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Early Signs of Labour - What to look for

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pregnancyHas labour started?

This is an obsessive question for any woman in the late stages of pregnancy. If you're close to the due date, or even worse, overdue, every little twitch and cramp gives you hope that the time has come. So what are the early signs of labour?

Could these be early signs of labour?

Labour is the process of preparing the body for baby delivery. It means the dilation or effacement of the cervix, which will become thinner and open up to 10 cm. It also means increasingly regular contractions that get closer together and increase in intensity.


As your labour develops you will feel stronger and stronger cramps which might mean you need to go to the toilet more often. You might also notice a bloody, mucous discharge on your underwear. This is called "the plug" (and the process of losing it is sometimes called "the show"). It's the mucous covering the cervix that keeps it sealed during pregnancy. This is not one of the certain signs of labour, as in rare cases, it could be lost weeks before birth. Your waters might break - in a flush or in a small stream running down your thighs. This doesn't necessarily happen prior to being admitted to hospital or by a midwife if giving birth at home and sometimes the doctors have to break the waters to speed up the birth process.

False signs of labour

If you're not sure if it is the real thing, it probably isn't. This is the reason why first time mums might feel patronised and treated with disrespect by the medical stuff when they arrive at the hospital and get sent back home. If you think it's the real thing, call your midwife or your GP straight away. They will check with you over the phone the frequency and duration of contractions and advise you what to do. If they recommend waiting at home for a little longer, it's worth taking their advice. Pregnancy labour, especially for first time mums, can be a long and hard process.

Taking a bath and getting a relaxing massage before it gets really serious will help a lot. You should also consider eating something light and drinking plenty of water. If you can, try and get some sleep, or at least try and rest in bed as much as you can.

How to deal with labour pain

Labour pain is one of the sure signs of labour and is caused by contractions of the uterus muscle trying to press the baby outwards and by the cervical muscle stretching.

Every one of us feels the pain in a different way. Some of us are more sensitive, some of us have a higher pain resistance. However, very few women go through labour with no pain at all, so it's very likely that you will not be one of the very, very lucky ones. If this is the case, how do you cope and what pain relief should you be looking for?

Pain relief techniques while in labour

You can try the natural solutions

  • Taking a bath
  • Getting a gentle massage of your lower back
  • Practising the relaxing posture
  • Breathing exercises. (You'll be grateful for those antenatal classes now!)

Or, you can try one of these:

  • TENS machine - a smart little gadget (Transcutaneous Electrical Nerve Stimulation) that can alleviate back pain. It sends a low electrical voltage to the the nerves in your back which stops the transmission of the pain stimuli to the brain and stimulates the natural pain relieving substances produced by your body. In other words, your brain ignores the painful area.

    Designed to help people with back pain, it has proved to help in labour as well. You can buy one (buying a second hand one from eBay could prove to be a good option) or you can rent one from Boots or other companies. It can only be used in the early stages of labour and make sure you follow the instructions carefully before using it. For obvious reasons, it cannot be used in the bath and the sticky pads cannot be placed on your tummy.
  • Entonox - You can use Entonox gas, a combination of oxygen and nitrous oxide (laughing gas). It's very likely that you will be offered gas at the hospital, or your midwife will bring one if you opt for a home birth. It has a quick effect, but needs to be used repeatedly in order to work throughout the labour.

    Some women swear by gas, others say it didn't do anything for them. "It just spaced me out a lot, I just felt distant from the pain, but the pain was still there," says Jemma regarding her first birth experience.
  • Epidural - The epidural is the procedure of administrating a dose of analgesic through a fine tube in your spine in order to cut the connections between the brain and the nerves irrigating the womb and the vaginal muscles. It works literally instantaneously and you will feel immediate relief in the first few seconds. The lower part of your body will be completely numb and you will feel no pain during birth. If the medical team decides upon a caesarean section, the anaesthetist will probably decide to continue topping up the epidural instead of a general anaesthesia.

    Epidurals may cause low blood pressure and a slight back pain could last for a few days after birth.

Talk to your midwife about your choices and mention them in your birth plan. You can download the BabyWonderland birth plan, complete it and take it with you to hospital or hand it to your midwife, if you're having a home birth. Your midwife will be able to offer detailed advice on any of these techniques.

What happens at the hospital during labour

If you opt for a hospital birth, get there when you're certain the real labour has started. A midwife will check your dilation and, based on her results, she will either send you back home, tell you to wait in a pre-birth waiting ward or send you to the delivery suite.

If you opt for an epidural, you will need to be at least 4 cm dilated as it's been proven to slow dilation. An epidural will be administered by an anaesthetist in the delivery suite.

After a number of hours, if your dilation doesn't increase in a sustainable way, the medical staff might start monitoring your baby's heartbeat and perform an ultrasound scan to check the baby's position. If the baby is still high and not pressing enough on your cervix to force dilation, the medical team might decide to perform a caesarean section.

If this is the case, don't be scared! A caesarean section is a common procedure and a lot safer than a prolonged labour that could distress the baby and bring more complications during and after birth.

Read our dedicated article on hospital birth to find out more about what you should expect.