Labor and delivery (11)
- Signs of labor: Know what to expect
- Episiotomy: Can you deliver a baby without one?
- Inducing labor: When to wait, when to induce
- see all in Labor and delivery
Postpartum care (7)
- Exercise after pregnancy: How to get started
- Maternity leave: Tips for returning to work
- Weight loss after pregnancy: Reclaiming your body
- see all in Postpartum care
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Signs of labor: Know what to expect
Bloody show: Loss of mucous plug
During pregnancy, a thick plug of mucous blocks the cervical opening to prevent bacteria from entering the uterus. When your cervix begins to thin and open, this plug may dislodge. You may notice stringy mucus or a thick discharge that's typically brown and sometimes tinged with blood.
After you lose the plug, labor could still be a week or more away.
Rupture of membranes: Your water breaks
The amniotic sac is a fluid-filled membrane that cushions your baby in the uterus. Sometimes the sac leaks before labor begins, causing a trickle or a gush of fluid.
If your water breaks before labor begins — or if you're uncertain whether the fluid is amniotic fluid or urine — consult your health care provider right away. Once the amniotic sac is no longer intact, timing becomes important. Your risk of developing an infection increases the longer the time between the sac's rupture and delivery. If labor doesn't begin on its own, your health care provider may need to induce it.
In the meantime, don't do anything that could introduce bacteria into your vagina, such as having sex.
Contractions: When labor pains begin
During the last few months of pregnancy, you may experience occasional, painless contractions — a sensation that your uterus is tightening and relaxing. These are called Braxton Hicks contractions.
As your due date approaches, Braxton Hicks contractions may strengthen or become painful. Eventually, real contractions will replace the Braxton Hicks contractions. To tell the difference, ask yourself these questions:
- Are the contractions regular? Time your contractions from the beginning of one to the beginning of the next. Look for a regular pattern of contractions that get stronger and closer together. If contractions come at least every five minutes, you're likely to be in labor. False labor contractions will remain irregular.
- How long do they last? Time each contraction from beginning to end. True contractions last more than 30 seconds at first and get progressively longer — up to 75 seconds — and stronger. With false labor, contractions vary in length and intensity.
- Can you stop the contractions? True contractions continue regardless of your activity or position. In fact, they often strengthen with increased activity, such as walking. With false labor, you may be able to stop the contractions by lying down or taking a walk.
- Where do you feel the contractions? True contractions tend to begin high in the abdomen, radiating throughout the abdomen and lower back. With false labor, contractions are often concentrated in the lower abdomen.
Expect false alarms
The boundary between your body's preparation for labor and the actual process of labor isn't always clear. Some women have painful contractions for days with no cervical changes. Others feel only a little pressure or a backache as the cervix gradually dilates.
Call your health care provider if you wonder whether you're in labor. Preterm labor can be especially sneaky. If you have signs of labor before 36 weeks — especially if they're accompanied by vaginal spotting — see your health care provider for an exam.
If you arrive at the hospital in false labor, don't feel embarrassed or frustrated. Think of it as a practice run. Real labor isn't likely to be far behind.
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