What are the signs for the onset of real labour
At first, you may feel Braxton-Hicks contractions. When real labour begins, these contractions get considerably intense. As their frequency increases, they become more painful and can not be relieved by a change in position. The pain first begins in the lower back and then spreads to the lower abdomen and legs. This may be accompanied by diarrhoea. Contractions are now taking place at regular intervals, and should be timed. You may also have a pinkish or blood streaked discharge from the vagina. In 15% of cases, it has been seen that the water bag breaks (also known as rupturing of membranes) before labour begins. When this happens, water (actually amniotic fluid) may either gush out or just trickle. If you begin experiencing these symptoms, call your doctor and rush to the hospital.
What are Braxton-Hicks contractions
This is a method by which the pregnant uterus does a practice run prior to actual labour. The uterus is warming up in preparation for the grand finale - the arrival of your baby. They begin around the 20th week of pregnancy. You will feel a tightening of your uterus that is usually painless, but can be uncomfortable. The contraction begins at the top and slowly spreads downwards. They can last from 30 seconds to over 2 minutes. As you come closer to the time of delivery, these contractions may become more frequent and intense, bordering on painful. You may even mistake them for actual labour contractions. Braxton-Hicks contractions can trigger early effacement (thinning of cervix) and dilatation.
How should I deal with Braxton-Hicks contractions
As your due date draws nearer, your Braxton-Hicks contractions will become more intense, painful and frequent. Lying down and relaxing or walking around can help relieve the discomfort of these contractions. Changing your position may stop the contractions completely.
What is a "bloody show"
Another sign of the commencement of labour is that your vaginal discharge will thicken and increase and you might find a blob of mucous escape from your cervix (looking like pink vaginal discharge). As the cervix begins to thin and open, the mucous plug that seals the opening of the uterus, slides out through the vagina, a couple of weeks before the onset of labour. You may notice a blood-tinged mucous discharge known as "bloody show."
Does a "bloody show" indicate commencement of labour
This just indicates that your cervix is effacing and dilating in preparation for the onset of labour, which could still be two or three weeks away. In subsequent pregnancies, this happens just as labour begins. If this is followed by contractions, then do not hesitate to go to the hospital, because it could indicate the commencement of labour. On the other hand, if your discharge becomes bright red or you just start bleeding even a little, contact your doctor at once, as it could be an indication of premature separation of the placenta (placenta praevia), and requires prompt attention.
Am I leaking urine or have my membranes ruptured
Just smell the wet spot on your underwear. If it smells sweet, it must be amniotic fluid. This stops once you stand up, as the baby's head moves into position and acts like a stop cork. However, if the spot smells like ammonia, you have most probably urinated. A constant trickle or a sudden gush from the vagina usually indicates that "your waters have broken" or that your membranes have spontaneously ruptured. By "waters", one means the amniotic fluid surrounding the foetus during pregnancy. This is a sign that labour should commence within the next twenty four hours.
What if my membranes rupture in public
What if my membranes rupture in public
This is highly unlikely as in 75% cases, membranes are known to rupture only after labour progresses. And once the water breaks, the flow is only heavy if you are in a sleeping position. So even if it does occur, you are hardly likely to be lying down in public. When you are standing or walking, a little amniotic fluid might trickle out at the most, because the foetal head blocks the opening of the uterus. And since contractions haven't yet started, there is no force trying to push the fluid out. If you are still worried about rupturing your membranes ruptured in public, wear a panty-liner for the last couple of weeks.
My water bag has broken but I have no contractions
The first contractions normally start within 12-24 hours after the water breaks. However, in 1 out of 10 cases, labour has to be induced, because once the membranes have ruptured, the risk of infection to the mother and child increases. So you must report this to your doctor, and in the meantime, keep the vaginal area clean and use a sanitary towel (not a tampon). Don't have a bath or indulge in sexual intercourse. And of course, resist from carrying out your own internal examination. However, if you think you can feel something in your vagina, make sure that you get immediate medical attention, as it could be a prolapsed umbilical cord.
Some people say diarrhoea indicates commencement of labour
This is true. Just before the onset of labour, some women experience loose motions. So if you have diarrhoea, get your hospital kit ready, because it could indicate commencement of labour.