Approach of Labor

June 26, 2017

Labor usually begins between 37 and 42 weeks after the first day of the last menstrual period. Several weeks before labor, there may be signs of its approach.

Lightening, or dropping, refers to the settling of the baby’s head into the pelvis. If and when this occurs, you may notice greater ease in breathing, less heartburn, increased pressure in the pelvic area, greater frequency of urination, and awkwardness when walking. You may also have more lower backaches and difficulty sleeping.

This may occur two to four weeks before labor in first pregnancies, but it may not occur until labor actually begins in second or later pregnancies.

Vaginal secretions increase during the last weeks of pregnancy. If changes in the cervix occur, you may note brown, pink, or blood-tinged mucous. This is also commonly noted after the examinations of the cervix done in the last few weeks of pregnancy. This is called loss of the mucous plug or bloody show.

Weight change, either a loss or leveling off of weight, is often noted shortly before labor begins.

Some women experience energy changes shortly before labor begins such as a sudden urge to clean the entire house, wash the walls, rearrange the furniture, and so forth. Resist the urge! Save your energy for labor.

The baby’s movement will decrease just prior to labor.

Braxton-Hicks contractions may increase in frequency. This is false labor, though sometimes the contractions are sufficiently strong and frequent enough to be confused with true labor.

The false labor, or pre-labor, may go on for many hours or even several days, causing extreme fatigue. It may be necessary to give a safe, mild sedative to help you rest. Following this rest, it is common for true labor to begin.

Ruptured membranes can occur when a membrane stretches, develops a weak spot, then opens up and releases amniotic fluid. The sac or membrane that contains the amniotic fluid protects the baby and serves as a barrier to infection from the vagina.

The rupture may occur as a sudden gush of watery fluid or as an uncontrollable continuing trickle. Rupture of membranes usually occurs during labor, but in 10% of cases it happens before labor has begun.

Two complications occasionally result. If the head is not engaged in the pelvis, the cord may fall into the vagina and then be compressed between the baby’s head and the pelvic walls, which could deprive the baby of oxygen. The other possibility is that with the passage of time, infection of the uterus and its contents may develop.

If you suspect that your membranes have ruptured, you should be evaluated by your physician or nurse midwife. If you are at term, labor usually begins within 12–24 hours. If labor does not begin on its own, it may need to be induced.

If the membranes rupture before 37 weeks, it may be better for the baby to have more time before labor begins. When the membranes rupture, do not place anything into the vagina. Do not use tampons, douche, or have sexual intercourse in order to avoid introducing infection.

As mentioned earlier, it is common to have a bloody show in late pregnancy or after examination of the cervix, but passage of blood like a period is not normal and could represent a problem with the placenta. You should notify your care provider immediately if this occurs.

In summary, you need to be seen when the following occur:

  • Regular rhythmical contractions with intervals of five minutes or less
  • Suspected rupture of membranes
  • Any bleeding more than a bloody show

If any of these occur during office hours, please call the office and come in to be examined. If any of these occur outside office hours, please go to the hospital to be examined.

Please phone the office at (970) 493-7442 before going to the hospital and the answering service will put you in contact with your physician or nurse midwife.

TRUE Labor

  • Contractions often felt more in the back
  • Contractions become progressively stronger, longer, and closer together over time
  • Intensity increases with activity changes
  • Bloody show often present
  • Progressive effacement and dilation of cervix

  • Contractions felt more in the abdomen
  • Contractions remain variable in interval, duration, and intensity
  • Intensity decreases with change in activity
  • No bloody show
  • No progressive effacement and dilation of the cervix
The false labor or pre-labor may go on for many hours or even several days, causing extreme fatigue. It may be necessary to give a safe, mild sedative to help you rest. Following this rest, it is common for true labor to begin.
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