Am I in labour?

How to tell if it’s a false alarm or the real thing

Your Pregnancy - - Contents -

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.


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.


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.”

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