The “You’ll just know” Debate

Disclaimer: do not take any information here as medical advice, always check with your care provider (Dr, midwife, OB) before trying anything and definitely check in with them or visit your L&D department if you have a feeling something is wrong.

woman labour

Can we talk labour for a minute?

One common question that expecting women and their support people have is: “How will I know I’m in labour?”.  And, honestly, this is one tough question to answer.  Many people will say that “You’ll just know.”  “When it’s time, you know.”.  We are trained from media (TV, movies, etc) to expect a big gush when our water breaks, then hard and fast contractions, rushing to the hospital, being wheeled down the hall in a wheelchair and then furiously pushing for a few minutes before baby comes.  These are some of the very obvious signs of labour.  The truth is that labour signs can build up over days or weeks and once things get rolling, you may not recognize the signs until you are well into the active phase of labour.

But this can be a good thing!  Evidence tells us over and over that the healthiest births are the ones that are least tampered with, and a slow, steady (and sometimes sneaky) start to labour can help prevent us and our care providers from jumping in too early with unnecessary interventions.  Having a slow start to labour can help mom and baby adjust to the rhythm and flow before things get intense.

Some early signs (days and weeks before baby is born) that your body is preparing for labour include:

– Baby “dropping” or engaging.

– Losing your mucus plug.

– Nesting.

– Braxton hicks practice contractions.

– Frequent and/or watery bowel movements.

Early labour is characterized by regular contractions that get progressively closer together and stronger.  The trick with these is that they may feel like cramping or just an annoying back pain for some women and they may not recognize them as labour (I was one of those!).  If you are feeling like you may be in early labour try laying down, having a relaxing bath or shower and drinking some water (see Disclaimer above).  If you are dehydrated, it can increase the level of oxytocin in your system, causing irritable but not labour contractions.  If the cramping does not subside once you have had a drink of water and relaxed, you may be in early labour.  Do not be surprised if this early labour comes and goes, or persists for days; it can be absolutely frustrating, but completely normal for some women.

Now, back to the original question: “How do I know it is labour?”.  Labour signs are sneaky and don’t always start the same way for every woman.  For one woman, labour signs may start with Nesting, progress to back pain and then jump right into full on labour.  For others, they may just wake up one day in full blown labour without any other signs, and others still will trickle along, having lost their mucus plug weeks before labour starts, or even having any other signs.

As a doula, I can give you information to help you assess the signs, we will discuss how you are feeling and whether it is appropriate at this time to assume labour has started (it is always best to discuss with your care provider what signs they are looking for and when they want to be called), and support your choice for the next steps (wait some more, give some coping suggestions over the phone, have me come over and see how you are managing in person, meet you at your planned place of birth, etc).

The truth is, it is sometimes not until labour is over that you can look back and go “Oh, so those middle of the night cramps that were waking me up every 30 minutes was the real start of my labour”.  When deciphering labour signs, hindsight is 20/20 after all, even for us doulas.

But, my clients will always be able to call me to listen, help them understand and support them when (and if!) these early signs start to appear.

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