Be prepared before labour starts
Labour typically begins between the 37th and 42nd week of pregnancy. It is a natural, physiological process that usually begins when you and your baby are ready. Plan to wait for labour to start naturally unless medical concerns arise. It is best to be prepared for whenever your labour might begin. Being prepared can increase your confidence in your ability to cope with labour and give birth.
To prepare for labour, you can:
- Learn about the process of labour and birth.
- Think about comfort measures you want to try as you move through the stages of labour and talk about these with your support person and health care provider.
- Pack a bag with the things you will need during labour and after the birth.
- Make a list of contact numbers, including your support person, your health care provider, and your hospital or birthing centre.
- Make a transportation plan so you will be able to go the hospital or birth centre quickly when needed.
- Collect supplies recommended by your midwife if you are planning a home birth.
Watch for early signs of labour in the last few weeks of your pregnancy
During the weeks leading up to labour, you may experience signs that labour will begin soon. Signs that labour can begin soon include:
- An easier time breathing due to your baby moving further down into the birth canal, which leads to lessening pressure on your lungs. This is called lightening.
- Increased vaginal discharge or the loss of your mucous plug.
- Irregular cramping or Braxton Hicks contractions.
- A sense of renewed energy.
These signs do not mean you are in labour. They are signs that labour may begin within the next couple of days or weeks. When you experience these signs, listen closely to your body as it prepares for labour.
Start of Labour
The start of labour is marked by strong, regular contractions or the rupture of your membranes. If you have either or both of these signs, contact your health care provider.
If you have strong, painful contractions that occur regularly, every five minutes and lasting for almost one minute, your labour may have begun. Your support person can help time your contractions. Labour contractions cause your cervix to shorten and thin (efface) and widen (dilate) getting ready for the birth of your baby.
The bag of water that your baby is in may also break open, signalling the start of labour. This is known as the rupture of membranes. When this bag of water breaks, you may experience a large gush of fluid or a steady trickle of fluid. If you think that you may be leaking fluid, contact your health care provider.
It is important to record the:
- Time when the bag of water broke.
- Amount of the fluid.
- Colour of the fluid.
- Odour of fluid.
You can use the acronym TACO to remember this.
The fluid is normally clear but occasionally may look pink due to bleeding caused by changes in the cervix; this is okay. If the fluid is dark or green in colour, go to the hospital right away. If there is a large amount of bright-red bleeding, call 9-1-1 for an ambulance to take you to the nearest hospital.
If you are Group B Streptococcus positive, you will also need to go to the hospital right away or call your midwife once your bag of water breaks, so you can receive antibiotics.
It is normal for labour to last longer for some women than for others
The experience of labour and how long it lasts is different for every woman and every pregnancy. Learning about the three stages of labour will help you understand the progress of your labour, what to do, and how to best to comfort yourself.
First stages of labour
During pregnancy, your cervix is closed. During labour, your cervix widens (dilates) to 10 centimetres to allow for the birth of your baby. Dilation occurs during the first stage of labour. The first stage of labour is divided into the following three phases: early labour, active labour, and the transition phase.
During early labour, your cervix will first soften and shorten. If this is your first baby, early labour moves into active labour once you reach 3 to 4 centimetres of dilation. If you have given birth before, this happens at around 4 to 5 centimetres of dilation. Many women find this phase to be especially long. Try to move around, drink, eat healthy snacks, and rest during this phase.
During the active phase of labour, your cervix will continue to dilate to 8 centimetres. Your contractions will become stronger, closer together, and last longer. This is often the phase when women rely heavily on their support system and may ask for pain medication. Most women are admitted to the hospital during the active phase of labour if they are planning a hospital birth.
During the transition phase of labour, your contractions will become even closer together and last longer as your cervix completely dilates from 8 to 10 centimetres. This is a short phase, but it is often the most challenging phase for women. Remember that the contractions are strong because your baby is coming.
During the second stage of labour, pushing occurs – this is when your baby will be born
When your cervix is 10 centimetres or fully dilated, you may start to feel the urge to push. You should not begin to push until you are fully dilated and feel the urge to push. The length of this stage can vary among women. It can take up to two to three hours or longer, especially if you do not feel a strong urge to push. It may be shorter for women who have had a baby before.
When pushing, listen to your body, use positions that feel are best for you, and push when you feel the urge to push. It is also important to listen to the guidance of your health care providers. They may suggest positions for pushing and when to stop pushing.
During the third stage of labour, the placenta will come out
Not long after your baby is born, you will feel some mild contractions again and you will then be able to push out the placenta. This is usually a quick process. If the placenta does not come on its own, your health care provider may need to remove it for you.
Learn more about labour progress
You can find out more about the stages of labour and ways in which to cope with labour from the following resources.
- Your health care provider
- Perth District Health Unit, Huron Perth Healthcare Alliance – Stratford General Hospital Perth County Prenatal Classes
- Society of Obstetricians and Gynaecologists of Canada: Pregnancy
- Mother’s Advocate
Adapted and reprinted with permission by the Best Start Resource Centre.
August 12, 2016