Newborn and Infant Care

Labor and delivery

12/21/1997 07:12PM

Question:

What can I expect during labor and delivery? How will I know that I am in labor?

Answer:

When labor begins many changes are occurring within your body. These changes allow for the baby to be born. Prior to labor beginning many women experience the baby dropping. This is when the baby moves into the pelvis in preparation for birth. You might notice that you can breathe easier because the baby no longer presses on the diaphragm. However, you might notice that you urinate more frequently, have more edema in your legs, and experience pelvic pressure. These are common changes that occur once the baby is in the pelvis. Another way your body prepares for labor is through Braxton Hicks contractions, which are irregular contractions. If you have taken childbirth classes and learned breathing and relaxation techniques during a Braxton Hicks contraction is a good time to practice. The cervix will also become softer in order to stretch and dilate in preparation for birth. Bloody show, (a pink tinged discharge) is a sign of impending labor. This occurs when the cervix softens and thins and small surface capillaries bleed. The rupture of membranes (breaking of your bag of water) occurs sometimes prior to beginning contractions. When your membranes rupture you need to notify your health care provider and follow their instructions.
True labor will result in progressive changes in the cervix dilatation and effacement (thinning). The contractions of labor are usually regular, and increase in frequency, length and strength. The pain of labor will start in the back and move around to the abdomen, and is often worst when walking. False labor does not produce changes in the cervix. The contractions are irregular and do not change in frequency, length, or strength. They are often described as a hardening of the abdomen without much discomfort. When discomfort is present it is usually in the lower abdomen and often goes away with walking. Often times it is difficult to know the difference between true and false labor without a cervical evaluation. It is important to discuss with your health care provider when they want you to call them regarding labor, and when you should go to the hospital. This varies depending on your personal history, distance from hospital and preference of your health care provider.
During actual labor you can expect mild discomfort to begin with. The contractions will get closer together, last longer and become more uncomfortable as labor progresses. Labor is a slow process. Early labor will usually last much longer than hard labor. The length of labor varies with each person and each pregnancy. It helps to be prepared for labor, knowing that labor is not pain free, but is something that many women are able to cope with, and use little if any medication for relief of pain. Prior to entering the hospital you need to discuss with your health care provider your options for pain control which will vary widely depending on where you are delivering.
In order to help you understand all the changes that are going on you might want to talk with your health care provider about taking a prenatal education class.

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Response by:

Tina Weitkamp, RNC, MSN
Associate Professor of Clinical Nursing
College of Nursing
University of Cincinnati