Signs and Symptoms
of Labor at Term.
Introduction.

The onset of labor is perhaps the most anticipated aspect of pregnancy.  After months of waiting and excitement, the beginning of labor and its culmination in the delivery of a newborn is an amazing experience for the expectant patient and her partner to share. Although aspects of labor may often vary from patient to patient, there are some common key components that are helpful to review.

Lightening

As your baby grows and becomes heavier during the last few weeks of pregnancy, many expectant mothers experience a sense of increasing pelvic pressure.  This pelvic pressure is a result of the baby’s descent within the pelvis often referred to as “lightening.”  As this occurs, the patient may be able to breathe more easily while often reporting low back discomfort and the need to urinate more frequently due to reduced bladder capacity.  As the baby drops, patients may also experience increasing episodes of contractions.

Braxton-Hicks contractions

Not all contractions are created equal.   False labor or Braxton-Hicks contractions are often more mild in nature and frequently irregular in their pattern.  These contractions will seldom be strong enough to take your breath away, as real labor pains can. Braxton-Hicks contractions may often occur about the same time every day, or after exercise or intercourse, only to frequently subside after resting.  These false labor pains may become increasingly frequent as your body readies for labor, helping to slowly soften, dilate, and efface the cervix which may take several weeks for many women.


Labor: The “real deal”

In contrast to Braxton-Hicks contractions, real labor contractions often strengthen over time.  If these contractions become as frequent as every two to five minutes, with each contraction lasting close to a minute, a patient should lie down after emptying her bladder and drinking some fluids to see if the contractions subside.  If the patient is at home, taking a warm bath may help to see if the contractions will subside.  If the contractions continue after these interventions or are associated with a bloody discharge, loss of the patient’s mucous plug, a gush of water from the vagina, or a sudden decrease in fetal movement, the patient should be evaluated to see if she is in labor.  A patient’s individual medical and pregnancy concerns will influence how long her doctor would recommend that she wait at home before being medically evaluated for labor.  This should be discussed with the patient’s doctor if they have not already done so. Determining whether labor is real can be challenging for a patient so she should not feel embarrassed or disappointed if her contractions prove to be a false alarm.


As labor ensues, repetitive contractions will push the baby against the cervix resulting in the gradual thinning and dilation of the cervix until it is completely dilated.  Once this occurs, the mother may start pushing to facilitate the delivery of her baby.  A baby’s skull is made of six moveable boney plates that enable the normally round fetal head to assume an oblong shape called “moulding.”   The process of moulding allows a baby to navigate the birth canal with greater ease during the course of labor. With this in mind, a patient should not be alarmed at the appearance of her newborn’s moulded head immediately after delivery. A newborn’s head will normally assume a round shape again within 24 hours.

Labor plan

Toward the end of a patient’s pregnancy, her mind will naturally turn toward thoughts of her own labor and delivery.  This is a good time to discuss her individual labor goals and hopes as well as any concerns she may have, with her doctor. Although there are many aspects of labor that one cannot plan nor control, considering a birthing plan may be a good tool to help begin a conversation with her doctor about her labor experience aspirations. 


Unless the patient is planning a scheduled cesarean delivery, they also may wish to discuss with their doctor the different pain management options that are available at the hospital where will deliver.  Whether the patient is considering an epidural or a natural labor without pain medications, the goal of their doctor and the nurses that will assist the patient during labor is to have a memorable and safe birth experience.


Conclusion.

We are excited that you are drawing closer to the delivery of your newborn and hope this discussion about the different aspects of labor has proven helpful.  Regardless of the nature of your contractions, if you are uncertain whether your contractions represent true labor or false labor, it is always wise to be medically evaluated to ensure that both you and your baby are okay.  If you have any additional questions with regard to the process of labor, please feel free to discuss them further with your doctor.