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How will I know when I am in Labour?
Did you know only around 60% of women go into labour spontaneously?
The number is probably less than this, around 40% of labours are induced, so 40% of women don't have to put this into practice!
But most women express that they would prefer to go into labour naturally and this is usually one of the first questions they have, especially as they near their due date.
What are the early signs of labour?
In the days and weeks proceeding labour you may feel / see some signs that your body is making changes to ready it for birth.
It is hard to define where labor begins!
You might start to loose your mucus plug, your belly may 'drop' and you may feel increasing pressure in your pelvis
You may have already been experiencing 'practice contractions' called Braxton hicks contractions throughout your pregnancy or these might start ramping up in the final weeks!
In the movies the first sign of labour is your waters breaking, but did you know this only happens in 1 out of 10 cases!
For most of us the first sign of labour is ' true labor ' or ' labor contractions '. These differ from Braxton hicks as they don't stop, they are 'regular', they may be painful and they are increasing in intensity.
The start of having contractions can feel like period pain, back pain or stomach ache, after a while you may start to notice that the contractions start, increase in intensity, peak and then start to fade away.
At first they may be once every hour or so, or be irregular but the time between them generally decreasing.
In early labour you will probably be able to talk through the contractions at first, and be able to carry in every day tasks.
As Labor progresses things start to change.
The contractions get closer together and more intense, for example five minutes apart and you may feel like you have to pause and breath through them, and feel as though you want to slow down and get in your zone.
What is 'Active Labour'?
The Medicalization of childbirth has led to the definition of the 'stages' of labour.
There is evidence that if you attend the hospital or the birthing center before you are in 'active' labour, you have a higher likelihood of labour augmentation with oxytocin, epidural, and needing a caesarean.
This is probably because the longer you are in hospital, the more interventions you are offered.
The NHS defines active labour as 4cm dilated and you are having regular contractions (3 contractions in 10 minutes).
Once you get to this point you will often call the maternity unit for medical advice, and they will offer their opinion on if you should come in for assessment.
At this point you will probably be 'in the zone' and requiring your coping mechanisms during the contractions.
But at home, you can't give yourself a cervical exam (not that it tells you anything about how long it will be until the baby arrives - but that is another post for another day!).
What you can do is time contractions - so let's take a look at that!
Contraction timers and apps
As we have embraced technology, you'd think as a virtual doula I would recommend a nifty contraction timer, but this is where you might be shocked!
A lot of companies including hypnobirthing companies have developed Apps with built-in algorithms that alert you when you have met the (3 in 10) threshold, this seems like a great idea, right?
You press a button when the contraction begins and again when it ends, simple!
Some even have built-in positive affirmations, symptom / health trackers, and relaxation tracks you can toggle between.
Timing contractions seems like a win-win situation!
How a contraction timer app contributed to sabotaging my first birth.
I downloaded the App developed by the hypnobirthing course I had done, it seemed great. (it was actually named after one of my baby names)
When contractions started I went on a walk with my husband, every time I got a contraction, I pulled the phone out of my pocket, hit start, and then hit stop when it was over, eventually I just kept the phone in my hand.
When things got more intense, I put on my TENs machine, now I had two buttons to press, my contraction timer and the Boost button.
Quite quickly the App told me I was in active labor, the color changed and a little symbol appeared!
My husband called the hospital, and they spoke to me, they said they thought I should stay at home a little longer - I know now they were listening to how I coped with the contractions whilst I was on the phone, I could talk, I was rational and therefore their clinical decision was that I was not yet in active labor.
So we waited, but the App kept flashing, and we were worried about leaving it too long I was still timing all the contractions, and I felt flustered, and frustrated when the contractions seemed to space out, eventually we decided to go into the hospital anyway!
I was 3 cm and so began the cascade of intervention.
Looking back, I was not in active labor, I was coping well with contractions, I could talk through some of them and some of them were pretty short and/or far apart.
Crucially - I did not feel like I needed more support, I just thought I needed to go in because the App told me it was time!
How using contraction timing can impact early labor.
Every time you get your phone out, you take yourself out of 'the zone'.
You are placing your focus externally not internally,
You are relying on technology to tell you when you need additional support, not listening to your body and your instincts.
It is really actually very hard to know when a contraction begins and ends, you might feel worried that you are 'not getting it right' or that you missed one!
You are paying attention to the timing and length of your contractions, not how they feel and how you are coping with them.
Seeing the times listed in front of you can feel frustrating if they are not getting closer together or longer, you could start second-guessing yourself!
You will see everything else on your smart phone as well, messages, missed calls and social media notifications!
If your partner is doing the timing, they are concentrating on the timing and not you. They might not want to step out to get you a drink, or may need to stop doing that amazing massage or counter pressure to click the button!
What I suggest instead as your virtual doula!
When your contractions start, ignore them whilst you can, carry on with everyday life, rest, sleep, and conserve energy!
Once you can't carry out tasks during contractions you should start to take your focus inward, concentrate on getting through each contraction, and then relax between them, using your breathing and relaxation techniques.
When you feel like the contractions are regular, you aren't getting much space between them and perhaps you would like some additional support, now is the time to ring the midwife.
Now... here is the kicker, the hospital is going to ask for the timings of your contractions...
This is why I recommend your partner use a stopwatch to time a few of your contractions when they feel that they are getting regular and Intense, they shouldn't tell you they have started doing this, it's for information only!
They should avoid downloading an App though as if they see the 'Active labor' alarm they are going to start influencing the decision to go into the hospital.
Who am I?
I am Charlotte, a Virtual Doula, providing bespoke evidence-based pregnancy support to families who want an empowering birth.
With 10 years + of clinical research experience, a biomedical science degree, and two hospital births under my belt, I use my knowledge to provide pregnancy support to help you make informed decisions about your pregnancy, birth, and postpartum.
I provide pregnancy support for all types of births, including hospital births, helping you to navigate NHS guidelines and have an empowering positive birth.
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