How to know if you’re in labour

EEOWW! Without thought, your hand protectively flies to your distended belly. Was that a Braxton- Hicks contraction or the real thing? Whatever it is, it’s definitely the start of labour…isn’t it? How to know when you’re really in labour is something many women wonder as their due date approaches. Even if you’ve had a baby once before, each labour experience can be different and how you deal with the experience may also change.

Signs of Pre-Labour

Any of these symptoms might signal the onset of labour:

• a happy burst of energy
• a bout of indigestion, the body’s attempt to clean out your system to make space for the baby to move down
• a little show of blood
• a sudden bursting of your water
• persistent lower back pain
• abdominal pain with a crampy feeling (contractions)

What to do if You’re in Pre-Labour

Many women experience Braxton-Hicks contractions (weaker, less regular contractions that do not increase in intensity, regularity or duration over time). This might signal early labour, not real labour. Contact your healthcare practitioner. Your doctor or midwife will assess your situation, give you guidance and provide support. You are not being a nuisance by calling, nor should you feel awkward about any of your questions or concerns. 

If you’re experiencing Braxton-Hicks or any other other signs of pre-labour, the important thing is to stay calm, advises registered midwife Carmen Felix. “Running around cleaning the house or setting up the baby’s room in anticipation will only sap the energy you will need during the advanced stages of labour and for the actual delivery of your baby. Relaxing will also enable your mind and body to find ways to cope more effectively with any pain or discomfort.”

The 5-1-1 Rule

You will know you’re really in labour if you follow the 5-1-1 rule, says Carmen. “The contractions should come every five minutes and last one minute and if that pattern goes on for one hour then it means the labour is going somewhere.” For repeating moms, Carmen says labour may progress quicker and not to wait as long as the 5-1-1 rule before contacting your health provider. For these moms, you will know you’re in real labour if your contractions are 30 to 45 seconds and are repetitive beyond half an hour.

What Happens Next?

After an initial assessment, your practitioner might suggest that you relax in the comfort of your home. During this time, some women are able to eat their meals; others might be able to nap. There is comfort in continuing a regular schedule for some, while others prefer the distraction and comfort found with the company of family or friends. A warm shower can help ease aches, while a stroll can be relaxing for others. “Staying mobile encourages labour to progress,” says Carmen. “The more mobile you are, the more you can also cope with the contractions.” It is best to contact your doctor or midwife if there is any blood loss or if your water breaks. “When that happens, you don’t necessarily go into labour, though the majority of women do.”

During Heavy Labour

You need strong, regular contractions for at least two to three hours before your cervix moves, says Carmen. Textbooks describe a progression of one centimetre every two hours (for the average, first-time labour), For repeating moms, progress is faster. Dilation can occur at one centimetre or more per hour. Practise breathing techniques, which will help you to cope with the intensity of labour. Rehearse in your mind what exactly will happen at each stage of labour. Preparation often helps moms cope better with the demands of labour and your response to pain. Regardless of where you choose to deliver, it is important to keep in close contact with your healthcare provider and give progress updates. Heed their advice. Soon enough, they will be telling you to PUSH!

Carmen Felix works at The Midwives Collective of Toronto. She is a mom to twins Finn and Lilly.