Signs of Labor & Preparing For Birth

Once you reach the third trimester, you should talk to your doctor or midwife about labor and delivery. Learn your options for pain relief. Find out how to reach her if you go into labor. And ask her at what point in labor should you call.

Before you reach the last few weeks of pregnancy, you and your partner should visit the hospital or birthing center. Make sure you know how to get there, where to park and where to check-in. Find out if you can pre-register so that your insurance information is already in the computer when you arrive.

Signs of Labor

Many women, especially with their first babies, think they are in labor when they’re not. This is called false labor. So don’t feel embarrassed if you go to the hospital thinking you’re in labor, only to be sent home!

If you think labor has begun, you should call your doctor or midwife. They can decide if it’s time to go to the hospital or if you should be seen at the office first. Learn the signs of labor so you will know when the time has come.

Call your doctor if you experience any of the following signs of labor:

Contractions that come at regular and increasingly shorter intervals. Contractions should also become stronger over time.

You have lower back pain that doesn’t go away. You might also feel premenstrual and crampy.

Your water breaks (can be a large gush or a continuous trickle).

You have a bloody (brownish or red-tinged) mucous discharge. This is probably the mucous plug that blocks the cervix. Losing your mucous plug usually means your cervix is dilating (opening up) and becoming thinner and softer (effacing). Labor could start right away or may still be days away.

What are Preterm Labor and Preterm Birth?

Premature labor (another name for preterm labor) is labor that begins before the 37th week of pregnancy. A doctor will often take steps to try to stop the labor as the risk to the baby’s survival is high at this point. Premature birth occurs about 12% of the time and is the number one cause of infant deaths in the United States.

Who is at risk of going into preterm labor and having a preterm birth?

There is no way to predict which women will experience preterm labor or premature birth, but here are some factors that may be involved in having preterm labor and birth:

Trichomoniasis (an infection)
Bacterial vaginosis (an infection)
Shortened cervix
Previous premature labor or birth

Risks of Preterm Birth to the Baby

Low birth weight
Underdeveloped organs
Under developed lungs, breathing problems
Greater risk for cerebral palsy (CP)
Greater risk for learning disabilities
Greater risk for developmental disabilities
Greater risk for serious infections

Preventing Preterm Delivery

Unfortunately, these preventions are not effective most of the time, but because they are helpful some of the time, these are some methods for prevention:

Treating high risk women with progesterone
Bed rest
Medications

Medical Pain Relief During Childbirth

While you’re in labor, your doctor, midwife or nurse should ask if you need pain relief. It is her job to help you decide what option is the best for you. There are many different kinds of pain relief. Not all options are available at every hospital and birthing center. Plus your health history, allergies, and any problems with your pregnancy will make some options better than others.

Types of pain relief used for labor and delivery include:

Intravenous or intramuscular analgesic

A doctor gives you pain medicine through a tube inserted in a vein (intravenous) or by injecting the medicine into a muscle (intramuscular). These medicines go into your blood and help ease the pain. Opiods including morphine, fentanyl and nalbuphine are usually used for this type of pain relief. This option does not get rid of all the pain. Instead it usually just makes the pain bearable. After getting this kind of pain relief, you can still get an epidural or spinal pain relief later.

Some disadvantages of getting intravenous or intramuscular analgesics include:

They make you feel sleepy and drowsy.
They can cause nausea and vomiting.
They can make you feel very itchy.
These medicines cross into the baby’s bloodstream. So they can affect the baby’s breathing, heart rate and cause him/her to be very sleepy after birth.

Epidural anesthesia

A doctor injects medicine into the lower part of your backbone or spine. The medicine blocks pain in the parts of the body below the shot. During a contraction, the feeling of pain travels from the uterus to the brain along nerves in the backbone. Epidurals block the pain of contractions by numbing these nerves.

Epidurals allow most women to be awake and alert with very little pain. Many women who get epidurals do not feel any pain during contractions and childbirth. Medicines used in epidurals include novocaine-like drugs that block the pain in that region combined with opiods like fentanyl.

Some disadvantages of getting an epidural include:

It can make you shiver.
It can lower your blood pressure.
It can make you feel very itchy.
It can cause headaches.
It many not numb the entire painful area. So women continue to feel pain in an area of the abdomen and back.

Pudendal Block

A doctor injects numbing medicine into the vagina and a nearby nerve called the pudendal nerve. This nerve carries sensation to the lower part of your vagina and vulva. This is only used late in labor, usually right before the baby’s head comes out. With a pudendal block, you have some pain relief but remain awake, alert and able to push the baby out. The baby is not affected by this medicine and it has very few disadvantages.

Spinal anesthesia

A doctor injects a medicine into the lower part of your backbone. This medicine numbs the body below where the medicine was injected. Spinal anesthesia gives immediate pain relief. So they are often used for women who need an emergency Cesarean section. Spinal anesthesia uses numbing medicines similar to novocaine combined with opiods like fentanyl.

Some disadvantages of spinal anesthesia include: