Labour

Labour is the period when the body gets itself ready to push out the baby and the placenta from the uterus. The uterus accomplishes this by tightening repeatedly (causing painful contractions), which moves the baby downwards, and causes the neck of the womb (the cervix) to become wide enough for baby to pass through. The cervix is closed during pregnancy, but begins to soften and dilate as labour starts, to get as wide as 10cm. Once the baby is delivered and the placenta is out, the contractions subside.

Before the day arrives, you would have discussed extensively with your doctor and made a decision about what mode of delivery is best for you – depending on your previous history, the present condition of both you and your baby, and your personal preferences. If the plan is for you to have a spontaneous labour and delivery, make sure you have your bag packed, ready with the items on the list given to you during your antenatal visits. You should also have a good plan of how you will get to the hospital from wherever you might be when labour starts. Another important thing that will be discussed is pain management – you will be offered an epidural, which is a type of pain relief given during labour to make the whole process easier to bear. The decision on whether or not to have an epidural rests with you, unless there are medical contraindications like a bleeding disorder or an abnormally low blood pressure. Be sure to ask questions, clarify any reservations you might have, and get sufficient information on what to expect with an epidural.

As the time of labour approaches, you may begin to feel your baby’s head descending into your lower abdomen, have worsened low back pains, and urinate very often. A vaginal examination during an antenatal visit might have picked up that your cervix is beginning to soften and be drawn upwards. You could also have more frequent Braxton Hicks contractions (false labour) around this time.

You might experience a ‘show’ – This happens when the mucus plug that covered the cervix comes off and is passed out through the vagina. You will notice a thick mucoid discharge, which may be blood streaked. While this is one of the signs that labour is about to happen, it doesn’t happen obviously to everyone, and even when it does happen, it can still take some days before labour starts.

A more certain sign that labour has started is the beginning of contractions. Labour contractions are different from Braxton Hicks contractions in a number of ways. They are regular and painful, and usually get increasingly stronger and more consistent with time. Also, the contractions do not stop when you change position, and each one may last for about 30 to 60 seconds.

Sometimes, the sac containing the baby might rupture, and the water surrounding the baby (amniotic fluid) begins to leak out; this is called your water breaking. You might feel a gush of some fluid between your legs. If this happens, or if you suspect that your water has broken but you aren’t absolutely sure, it is important for you to contact your doctor immediately and get to the hospital as soon as possible. Active labour should start soon as possible after your water breaks, in order to reduce the risk of an infection getting to the baby. If your water breaks and labour hasn’t started actively, you might need to have an induction of labour.