How to know if you're in labour

Waiting for baby to arrive can really test your patience! Midwife Grace Nixon reveals how to know whether you’re in labour or not. 

Am I in labour? This is THE question every first-time parent will ask, and Google, and gather stories about again, and again, and again. Even our lovely editor admits that she Googled this question for her second baby, and I’m sure she’s not alone!

A WAITING GAME
There is much debate over what percentage of babies are born before or after their due dates, and whether firstborns are more or less likely to come early or late. Here are the facts: around 2-5% of babies are actually born on their estimated due date (so clearly they’re the minority!), while 12% arrive before 37 weeks and 82% are born between 37 and 41 weeks. You can do all you like to encourage your baby to come earlier or later, but ultimately, they’ll come when they come! If we could predict a baby’s arrival (oh how orderly that would make delivery!) then most likely we would. But really, birth is one of life’s grandest and most exciting surprises, so go ahead and embrace it!

The first thing you need to know about labour is that it’s not like in the movies. You know the scene where the pregnant woman’s waters break dramatically on the side of a busy road and everyone freaks out, rushes her to the hospital where, next thing you know, she’s sweating profusely and huffing and puffing? Yeah, it’s not like that! Theories suggest various signs of labour, including baby ‘dropping’, and ‘nesting’ behaviour and Braxton Hicks contractions for the mum-to-be. However, the only true sign that you’re in labour is, in fact, contractions. But before we get to those, let’s look at some other indications that the party is getting started.

THE 'BLOODY SHOW'
This is a mucousy plug that sits inside the cervix to seal it shut for the duration of pregnancy. It is clear mucous that’s often blood-stained, stringy and snot-like in texture. For some women, it comes away weeks before labour, while others never even notice it, as it presents during labour. A show is a sign that the cervix is starting to open and is seen as vaginal discharge. It’s your body preparing for labour, but isn’t necessarily a sign of imminent labour.

WATERS BREAKING
This event is most commonly assumed to be a sign of imminent labour, but that is not always the case. Contrary to the dramatic movie example, the waters of only 10% of women at term (37 – 42 weeks pregnant) will break before they go into labour. Of those 10%, more than half will then go into spontaneous labour within 24 hours. The amniotic sac has provided a safe cocoon for your baby to grow in, so once it has been broken, it’s no longer a safe and sterile environment for your baby and there are increased risks of infection. If you have risk factors, such as testing positive for GBS (Group B Strep) in pregnancy, or any signs of infection, such as fever or a high maternal heart rate, you’ll be advised to go to hospital to be immediately induced. If you have no risk factors, you’ll be allowed 18-24 hours to go into spontaneous labour at home, after which you’ll be advised to go to hospital to be induced. So, are your waters breaking a sign of labour? Maybe! However, when they do break, you’ll either go into labour on your own or be induced within 24 hours.

PATTERNS AND STAGES
Contractions or ‘surges’ that increase in length, strength and frequency until they reach a consistent pattern (for most people) are your most sure sign of labour. Labour pains will usually start off like period pain (a dull cramping in your pelvis) or lower back pain. The pain will come and go in an irregular pattern and this is called ‘early labour’. On average, this stage lasts around 12 hours but for some women it can last days, while others skip this part of labour altogether.

The best place for you to be in the early stage of labour is at home. During this stage your cervix is effacing (thinning out) and dilating to about 3cm. Early labour will then become ‘active labour’ when, for most women, contractions settle into a regular pattern. A contraction pattern might be one contraction lasting one minute and occurring every 2-3 minutes. The key here is the pattern and whether or not the contractions are increasing in intensity over time.

Every woman is different and every labour is different; even subsequent labours for the same woman can vary hugely. Her first labour might have seven hours of early labour at home while the next might miss that stage altogether. One woman might have a long early labour with inconsistent contractions for 16 hours, while another might be 4cm dilated and not even be in labour (true story!).

Let me just reassure you though, you WILL know when you’re in labour. Contractions can’t be ignored and your LMC will be happy to guide you. Make sure you discuss the signs of labour with them before it happens, and at what stage they’d want you to call them. Your LMC will be able to ascertain whether or not baby is on the way. Good luck!

Grace Nixon is an Auckland-based midwife and nursery specialist. Go to practicalparentingantenatal.com to learn about her antenatal classes, where they discuss what happens before and after baby arrives in equal measure.