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The Signs and Stages of Labor

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by Kassel K
As your baby’s birth approaches, it is normal to be both anxious and excited. Knowing what to expect can help to calm your nerves. Read about the signs of imminent labor and the stages of labor and delivery .
A spicy meal, a long walk, house cleaning, jumping jacks… There seems to be no end to the old wives’ advice for coaxing your little one to come out into the world. While these superstitions add comic relief to your pregnancy, they will not start labor. Every baby is different and every pregnancy is different. But that does not mean you have to just sit and wait. As your body prepares for birth, there are many signs that you can watch for. The better you understand these signs, as well as the stages of labor that will follow, the more confident and relaxed you can feel going into the delivery room.

Signs of Labor

Dropping or Lightening

During a pelvic exam, your doctor can describe how far your baby has dropped using “stations.” The term “-3 station” means that the baby’s head is not yet in the pelvis. “0 station” means that the head is at the middle of the pelvis. This is also called engaged. When the head is beginning to emerge from the birth canal, the term “+3 station” is used. +3 occurs during delivery and is also called crowning.

Effacement

Effacement is the thinning of your cervix in preparation for delivery. The cervix is the opening to the uterus (or womb) where the baby is carried during pregnancy. You cannot feel effacement, but your doctor will measure it during a pelvic exam. Effacement is reported as a percentage. If you are “50% effaced,” your cervix has thinned to half of its original thickness. When you reach “100% effaced,” the cervix is completely thinned out and ready for a vaginal delivery (when full dilation has been achieved).
Changes in the Cervix During Pregnancy
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© 2011 Nucleus Medical Media, Inc.

Dilation

The cervix must open, or dilate, to allow the baby to pass through and be born. Measured in centimeters (cm) from 0 to 10, dilation tells you how far the cervix has opened. Dilation may begin slowly, without apparent contractions, in the days or weeks before birth. Once active labor begins, the cervix dilates to 10 cm. You will not feel dilation, but your doctor will measure it. If the baby is preterm and smaller than a full-term baby, then delivery can occur prior to 10cm dilation.

Show, Bloody Show, or Loss of Mucus Plug

During pregnancy, a thick plug of mucus fills the cervical opening. This plug is here to keep bacteria out of the uterus. As the cervix thins and opens, this plug may fall out. When it falls out, you may notice stringy mucus or a thick discharge that is brown, pink, or reddish. Labor usually begins within 72 hours of this “show.”

Nesting

Some women have an urge to clean and organize their homes. This is called nesting and is thought to be an instinct to prepare your home for birth and the baby. These feelings may occur any time during pregnancy, but are strongest just before labor. Be sure to save some energy for delivery and baby care.

Water Breaking or Rupturing of Membranes

During pregnancy, your baby is cushioned and protected by a fluid-filled sac called the amniotic sac. This sac can break before labor begins. You may feel water running out of you or your underwear may be constantly wet. The flow can be dripping (if you are standing up) or gushing (if you are lying down). If you think your water has broken, call your doctor immediately.

Braxton Hicks Contractions (False Labor)

These are contractions that occur toward the end of pregnancy. As your due date approaches, they may become stronger and more painful. Your doctor may ask you to time your contractions to determine if these contractions are the start of labor. Time from the beginning of one to the beginning of the next. There are a few ways to tell Braxton Hicks (false labor) contractions from contractions of early labor:
  • Timing
    • True labor contractions come at regular intervals and get closer and closer together
    • Braxton Hicks contractions are irregular and do not get closer together
  • Change with movement
    • True labor contractions continue no matter what you do, including walking
    • Braxton Hicks contractions may stop when you walk or change positions

Stages of Labor and Delivery

Stage 1: Early and Active Labor

 

RESOURCES

American Congress of Obstetricians and Gynecologists
http://www.acog.org/

Mayo Foundation for Medical Education and Research
http://www.mayoclinic.com

Women’s Health.gov
http://www.womenshealth.gov/pregnancy

 

CANADIAN RESOURCES

The Society of Obstetricians and Gynaecologists of Canada
http://www.sogc.org/index%5Fe.asp

Women's Health Matters
http://www.womenshealthmatters.ca

 

References


Childbirth. Women’s Health.gov. Available at: http://www.womenshealth.gov/Pregnancy/. Accessed August 8, 2005.


How to tell when labor begins. University of Michigan Health System website. Available at: http://www.med.umich.edu/obgyn/smartmoms/labor/labor/beginning.htm. Accessed August 8, 2005.


Normal pregnancy, labor, and delivery. The Merck Manual of Diagnosis and Therapy online.Available at: http://www.merck.com/mrkshared/mmanual/section18/chapter249/249a.jsp. Accessed August 8, 2005.


The process of labor: labor stages. Sutter Health website. Available at: http://babies.sutterhealth.org/laboranddelivery/labor/ld%5Fstages.html. Accessed August 8, 2005.


Signs of labor: know what to expect. Mayo Foundation for Medical Education and Research website. Available at: http://www.mayoclinic.com/invoke.cfm?objectid=7E57E034-98E4-49A9-84053CC4E2CC170A. Accessed August 5, 2005.


Stages of labor. Palo Alto Medical Foundation website. Available at: http://www.pamf.org/health/healthinfo/index.cfm?section=healthinfo&page=article&sgml%5Fid=tn9759. Accessed August 8, 2005.

 

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