What is labor?
Labor is when you have contractions that cause your cervix to open (dilate). Your cervix is the opening at the bottom of your uterus (womb, where your baby grows) and it has to be dilated to 10 cm for the baby to come out. Through the labor process your cervix also gets softer and thinner.
How to know if you are in labor
Many people who are pregnant have practice contractions before labor really begins. Here are some ways to tell the difference between practice contractions and true labor contractions.
Practice contractions (sometimes call Braxton-Hicks):
- Feel like a tightening of your abdomen
- Do not get stronger, closer together, or last longer over time
- Usually go away with a position change, hydration, or a shower/bath
*If you are less than 37 weeks pregnant and you feel more than four contractions in an hour that do not go away with rest you should call your provider*
True labor contractions:
- More painful than a practice contraction
- Will get stronger over time
- Will not start and stop with position changes, hydration, or a shower/bath
- Usually feel like they start in your back and move to the front of your body
- Will take your full attention and usually require you to stop talking and breathe through them
*There are many normal things that you may experience when you are in labor. Some of these include nausea/vomiting, diarrhea, and losing your mucus plug.*
When to come to the hospital
Painful contractions can happen intermittently in the weeks leading up to labor. When contractions are in a regular pattern, you might really be in labor.
Most full term, low risk pregnant people can follow the “5-1-1 rule.”:
- Contractions every 5 minutes
- Contractions last for at least 1 minute each
- This pattern continues for at least 1 hour
Sometimes, even if you are having contractions that follow the 5-1-1 rule your cervix may not be ready to open yet. When you come to the hospital, we may recommend that you return home so that you can be more comfortable and then come back to the hospital when your contractions are stronger.
You should also come to the hospital or call your provider if you are experiencing vaginal bleeding, if you think your water broke, or if you are not feeling the baby move as much as usual.
How long will your labor be?
Everyone’s labor is different. It is very difficult to predict how long someone’s labor will be. Some people are only in labor for a few hours but there are some people who are in labor for 24 hours or more. You are more likely to have a longer labor if you are having your first baby or if your labor is being induced. A cesarean section is sometimes needed during labor if the cervix does not open completely despite medication or the baby needs to be delivered quickly because of a problem for the you or your baby.
What happens when it’s time to push?
When you are 10 cm dilated it will be time to push. Here are some things to expect:
- A strong urge to bear down like you are having a bowel movement.
- The urge to push may be diminished with an epidural.
- Your doctors, midwives, and nurses will work with you to help you push with your contractions.
- You can push in many different positions and your birth team will help you find a position that is comfortable for you and safe for your baby.
- Pushing can be hard work and may take up to several hours.
- Pushing can take longer if you are having your first baby or if you have an epidural.
- Pushing usually goes faster for someone who has had a baby before or someone without an epidural.
- If the baby does not move down the birth canal with pushing, or needs a quicker delivery for the safety of you or your baby, your team might talk to you about using a vacuum cup, forceps or doing a Cesarean section.