Will You Know When It's Time?

Labor doesn't often happen by the book, and is different from woman to woman and from pregnancy to pregnancy. And no matter how much you may have prepared, it still may not be what you expect! But will you really know when labor begins? Several different women share their experiences of early labor.
Nancy Price

Quick and easy
For Amanda Dockery of Douglas, Georgia, labor turned out to be just the way she expected. "My water broke and woke me up at 8:15 one morning, and I began having contractions around nine. I got up and stayed active, and the contractions progressed to being regular and ten minutes apart pretty quickly. Over the next couple hours, they got harder and more forceful, and soon were about five minutes apart." At 12:45, she was examined and found to be two centimeters dilated and 75% effaced.

"There was a risk of infection because my water had broken, so my doctor sent me to the hospital. It was about 3 o'clock when I got into the labor room, and by then, I was 4 to 5 centimeters dilated." She started transition at about 6pm, when she was eight centimeters dilated and fully effaced. "I was hot and uncomfortable, and could really feel the baby's progression downward. After a while, I started to push a little, and then my body just took over and pushed on its own."

Amanda was promptly taken to the delivery room, and at 7:11pm, her son was born. "My doctor commented to my husband that that was the way labor should be - quick and easy."

Not always textbook cases
But not all labors follow the textbook description. Is it possible that you really might not know when you're about to give birth? There is room for doubt when labor proceeds far more slowly or quickly than "normal," is relatively painless or the symptoms are simply not what you expect.

Robert B Cole, M.D., an obstetrician/gynecologist in private practice in Walnut Creek, California, estimates, "Probably twenty percent of my patients make one or two trips to the hospital before being admitted."

It's not always a simple matter of wishful thinking, as false labor can seem very real. It probably is not true labor if the contractions are not regular and rhythmic, do not increase in frequency and intensity, or if they fade with activity. Says Dr Cole, "She could be feeling Braxton-Hicks, or may have prodromal labor -- contractions producing little cervical change."

Repeated trips to the hospital can be very stressful and may negatively impact a woman's confidence in her body. Dr Cole notes, "If a woman comes in several times, when it is finally the real thing, sometimes she has trouble believing it herself."

"False" labor
"I started to have regular contractions at thirty-four weeks, possibly due to a urinary tract infection," says Yvonne DeBusschere of Ojai, California. "Since I was barely dilated with no effacement, I was sent home with orders for partial bed rest. That 'false' labor felt like most of my real labor - the contractions were three to five minutes apart, and very strong." Over the next four weeks, the contractions sent Yvonne and her husband to the hospital several times. "We were always thinking 'This is it!' Every time, though, we were sent back home, disappointed."

Finally, one night the contractions progressed to a point where they were too uncomfortable for her to sleep. "We went to the hospital again, but I almost didn't bring the suitcase because I was certain I would be told to go back home again." Two centimeters dilated and fully effaced, Yvonne was admitted, and gave birth to a son later that morning.



Slow and irregular
When labor builds slowly and irregularly, it may be tough to determine at what point prelabor matures into active labor. The night before the birth of her second child, Diane Weatherford of Austin, Texas, remembers, "I was feeling crampy, but went on to bed. At about 4am, I was awakened by a very painful contraction. It was very sharp compared to the mellow early labor I had with my first child. Crazy as it seems now, I wasn't sure if it was the real thing. The contractions were thirty minutes apart and just didn't seem to be regular enough."

By seven the next morning, her contractions were five to ten minutes apart, then slowed to about every fifteen minutes. At 12:30, "When they were five minutes apart and regular, I called the midwife." Three hours later, her daughter was born.

Is it the real thing?
When labor builds slowly and irregularly, it may be tough to determine at what point prelabor matures into active labor. The night before the birth of her second child, Diane Weatherford of Austin, Texas, remembers, "I was feeling crampy, but went on to bed. At about 4am, I was awakened by a very painful contraction. It was very sharp compared to the mellow early labor I had with my first child. Crazy as it seems now, I wasn't sure if it was the real thing. The contractions were thirty minutes apart and just didn't seem to be regular enough."

By seven the next morning, her contractions were five to ten minutes apart, then slowed to about every fifteen minutes. At 12:30, "When they were five minutes apart and regular, I called the midwife." Three hours later, her daughter was born.

In and out of the hospital
Holly Jahangiri of Houston, Texas, also woke one morning to strong contractions, though hers were already three to five minutes apart. "At 11am, the doctor informed me that I was only fingertip dilated (about 1 centimeter), just slightly effaced, and the baby was still high. Feeling disheartened, I went home and took a nap." At 3pm, the contractions were still regular, "So I went to the hospital for a quick check, and I'd dilated to nearly three centimeters! Despite the pain, my mood instantly improved."

Nevertheless, after spending several hours pacing the halls of the maternity ward with no more progress, Holly was sent home to have dinner and get some rest. "That night, I remember crying and saying, 'If this is just false labor, shoot me now. I quit!'" The next morning, the contractions had slowed, "but what they lacked in frequency they made up in intensity. When the doctor examined me at 8:30 and said, 'You're at five centimeters! You're going to have this baby today!' I started to cry, and I think I even hugged her. By the time I was re-admitted to the hospital, I was dilated to six centimeters and excited that I would soon be holding my baby." Her son, weighing nearly ten pounds, was born late that afternoon.

Barely made it to the hospital
Sometimes even first labors happen very quickly. Sabine Won of San Carlos, California, recalls, "I didn't have any of those 'typical' signs before I went into labor, like my water breaking or losing my mucus plug. Out of the clear blue, I felt a tightening sensation, similar to menstrual cramps. It felt like someone was squeezing my insides, and I found it really hard to relax. I knew immediately it was labor." Within one hour, her contractions had progressed from ten minutes apart to two. "I couldn't believe everything was happening so fast. We thought we'd stay at home for at least an hour, because that's what my doctor and all the books said to do. Looking back, we shouldn't have waited that long - I was obviously not a textbook case."

At the hospital, "I had no sooner ripped my clothes off and put on the hospital gown when I felt like pushing. The nurses took their time and said to relax, but I knew the baby wasn't going to wait. I got their attention and a nurse checked me... I was ten centimeters already!" Sabine delivered her baby girl three hours after her first contraction.

Not always sure - so ask
Hilary Price of Seattle, Washington, realized she was in labor not because of the pain, but because of the consistency of the contractions. "The 'real' contractions weren't more painful or longer than the Braxton-Hicks I'd been having for a couple weeks. If they hadn't been so evenly spaced, I'm not sure I would have known for sure. My doctor always said, 'You'll know when it's for real,' but it just didn't seem painful enough. I could certainly talk and joke and do things normally."

She was six centimeters dilated upon her arrival at the hospital. "The doctors were amazed I was taking it so well, but it really didn't hurt that much." Following ten hours of labor and just minutes after her son was born, "I had the nurses laughing because I said to my husband, 'That wasn't so bad! I could do that again!'"

If you think you might be in labor or have any questions, you should always feel comfortable contacting your healthcare provider. "There should be good, clear communication between doctor and patient," says Dr Cole. "If you're concerned about some symptom, go in and be checked." Above all, try to relax your mind and body and know that you're not going to miss this very extraordinary event. The old saying is true: nobody ever accidentally slept through childbirth.PregnancyAndBaby.com

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