Is My Labour Starting?

Birth ball

What is labour?

Labour describes the natural process which leads, ultimately, to the birth of your child. True labour is characterised by regular, painful uterine contractions and changes in your cervix. At the start of labour, you will notice the contractions are shorter, milder and spaced out. As labour becomes established, the contractions will become stronger, longer and closer together. The changes in your cervix will be felt by your doctor or midwife when they perform a vaginal examination.

What are Braxton-Hicks contractions?

Braxton-Hicks contractions are irregular tightenings of the uterus. Think of them as “practice contractions.” Your uterus is practising for labour. Braxton-Hicks are common in the late stages of pregnancy. They usually feel tight and can be very uncomfortable, but they shouldn’t be painful. Braxton-Hicks are also usually irregular.

What changes does the cervix undergo during labour?

Early in pregnancy, the cervix is a long tube of muscle whose job is to protect the baby and keep the pregnancy in place. As full term approaches, the cervix begins to soften and shorten (called “effacing”). The cervix also moves forward (anteriorly) in the vagina. Eventually, when fully effaced, the cervix is flat, like a coin. The cervix then begins to dilate.

Cervix

What is “latent” labour?

The natural process described above, whereby the cervix softens and becomes effaced, can last hours to days. These are the very early stages of labour (latent labour), which will eventually lead to “established” labour. However, because latent labour can last several days, women are encouraged to mobilise as much as possible and irreversible interventions, such as breaking the waters or an epidural, are not recommended.

Provided your pregnancy is low risk and your doctor has no other concerns, there is no need to be in hospital during the latent labour phase. Once the cervix is fully effaced and 3-4cm dilated, established labour is diagnosed and women are admitted to the birth suite.

So how do I know when to come into hospital?

If you aren’t sure, please ask your obstetrician or midwife! Labour is a process. It can be hard for you to know what is happening, especially if you are a first-time mum. We would always prefer you to check in with us rather than be worried, or miss something, at home.

If you have a question, or you have decided to come into hospital, phone the Delivery Suite of your booked hospital. The midwives will give you advice, tell you when to come in and make sure a bed is ready for your arrival.

We definitely want you to call the hospital if any of the following apply:

  • You are having regular painful contractions, every 7-8 minutes, each lasting 30 seconds, which are becoming more painful and more regular
  • You think your waters have broken
  • You have vaginal bleeding
  • You are worried about the baby’s movements
  • You are preterm (less than 37 weeks) and having any painful contractions
  • Your baby is not head first, i.e. your baby is breech or transverse
  • You are worried that something (anything!) is not right