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MoonDragon's Pregnancy Information
TRUE VS FALSE LABOR




Labor is the process through which your baby is born. Your body produces contractions which tighten and relax the muscles of the uterus. These contractions eventually form a pattern; becoming closer together, stronger, and lasting longer. The contractions work to efface (thin out) and dilate (open up) the cervix, which is the bottom part of the uterus. Once the cervix is open (100 percent effaced and completely dilated to at least 10 cm) the baby can be pushed out of the uterus through the cervix and into the birth canal (vagina) to be delivered.

Labor and delivery are different for every woman and different for each pregnancy in the same woman. For first babies, the average labor lasts 12-16 hours; starting from the beginning of regular contractions until the baby is delivered. Because every birth experience is unique it could be as little as 6 hours or up to 24 hours or more. For subsequent babies, labor averages between 6-8 hours. However, some women may labor only a few hours up to a few days and still have it be considered normal.

SIGNS OF PRE-LABOR

You may experience certain changes that indicate the onset of labor is near. These may be:
  • Increased frequency of Braxton-Hicks Contractions. The uterus is getting itself ready for labor by "exercising" the uterine muscles.

  • Lightening - Relaxation of uterine ligaments allowing baby to settle deeper (drop) into pelvis. This usually occurs two to four weeks prior to labor with first pregnancy. It occurs just prior to or during labor in subsequent birth. There is less pressure on the stomach and lungs with more pressure on the bladder and more frequent toilet trips. If this occurs you should wait and watch for more signs of labor.

  • Discharge of mucous plug and increased vaginal secretions. The mucus plugging the opening of the cervix is released, as the cervix begins to thin and open. It may appear as slightly blood tinged mucus and may appear from hours up to a few weeks before labor starts. When this occurs, stay well rested and make sure everything is ready for when labor begins.

  • Diarrhea or loose bowels (nature's way of cleaning the bowel before labor to make room for the baby to be born). This can occur from hours to days before labor. Along with diarrhea-type symptoms, a woman may feel nausea or mild cramping. The best thing you can do is to rest, drink plenty of fluids, and prepare for labor. A 1 to 2 pound weight loss may occur during this time.

  • Nesting - You begin preparing for the arrival of your new baby. i.e. with a sudden burst of energy. It is a sudden urge or impulse to hurry up and clean the house and arrange "the nest". This can occur a day or two before labor begins. Be careful not to become overtired.

contraction wave


SIGNS OF LABOR

No one really knows exactly how labor begins. We do know that a woman's body produces chemicals called prostaglandins. Toward the end of the third trimester of pregnancy, these rostaglandins can cause the cervix to soften and shorten. We also know that a woman's body produces oxytocin, a hormone released from the pituitary gland. Oxytocin causes the uterus to tighten in a rhythmic pattern; making contractions closer together, stronger and of longer duration.

Signs that labor is coming vary from woman to woman. For some women, labor begins unexpectedly; others feel that labor may never begin. Some women experience labor in phases over a period of several days. However, experiencing false labor, often called Braxton-Hicks contractions, does not mean that you are not making progress. These contractions may cause the cervix to tilt forward, to soften, and to thin. The cervix needs to soften and thin before it will open. Any of the following signs may occur indicating impending labor.
  • Bloody show may be seen at beginning of labor (a pinkish vaginal secretion of blood and mucus).

  • Ruptured membranes, also known as the water breaking, is a dampness, sudden gush or slow leaking or trickle of fluid from vagina. This is a spontaneous rupture of the amniotic sac surround the baby, causing the fluid to leak out. This may occur anytime from the onset of labor to the birth of the baby. Call your midwife or health care provider to report the color, odor, amount and time of the rupture. Do not use tampons with ruptured membranes. Use sanitary napkins or incontinence pads, if needed. Do not use a tub bath without consulting with your midwife first. Do not have sexual intercourse or put anything into the vagina when the bag breaks to prevent infection.

  • Contractions. These are tightening of the uterine muscles and may vary from weak to strong pressure or pain. These may occur anytime pre-term or at term. When you experience contractions, you will need to decide whether or not they are true or false labor contraction.

uterine contractions


True labor contractions produce measurable progress-the cervix effaces and begins to dilate. Some women experience false labor contractions prior to true, active labor starting. The following lists explain the difference between true and false labor.

TRUE LABOR CONTRACTIONS
  • Contractions become regular as labor progresses.
  • Get stronger over time.
  • Walking or change of activity makes them stronger.
  • Resting does not make them go away.
  • Felt in back and radiate to the front.
  • Cervix effaces and dilates.
  • Last longer as labor progresses (duration).
  • Shorter rest periods between (frequency).
  • Come every 20 to 30 minutes or start closer together.

Contractions do not feel the same for everyone. Some women describe contractions as a constant pressure sensation in the lower back. Other women describe it as a very intense cramping in their abdomen. Most women, however, describe contractions as a tightening feeling which starts in the back and comes around to the front of their abdomen making it feel very hard.

In labor, the muscles of the uterus start contracting from the top of the uterus, known as the fundus. The contractions move from the top of the uterus to the bottom in a wave-like action. These rhythmic labor contractions make the abdomen feel very firm to the touch.

start of labor - movement of uterine contractions


Each contraction is like a wave. As it builds, the tightening becomes stronger and stronger until it reaches the peak where it feels the strongest. As the contraction comes down from the peak, the tightening becomes progressively milder and then disappears until the next contraction occurs.

contraction wave


FALSE LABOR CONTRACTIONS
  • Are usually irregular and short (varying in length and intensity).
  • Do not get close together.
  • Walking or change in activity or position does not affect the contraction or they decrease in intensity.
  • Resting may help stop them.
  • Usually felt in the front and groin area.
  • Cervix may soften, but does not change significantly.

