The onset of labour is marked by strong, regular, frequent and painful contractions and these cause the baby’s head to move down whilst the cervix starts to thin and open up. With your expected due date coming closer your uterus will start to contract more frequently.
How does labour begin? The start of labour happens when certain chemicals are produced from the body called prostaglandins which initiate labour. The body prepares itself for the onset of labour. The cervix becomes soft, centrally placed in the vagina and starts thinning also, which is termed as effacement. If a baby is born before 36 weeks it is called a preterm baby and labour as preterm labour. There are various risks involved with a preterm baby especially the respiratory support.
Contraction of the uterus (commonly known as labour pains)
The contractions are felt in the beginning as tightening of the abdomen lasts for 15-20 seconds. It may be associated with pain or a feeling of push towards the vagina. The pain may be felt only in the back or lower abdomen and it radiates from the back to lower abdomen and then towards the thighs. The frequency of such contractions might be initially every 20-30 min. The frequency gradually increases and becomes regular and the woman may feel it every 5-10 minutes. It becomes more painful also. During the contraction, if one keeps her hand over the abdomen, it feels hard as a rock. The false labour pains are not regular and don’t have the characteristic radiating feature from back to thighs. They may be very irregular.
It is a blood mixed mucoid discharge. It might start before the woman perceives the contractions or later. There is a mucus plug blocking the cervical canal. When the dilatation of the cervix begins then this mucus plug falls down and it is streaked or mixed with blood. But if the blood is more than this, the woman should immediately reach the hospital.
Leaking of the waters
It is due to the leaking of the water bag or breaking of the membranes. There is continued leaking of water or sudden gush of water coming out of the vagina. It appears as if there is a sudden loss of control over passing urine. One should notice the colour of the water leaking and its amount. Apply a sanitary cotton pad till you reach the hospital.
If one starts feeling the contraction after every 10 minutes or there is leaking of the water, then one must rush to the hospital. The presence of show means you can still wait for the contractions to be perceived in every 10 minutes and then leave for the hospital. If the leaking starts then it is preferable not to wait for the contractions to begin and reach the hospital earlier.
Diagnosis of labour
It is monitored whether the contractions are true or false. The baby‘s heart rate is checked, that the baby is not in distress. It has been seen that if the baby is in distress, the mother goes into labour. This is a safe mechanism that the nature has structured to guard the fetal well being.
An internal checkup is done to see the consistency, position of the cervix, dilatation, and effacement of the cervix. This is called the Bishop system of scoring the cervix favourability. A score more than 6 means the cervix is extremely favourable for a normal vaginal delivery (childbirth).
Progress of labour
After it has been established that you are in labour, you are admitted in the labour ward.
Fetal heart rate monitoring is done intermittently in low risk and continuous in high risk women. Repeat per-vaginal examination is done after 4 hours to see the progress of labour. The effacement and dilatation of cervix and descent and rotation of the fetal head is observed on per-vaginal examin.
It is important to note that 10 percent of women will feel this labour pain in their back and this pain is starkly different from your regular back pain.
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