The Signs: How Do You Know You're in Labour?

Every woman’s labour experience is different. And even with the same woman, each labour can be completely different. Some labour signs start slowly and then speed up unexpectedly, while others start rapidly and then slow down. Some experience labours that are very fast and lasting only a few hours. There are those that are very long, and even lasting a day or two.

The average length is about 15 to 16 hours for first-time mothers and 7 or 8 hours for women with previous childbirths.

The body provides several clues that the onset of labour is approaching. There are also signs of pre-labour that indicate the body is preparing for delivery in the weeks to come.

Signs of Labour

The Contractions

You may have contractions throughout your pregnancy, these painless tightenings are called Braxton Hicks contractions.
Whereas labour contractions are rhythmic and painful contractions that feel stronger and last more than 30 seconds. They become longer, stronger and more frequent to push the baby down and open your cervix for the exit of the baby.
Labour starts with strong, regular contractions. Vaginal discharge can come at the same time, it is a small amount of sticky, jelly-like pink mucus and called a show.

Water Breaks

Babies develop and grow inside a bag of amniotic fluid. During the labour, the amniotic fluid drains out through the vagina which is called waters breaking.
If your waters break before labour starts, contact your doctor immediately for advice. Without amniotic fluid, your baby is no longer protected and there is a risk of infection

Three Stages to Labour:

First Stage of Labour – Dilation

The cervix needs to open about 10cm for a baby to pass through. This is called being “fully dilated”. Contractions help to soften the cervix so that it gradually opens.

That process can take hours before the labour, you may prefer to stay home and try to sleep or take a warm bath to relax at this stage. Walking around helps the baby move down into the pelvis. For a first pregnancy, the full dilation usually takes 6 and 12 hours. It is often quicker in subsequent pregnancies.

To help you overcome the urge to push, try breathing out slowly and gently. Some people find this easier lying on their side, or on their knees and elbows, to reduce the pressure of the baby’s head on the cervix.

Second Stage of Labour – Delivery

This is the “pushing” stage. It begins when the cervix is fully dilated and lasts until the birth of your baby. This is the part of labour where you help your baby move through your vagina by pushing with your contractions.

After your cervix is fully dilated you can push when you feel you need to during contractions:

• Take two deep breaths as the contraction starts and push down.
• Take another breath when you need to.
• Give several pushes until the contraction ends.
• After each contraction, rest and get your strength up for the next one.

This stage may take at least an hour, the baby’s head moves down the vagina until it can be seen.

Once your baby’s head is born, most of the hard work is over. With one more gentle push, the body is born quite quickly and easily. You can have your baby lifted straight onto you before the cord is cut by your midwife/nurse or birth partner.

Third Stage of Labour – The Placenta

The third stage of labour is after the baby’s birth when your womb contracts. These contractions cause the placenta to come out through your vagina. If the placenta does not get expelled by your contractions, you may get an injection in your thigh which will speed up the release of the placenta. The injection of syntocinon makes the womb contract and helps to prevent heavy bleeding (postpartum hemorrhage).

Written By: Dr. Tina I Ureten, MD, RDMS, RDCS