Labour : How do I know whether I am in labour?



Birth is a normal and natural process. About 70 – 80 % of babies are delivered via normal birth each year. Delivering a baby is a great challenge, and most women find the thought scary and intimidating initially. With better information and preparation, most women find it comforting to know what to expect during labour and delivery. One is likely to look back once it’s done and find nothing but the purest joy of having your baby in your arms.
a)      Am I in Labour?
This is a question most women are concern about but yet afraid to ask….as though we are expected to know this instinctively. Let us reassure you that it is a perfectly normal question and the midwives and obstetricians are most happy to answer all your questions and address your doubts.The signs which show that you are going into labour include:
(i) Passing out a mucous plug
Throughout pregnancy, a mucous plug is situated at the opening of the neck of your womb (cervix) to prevent ascending infection. This mucous plug is clear and gelatinous looking. Before the onset of labour whereby the cervix is dilating and effacing, the mucous plug occasionally becomes dislodged and being passed out. However, it is difficult to predict when the labour is going to start with this sign. It could be in one or two days, or even weeks away as the cervix continues to open up gradually over time. Some women may not notice the passing of mucous plug as there is already increased vaginal discharge during pregnancy
(ii) Bloody show
Passing of a mucous discharge with pinkish or brown tinge or with blood is a sign of cervical dilatation. It is caused by the rupture of blood vessels at the cervix as it dilates and efface, preparing for the actual labour, which may take place in one to two days. You do not need to rush to the hospital with the first sight of show. However, if the bloody show is heavy, bright red and/or associated with severe tummy pain, you should contact your obstetrician immediately as you could be experiencing complications such as placenta praevia or placental abruption.
(iii) Your water breaks (Rupture of membrane)
Some women may experience a sudden loss of pale, clear or straw-coloured fluid, which typically gush out between their legs and soaked their pants and clothes. It can also happen when they are lying down in bed. This is a sign that your water bag has broken. However, it is sometimes difficult to distinguish that from urine. One of the clues is that the amniotic fluid is ordourless. Urine has a smell of ammonia. Another clue is if you continue leaking the pale coloured fluid despite squeezing your pelvic muscle (Kegel exercises).Please contact your obstetrician if you experience rupture of membrane. Do not have sexual intercourse or introduce anything into your vagina such as tampon because this may potentially cause infection to your baby.
(iv) Regular contractions
The onset of regular and painful contractions associated with progressive engagement of your baby’s head and dilatation of the cervix is the most significant sign of labour. These contractions initially feel like menstrual pain or lower backache and can be irregular. During early labour, these contractions could be as far apart as 20-30 minutes. However, as the labour progresses, the contractions become more regular and intense, happening every 10-15 minutes or less. When the intervals are consistently 5 minutes apart, you should call your obstetrician. 
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