In short: labor begins with regular contractions, increasing in strength and frequency, and/or the passage of amniotic fluid. False contractions (Braxton-Hicks) are irregular and disappear when changing positions. If you have any doubts, call the maternity hospital.
What are the harbingers of labor
A few days or weeks before the real birth, the body begins to prepare. These changes are called harbingers: they do not mean that labor will begin right now, but they indicate that everything is going according to plan.
Typical harbingers: lowering of the abdomen (the baby's head is pressed against the pelvis), frequent urge to urinate, slight pulling pains in the lower abdomen and lower back, thinning of the stool, increased vaginal discharge.
A separate sign is the passage of the mucous plug: a lump of mucus (sometimes streaked with blood) that covered the cervix throughout pregnancy. This can happen 2-3 weeks before the birth or right the day before.
False contractions: how to recognize them
Braxton Hicks contractions are irregular uterine contractions that begin in the second trimester and intensify towards the end of pregnancy. Their main difference from true contractions:
- irregular — the intervals between them are different;
- do not increase in intensity;
- disappear when changing posture, walking or a warm bath;
- usually felt only in the lower abdomen, not "girdle".
If you change position, drink water, lie down for 30 minutes - and the contractions stop or become less frequent, most likely this is a false birth.
Signs of true contractions
True contractions have a clear pattern: they become longer, stronger and more frequent. Obstetricians use the 5-1-1 rule: contractions every 5 minutes, last about 1 minute, last at least 1 hour. With such a rhythm, it's time to go to the hospital.
Pain during true contractions often begins in the lower back and "rolls" forward, covering the entire abdomen. It does not go away from the change of position - only slightly changes the character.
Count the contractions from the beginning of one to the beginning of the next. Write down the time – this will help the midwife assess the situation over the phone.
The Discharge of Water
Amniotic fluid rupture is another clear signal of the onset of labor. Water can break abruptly (fluid flow) or gradually (feeling of humidity). They are usually light, transparent, odorless or with a slight sweet smell.
Green or brown water is a reason to immediately call the hospital: this may mean that the child has excreted meconium (original feces), which requires a quick assessment of his condition.
After the water breaks, it is advisable not to take a bath and go to the hospital for a few hours, even if there are no contractions yet. The membranes no longer protect the baby from infection.
How to Track Contractions
Use a phone app or just a watch. Write down:
- the time of the beginning of the contraction;
- its duration (how many seconds/minutes);
- interval until the next bout.
Show the records to the midwife - this will significantly help when admitting to the hospital. If the contractions are irregular, but very painful, also call: everyone's pain threshold is different.
What to take with you to the hospital
It is better to pack the bag in advance, at 36-37 weeks of pregnancy. It usually includes: an exchange card and passport, an insurance policy, slippers and a bathrobe, hygiene items, clothes for the baby for discharge, a phone charger.
A detailed birth plan should be discussed with the doctor in advance - this will help the maternity hospital team understand your wishes.
When to see a doctor
Immediately call the maternity hospital or call an ambulance if:
- the water has broken (especially if it is green or smelly);
- contractions every 5 minutes and last more than 1 minute;
- there is bleeding – bright red blood (not a mucous plug);
- you have stopped feeling the baby's movements or there are significantly fewer of them;
- Severe headache, visual impairment, pain under the ribs are signs of preeclampsia.
Frequently Asked Questions
Can labor begin without contractions?
Yes. Sometimes the water breaks first, and the contractions come later. In this case, you still need to go to the hospital - labor has already begun.
How long does the latent (initial) phase of labor last?
In primiparous women, it takes an average of 8–20 hours, in multiparous women, much faster. Do not rush to the hospital at the first contraction: call the midwife and follow her recommendations.
What should I do if I am not sure that this is childbirth?
Call the hotline of the maternity hospital or your obstetrician-gynecologist. Describe the frequency and length of contractions. A specialist will help you figure it out and, if necessary, invite you for an examination.
Can a mucous plug come off in the shower unnoticed?
Yes, it is possible. The absence of visible discharge of the plug does not mean that there is something wrong with the neck: the plug can come out gradually, in small portions.
Conclusion
The onset of labor is a process, not a single event. Harbingers, false contractions, the breakdown of the cork, and finally regular contractions or the outpouring of water are all parts of the same picture. Knowing the signs helps you stay calm and make the right decisions. Trust your body and do not hesitate to call the maternity hospital if you have any doubts.
Bibliography
- WHO. WHO recommendations: intrapartum care for a positive childbirth experience. Geneva: World Health Organization; 2018. https://www.who.int/publications/i/item/9789241550215
- ACOG Practice Bulletin No. 107. Induction of Labor. Obstet Gynecol. 2009.
- NICE guideline NG207. Inducing labour. National Institute for Health and Care Excellence; 2021. https://www.acog.org/womens-health/faqs/when-pregnancy-goes-past-your-due-date
- Cunningham FG et al. Williams Obstetrics, 25th ed. McGraw-Hill; 2018.
- Ministry of Health of the Russian Federation. Clinical recommendations: Normal delivery. 2021. https://cr.minzdrav.gov.ru/
- Simkin P, Ancheta R. The Labor Progress Handbook. Wiley-Blackwell; 2017.
This material is for informational purposes only and does not constitute medical advice and is not a substitute for medical advice. If a child's sleep is accompanied by alarming symptoms, a pronounced deterioration in health, problems with breathing, feeding or weight gain, it is necessary to consult a qualified medical specialist as soon as possible, and not rely only on information from the Internet.
