Prelabor and Labor

Medically, labor is divided into three stages. In the first stage, your cervix opens fully to allow your baby to pass through; in the second stage your baby is born; in the third stage the placenta is delivered. All these stages are discussed in detail over the following pages. In addition to these stages, most women experience prelabor. Your experience of labor will be much more colorful and exciting than the medical definition above. Go into it believing that very little can go wrong, and very little will go wrong.

Prelabor

Before real labor begins, hormones from your uterus and your baby prepare your body for birth. During the last few weeks, you’ll probably notice signs of your coming labor. But just as each woman’s experience of labor and birth is unique, so these prelabor symptoms affect everyone in different ways. They do provide useful signals to warn you that labor is imminent.

Engagement - To position himself for the journey through the birth canal, your baby will move lower down so that his presenting part, usually his head, settles into your bony pelvis. This is known as engagement, and you’ll experience it as a feeling of lightening. You may actually see your belly drop down. If this is your first pregnancy, your baby will probably engage two to three weeks before the labor starts. If you’ve had previous babies, your baby’s head may remain higher until just before labor starts, because your uterine muscles may have stretched and so will exert less pressure on your baby. You’ll know when your baby has engaged because there’s less pressure on your diaphragm and breathing becomes easier. On the other hand, you’ll probably find you have to pass urine more often, as your baby will now be pressing down on your bladder.

Braxton-Hicks contractions - Your uterus practices for the strong contractions needed in labor with weak, irregular contractions, named after the doctor who first described them. Most women feel these during the last few months. If you place your hand on your abdomen, you may feel a hardening and tightening of your uterus, which lasts for approximately 25 seconds.

Unlike real labor contractions, these are usually painless, although some women find them uncomfortable. If you do feel any discomfort, sit down quietly until the feeling eases. You may find you get more and stronger Braxton-Hicks contractions as real labor approaches. This is your body’s way of preparing the cervix to dilate and increasing the circulation of blood to the placenta. When you feel a run of Braxton-Hicks, practice the relaxation techniques you’re going to use during labor; the tightening and relaxing of your uterus will give you a good idea of how a contraction feels as it waxes and wanes.

Some mothers misinterpret Braxton-Hicks as real labor pains and go to the hospital, only to be told they can go home again.

Nesting instinct - You may suddenly feel like making final preparations for the arrival of your baby. If you want to rush around cleaning or decorating the house, or cooking large meals, try to restrain yourself. Save this extra energy for coping with labor and delivery.

The show - An obvious sign that labor is coming soon is the appearance of the show-the plug of mucus that seals your cervix in pregnancy, providing protection against infection. Although the show often doesn’t appear until labor is underway, the cervix may widen enough for the mucus plug to be dislodged up to twelve days before labor begins. This sticky substance may be slightly brown, pink, or blood-tinged from the capillaries that attached it to the cervix. The show signals dilation of the cervix.

Premenstrual feelings - You may notice some physical and emotional changes similar to those you have before a menstrual period. You may also feel crampy, with some pressure in your rectum, and feel the need to empty your bowels and pass urine more often than usual.

Your Baby’s Descent

Your doctor or midwife will check this by internal examination and measure it in “stations,” lines measured in centimeters from -5 to +5 in relation to the level of your ischial spines and your baby’s head. When his head first enters your pelvis, it is at station-5. When the top of his head is level with your ischial spines it is at station 0 (engaged). The remaining stations describe the head’s position as it passes via the birth canal to the vaginal opening, station +5.

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