Understanding the Stages of Labour and Birth: A Comprehensive Guide

Highlights

• Labour start times vary for each pregnancy.
• Early signs of labour usually appear between 37 and 42 weeks of pregnancy.
• Common early signs include cramps, a ‘show’ (bloodstained discharge), and waters breaking.
• Braxton Hicks contractions are not the same as true labour contractions.
• Labour progresses when contractions become regular, longer, and stronger.

In This Article

• Early Signs of Labour
• Understanding ‘A Show’
• Timing Early Signs of Labour
• Recognizing True Labour
• Warning Signs That Require Immediate Attention
• Tools and Assistance

Early Signs of Labour

The early signs of labour are physical and hormonal changes in the body as it prepares for birth. These may include:

• Cramps similar to period pain
• Lower backache
• Diarrhoea
• Changes in vaginal discharge
• Bloodstained discharge (‘a show’)
• Waters breaking

It is not possible to predict the exact start of labour, as every pregnancy is different. Recognizing these early signs as distinct from normal pregnancy discomforts can help determine when labour is approaching.

Other signs that labour may be near:

• The baby drops deeper into the pelvis, increasing pressure on the bladder and leading to more frequent urination.
• A sudden burst of energy and an urge to prepare for the baby, commonly referred to as “nesting.”

Understanding ‘A Show’

‘A show’ refers to bloodstained or pink-coloured discharge that may appear on underwear as labour approaches. It is a thick mucus plug that seals the cervix, protecting the baby from infection throughout pregnancy.

A ‘show’ indicates that the cervix is beginning to open. This can happen days or even weeks before contractions start. The mucus plug may appear jelly-like, watery, or sticky and can come away in one piece or several smaller pieces over a few days. Some people do not notice a ‘show’ at all.

Timing Early Signs of Labour

Early signs of labour typically begin between 37 and 42 weeks of pregnancy. If this is the first pregnancy, the baby’s head may engage (‘drop’) into the pelvis around 36 weeks.

Labour can begin differently for different people. The first stage of labour, when the cervix starts to soften and dilate, can last for several hours or even days. Initially, there may be little sensation, but as contractions become stronger and more regular, discomfort increases.

Recognizing True Labour

Labour has started when contractions become regular, longer, and stronger. These contractions help thin (efface) and open (dilate) the cervix.

Differences between true labour contractions and Braxton Hicks contractions:

• True labour contractions are regular, increase in strength, and cause the cervix to open.
• Braxton Hicks contractions are irregular and do not lead to cervical dilation. They are often referred to as “practice contractions.”

For a first labour, the first stage typically lasts between 8 to 12 hours. Staying home during early labour is often recommended, as it allows for freedom of movement and comfort.

A trip to the hospital or birthing location is recommended when contractions occur every 5 minutes or as advised by a healthcare provider. Contractions should be timed from the beginning of one to the beginning of the next.

Warning Signs That Require Immediate Attention

Urgent medical attention is needed in the following situations:

• Labour is progressing rapidly, and there is concern about reaching medical assistance in time.
• Heavy vaginal bleeding.
• Severe headache or blurred vision, which could indicate a condition such as pre-eclampsia.

Additional concerns requiring immediate contact with a healthcare provider:

A strong sensation of pressure in the vagina or bottom, or an urge to push.

Waters break, and the fluid is green or brown, which could indicate that the baby has passed meconium (first stool) and may be in distress.

Vaginal bleeding occurs at any stage.

Signs of labour appear before 37 weeks, indicating possible premature labour.

Noticeable changes or concerns regarding the baby’s movements.

Tools and Assistance

Here are some tools and resources that can assist you during the early stages of labour:

1. Contraction Timer Apps
   Use mobile apps designed to help you track the frequency, duration, and intensity of contractions. These apps can help you determine when it’s time to head to the hospital or birthing center.
2. Hospital Bag Checklist
   Preparing in advance by packing a hospital bag can ensure that you’re ready when labour begins. Include essentials like comfortable clothing, toiletries, and baby items.
3. Breathing Exercises and Relaxation Techniques
   Practicing breathing exercises can help you remain calm and manage discomfort during early labour. Techniques like deep breathing, visualization, and progressive muscle relaxation can be beneficial.
4. Warm Compress or Heating Pad
   Applying a warm compress or heating pad to the lower back or abdomen can ease the discomfort from early contractions. This is a non-medical option to relieve pain.
5. Support Person or Doula
   Having a birth partner or doula present during labour can provide emotional and physical support. A doula can help guide you through labour, assist with relaxation techniques, and provide reassurance.
6. Healthcare Provider Contact
   Keep the contact information for your midwife or doctor handy, so you can reach them quickly if you have concerns about the progression of your labour or if any unusual symptoms arise.
7. Emergency Plan
   Have a plan in place for getting to the hospital or birth center. Know the quickest route and the best method of transportation, especially if you live far from your birth location.

These tools can provide additional support and help you feel more confident and prepared as you approach labour. Don’t hesitate to ask your healthcare provider for more specific advice or resources suited to your personal needs.