Labor and Delivery

No one can predict when labor will start. One woman can have all the signs that her body is ready to deliver, yet she may not have the baby for weeks. Another woman may have no advance signs before she goes into active labor. First-time deliveries are harder to predict.

Signs that labor may start soon

Late in your pregnancy, your doctor or midwife will tell you what to do when you think you are in labor. Early labor can be different for every woman. At first, your contractions may not be regular, and they may happen only now and then.

You may have signs that early labor is not far off.

• The baby may settle into your pelvis. Although this is called Reference dropping, or lightening, you may not feel it.
• Your cervix may begin to thin and open (Reference cervical effacement and dilatation). Your doctor checks for this during your prenatal exams.
• Reference Braxton Hicks contractions may become more frequent and stronger, and perhaps a little painful. You may also feel cramping in the groin or rectum or an ongoing ache low in your back.
• Your amniotic sac may break (Reference rupture of the membranes). In most cases, rupture of the membranes occurs after labor has already started. In some women, this happens before labor starts. Call your doctor right away or go to the hospital if you think your membranes have ruptured.

The key to knowing when you're in labor is that the contractions start to get longer, stronger, and closer together. You will feel them even when you change positions and are walking or moving around. After a while, it will become hard for you to talk during a contraction. You may have to stop to focus on your breathing.

When to call a doctor

Many women stay at home during early labor. During this time, it's important to know when to call your doctor or midwife.

You or someone else should call 911 or other emergency services immediately if you think you may need emergency care. For example, call if you:

• Have severe vaginal bleeding.
• Have severe pain in your belly or pelvis.

Call your doctor now or go to your hospital's labor and delivery unit immediately if you:

• Have any vaginal bleeding.
• Have had regular contractions for an hour. This means about 4 or more in 20 minutes, or about 8 or more in 1 hour, even after you have had a glass of water and are resting.
• Have a sudden release of fluid from your vagina. It is possible to mistake a leak of Reference amniotic fluid Opens New Window for a problem with bladder control.
• Have low back pain or pelvic pressure that does not go away.
• Have noticed that your baby has stopped moving or is moving much less than normal. See Reference kick counts for information on how to check your baby's activity.

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