Signs of Labour and When to Page

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How do I know if I am in labour?​

Labour is one of the most anticipated moments of any pregnancy. It is the event we have all been waiting for, meeting your baby! However, before your baby is in your arms, you will go through labour. Labour is a time filled with many unknowns for new parents: What will it feel like? Can I cope? Am I ready? How do I support my partner through labour? These are all great questions your midwives can help you prepare for and guide you through the exciting event of labour and birth.

When will labour happen?
The majority of clients deliver their babies between 37 and 41 weeks of pregnancy. It is not possible for your midwife to predict exactly when you will go into labour.

Loss of mucus plug
The mucus plug is a very thick mucus which can be streaked with brown or red blood. You may notice it on wiping or mixed with your regular discharge. While the loss of your mucus plug does indicate your body getting ready for labour, it can still take up to a week or more before labour actually begins. You do not need to page your midwife to tell her you have lost your mucus plug.

Braxton Hix
Braxton hix contractions are irregular, infrequent and while they may be painful they are not as strong as labour contractions. Braxton hix contractions can happen for weeks before labour begins and your baby is born.

When will my waters break?
Unfortunately, your midwife can not predict when your waters will break. Some clients’ waters break before they have any contractions. Most of the time these clients will go into labour within 24 hours, but sometimes these clients need an induction to help bring on labour. For other clients, the waters break while already in labour. For a third set of clients, their waters do not break on their own and the midwife has to break the waters during labour. If you think your waters have broken at any time, page your midwife and put on a pad. As a reminder, the waters do not have to break for a client to be in labour.

Labour contractions

  • Early Labour (1st stage): Early labour can go quickly or last for many hours. Early labour is best completed in the comfort of your home. During early labour, contractions become more regular and increase in strength and duration. For example, contractions might be 10 minutes apart, lasting for 30 seconds. At this stage, it is important to eat and drink regularly, rest/relax, and DO NOT time contractions. You can take 1g (two extra strength) Tylenol and 50-100mg Gravol (Pink Box) every 4-6 hours as needed. You do not need to page your midwife at this stage unless you have concerns.
  • Active labour (1st stage): Active labour generally occurs when your contractions are strong, regular and close together. The cervix is generally 4cm or more dilated to achieve active labour. In active labour, contractions will come every 3 to 4 minutes, each contraction lasting for 60sec or greater and this pattern has continued for 1 hour. This is called the 4-1-1 pattern. Please page your midwife when you have reached the 4-1-1 active labour pattern. At this time your midwife will usually suggest a labour check to see how dilated your cervix is. Your midwife will also decide at this time if you are ready to move to your chosen birth location (hospital/birth suite).
  • Pushing (2nd Stage): When your cervix has reached 10cm it is fully dilated and you can begin pushing. Most clients who do not have an epidural will have an uncontrollable urge to push once fully dilated. For clients with epidurals we may wait until you are feeling more pressure before beginning pushing, your midwife will let you know. When it is a client’s 1st baby, you can expect pushing to last up to 2 hours. For clients who have already given birth, pushing is generally considerably faster. While pushing is a lot of effort, at the end you get the best reward, the birth of your baby!
  • Birth of Placenta (3rd Stage): After your baby is born the soft placenta also needs to exit from the uterus through the vagina. Please see Third Stage Management for more information.

Other reasons to page your midwife:

  • Bright red bleeding more than spotting
  • A temperature of 38ºC or greater
  • A headache that will not go away (see Gestational Hypertension)
  • Reduced fetal movements (see Fetal Movements)
  • Any other concerns