Labor and Birth

When labor approaches your body undergoes changes as it prepares for the birth of your baby. Knowing the signs of labor will help you wait through "false labor" without anxiety and be prepared for "true labor" when it arrives.

Once you reach the third trimester, you should talk to your health care provider or midwife about labor and delivery, you should consider your options for pain relief, find out how to reach your health care provider when you go into labor, and ask at what point in labor should you call or go to the hospital.  Additionally, before you reach the last few weeks of your pregnancy, it is a good idea to visit the hospital or birthing center to make sure you know how to get there, where to check-in and how to pre-register.

Labor Symptoms

It is important to remember that your due date is only an estimate and that the beginning of labor is unpredictable. In fact your labor may begin as much as 2 weeks before or after your due date and still be considered normal. 

Many women, especially with their first babies, think they are in labor when they in reality they are not.  However, since you may not know whether you are in true labor or not, if you think labor has begun you should call your doctor or midwife no matter what time of day or night. 

Typical signs of labor include:

• Contractions between 5 and 10 minutes apart that come at regular and increasingly shorter intervals. Contractions should also become stronger over time.
• You can no longer walk or talk during contractions.
• Your water breaks (can be a large gush or a continuous trickle).
• You experience vaginal bleeding.
• You have a bloody (brownish or red-tinged) mucous discharge. This is probably the mucous plug that blocks the cervix.
• You have lower back pain (back labor) that does not go away.
• You have constant, severe pain.
• You feel reduced fetal movement.

Labor and Delivery Pain

Almost every woman is concerned about how they will manage the pain of labor and delivery.  No one can predict the amount of pain you will feel during labor since every labor and birth is different and the pain depends on your pain tolerance, the size and position of your baby, the size of your pelvis, and the strength of the contractions. 

Different women respond to the pain of labor and delivery in different ways. Childbirth education classes can help you learn breathing and relaxation techniques to help you deal with the pain.  Many women get some form of pain relief through medication.  For additional information please visit the page Managing pain.

Where to Deliver and Who Should Deliver

You may have a choice in where to deliver your baby. You will need to contact your health insurance to find out what options are available.  In general, you can choose to deliver at a hospital, birthing center or at home.

Healthy women who are at low-risk for problems during pregnancy, labor and delivery may choose to deliver at a birth or birthing center.

Healthy pregnant women with no risk factors for complications during pregnancy, labor or delivery can consider a planned home birth. Home births are common in many European countries but in the U.S. they are still controversial.

You also may have a choice in the type of health care provider you would like to deliver your baby. An obstetrician-gynecologist (OBGYN) is a medical doctor who specializes in the care of pregnant women and in delivering babies.

A certified nurse midwife (CNM) and a certified professional midwife (CPM) specialize in prenatal care, labor, and delivery. Both can be a good option is you are at low-risk for problems during pregnancy, labor, or delivery.

You may also be able to choose to have a doula assist with labor and delivery. A doula is a professional labor coach who gives physical and emotional support to women during labor and delivery. They offer advice on breathing, relaxation, movement and positioning. Doulas also give continuous emotional support and comfort to women and their partners during labor and birth.

C-section

With a c-section your baby is delivered through surgery instead of coming out through your vagina.  In a C-section the doctor will make a cut into your abdomen and uterus and remove the baby. For additional information about C-sections, please visit the page cesarean birth.

In the last several weeks of pregnancy you may notice that your abdomen gets hard and then gets soft again.  These irregular cramps are called Braxton-Hicks contractions, or false labor pains.  False labor can occur just at the time when labor is expected to start so it is frequently hard for you to determine if what your are experiencing is true labor or false labor. Do not be upset or embarrassed if you are not able to tell the difference since sometimes the difference can only be determined by a vaginal exam. 

The following labor-related information has been adapted from the University of Michigan website.

One good way to tell the difference between true and false labor is to time the contractions.  Time how long each cramping period lasts and the length of time in between each contraction.  During true labor the contractions last about 50-80 seconds, they occur at regular intervals, and they do not go away when you move around

The table below gives you easy reference to some of the differences between true labor and false labor. However, remember that with the health of you and your baby it is best to be cautious so do not wait to call your health care provider if you think you are going into labor.   

The following list, adapted from the March of Dimes website, can help you prepare for your trip to the hospital or birth center.

For Yourself

A nightgown or big shirt to wear during labor
Socks
Washcloths and towels
Slippers
A few nightgowns, pajamas or T-shirts and sweat pants
A robe
Several pairs of underpants
Large, self-adhesive sanitary pads
Soap
Shampoo
Hairbrush
Toothbrush and toothpaste
Any other toiletries, cosmetics or hairstyling equipment you want
Phone numbers for people you want to call
A telephone charge card
Clothes to wear home (be sure they are loose fitting)

For Your Baby

Most hospitals provide the basics for newborns during their hospital stay: a knit cap, an undershirt, diapers and blankets. When it comes time to take the baby home, you will need your own things.

A receiving blanket
Clothes to wear home, including an undershirt, cap and socks
Disposable diapers (most hospitals provide these)
Bunting or a warm blanket if it’s cold outside
A car seat (if baby is to be driven home)
All states screen newborn babies for certain metabolic disorders soon after birth. Before delivery, discuss the tests with the health care provider who will take care of your baby.