In Labor - Pregnancy Labor and Signs of Labor
After the answer to the very first question you asked (Am I pregnant?) at the beginning of the journey was answered with a resounding, Yes, the next question focused on the ending of the journey - labor and delivery. What's labor and delivery like? Will I be prepared for it? How will I know I'm in labor?
Are These Contractions the Real Thing?
All of the questions are valid and are commonly asked. As you move through the second trimester and arrive in the third trimester, you will experience contractions that are preparatory to the real thing. They're called Braxton-Hicks contractions and they give you a small taste of what labor will be like. Braxton-Hicks contractions are irregular contractions, and you'll feel a tightening in the abdomen that comes and goes. They don't get closer together and there is no increase with movement or how long they actually last. They don't get stronger - they just go away after a while.
What is Labor?
According to eMedicine, labor is defined as "a physiologic process during which the products of conception (ie, the fetus, membranes, umbilical cord, and placenta) are expelled outside of the uterus. Labor is achieved with changes in the biochemical connective tissue and with gradual effacement and dilation of the uterine cervix as a result of rhythmic uterine contractions of sufficient frequency, intensity, and duration." Not very romantic, is it? The fact is that some women experience very distinct signs of labor while others get to the end of the pregnancy, go into labor, and aren't quite sure how it all happened. There didn't seem to be any warning for them.
Some Signs of Labor
So, how can you tell when you are in true pregnancy labor? There are some signs of labor that indicate the hormonal and physical changes are happening and labor will begin shortly. The first of these is what is called "lightening", or some people refer to it in terms of the baby having "dropped". It means that the baby has settled into the pelvis and the head is in position to begin the descent into the birth canal. Since the uterus rests on the bladder, the urge to urinate more frequently will be a constant feeling. Next there is the mucus plug, or the bloody show. As the cervix begins to widen, the mucus plug that has accumulated at the mouth of the cervix is discharged into the vagina. The plug may be clear, pink, or slightly bloody. Labor pains may begin soon after this, or within a couple of weeks.
Here Come the Real Ones!
Contractions, or labor pains, feel different for each woman. The abdomen becomes hard with the contractions and between contractions, the uterus relaxes and the abdomen softens. These contractions usually move in waves, and unlike Braxton-Hicks, they don't stop or become less intense, quite the contrary. Even though they are intense, for the first while you will be able to rest between them until transition and birth.
Only one in ten women experience their water breaking, also called the rupture of the membranes. If your water breaks outside of the actual delivery, then there will be a rush of amniotic fluid, which should be odorless. This is the real precursor to delivery, so if you're at home and the amniotic fluid sac breaks, call your midwife or doctor who will tell you to get to where you plan to give birth as soon as possible. Labor ending in birth will happen soon from this point.
As labor progresses, effacement (stretching) and dilation (thinning and opening) of the cervix continues until the baby's head moves out of the cervix and into the birth canal on the way out. Effective uterine contractions - labor - results in effacement and dilation. Your cervix will continue to dilate until the baby can move forward with the contractions and ultimately labor produces birth.
Your Midwife is On Side
If you have a midwife attending you during the birth of your baby, then as soon as you go into labor you'll call her and she'll come and assess you - at your home or before you go to the birth center. During labor, your midwife will support you and help you, as well as any birth partners you may have accompanying you. Since you and she talked about the way you wanted to give birth, she will be there to help you have the birth you want, monitoring your health and that of your baby throughout the process. She can help you get into positions that make the labor pains more bearable and assist you to help your labor progress. She can suggest ways to deal with the contractions and if there are any concerns, she is the one to liaise with medical staff. Immediately after the baby is born, she'll help you get comfortable and begin feeding the baby.
A midwife can help you through the labor process calmly and quietly, encouraging, coaching, and helping to make the birth experience a good one. Usually a midwife stays with you for as long as six weeks after the birth. She can be helpful in all of the initial check-ups for both you and your baby, as well as helping you with circumcision plans if your baby is a boy and you desire to have him circumcised. Her role is varied and helpful, and she'll stay with you throughout the experience and beyond.