Labor
Prodromal Signs of Labor
Pre-Labor Signs
Lightening, Engagement, or “the baby dropped”
Due to relaxation of the pelvic ligaments, softening of the lower uterine segment, and somewhat to a reduction in amniotic fluid volume, the fetus moved deeper into the pelvis. This typically occurs 10 days to four weeks prior to the onset of labor in primips, and just prior to or in labor for multips. Shortness of breath and heartburn are improved while urinary urgency is increased.
Loss of Mucous Plug
This is the extrusion of the plug of mucous that was filling the cervical canal during pregnancy (acting somewhat like a cork in a bottle). A few drops of blood may escape with the plug but this is not to be confused with the true bloody show of active labor.
Nesting Instinct
This is when the woman’s behavior focuses on getting the “nest” (baby’s environment) ready for the arrival of the baby. It is oftentimes manifested by rearranging of the nursery, checking and rechecking that everything is just right.
Spurt of Energy
Many women experience extra energy within approximately 24 hours prior to the onset of labor. It is thought that this spurt of energy is nature’s way of providing extra energy for the physical demands of labor. The actual etiology of this phenomenon is unknown. Once identified, this energy should be saved for labor and not expended on cleaning the house or other chores.
Weight Loss
Within a few days of labor changing estrogen and progesterone levels affect maternal fluid balance causing the mother’s weight to either stabilize or to drop from 1 to 3 pounds.
Flu-like Symptoms and Frequent Soft Bowel Movements
Many women experience frequent soft bowel movements which are hormonally induced to clear the lower intestinal tract. This allows more room for the baby to move down in second stage labor. In addition, some women in early labor just feel generally unwell.
(For more information, see Pre-Labor Readiness” in the Addendum section.)
True Labor vs. False Labor
True Labor:
- Contractions
- Regular pattern
- Over time they become closer, stronger and longer.
- Walking may increase frequency and/or intensity.
- Early contractions usually less than 60 seconds in duration.
- May be accompanied by a backache.
- A hot bath, heating pad or relaxation will not stop them.
- Cervix
- It ripens (softens), effaces (things out) and dilates (opens up).
- Amniotic Sac
- Intact or ruptures.
- Baby
- Engages (starts to descend the pelvis).
- Mother
- May have diarrhea.
- May lose mucous plug.
- In 10% - 12% of the cases there is a spontaneous rupture of membranes.
False Labor:
- Contractions
- Usually an irregular pattern (but can be regular and will dissipate with hydration.)
- Can vary.
- Walking of changing position may stop them.
- May last 30 – 45 seconds in duration or longer than 60 seconds.
- May be accompanied by a backache.
- A hot bath, heating pad or relaxation may stop them.
- Cervix
- It may ripen and may show minimal effacement and dilation.
- Amniotic Sac
- Intact.
- Baby
- May or may not descend in the pelvis.
- Mother
- Seldom has diarrhea.
- Loss of mucous plug not associated with false labor.
- Rupture of membranes not associated with false labor.
Changes of True Labor
Effacement
The thinning or obliteration of the cervix which occurs with labor. When the length of the cervix is reduced by one half it is referred to as 50% effaced; when it has thinned out as completely as the adjacent lower uterine segment, it is referred to as 100% effaced.
Dilation
Stretching of the external os (opening) of the cervix to accommodate passage of the fetus and is expressed in centimeters with 10 centimeters being fully dilated.
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