Am I in labour?
How to tell if it’s a false alarm or the real thing
IT STARTED IN the middle of the night with lower back and period-like pains. A few hours later there was a “bloody show” and I knew we were in business. I did know not to expect a great big breaking of waters and a siren-screeching rush to hospital, Hollywood style, but I didn’t expect that it would be more than 24 hours before I was in actual labour. I had a full, tiring day of stop-start, stop-start and “is it/isn’t it happening?” It was a question no one could answer until, well, more happened. That’s the tricky part of knowing when you’re in active labour: if you’ve never done it before, it’s easy to think you are when you’re really only in the pre-labour (or latent) stage – the first of three stages in labour. “Every woman’s experience of labour is different,” says Dr Deon van Zyl, a Cape Town obstetrician/gynaecologist. But, he says, women ordinarily experience various combinations of these symptoms in pre-labour: Persistent lower back pain or abdominal pain, with a premenstrual feeling and cramps. Painful contractions or tightening that may be irregular in strength and frequency, and may stop and start. Broken waters. Your membranes may rupture with a gush or a trickle of amniotic fluid. A brownish or blood-tinged mucus discharge (bloody show). If you pass the mucus plug that blocks the cervix, labour could start soon, or in a few days. It’s a sign that things are moving along. An upset tummy or loose bowels. A period of feeling emotional, excited or moody. You may feel restless, anxious or impatient. Disrupted sleep.
COPING WITH PRE-LABOUR
It’s going to be difficult to rest, relax and reserve your energy when your whole world’s about to change, but that’s exactly what you should be doing. Sister Nicolette Barkhuizen, a midwife from Your Birth midwifery services in Johannesburg, suggests trying to ignore the contractions at first, having a long, warm bath to relax and sleeping if you’re able to. Also, remember to keep hydrated and eat if you’re hungry. “If the contractions seem further apart, less intense, or go away, it’s probably not real labour. But if contractions continue, get longer, closer together and more intense, you can start to time the contractions,” she says. You can use a normal watch or stop watch on your cellphone to count the frequency and duration of contractions, but why not make your life easy and rather use an app? Dr van Zyl recommends a few: Contraction timer (Google Play); Full Term, a labour contraction timer, Pregnancy Reference and Kick Counter (iTunes); and Lamaze, a full pregnancy-to-parenting app that tracks your appointments, pregnancy milestones, contractions and even nappy changing and breastfeeding routine (Google Play/ iTunes). If you find you’re experiencing real contractions (see “Braxton Hicks? Know the Difference” to the right), you should keep calm and notify your midwife or doctor that you’re pre-labour. “But always notify your care provider immediately if your water breaks,” stresses Sr Nicolette. If you’re using a doula, now is a good time to call her in to assist you to breathe correctly and stay relaxed, she adds. “You can also make use of a TENS machine for pain management.” What not to do is equally important. “Don’t panic, tire yourself out by walking long distances, take medication or drink any home remedies without your care provider’s consent,” she says. She also suggests not jumping the gun and phoning all your friends and family to announce you’re in labour, or going to the hospital/calling your midwife in too early.
READY, SET… GO?
The rule of thumb for when to go to hospital is: only when you’re having three contractions over a 10-minute period. However, Dr van Zyl recommends discussing this with your gynae as every pregnancy has different risk factors. “And if your membranes rupture (water breaks), please go straight in so that the doctors can make sure that your baby is safe. Sometimes the flow of water can cause the cord to shift and end up in a position where your baby is not getting enough oxygen. You can always go home again if everything’s fine.” If you’re having a home birth, the same rules apply: the midwife only needs to come when you’re in active labour unless there is some other risk factor. “I would strongly recommend having a doula,” adds Nicolette, “as the doula can also help to time contractions and to notify the midwife when the mom seems to be in established labour.”