A labouring woman with a canula in her hand.
There are several signs that labour may have begun but knowing when is the right time to go to the hospital can still be difficult to tell. Familiarise yourself with what the signs below and call the maternity department at your hospital and explain what is happening if you are experiencing any of them. The hospital will ask certain questions to determine whether true labour is underway.
In the third trimester, as the baby descends deeper into the pelvis approximately two to four weeks before birth, contractions will progress from more noticeable and possibly uncomfortable Braxton Hicks contractions that prepare the body for birth by softening the cervix, to stronger, achy spasms in an inconsistent pattern that slowly open the cervix in the earliest phase of labour, known as latent labour.
Both these kinds of contractions differ to regular contractions that are painful, close together, forceful, sharp and usually accompanied by back pain, which all indicate that active labour has begun.
By timing the length of the contractions as well as the time between each contraction, you can see if they are becoming more frequent. If they are five minutes or less apart, and last for a minute or more over an entire hour, it is time to leave for the hospital. If contractions slow down or become less painful by eating, drinking, showering, moving or changing the position of the body, then it may not be necessary to leave home yet. Often contractions can slow down after already leaving for or arriving at the hospital but it is better to err on the side of caution.
- Having a bloody show
If the cervix has started to open, the mucus plug that has acted as a seal to prevent infection reaching the baby can be released as a jelly-like discharge, either in tact or as several portions. Hints of light brown, pink or red are sometimes within it, which is why many medical professionals refer to it as the “bloody show”. It can be dislodged several weeks before birth but more commonly shifts only a few days or a few hours before. This may lead to the rupturing of the membranes following shortly afterwards. But the mucus plug can also be broken during sexual intercourse or a vaginal exam and doesn’t necessarily mean the cervix has started to open. Only a vaginal exam can determine if the cervix has begun to dilate and how much, and this will need to be done at the hospital.
- Rupturing of the membranes
Known better as “the waters breaking”, this is when the amniotic sac that surrounds and protects the baby bursts and fluids flow from the vagina, anytime from several days to several hours before the baby is actually born.
Some women may be concerned that they have lost control over their bladder when this happens but amniotic fluid will not smell like urine and the flow cannot be controlled by contracting the uterine muscles. It can gush suddenly or trickle slowly, and will be a clear colour (not yellow) or it may contain traces of pink when it breaks. Sometimes the breaking of the waters and the bloody show occur at the same time.
Some women need to have their waters broken artificially by the doctor so don’t expect or wait for this to happen if you are having regular contractions or there any other signs of labour.
You must go to the hospital as soon as possible if you are experience any of the following things:
- Bleeding because this can be a sign of premature separation of the placenta or placenta praevia.
- If the waters or the mucus plug are tinged with green, dark brown or yellow when they detach, because this may indicate the presence of meconium (the baby’s digestive fluid which eventually becomes the first bowel movement), which increases the risk of infection.
- Vomiting for long periods
- No movement from the baby
- Unbearable, unrelenting pain
- An urge to push
- Blurred vision or dizziness
Most hospitals will also recommend you leave home without delay if you experience any labour symptoms and have other existing medical conditions, if you are less than 38 weeks pregnant, if you are pregnant with two or more babies, or if you live a long distance away from the hospital.