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June 25, 2019

How Will I Know When I Am In Labor?

It’s so hard to believe people when they tell you “trust me you will know when you are in labor.”

It feels like it should be so cut and dry, but is it? This question always reminds me of the “Am I pregnant?” question because, just as the many signs of your next period are the same as signs of being pregnant….so many of the signs of being in labor are similar to just end of pregnancy every day life.

So, you are feeling crampy, you have a bit of spotting or some discharge that resembles what people have described as a mucous plug, but how do you know?

Let’s start at the beginning:

Often around 10-14 days before you go into labor you get your first signs of early labor…why is this? Well, to keep it simple your body is preparing and hormones are starting to release into your system.

With first time mom’s this may be baby dropping. Which is just what it sounds like, baby has engaged itself down into the top of your pelvis, so your belly may go from feeling like it’s in your throat to now feeling like low pressure into your pelvis.

For many, this moment of baby dropping is fairly obvious but can be confused with early labor. As a doula, I will get my first “Am I In Labor?” phone calls or texts from clients when this happens. It may feel like a few contractions started, “lightening crotch” or a quick electric zing down the inside of your thighs or right through your vagina are often signs of this happening. For most people, baby settles in and all of these symptoms will dissipate.

For second time/third/etc mom’s, the defined moment of dropping doesn’t always happen, but instead an annoying pattern of what we call prodromal labor.

So, what is prodromal labor? While we do see it more with second time mom’s it is good to know that it can happen for anyone. It is essentially a pre-labor warm up, but it feels more intense or some say more painful, then Braxton Hicks contractions. This can result in a premature trip to the hospital, phone call to your doctor or just worry when it continues to happen, go away, happen again. Prodromal labor is another reason doulas are helpful. This is a time when having a person to navigate labor with you, instead of having to call or go into the office or hospital for assessment can result in better outcomes.

How do you know if it’s prodromal labor and not the real deal?

The typical way prodromal labor shows up is, after a long day (often after chasing your other kids around all day), you start relaxing…you take a hot bath or lay in bed, and suddenly upon the relaxation of the rest of your body, your uterus decides it’s time for a work out.

This can often be 3-4 hours of active uterine exercise that results in no cervical change. Sometimes it seems to progress towards a normal labor pattern, but after 3-4 hours it goes away completely.

I have seen this happen every night for up to 2 weeks with my 3rd-4th time mom’s. A good way to understand this is to picture your uterus almost in a muscle spasm after a long day, thinking maybe it’s time to push a baby out, but then realizing your baby just isn’t quite ready yet, it eventually calms down.

My response to these very frustrated mom’s is, take a hot bath or shower, TONS of water/hydration, and getting to bed early to try to beat it to sleep. Sometimes we also discuss CBD Bath bombs and a small glass of wine if it feels like a good fit.

I Lost My Mucous Plug and I am Feeling Crampy…am I in Labor?

So, this is an amazing early sign/symptom of your cervix opening! However, you are not in labor yet. This is another way your body slowly begins to prepare…

What does your mucous plug look like? It can be a big mucous blob with a bit of blood in it. Although some don’t have any blood at all and some look like a blood clot.

It keeps coming out…I have seen a lot of blobs throughout the day. Totally normal! It can actually come out throughout the course of weeks and can actually partially regenerate if it came out too early.

While, this is the first thing to happen to show us that the cervix is starting to change and often leads to a GREAT head start for when labor begins…we are still in those early phases.

I am feeling a ton of fluid leaking. We do a few quick tests to see if your water has broken. One is, put a fresh pad in your underwear and lay down for 20-30 minutes. Then stand up. If you get a big gush/the pad is soaked thats a good indication that it has a leak or has broken.

The other test is to do a few hard coughs and see if a big gush comes out.

Does this mean I am in labor?

While your water breaking does put you on a bit of a 24 hour time clock to when the Dr or midwife will now want to see you progressing with your labor, it does not, unfortunately, indicate that labor has started. Make sure you have a clear understanding of your doctor/midwife’s policies for what to do when your water breaks.

If you are pretty sure your water has broken, call your doula first then your midwife or doctor. We always say call your doula first just so your birth team is all on the same page…this keeps your doula in the loop but also, your doula is there to help you ask the right questions at all times. Your doula should ask you a series of questions about your birth plan and then give you a list of questions and requests for your midwife/dr when you call to notify them of these new changes. Remember, your doula is fully focused on you and only you…your doctor or midwife may have many patients they are managing at once. Our goal is to keep you on track with your original goals, so it’s important you loop us in with every step along the way.

I have diarrhea, I’m nauseous/pukey and my back aches….

This is a classic sign of hormones flooding your system. It happens as things are starting to thin and progress. It could very well be early labor but with the absence of intense contractions, we are still unsure with these things being the only symptoms. As with many of these other symptoms, we are always waiting for the combination of things and not just one single thing.

What is the list of early and possible labor symptoms:

  • nausea
  • back ache
  • diarrea
  • cramping
  • lightening crotch
  • contractions
  • agitation
  • mucous plug
  • spotting and bloody discharge

I am having contractions, but they are not consistent.

This is the hard part…when you are having contractions, they feel intense, but you just are not sure if this is the real deal.

So, while we acknowledge they may feel intense, we always have to follow a combination of guidelines to assess our next steps. First things first, if you are just not sure if they are strong enough….THEY ARE NOT STRONG ENOUGH. We are looking for a combination of Longer, Stronger and Closer together. If your contractions are the typical 5 minutes apart and 1 minute long, but you are talking through them, walking, just feeling it’s a tightening but not intense pain…there is a really good chance these are not changing your cervix. We want the gap to start to close where they are getting closer together while simultaneously getting longer. Some people will start having 20-30 second contractions, even though they may be 3-4 minutes a part, chances are that short contraction is not doing much.

Here is what we are working towards when assessing the contraction monitor when this client sent this over, we were racing out the door…

Where as seeing something like this may indicate we still have a while to go or as a doula, I would probably start heading to their home instead of pushing them go to to the hospital. (notice the random length of contractions, inconsistency and very short contractions)

As with anything, there are exceptions to any rule. If we are seeing short contractions (30-45 seconds long), 3 minutes apart, but you are suddenly showing noticeable hormonal changes. Throwing up, shaking, suddenly fight or flight/panic is setting in to mom, or she’s getting rectal and pelvic pressure at the peak of every contractions, we start making decisions to head to the hospital or call the midwife/dr.

As with all new things in life, the best thing you can do is know signs and what to look for as things start to change. However, its also important to stay in contact with your doula or birth team if things seem to be changing and you are feeling worried or unsure. It’s important to set worried feelings at bay and not allow them to hold your labor back, by surrounding yourself with those that are experienced and can reassure you that everything you are feeling is normal.

Still not sure? I’m always happy to chat – chelsea@ommamas.com