Sunday, June 5, 2011

Am I in labor?

Labor is the culmination of months of gestation, the precursor to birth, and the turning point of the greatest significance in a pregnancy. 

Yet, it's often one of the hardest things about pregnancy to define.

In this day and age, most women go into their pregnancies, particularly their first ones, with expectations about how it will go.  They've been brainwashed by television and movies, about the sudden arrival of labor, usually by a dramatic burst of water.  Screaming and yelling ensues, and shortly thereafter a baby arrives.

Trouble is, it hardly ever works that way. 

I'd like to try and clear up some of the misconceptions about labor here, and help you determine when labor actually begins.  It's not usually a black and white issue, more shades of gray.

- Only about 10% of women will have their amniotic sac rupture prior to the onset of labor.   Far more likely, you will experience hours or even days of contractions prior to a spontaneous rupture.  Left alone, most women will not have their water break until they reach about 5 or 6 cm dilation.  If your water breaks, even if you aren't in labor, you need to go to the hospital or call your midwife.

- You only have a 5% chance of having the baby on your actual due date.  Some babies come early, some babies come late, very few of them actually show up on the day you circled on that calendar.  Most women should be prepared to labor anytime after 37 weeks, though it can begin earlier for some.

- Your due date isn't an expiration date.  Left alone, most first pregnancies would go postdates.  What this means is that if you get to your due date, then pass it, and still don't have a baby, it doesn't mean that there is anything wrong.  The average first pregnancy left alone would be closer to 41 1/2 weeks, not the 40 we are accustomed to.  Healthy women with uncomplicated pregnancies can go two to three weeks past their due date without medical concern usually.

- You may not know when you are actually in labor, especially if it's the first time.  Assuming that it begins on it's own, labor is a very gradual process.  You experience an increase in Braxton-Hicks contractions, which eventually turn into pre-labor contractions.  Those eventually turn into early labor, and it's often difficult if not impossible to know when you've crossed the line for good. 

- Many women have false alarms, particularly as the Braxton-Hicks contractions increase.  They can occasionally become a little painful even.  It is normal to have these false alarms, but still frustrating.

- The hallmark of true labor are contractions that do not go away with changes in activity.  Towards the end of your pregnancy, you may notice that you have contractions when you are tired or have over-done it.  Dehydration can also trigger contractions.  Getting rest and staying adequately hydrated will lessen these type of contractions eventually.  If they keep coming no matter what you do, it is more likely to be true labor.

- Most women have digestive problems prior to the full onset of labor.  You may become nauseous or have diarrhea.  You may not feel like eating at all, but should focus on light meals.  Many women also have headaches and backaches before labor.  Nesting is common, a sudden urge to clean or organize the baby's room.  None of these are slam dunk signs that labor is near, but they often are precursors.

- Early labor can last for hours or even days for some women.  At this stage, you have decent breaks between contractions, and they still may be somewhat irregular.  You aren't too uncomfortable and can go on with your normal activity levels.  Many women never realize they are in this stage, particularly with a first baby.  In this stage, you should focus on resting when you need to and eating lightly. 

- The average first labor is 14 hours.  This is the time that mother perceives labor, though in most cases it has undoubtedly been longer than that.  The natural labor process brings with it a gradual increase in endorphins, which enables the mother to tolerate the increasing discomfort from the contractions.  Having said that, 14 hours is an average.  Some women have very rapid labors, some have very prolonged labors.

- It is common to wake up in full blown labor or having had your water break.  This is because of the fact that it's often possible to sleep through the earliest stages of labor.  Your body is in a relaxed state during sleep, and the contractions are often far more effective than they are when you are awake. 

- I don't rely on any time frame or charting to decide when to go to the hospital.  From my personal experiences, and those of my clients, they are good tools generally, but seem not to apply more often than they do.  I'm referring to the 1 minute contraction, every 5 minutes, for 1 hour rule.  Some women have extremely effective contractions every 10 minutes.  Some can contract every 5 minutes for 12 hours with almost no cervical change.  I look to the other symptoms for guidance of when to go.
    * Drastic increase in discharge, or bloody show
    * Increased pressure
    * Back pain with contractions that increases over time
    * Inability to talk during contractions

- You really can't judge how you will do with tolerating labor until you've been there.  Some women have astonishingly high pain tolerances, others sense every twinge and it becomes unbearable quickly.

- Most hospitals will not admit you unless you are 3-4cm and having regular contractions at least every 5 minutes. 

If you aren't sure you are in labor, it never hurts to call your doctor or midwife.  Chances are that they will want you to come in and be checked.  Good luck!!! 

No comments:

Post a Comment

Popular Posts