Written by Henci Goer ( author of Obstetric Myths vs Research Realities)
Source www.hencigoer.com june 2007

For those of you with visions of either giving birth in your car or making repeated “false alarm” calls, this checklist is for you.

To begin with, forget about TV portrayals of labor, where pregnant women suddenly look startled, clutch their bellies, and gasp, “This is it!”

<!–inline-more–>

You’ll have time to figure things out. The average labor lasts nine hours in first-time mothers and six-and-a-half in women laboring again — and that’s from the onset of regular, painful expansions, occurring five to three minutes apart. Most women have several, if not many, additional hours from the time the first vague twinges begin and this pattern setting in.

While you’re waiting to see what develops, here are seven guidelines that will help you distinguish between prelabor contractions and the real McCoy.

  1. How do the contractions feel?Labor contractions are felt low in the groin or in the lower back. They may radiate from front to back or back to front or down your legs. They are dull and crampy like menstrual or gas cramps. Prelabor contractions, which you may have been experiencing for months, feel like a tightening across your belly or like the baby suddenly stretched in all directions.
  2. How strong are they?A good, business-like labor contractions is strong enough that you cannot walk or talk while you are having it.
  3. How close together?To measure the contraction interval, time from the beginning of one to the beginning of the next. You are looking for a mostly regular pattern three to five minutes apart. The usual advice, barring special considerations, is to make your move when they have been this close together for a couple of hours if this is a first baby and an hour if you have given birth before.
  4. How long do they last?Contractions should last roughly a minute from start to finish. Sometimes in early labor they may seem to last much longer but that’s generally because they are mild enough that it’s hard to tell when they begin and end.
  5. Has the pattern changed over time?Labor contractions will get longer, stronger, and closer together over time. Often contractions go along at one level and then intensify over a fairly short time period, say, an hour or two, as labor shifts gears from early to active phase. Prelabor contractions can sometimes be quite regular over several hours, but the pattern stays the same.
  6. Does changing your activity affect them?Prelabor contractions usually peter out if you get them while you are active and switch to something relaxing such as taking a warm bath. Likewise, if you have been resting and get up and move around, they generally go away. You may be able to get labor contractions to back off somewhat, but with rare exceptions, nothing makes them go away short of having the baby.
  7. Did your bag of waters break?If they broke with a pop or gush, the contractions that follow will almost certainly develop into progressive labor. With a slow leak, contractions may or may not lead anywhere.
  8. You want to use your common sense, of course.If this is your second baby and you wake up with powerful contractions three minutes apart but only thirty seconds long, you don’t want to hang around waiting for them to be a minute long. On the other hand, if you’ve been having contractions five minutes apart for three hours, but you can still keep doing whatever you were doing while you’re having them, there’s no need to panic.

If you are not sure what’s going on and it’s during the day, you can give your midwife a call.

And there you have it: a simple, nearly foolproof (nothing’s perfect) method of ensuring that your baby is born where you intend it to be born and with much less likelihood of jumping the gun.

References

  • Kilpatrick SJ and Laros RK. Characteristics of normal labor. Obstet Gynecol 1989;74(1):85-87.
  • Simkin P, Whalley J, and Keppler A. Pregnancy, Childbirth, and the Newborn. New York: Meadowbrook Press, 1991.