Note: It is always a good idea to call your midwife or health care provider when in doubt.

I will often tell a mom with contractions that if she is not sure about whether or not she is in true labor, to go take a warm shower or bath and then go to bed for a while. If they are not real contractions, they will often stop after she goes to bed. The bath helps to relax tensions before resting.

Many women experience "Braxton Hick's" contractions during late pregnancy. I often suggest that when these things do occur, they are what I call "getting ready contractions" and can be used to practice breathing and relaxation techniques before true labor begins. I also feel that they, although not real labor contractions, still do some good in helping the uterus "exercise" before labor starts and sometimes they actually help dilate and efface the cervix some before actual labor begins. I was always 4 cm dilated and 50 percent effaced whenever my labors actually started.

EFFACEMENT

Effacement is the gradual thinning, shortening, and drawing up of the cervix, This is measured in percentages from 0 to 100 percent.

DESCRIPTION
EFFACEMENT OF CERVIX

No changes to cervix.

0% Effaced

Cervix is half of the normal thickness.

50% Effaced

Cervix is completely thinned out.

100% Effaced


The cervix initially is long, thick and closed. As labor progresses, the cervix shortens and effaces until it is 100 percent effaced; becoming paper thin. The cervix dilates gradually as labor progresses. It is measured in centimeters and dilates to approximately 10 cm. The midwife or health care provider estimates dilation by feeling the opening cervix during a pelvic exam.

effacement


DILATION

Dilation is the gradual opening of the mouth of the cervix that permits the baby to move into the vagina and out of the mother's body. Dilation is measured in centimeters (cm) from 0 to 10 cm.

dilation of cervix


THINGS TO DO DURING LABOR

Many women feel more comfortable at home in the early part of labor. If you are planning on a homebirth, you will not need to worry about getting to the hospital or birth center to continue the birth of your baby. Be sure to call your midwife and let her know your labor has started so she can begin her trip to your home.

If planning a hospital or birth center birth, remain at home during early labor. You will need to call your midwife or health care provider when your labor starts to let them know you will be coming in when your labor has progressed enough. They will let you know when to start thinking about moving to your birth location (such as your contractions are 5 minutes apart).

If you think you are in labor, you can try these things:
  • Go for a walk. Walking can make contractions stronger. Be sure not to walk too much and become fatigued. You must also conserve your energy. You can use your birth partner as a support during contractions. Do not wander too far from home in case labor picks up quickly and you need to be at home or on the way to a medical facility for the birth.

  • Relax. Make sure you rest, especially if it has been a busy day. Let your partner, family or friends help you out by taking over household chores and babysitting any other children in the household. If labor is mild, sleep when you can.

  • Shower or bathe. Warm water will relax muscles. Women often find warm water will help to lessen discomfort of labor contractions while keeping the woman relaxed and working comfortably with her labor.

  • If you are being transported to a medical facility, finish packing if you do not already have a labor bag prepared. Remember to pack your comfort items and any other things you will need.

  • MoonDragon's Pregnancy Information: Labor Bag Preparation For Transport
    MoonDragon's Pregnancy Information: Birth Plan

  • Eat lightly. Eat foods that are easy to digest such as toast with jelly, soup, crackers, bagels, or fruit. This will help keep your energy up and prevent dehydration.

  • Visit the toilet often. You will need to keep your bladder and bowel as empty as possible to help keep the labor progression normally.

  • Wait and watch your body for signs that you are in labor. If contractions now feel stronger and last longer or now feel stronger and are closer together, you may be in labor. Usually, when contractions feel strong and are coming approximately every 5 minutes and last 45 to 60 seconds over a period of an hour or more, you are in labor.

  • If you think you are in labor, call your midwife or health care provider.

TIMING CONTRACTIONS

When you call your midwife or health care provider or arrive at the medical facility you will be asked how far apart your contractions are. Contractions are measured by their frequency, duration, and strength.

Frequency: How often are they coming? Time contractions from the start of one contraction to the start of the next contraction.

Duration: How long does it last? Time contraction from the start of the contraction to the end of the same contraction.

Strength: How strong is it? The midwife or health care provider feels the strength of the contraction by placing a hand on your abdomen and feeling the uterus tighten.

Timing Contraction


WATER BREAKING (RUPTURE OF AMNIOTIC MEMBRANES)

The amniotic sac breaks spontaneously for approximately 25 to 30 percent of women. This can occur with contractions or before contractions have been felt.

Some women experience a gush of amniotic fluid from the vagina while others may feel a steady trickle of fluid. Since this can happen anywhere, you may want to keep a towel in your car or at work during the last month of your pregnancy.

If you suspect your amniotic sac has broken, you should immediately call your midwife, health care provider or the medical facility for further instruction. Be prepared to tell them the amount, color, and odor of the fluid and the time that it occurred.

MoonDragon's Pregnancy Information: Premature Rupture of Membranes

LABOR & DELIVERY INFORMATION LINKS

MoonDragon's Pregnancy Information: Preparing For Birth
MoonDragon's Pregnancy Information: Normal Labor & Delivery
MoonDragon's Pregnancy Information: Initiating Labor - Getting It Going
MoonDragon's Pregnancy Information: Labor - Stage 1 (Dilation & Effacement)
MoonDragon's Pregnancy Information: Labor - Stage 2 (Pushing & Birth)
MoonDragon's Pregnancy Information: Labor - Stage 3 (Delivery of the Placenta)
MoonDragon's Pregnancy Information: Labor - Stage 4 (Immediate Postpartum)





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