contractions

    Signs of Labour

    Is this labour?

    Let’s look at some of the signs your labour may be starting (4,5):

    • Diarrhoea or loose bowel motions (for some women this may occur, and a good way of looking at it is it’s the body’s natural way of cleaning out in preparation for birth).
    • Backache – this can be constant or on and off.
    • A show – this is usually a bloody/mucous lump of discharge that you will discover in your underwear or wiping on the toilet. This is normal, however, if you think there is a lot of blood, the blood is bright red, or you are concerned at all, it’s important to call your midwife, doctor or hospital for advice.
    • A sudden need to vomit, or feeling nauseated.
    • Your waters break – this may or may not happen with contractions. Either way put on a pad and talk to your primary pregnancy care provider as soon as this happens. They will ask you about how much fluid is there and what colour the water is.
    • Period like cramps that come and go.
    • Contractions – the way to know the real contractions from Braxton hicks is their regularity, intensity and “pain.”

    What do I do now?

    If this occurs and you are feeling uneasy, uncomfortable or have any concerns, you should contact your midwife/doctor/hospital and ask their advice. Early labour can last for many hours (sometimes days) and the safest place to be (in a normal, low-risk pregnancy) is at home. Please note that if you have any risk factors at ALL, it is important that you seek the advice of your health professional once labour commences.

    What starts labour?

    The answer is we aren’t sure. Several factors contribute to our labour starting, but science really can’t pin down any one responsible factor.

    We do know a few things:

    • The ability of the uterus to detect and use progesterone – the hormone that maintains pregnancy – decreases6;
    • Estrogen and oxytocin work together to start the production of prostaglandins – the hormone that is responsible for softening the cervix6;
    • Inflammatory processes start in the walls of the uterus7;
    • The cellular make-up of the cervix changes, helping to soften it8;
    • The baby’s lungs release a chemical that contributes to the process8;
    • The pressure on the uterus from your growing baby contributes9;
    • The uterine muscle changes how it detects hormones9, and
    • The balance of substances in the fluid around our cells changes6.

    What triggers these events to happen in well women is something we don’t know. Sometimes other factors can contribute to this process starting – such as infection or other pregnancy complications. Regardless of the reason, the factors that contribute to labour starting are the same for most women.

    Thinking about labour.

    Birthing is essentially an intuitive and primal physiological process which is controlled by several factors. The factors above influence the start of spontaneous labour (when you start labour on your own). These are followed by the actions of a few ‘labour hormones’. These hormones act together to create contractions – rhythmic waves of smooth muscle tightening, which act to open your cervix and push your baby down and out.

    These hormones usually work best when:

    • we let them work how they are supposed to and don’t interfere with the process too much,
    • are in an environment where we feel safe, relaxed and supported,
    • are not afraid of the birthing process, and
    • don’t overthink what we are doing.

    The ‘primal (or instinctive) brain’ is responsible for natural birthing in all mammals, and sometimes human beings are too smart. So smart, that the thinking part of our brain can override the instinctive part, and we can sabotage our births by overthinking them10. Sometimes we can’t help but do this, especially when we are in an unfamiliar environment. Our need for privacy and a measure of control in our birthing space is a vitally important, but sometimes challenging need to meet in a medicalised birthing society.

    What is safe?

    For a woman with no medical, pregnancy or birthing complications, the best way to support this need is by ensuring she is labouring in an environment where she feels safe and comfortable. For most women in the early stages of labour, this is at home. Therefore, many women who go to the hospital in early labour are often encouraged to go home by midwives.

    We know that you will likely labour faster and without interference in your environment. But for some women, where they feel safest is in the hospital. The factors that determine where a woman feels safe is unique to each woman and need to be discussed during your pregnancy and in consultation with your primary care provider.

    For more information about the signs of labour, click the links below.

    Nikki-Lee Rossiter (BMid), Registered Midwife
    Photo by Tyler Olsen used under license from Shutterstock.com

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