Pregnant woman in labour leaning against bed

How do you know you are in labour? What are the first signs to watch out for? And how do you know if it’s Braxton Hicks or true labour? Our expert doula explains some the signs to look out for so you know when you’re really in labour.

Signs your body is preparing to go into labour:

  • Near the end of your pregnancy (two to three weeks before birth in first-time pregnancies), your baby will move down or ‘drop’ – this is also called lightening. When this happens, you’ll be able to breathe better and will feel less burning in your chest after you eat. If this isn’t your first baby, this may not happen until closer to the time you’ll give birth.
  • Increased urge to urinate because there’s more pressure on your bladder.
  • Weight loss of 0.5-1.0kg. This is usually “water” being lost.
  • Increased backache and pelvic pressure due to baby descending in preparation for birth.
  • As your body prepares for birth, you might notice increased vaginal secretions and/or diarrhoea.
  • A sudden burst of energy – this usually last for 24 to 48 hours and most women spend this time ‘nesting’ or making sure that everything is in order for the baby’s arrival.
  • Ripening of the cervix. This is the cervix softening and thinning in preparation for birth.

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How do you know if you are in labour?

  • Loss of mucus plug/bloody show

While you are pregnant, you have a thick mucus plug in your cervix. As the baby’s birth gets closer, your cervix begins to thin and open (also called ‘ripening’), and the plug may come out. You may notice a pink, red, or brown discharge – this is called bloody show. It is a sign of your cervix changing shape and your body preparing for the birth of your child.

  • Your water breaks

Your baby is inside a bag of water (amniotic sac) in your uterus. When the baby is ready to be born it’s normal for the bag of water to break. This may happen before labour starts, in the early stages of labour or when the baby is almost ready to be born. When it happens, you may have a little or a lot of water leaking from your vagina. Sometimes women do not know whether this is water from their uterus or urine. If you’re not sure, call your healthcare provider. When your water breaks, remember to record the time it happened, the amount of fluid, colour and the smell of the fluid.

  • Contractions

When the uterus contracts (get tight), rests and then gets tight again, it is called a ‘contraction.’ During the course of labour, and up until your baby is born, your body will experience many contractions. Pain associated with childbirth mainly comes from these contractions. All the contractions and pushing move your baby down the birth canal, to be born into this world.

Woman in labour in hospital with partner

What do Braxton Hicks contractions feel like?

Late in your pregnancy, you may have contractions (where the uterus tightens, rests, and tightens again) that are very strong. They may come and go for hours or days and then stop. These contractions are helping your womb (uterus) get ready for birth and are called pre-labour, practice contractions or Braxton Hicks.

What do real labour contractions feel like?

  • Lower back pain radiating around to the front and back again.
  • Menstrual cramps or gas pains.
  • Wavelike in the beginning.
  • Becomes more intense as the labour progresses (strong, longer, more painful).
  • Usually, you will not be able to talk, laugh or sleep through a contraction.
  • Later on, you may also have nausea, vomiting, chills, painful backache, tremors and a sense of desperation.

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How do you time your labour contractions?

By learning how to time your contractions, you will know when you are really in labour. Time your contractions when the contractions come closer together and/or the contractions get stronger, or when your water breaks.

It is advisable to time for at least three contractions in a row to see what the pattern is. Write down:

  • When each contraction begins and ends.
  • How far apart the contractions are.
  • How long each contraction lasts.
  • How strong the contractions feel.

Woman in labour with partner and nurse

What should I do if I think I’m in labour?

If you think you are in the early stages of labour, it is best to stay at home. Take a shower, have a light meal, walk around or REST – these are all great ways to cope with early labour. You do not need to go to the hospital or midwifery unit straight away. You should only go to your place of birth if:

  • you are bleeding from your vagina.
  • your contractions are five to six minutes apart and are also increasing in intensity. (Your healthcare provider may ask you to go to the hospital earlier).
  • your water breaks.

It is always a good idea to communicate with your care provider about your specific situation.

How do you know if you have Braxton Hicks or are in false labour?

“False labour” or prodromal labour, is a common experience as you approach your due date. There’s also a difference between Braxton Hicks contractions and prodromal labour, as prodromal labour is more than the quick, tightening feeling of a Braxton Hicks contraction. It is somewhere in between Braxton Hicks and labour contractions. As you may experience multiple “contractions”, you may think you’re in real labour and thus prodromal labour is very confusing and can be frustrating as it feels almost like the real thing! But it isn’t – the contractions may dilate or soften your cervix a bit, but they don’t lead to imminent birth.

False labour is usually erratic in time and intensity and no clear pattern can be established. For a varied amount of time they may come every 3 minutes, then 10, then 5 and then 15 again. Most of the times it’s felt in front of the uterus and you may even be able to sleep through them, albeit uncomfortably so! If the contractions stop when you use the bathroom, bath or shower, drink water, change positions, or lie down, then they’re probably not the real thing.

The most important difference is that real labour mostly occurs at regular intervals and closer together as time goes on. Generally, contractions during labour last about 30 to 60 seconds, getting longer as labour progresses. They also increase in intensity, don’t change with movement or position, and are often felt in both the front of the body and the back.

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Signs and symptoms of false labour versus true labour

Use our handy table if you are not sure whether you are really labour or not:

FALSE LABOUR TRUE LABOUR
Contractions do not come more frequently Contractions come more frequently
Contractions are not changed by walking (may stop) Walking, warm bath, breathing and birthing ball relieves contractions
Contractions are strongest in the front Contractions usually begin in the back and move to the front
Contractions do not get stronger Contractions gradually get stronger and closer together
Contractions have no regular pattern/are erratic. Contractions usually have a regular pattern
Usually have no show Usually have a show

 

nicci-coertze-bereavment-doula-babyyumyum-expert
The fact that I am a professional doula helps immensely in my career as a birth photographer. Hospitals are more open to allowing me into their wards and theatre personnel and doctors know that I am properly trained to adhere to all procedures in the theatre, which a lay photographer may not be aware of. Also, as someone who has witnessed many, many births, I know how to stay out of the medical personnel's way, without compromising on your precious photos.