When Labor Starts
Labor is when contractions become regular and the cervix begins to dilate. Also, by definition, labor starts when the water bag breaks. Sometimes it is obvious when labor starts, but sometimes it’s not so clear.
What to Look For at Home
- Leaking fluid: Any pregnant woman who thinks she is LEAKING AMNIOTIC FLUID must be evaluated in the office or hospital. At times, it can be difficult to distinguish leaking amniotic fluid from leaking urine. Women who are not sure can try the following: go to the bathroom, urinate, and wipe dry. If there is still leaking, it may be amniotic fluid. It is more common to leak urine with coughing or sneezing. Sometimes women leak urine when the baby moves. And leaking fluid is different than the mucous-like vaginal discharge common to pregnancy.
- Contractions: After 37 weeks we no longer speak of Braxton Hicks contractions. All contractions can be considered labor contractions, its just a question of early labor or full on labor.
- Timing: Contractions are timed from the beginning of one to the beginning of the next. Its not necessary to time the duration of each contraction. And, its only necessary to time contractions which are PAINFUL.
- What it feels like: Labor contractions should have a gradual onset, then peak, then go away as slowly as they came on. And between contractions there should be almost no pain. There should be a true space between contractions. Contractions worth timing should be PAINFUL. A pregnant mom should not be able to walk or talk during a true, strong, labor contraction. If she can walk, talk or smile during the contraction, it is still early.
- Bleeding: The cervix bleeds as it dilates. The resulting discharge can be brown, red tinged, or red. A normal amount is MUCH LESS than a period, but it can be quite red. Bleeding like a PERIOD can be normal, but any woman with that much bleeding should be seen at the hospital.
Going to the Hospital
Many women are afraid to show up at the hospital too early just to be sent home. It’s useful to understand labor in different stages. It starts with home labor and then hospital labor. Once in the hospital, there is the slow part of labor, the fast part of labor, pushing, delivering the baby and delivering the placenta. Sometimes its obvious that a patient should be admitted in labor; other times it’s more difficult to figure out. The process of diagnosing labor can be confusing and/or frustrating, for patients and for the hospital staff.
Home labor Typically turns to hospital labor WHEN:
- The water bag breaks.
- The contractions are coming closer than every 5 minutes, and have been that frequent for 90 minutes.
- The cervix is dilated WITH painful contractions. (4 centimeters usually enough, 2 cm may not be enough)
- The cervix dilates over one or two hours. (3 goes to 4 cm is usually enough, 2 cm to 3 cm may not be)