Common Questions About Labor

Many questions arise as you get closer to your due date. The more you know and understand about the process of labor, the better prepared you will be to choose the best options for you.

What is Labor?

Labor is the process through which your baby is born. Your body produces contractions which tighten and relax the muscles of the uterus. These contractions eventually form a pattern; becoming closer together, stronger, and lasting longer. The contractions work to efface (thin out) and dilate (open up) the cervix, which is the bottom part of the uterus. Once the cervix is open- 100% effaced and completely dilated (10 cm)-the baby can be pushed out of the uterus through the cervix and into the birth canal (vagina) to be delivered.

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How Does Labor Start?

No one really knows exactly how labor begins. We do know that a woman's body produces chemicals called prostaglandins. Toward the end of the third trimester of pregnancy, these prostaglandins can cause the cervix to soften and shorten. We also know that a woman's body produces oxytocin, a hormone released from the pituitary gland. Oxytocin causes the uterus to tighten in a rhythmic pattern; making contractions closer together, stronger and of longer duration.

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What Do Contractions Feel Like?

Contractions do not feel the same for everyone. Some women describe contractions as a constant pressure sensation in the lower back. Other women describe it as a very intense cramping feeling in their abdomen.

Most women, however, describe contractions as a tightening feeling which starts in the back and comes around to the front of their abdomen making it feel rock hard.

We know that in labor, the muscles of the uterus start contracting from the top of the uterus, known as the fundus. The contractions move from the top of the uterus to the bottom in a wave-like fashion. These rhythmic labor contractions make the abdomen feel very firm to the touch.

Each contraction is like a wave. As it builds, the tightening becomes stronger and stronger until it reaches the peak where it feels the strongest. As the contraction comes down from the peak, the tightening becomes progressively milder and then disappears until the next contraction begins.

How Long Will My Labor Last?

Labor and delivery are different for every woman. For first babies, the average labor lasts 12-16 hours; starting from the beginning of regular contractions until the baby is delivered. Because every birth experience is unique it could be as little as 6 hours or up to 24 hours or more. For subsequent babies, labor averages between 6-8 hours.

How Will I Know If I'm In Labor?

Signs that labor is coming vary from woman to woman. For some women, labor begins unexpectedly; others feel that labor may never begin. Some women experience labor in phases over a period of several days. However, experiencing false labor, often called Braxton-Hicks contractions, does not mean that you are not making progress. These contractions may cause the cervix to tilt forward, to soften, and to thin. The cervix needs to soften and thin before it will open. Any of the following signs may occur indicating impending labor.

Signs of Labor

What is True Labor?

True labor contractions produce measurable progress-the cervix effaces and begins to dilate. Some women experience false labor contractions prior to true, active labor starting. The following lists explain the difference between true and false labor.

False Labor

• Contractions are irregular and vary in length and intensity.
• Change in activity or position usually decreases intensity.
• Cervix may soften, but there is no significant change.

True Labor

• Contractions become stronger, longer, and closer together over time.
• Contractions continue or become stronger with a change of activity (for example, walking makes them stronger).
• Cervix effaces and dilates.

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What is Effacement?

Effacement is the gradual thinning, shortening, and drawing up of the cervix. This is measured in percentages from 0%-100%.

Effacement Chart

The cervix initially is long, thick and closed. As labor progresses, the cervix shortens and effaces until it is 100% effaced; becoming paper thin. The cervix dilates gradually as labor progresses. It is measured in centimeters and dilates to approximately 10 cm. The doctor or nurse estimates dilation by feeling the opening cervix during a pelvic exam.

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What is Dilation?

Dilation is the gradual opening of the mouth of the cervix that permits the baby to pass into the vagina. Dilation is measured in centimeters from 0-10 cms.

Many women feel more comfortable at home in the early part of labor. If you think you are in labor, you can try these things:

• Go for a walk. Walking can make contractions stronger. Be sure not to walk too much. You must also conserve your energy.
• Relax. Make sure you rest, especially if it has been a busy day.
• Shower or bathe. Warm water will relax muscles.
• Finish packing. Remember to pack your comfort items and your Birthing Center Binder.
• Eat lightly. Eat foods that are easy to digest such as toast with jelly, soup, crackers, bagels, or fruit.

Wait and watch your body for signs that you are in labor. If contractions now feel stronger and last longer or now feel stronger and are closer together, you may be in labor. Usually, when contractions feel strong and are coming approximately every 5 minutes and last 45-60 seconds over a period of an hour or more, you are in labor.

If you think you are in labor, call your doctor or the hospital. See Signs of Labor.

How Do I Time Contractions?

When you call your doctor or arrive at the hospital you will be asked how far apart your contractions are.

Contractions are measured by their frequency, duration, and strength.

Frequency - How often are they coming? Time contractions from the start of one contraction to the start of the next contraction.

Duration - How long does it last? Time contraction from the start of the contraction to the end of the same contraction.

Strength - How strong is it? The nurse feels the strength of the contraction by placing a hand on your abdomen and feeling the uterus tighten.

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What If My Water Breaks?

The amniotic sac breaks spontaneously for approximately 25-30% of women. This can occur with contractions or before contractions have been felt.

Some women experience a gush of amniotic fluid from the vagina while others may feel a steady trickle of fluid. Since this can happen anywhere, you may want to keep a towel in your car or at work during the last month of your pregnancy.

If you suspect your amniotic sac has broken, you should immediately call your doctor or the hospital for further instruction. Be prepared to tell them the amount, color, and odor of the fluid and the time that it occurred.