There it is again. Another contraction. Your mind tries to figure it out. Is it labor? Is it Braxton-Hicks? Come on, that definitely feels like too much pressure down there!
Through each step of pregnancy, you’re growing a baby, but you’re also preparing emotionally and physically for the final, most challenging leg of pregnancy’s marathon. Labor and delivery. Wondering what to expect?
How Do I KNOW?
Many women feel Braxton-Hicks contractions — occasional, irregular cramps — in the middle of pregnancy beginning around the 20-week mark. Braxton-Hicks are an uncomfortable nuisance but not the real McCoy. They’re more erratic than active labor, tending to last 10 – 20 seconds every 10 – 15 minutes. Make sure you’re getting enough fluids.
“The most common cause of false labor is dehydration. Pregnant women get dehydrated much easier than non-pregnant women,” Chettiar says.
Hot baths and showers can provide relief. It’s very common to think that some of what you’re feeling is “too much” and that something MUST be going on, but take heart. These are, for the most part, the effects feeling your baby’s weight on your muscles.
“Heat is a natural muscle relaxant so a heating pad on your back — not your belly — is a great option,” Chettiar advises.
LABOR: First Stage
Some signs of early labor include your water breaking, backache, blood-tinged discharge, menstrual-like cramps and low abdominal pressure. Stay close to home, try to rest and be prepared to head to the hospital as the time between contractions increases, which may or may not happen. Since women experience labor differently, some “go” faster than others and some barely progress. Time your contractions from the beginning of one to the beginning of the next (not the end). If they come every five minutes or so for at least one hour, this could very well be it.
And a quick tip about water breaking? Know that unlike dramatization of labor in movies, only about 15% of women have their water break spontaneously as labor begins.
Active Labor: It’s Go Time
If you’re in active labor, contractions are painful and rhythmic in nature, lasting 30 – 60 seconds and occurring every five minutes for at least one hour. Call your midwife or doctor. During this stage, expectant moms feel a wide range of emotions from anxiety and fear about the labor process to excitement that they’ll soon be cuddling their long-awaited baby.
To stay comfortable, try natural pain relief like intermittent walking (unless you’ve dilated beyond seven centimeters), sitting on a labor or peanut ball, or asking your partner for a gentle massage on your lower back.
“Listening to music for distraction and shallow breathing techniques are (also) helpful,” says OB/GYN Peter Caruso, M.D.
Labor and delivery nurse Genna DeBrabander also suggests activities like slow dancing, imagery and visualization, along with changing positions from one side of your body to the other for pain relief.
Active labor has advanced to transitional labor when the intensity of your contractions increases and the cervix dilates from seven to 10 centimeters.
At this point, you’ve entered the second stage of the labor process, which can last as few as 15 minutes to as long as three hours or more. During this stage, you’ll start to push.
Shallow breathing techniques during the first part of a contraction and pushing at the peak of a contraction can help you manage any pain or pressure you’re feeling. Caruso also recommends a squat bar to help ease pain during the pushing phase.
Your emotions may run the gamut, too.
“There are many emotional challenges, such as despair, hopelessness, inadequacy, elation and a sense of accomplishment,” DeBrabander says.
While this is the most physically and emotionally taxing part of the labor process, by the end of all of your hard work you’ll be rewarded with a baby in your arms.
The last stage of labor is the delivery of the placenta. You may barely notice these contractions after giving birth to your baby.
The placenta develops during pregnancy. It attaches to the uterine wall and is connected to your baby’s umbilical cord. This organ supports your baby throughout her time in your uterus, providing oxygen and nutrients and removing waste products like carbon dioxide. If you plan on keeping your placenta, let your doctor know.
After the delivery of your placenta, you may experience cramping as your uterus contracts. You’ll likely encounter perineum pain and swelling, too.
“Topical medications, oral medications and ice packs are great to aid these discomforts,” DeBrabander says.
Christa Melnyk Hines and her husband are the parents of two sons. She’s the author of the self-published book Confidently Connected: A Mom’s Guide to a Satisfying Social Life (2013).