You may have already noticed prelabor signs. These have probably included an increase in Braxton Hicks contractions, an increased vaginal discharge that might be pink tinged, your baby's head dropping to become engaged in your pelvic area, and sometimes diarrhea.
Now is when you're also most likely to see a "bloody show," that brownish or bloody mucous smear caused by the mucus plug being freed when your cervix dilates enough to let it slip out. And 10 percent of the time, your water will break just before you go into active labor.
Beyond that, the surest sign that you're really, truly, no kidding, actually in labor is regular contractions that increase in frequency, severity, and duration as time goes on. Before, with Braxton Hicks contractions, you could usually get them to slow down or stop by lying down, changing position, or downing a few glasses of water. This time, the contractions will most likely start in your lower back and radiate around to your abdomen and legs, causing pain that some women describe as "grabbing" or "pulling." They won't go away if you lie down or change position, and they'll get stronger over time. During this first stage of labor, the cervix thins, or effaces, and then dilates about 1 centimeter every hour. The contractions are between 5 and10 minutes apart. If this is your first baby, it takes lots of contractions to completely thin the cervix.
You may feel euphoric or energetic when you realize that you're in labor at last. You may start washing floors or get three closets cleaned out, top to bottom. You may feel so excited about your baby's arrival that you want to get every last-minute thing done that you can possibly think of, even the grocery shopping, because today is The Day. It would be better to take a leisurely walk. And get some rest too. You need to store up your energy for the active labor to come. Toward the end of this early labor stage, your contractions will become stronger and you may suddenly feel like curling up in a corner by yourself. When to alert your doctor that it is The Day depends on several things such as whether this is your first baby or your second, the distance from the hospital, whether the baby is known to be head-down, and if there is no bleeding and the baby is moving. Some women follow the 1-5-1 rule. That's when your contractions each last a minute or more, are no more than 5 minutes apart, and have been going on for 1 hour.
Originally published in You & Your Baby: Pregnancy.
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