If you’ve never given birth before it’s hard to imagine what labour feels like. It’s also natural to wonder how you’ll know if this is the real deal. This is often met with the rather unhelpful response: “you’ll know!”. Labour can feel very different for different women, so to help you decode what’s happening, Obstetrician and Gynaecologist Dr Brad Robinson has put together this essential guide to labour contractions.
This guide is crucial because of how much of a conundrum preterm delivery is. Preterm delivery is described – quite rightly – as the great challenge of modern obstetrics. It is essentially impossible to predict, and when it does occur it is very hard to stop. It is defined as delivery under 37 weeks of gestation, and it affects about 7.5 percent of women.
To be clear, Braxton Hicks are not labour contractions. But rather, it’s your body practicing for the big day. They feel like tightenings across your belly, and generally don’t hurt. The major difference between a Braxton Hicks contraction and a labour contraction is that Braxton Hicks won’t dilate your cervix. They also don’t come with any regularity, get longer or stronger or come closer together.
But they do serve some purpose, they’re not there just to drive you crazy! They tone the muscles in the uterus in preparation for labour, so your uterus is strong for when you really need it to be. You can read more about Braxton Hicks here.
A strange, but useful analogy, for Braxton Hicks contractions is the image of an old lawn mower.
I always think about the old mower where you pull the cord and the engine turns over once. Then you pull it again and it chugs a few times before spluttering out. But eventually, the engine gets warm and starts running efficiently.
So this rather unusual analogy describes how Braxton Hicks contractions warm your uterus up prior to the big event of labour so that when it is time to go, your uterus is warmed up and ready.
These are regular contraction before 37 weeks of pregnancy. If you are getting contractions every 10 – 12 minutes for longer than an hour, it’s worth putting a call in to your health care provider. Along with the tightenings of contractions you may also feel a dull backache, pressure in your pelvis or your abdomen and possibly cramping.
The difference with uterine activity that you need to be concerned about versus Braxton Hicks is that these cause a global tightening across your abdomen, so your entire belly gets hard not just one region of it. They are also painful and if it is genuine preterm labour they will stop you talking when you get them.
Early labour contractions are quite mild and will last between 30 to 90 seconds. Early labour contractions have been likened to strong period pain, so they are quite manageable at home. They may be well spaced to start with (around 20 minutes or more apart), but will still be regular.
Other signs that may suggest this is the real thing is your mucus plug may come away (also known as a ‘show’), or your waters may break. But ultimately if the tightenings continue to get more intense and start coming closer together, it’s probably time to let your partner know that labour has started. Early labour can last for up to 12 hours, so while you can manage the contractions at home, it’s worth staying there so you can rest in the comfort of your own home.
It’s understandably often really hard to know what to do and when to present to your hospital, so, if you have any questions, you should ring your birth suite which are typically staffed 24 hours a day, and explain to the midwives exactly what you are experiencing.
They’ll help guide your decision about whether to stay home with Panadol and a heat pack, or come in to hospital to be assessed.
The contractions you will experience in active labour are the ones that move your baby downwards, so it stands to reason that they are strong (and potentially painful). Your body has a lot of work to do in this time, so your uterus is flexing it’s muscles in an effort to deliver your bub.
Full blown contractions may feel like they are wrapping around you, or they may start in your back and move around to your torso. Your legs may ache and feel crampy. These generally last between 45 and 60 seconds, with three to five minutes in between.
This is when your body is doing the really hard work. Your cervix will dilate from around seven centimetres to 10cm in transition. Once you reach 10cm you can start to push the baby out. Transition can be intense with contractions lasting between 90 seconds to two minutes and come as frequently as 30 seconds to two minutes apart. In transition you may also experience shivering, nausea or hot flashes.
The key to identifying ‘real labour’ as opposed to a false alarm is that nothing will stop labour, so if those tightenings, turn in to painful contractions, and they just keep coming it’s probably time to head to the hospital.