Labour and childbirth

Many women are worried that they won’t recog-nize labour when it begins, but there are three clear cut ways it can happen: • Contractions: during the later stages of pregnancy the uterine muscle contracts ever}’ so often. These contractions are felt only in the front and are not true labour contractions .

True labour contractions start as a low backache, moving round to the front of the stomach. They come in regular bouts, occurring every half hour to begin with but rapidly progressing to once every 15 to 20 minutes (in the delivery stage they come about every two minutes).

With a first baby it is wise to wait until they are coming regularly, every 15 minutes or so, before going to hospital. With a subsequent baby, you may find it harder to decide on the right moment to leave home. With the responsibility of a larger family, you’ll want to make sure your other children are all right before you go. However, things happen much faster in a second labour, so if you want to be sure of getting to hospital on time, leave as soon as the contractions are coming every 20 minutes or so. • A ‘snow’ of blood or bloodstained mucus is another sure sign that labour has started. It’s usually only a slight bleeding but it’s unmistakable. As soon as you notice it you should go to hospital straight away. • Breaking the waters: in the womb the baby is bathed in fluid and covered by a membranous sac. This sac has to be ruptured before the baby can be born. When this happens clear fluid gushes out of the vagina and is an obvious indication that labour has started.

This is a very unusual way for a woman having her first baby to start labour as the neck of the womb is closed and the membranes are well supported – but it can happen. It is more usual in subsequent pregnancies, as the neck may be a little more open, and the sac unsupported.

It is sometimes difficult to be certain whether labour pains are the real thing. In the last weeks of pregnancy, the uterus contracts, limbering up to prepare for delivery. This is perfectly normal but, like any other muscular action, if it goes on too long it may be painful. These contractions are different from actual labour contractions which are caused by the opening of the cervix and the descent of the foetus through the pelvis. However, these false labour contractions can be mistaken for real labour.

Don’t hesitate to contact the midwife or hos-pital if you are uncertain; they never mind ‘false alarms’. It is far better to play safe than for the baby to be born en route to the hospital. False labours are more common in first pregnancies, though they can occur in later ones- particularly if a woman has been induced before and has no idea how labour starts.