Labor
What happens during "labor"?
Typically, there are three stages of labor. The first stage is early labor. That's when you initially begin to have contractions. They will probably be all over the place. Some will be every two minutes and they may be every twenty minutes. They are all over the map until they start to become more regular. When they are every five or six minutes consistently for approximately 2 hours in a normal pregnancy we usually recommend that you then proceed to the hospital where they can evaluate you. If it's your third or fourth or even second baby sometimes we say (when it is every eight to nine or even ten minutes) that they can be a little farther apart because second labor can sometimes occur more quickly. The first stage is defined by the cervix being closed to about 4cm dilated. Once you get to 4cm dilated the cervix then does tend to open at somewhat of a regular pace. That's the second stage of labor when it opens from 4 cm to 5 cm to 10 cm. At 10 cm is when you begin pushing. Pushing is the third stage of labor until delivery and then some people say that the fourth stage of labor is the delivery of the placenta and the recovery period.
What are the signs that I'm going into labor?
Signs that you're going into labour typically are menstrual type cramps, lower back pain, some spotting, or occasionally leakage of fluid. That can be a gush of fluid or sometimes a slow trickle that every time you clean yourself off, it continues to soak your underwear, and so you probably have ruptured your bag of membrane at that point in labour. So early labour signs can be breaking your bag of water, or irregular contractions that eventually do become regular.
What are "labor contractions"?
“Labour contractions” are the tightening of the uterine muscle. The uterus' sole purpose is to house a pregnancy and then contract around that pregnancy to force it through the vagina. In a “term pregnancy”--beyond 37 weeks--you won't stop regular labour contractions. Because it's a big muscle made up of millions of muscle cells the uterus doesn't necessarily contract uniformly, initially. It may start sporadically all over the place with irregularity, but eventually it becomes regular labour contractions to push that baby out.
What are warning signs that I need immediate medical help during labor?
Most hospitals in the United States have external fetal monitoring. So, if you are in the hospital, you will have belts that will be around your abdomen - one monitoring the contractions and one monitoring the baby's heart rate. Those will be monitored, and there's usually a central station (the nurse's station) where doctors can sit, and they can monitor your contractions. The cause for emergency would be if there were some signs of distress in the baby's heart rate. Usually we don't allow it to get to that point, but sometimes emergencies do happen, and that would be a warning signal. You'll have to trust your physician that you've developed a relationship with to assess the tracing and treat you appropriately when faced with a warning sign such as this.
