False labour or the real thing?

How will you be sure that your labour has really started? Knowing the signs to look for will help you feel more relaxed and better equipped to cope when the real thing finally kicks in.

In the final weeks of pregnancy, your body starts preparing you for birth and you should experience at least a few of these symptoms.
The head engages
Around 36 weeks, the baby’s head settles down into your pelvis. As this happens, you will notice that it is easier to breathe as there is less pressure on your diaphragm. There should also be less kicks in the ribs as your baby is further down. This is an early sign that you have entered the last few weeks of your pregnancy.

Practice contractions or Braxton Hicks contractions
Braxton Hicks contractions are intermittent, painless contractions that occur in the second half of pregnancy. Sometimes these contractions are also called pre-labour contractions. Not everyone will notice or experience these contractions, and some will have them more frequently. Don't panic if you don't notice them. Some women only notice them because they find them to be uncomfortable. The duration may vary and could be as long as 60 seconds. They will, however, remain irregular without an increase in duration and frequency.

If you experience discomfort with these practice contractions, try out the relaxation techniques you've learnt in your antenatal class, used to deal with labour. Often women will find that simply changing position can help with any discomfort caused by these contractions. A nice warm bath or shower can also help relieve any ache and promote relaxation.

Generally, true labour contractions will become regular, closer in frequency and stronger in intensity. A Braxton Hicks contraction might get closer together but not consistently, or they may feel stronger but go away when you move around. When you experience regular contractions (at least one in 10 minutes) that are increasing in duration and frequency you should arrange to be taken to the hospital or clinic where the baby is to be delivered.

You should call your doctor or midwife if you have regular contractions closer than 10 minutes apart prior to 37 weeks, as this might indicate pre-term labour and not Braxton Hicks contractions.

Feeling unsettled
Many women experience unusual mood swings in the days before labour. Whether this is due to nervousness and excitement about the impending baby or if it is caused by a secretion of the hormones that trigger labour, is hard to determine.

The start of labour is often signalled by your bowels emptying, as this stimulates the uterus to contract. If you have the urge to go to the toilet more often than usual or have an upset stomach, labour may not be far off. If this is the case, it is advisable to drink plenty of fluids and avoid eating foods which may stimulate labour further such as excessively spicy foods or high fibre meals.

A show
You may notice a mucous discharge tinged pink or brown with blood (called a show) which is a sign that your cervix is dilating. This “show” is the plug that has sealed your cervix during your pregnancy. This show may happen up to a couple of weeks before the actually labour begins or just before. If your discharge becomes bright red you should contact your doctor as this could indicate premature separation of the placenta (placenta previa), which requires urgent attention.

Rupture of membranes
Once you are experiencing any of the above mentioned signs that you are going into labour, your membranes may rupture at any time. When this happens you will experience a gush of water (amniotic fluid) running from your vagina and down your thighs. Once this has occurred, arrange to be taken to the hospital or clinic where the baby is to be delivered.

This is important irrespective of whether you are close to your date of confinement or not and also irrespective of whether your contractions have started or not. Once your membranes have ruptured your doctor or midwife will have to decide whether it is safe to wait for the onset of labour or if labour needs to be induced. Fortunately it is mostly safe to wait for labour to start spontaneously.
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