Labor and delivery, postpartum care

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Signs of labor: Know what to expect

Every woman's labor is unique. But understanding the typical signs of labor can help you know what to expect as your due date approaches.

By Mayo Clinic staff

On television, babies are often born with a rush of emotion and swift action. The mother doubles over from the pain of a single contraction, and the baby appears before the commercial break.

In reality, labor usually begins less dramatically.

No one knows for sure what triggers labor — and every woman's experience is unique. But understanding the typical signs of labor can help you know what to expect as your due date approaches.

Effacement: Ripening of the cervix

One of the first signs of labor is your cervix softening and thinning, or effacing. You won't feel this preparation for labor happening. Instead, your health care provider will check for signs of cervical change with vaginal exams.

Effacement is often expressed in percentages. When you're 50 percent effaced, your cervix is half its original thickness. Your cervix must be 100 percent effaced, or completely thinned out, before a vaginal delivery.

Dilation: Opening of the cervix

Another of the early signs of labor is your cervix beginning to open, or dilate. Your health care provider will measure the dilation in centimeters from zero to 10.

At first, these cervical changes may be very slow. In fact, some women are dilated 2 to 3 centimeters for days or even weeks before labor actually begins. Your progress isn't a good indicator of when labor will begin, but rather a general sign that you're getting ready for labor. Once you're in active labor, expect to dilate more quickly.

Bloody show: Loss of mucous plug

During pregnancy, a thick plug of mucus blocks the cervical opening to prevent bacteria from entering the uterus. When your cervix begins to thin and open, this plug may be discharged. You may notice stringy mucus or a thick discharge. It's typically brown and sometimes tinged with blood.

Losing the mucous plug is among the telltale signs of labor, but it's not a guarantee. Labor may still be days away.

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References
  1. Labor and birth. The National Women's Health Information Center. http://www.womenshealth.gov/pregnancy/childbirthandbeyond/laborandbirth.cfm. Accessed Dec. 16, 2008.
  2. Kilpatrick S, et al. Normal labor and delivery. In: Gabbe SG, et al. Obstetrics: Normal and Problem Pregnancies. 5th ed. Philadelphia, Pa.: Churchill Livingstone/Elsevier; 2007. http://www.mdconsult.com/das/book/body/113939576-5/783944298/1528/125.html#4-u1.0-B978-0-443-06930-7..50014-1--cesec14_618. Accessed Dec. 16, 2008.
  3. How to tell when labor begins. American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp004.cfm. Accessed Dec. 16, 2008.
  4. Herbst A, et al. Time between membrane rupture and delivery and septicemia in term neonates. Obstetrics & Gynecology. 2007;110:612.
  5. Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 6, 2009.
  6. You and your baby: Prenatal care, labor and delivery, and postpartum care. American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/ab005.cfm. Accessed Dec. 17, 2008.
  7. Johnston J. The nesting instinct. Midwifery Today with International Midwife. 2004;71:36.

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March 20, 2009

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