Many women who are having their first baby worry that they won't know when their labour starts. Sometimes, the first sign is when your water breaks, more often though you will feel abdominal cramps which are also known as contractions. They will grow stronger, more painful, and closer together as your labour progresses. If you are having a 'false' labour, these contractions will stop in a few hours. You should come to the hospital when your contractions are five minutes apart and last between 45 and 60 seconds in length. If your water breaks, you should come to the hospital. For more information please click here .
Before your labour and throughout your pregnancy, there are also a number of symptoms that you should be aware of. If you begin to have any of the following symptoms between check-ups, you should contact your primary caregiver right away.
- vaginal bleeding
- swollen hands or face
- burning when you urinate
- less kicking from the baby
- severe pain in your chest or abdomen
- unusual headaches
- gush of fluid from your vagina
- regular cramps (uterine contractions)
Preterm labour is any labour that starts before week 37 of your pregnancy. It may not always be easy to tell if you are having a preterm labour, however there are certain symptoms that you should be aware of. If you experience any of these as new or different symptoms from what you are normally used to, contact your primary care provider right away.
- Fluid flowing from your vagina. (This can be a sudden or constant and slow)
- Bleeding from your vagina.
- Low, dull backache.
- Pressure in your pelvis.
- A feeling of being full or heavy down below.
- A general feeling that something is just not right.
In certain circumstances, if you haven't begun labour, your primary caregiver may discuss induction with you. If you meet certain criteria, some of the following procedures may be performed as an outpatient procedure, meaning you don't have to stay in the hospital.
If your health-care provider decides you should move ahead with induction, an appointment will be booked for you. You will receive a phone call from KGH the night before your induction to confirm the time that you should arrive to start the induction process. When you arrive at KGH, go straight to the nursing station in Labour and Delivery on Connell 5. Someone will greet you and bring you to a room where your induction will begin.
The nurse will ask you questions as they check your vital signs and will also put the fetal monitor on your abdomen to make sure that the baby is healthy before they begin. The procedure will be performed by a doctor or resident. There are two ways this procedure may be done and during either procedure, your triage nurse will monitor you frequently. When you are stable, you may be sent home with follow-up care instructions and tole return to the hospital when active labour begins.
For more information you can read our Induction of Labour booklet.
Click here to learn more about Oxytocin
Cervical ripening for induction
A medicated gauze will be inserted into your vagina and is similar to a tampon, only smaller. You may experience some back pain and cramping as well as some pink discharge once it has been inserted. It will often it take several hours before you feel this. In rare occasions contractions start quickly and occur too often. In this case the medicated gauze can be taken out.
Mechanical cervical ripening for induction
This method involves the insertion of a catheter into your cervix. A balloon on the tip of the catheter is then expanded. It is quite normal to experience discomfort throughout the procedure, followed by some menstrual-like cramps, that may end within a half hour.
Misoprostol for cervical ripening and induction
Misoprostol is a medication used for cervical ripening and induction of labour. You will be given this medication to take by mouth. You may experience cramping or contractions right away. In other cases, it may take a few doses of the medication to cause cramping or contractions. You can be given this medication every four hours until you are ready for your induction or your labour has started. In rare occasions, contractions can start quickly and occur too often. In this case, you will be given a medication to stop the contractions.
Oxytocin is a hormone that is produced naturally and helps your uterus to contract. Oxytocin may be also recommended if your labour slows down or your contractions are not strong or frequent enough to allow your cervix to open. Click here to read more about induction and augmentation of labour with oxytocin.