotional, restless and anxious or impatient.
As there can be an overlap between pre-labour and the start of labour itself, it’s possible to confuse the symptoms of the two. How you feel and cope during the early labour phase will often depends on whether you’ve had a baby before, how you cope with pain and how prepared and knowledgeable you are for what labour may be like. The early phase or the first stage of labour is when your cervix dilates to 4cm. The best thing to do during this time will depend on what time of day it is, what you like doing, and how you’re feeling. Your midwife may recommend that you take paracetamol. However, there’s not a lot of evidence to suggest that paracetamol can help to relieve early labour pain.
Keeping calm and relaxed can help you to cope with the contractions or tightenings. It will also help your body to release the hormone oxytocin, which you need for your labour to progress. This could mean watching your favourite film, going for a walk, pottering around at home, or asking a friend or relative over to keep you company. You could alternate between walking and resting, or try taking a warm bath or shower to ease any pain. If you can, try to get some rest to prepare you for the work ahead. During early labour, you may feel hungry, so eat if you feel like it. Nibble on small amounts of high-energy foods to keep you going. This will help to comfort you and may even help your labour to progress more smoothly.
Early labour is a good time to try out different positions for labour and practice your breathing techniques. If you’ve got a TENS machine, early labour is the time to use it. It’s unlikely to help if you wait until you’re in active labour before you start using it. If you’re planning to have your baby in a hospital or birth centre, the active phase of the first stage of labour is the time to go. This is where your cervix dilates from 4cm to 10cm. For many women, the main sign is painful, regular contractions. These gradually become more frequent, longer, and stronger in intensity. Your midwife may have told you what to expect, such as contractions coming at least every five minutes and lasting at least a minute. However, for some women, labour progresses well without following a “textbook” pattern.
Listen to your body and watch out for how you’re feeling. As labour intensifies, you’re likely to talk less. You’ll find holding a conversation during a contraction more difficult. You may notice that you have to pause as each contraction builds, leaning forward and rocking your pelvis to help you through it. As your labour progresses, you may start to turn your awareness inward, focusing in on each contraction and using your breath to help you to cope. You might start “sighing” out from the start of each contraction. As your labour gets stronger, your appetite is likely to decrease, and you may feel hot and anxious. You may also start to feel less inhibited and care less about what you’re doing. This may help you to demand exactly what you need to help you cope!
You’ve probably talked to your midwife about what to do when you think you’re in active labour. But if you’re not sure whether the time has come, don’t be embarrassed to call. Midwives are used to getting calls from women who are uncertain if they’re in early labour or active labour, and who need guidance. It’s part of our job. The midwife will want to hear about what you’ve been experiencing, particularly how close together your contractions are. She’ll be able to tell a lot by the tone of your voice and how you respond to a contraction, so talking helps. It’s not always possible for a midwife to accurately judge whether active labour has started over the phone. That’s why it’s important to trust what your body is telling you as well as being guided by your midwife.
If you’re planning to have your baby in hospital or in a birth centre, you may not need to go in straight away. Instead, your midwife may give you some coping tips and advise you to stay at home until contractions become more frequent and stronger. Trust your instincts on when you think it’s the right time to leave the house or call in the midwife. This may mean ignoring pressure from your partner, mum, or whoever else is with you, until you feel it’s the right time to go. If you’re going to hospital or a birth centre, always phone before setting off, as your chosen unit may be busy. If that’s the case, the staff may ask you to stay home a bit longer or direct you to another unit. It’s a good idea to prepare for this possibility so that it’s not such a big disappointment if it happens to you.
When deciding when it’s time to leave, bear in mind that it can be harder to move as your contractions get longer, stronger and more frequent. Getting from your front door into your car may take a while as you pause for each contraction. Once your midwife sees you and can confirm you’re in active labour, she will admit you to the labour ward, or stay with you if you’re having a home birth. If she thinks you’re in early labour, she’s likely to encourage you to go home until you’re in active labour. Her decision will depend on how you’re coping and whether you’ve got a birth partner to give you good support.