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Labour The Real thing (or not?)

Labour doesn’t usually begin intensely and obviously the way it does on television or in films.

In real life, the beginning is usually a combination of little things that feel simply different from what is usual for you. For some women, it takes a few hours to realise that they are in labour. All of this is normal, and there is usually no need to rush to the hospital at the first signs of labour.

Labour waves
There is a difference between labour waves that mean you are in labour and the waves that help your body get ready for labour. Waves that mean labour has begun (“real labour waves”) have some of these characteristics:
•They occur in regular time intervals
• The time between the beginning of one wave and the next one gets shorter and shorter
• The feeling is more intense and you have to stop when a wave begins
• The wave lasts longer
• If you change position or use other methods of pain relief, the waves do not stop or become less intense
• The cervix is opening (dilating) or getting shorter (effacing) (this can be checked by a midwife or doctor)

With preparation waves (also called Braxton-Hicks Contractions) things go a bit differently:
• The intervals are random and remain irregular over time
• The strength of the waves varies and does not get more intense
• The length of the waves does not change or becomes shorter
• If you change position or take a hot shower, the waves slow down or stop
• The cervix is not opening
If you are not sure which type of labour waves you are having, have a glass of water or two and lie down for at least thirty minutes. If they slow or stop, they were preparation waves (which can also be caused by not drinking enough water).

You release your mucus plug
You might lose your mucus plug (also called bloody show) 24-48 hours before labour begins - it looks like pink-streaked jelly on your underwear or on toilet paper after you wipe. It can come at once or little by little over a period of time. Some women never see this plug because it comes out during birth, while for others, the plug releases a week or more before labour begins. Seeing it is a sign that your body is getting ready for labour.

Pregnancy hormones make your poo become soft before labour begins - this is nature’s way of emptying your bowels and making space for your baby. This can happen a few days or a few hours before your labour begins.

Release of waters (waters breaking)
Your waters may release in the early phases of labour or before your labour waves begin. There may be a lot of fluid, or just a bit. Everything is fine unless the fluid looks green or brown, which means your baby may have pooed in the uterus - in this case call your midwife or doctor. It is normal for your body to need some time to develop labour waves after your waters release.

Baby dropping (“lightening”)
Your baby usually drops a bit lower into your pelvis in the last weeks and days of pregnancy, sometimes just before labour. This makes you go to the toilet more often and gives you that “pregnancy duck walk”.

When should I call my midwife or go to the hospital?
This is really a choice that depends on who your practitioner is, where you are planning to give birth and how long it takes them to get to you, or you to get to them. Have a conversation with your caregivers about this, and keep in mind the following:
• If it’s your first baby, call your caregiver if your waters release (either a trickle or a gush),
• Use the 5-1-1 or 4-1-1 rule (depending on where you live in relation to your caregivers). This means that it’s time to call your midwife or head out to the hospital or birth centre when your labour
waves are four minutes apart (from start of one to start of the next one), and have lasted at least one minute each for one hour (i.e. a regular pattern over the past hour),
• If you’re feeling anxious or have questions, call your midwife or your hospital.

Information your midwife or doctor needs
When talking about what is going on, make sure you or your birth partner can describe most of these things:
• How often your labour waves are coming (every … minutes)
• How long your labour waves last (from start to end)
• How strong your labour waves are (can you talk through them; do they require all your attention) and how intense they feel
• How long your labour waves have been at this intensity, and what happened before that
• Has any water released, how much (gush, trickle) when and what did it look (colour) and smell like (neutral, stinky)?
• Anything else you feel is important to mention