Pre-Labour

Your labour and birth – pre-labour

According to the medical textbooks, labour has three distinct stages:

• The first stage of labour involves the full dilation – or opening – of the cervix, the muscle between the womb and the birth canal
• In the second stage of labour (delivery), the baby is pushed out of the womb, through the cervix and birth canal, and is born
• In the third stage the placenta is delivered 

But these three medical stages don’t usually reflect women’s personal experiences of labour; pre-labour and the long first stage generally take far longer than the intense experience of second stage, while third stage is often a blur, with most of your focus on your new baby rather than what is happening with your own body. 

Pre-Labour

In the final weeks of your pregnancy, before your baby is ready to be born, hormones will trigger your body to start preparing for labour. 

Every woman’s experience of pre-labour and labour will be different, but here are some of the signs that labour may begin in the next few days or weeks. These can occur in any order – over a few weeks, days or even hours – and you may not notice them happening. 

1. Engagement (also called ‘lightening’)

Before labour starts, your baby will settle deep into your pelvis. This can give you relief from heartburn and take some of the pressure off your lungs, making it easier to breathe. 

However, the baby will be pressing against your bladder, so you’ll probably feel that you need to wee even more frequently; and the increased pressure against nearby nerves and blood vessels often causes leg cramps and swelling of feet and ankles. Keep your legs elevated as much as possible and rest on your left side to help reduce foot swelling. 

Medical staff assess the amount that the baby’s head has ‘engaged’ in the pelvis, by looking at the location of the top of the baby’s head in relation to two bony projections in the middle of your pelvis, a ‘level’ or plane within the pelvis that is called ‘zero station’. For example, when the baby’s head is above this level by two centimetres, it’s called ‘zero station minus two,’ while one centimetre below this level is referred to as ‘zero station plus one’. 

2. Nesting / burst of energy

Towards the end of pregnancy you are often feeling so cumbersome and elephant-like that you can’t imagine wanting to get off the sofa for any reason; but quite often, you will wake up one morning with a strong desire to rush around cleaning, cooking and shining silverware. Try to be kind to your body; you’ll need all that extra energy for labour so don’t wear yourself out scrubbing floors just before you have a baby.

3. Weight loss

Some women find they lose up to 500 g a day or so before labour starts, as hormone changes reduce fluid retention. 

4. Lower back ache

Some women report a rhythmic, dull ache in their back, which makes them feel irritable and restless. 

5. PMS symptoms

Similar feelings to those that you might experience shortly before menstruation are common just before labour, such as irritability, headaches, and tiredness. Some women also experience diarrhoea.

6. The “Bloody Show”

The cervix is sealed during pregnancy with a plug of sticky mucous which can dislodge as the cervix starts to soften and dilate. This can happen a week or more before labour starts – or may not happen until during labour. The mucous plug is usually tinged with pink or brown blood and is called the ‘bloody show.’ If you have any bleeding – even if you suspect it is probably the ‘show’- it’s best to call your caregiver straight away to check. 

7. ‘Practice’ (Braxton Hicks) Contractions

In the weeks before labour, your womb will go into training for the marathon ahead, by starting a series of weak contractions that you might not even feel. These often last for about 30 seconds and come and go at irregular intervals. They may feel a little like period pain and you may feel a ‘tightening’ across your abdomen at the time. 

For some women, these contractions can be quite painful and they may even keep you awake at night. This is a great chance to start practicing those relaxation techniques you learned in pre-natal classes so that you’re ready for the real thing! 

As you approach the time your baby will be born (unfortunately, very few women ever have their baby on the so-called ‘due date’), the practice contractions might occur more often and feel stronger until you think – hang on, is this the real thing? 

This is often called ‘false labour’ – and many a pregnant woman has shown up at their hospital in the middle of the night thinking they are in labour only to be sent home, back to the waiting game.

If you are not sure whether you are in labour, start timing your contractions. How far apart are they, and how long do they last? You’re probably in labour if the contractions last more than half a minute and start to come closer together and get stronger. 

• Practice contractions don’t generally settle into a regular pattern and if you stand up and move around, they will often disappear.
• Real contractions will get progressively stronger and start to form a regular pattern. 

If you’re not sure – phone your caregiver or local hospital for advice. It could be a false alarm – or you may be in early labour. 

8. Your Water breaking

When the membranes of the amniotic sac rupture, the fluid that your baby is surrounded in will start to leak. You may experience a sudden big gush of fluid or a constant trickle. 

Once your water has broken, you will be leaking fluid for the duration of your labour, so it’s wise to keep a stock of heavy-duty pads that you can wear, or a collection of old towels with you. 

Pre-labour rupture of membranes only happens in around 5-10% of pregnancies; and 90% of the time, women then go into labour naturally within 24 hours. But there is a small risk of infection or complications with the cord if labour doesn’t start soon, so do call your caregiver for advice immediately when your water has broken.