woman in labor

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I’ve done all of my preparing for labor, but how will I know when I’m really in labor? When should I head to the hospital?

I know it can be nerve-wracking to think that you’ll have your baby in the grocery store or in the car on the way to the hospital, but most people have plenty of warning when they go into labor at term. As a matter of fact, it is more likely with a first baby to go into the hospital too early than to get there very late in the process. So don’t worry, that hospital tour you took when you were preparing for labor won’t be in vain!

About 10 percent of women break their water before labor begins. This may feel like a pop, followed by a big gush of fluid, or it may come as an on-and-off trickle. If you are not sure, try putting on a sanitary pad, lying down for a while, and then getting up and walking around. Amniotic fluid has a distinct odor, some say similar to Comet cleanser, so you should be able to distinguish it from urine or normal gooey vaginal discharge. A small amount of bleeding called “bloody show” is normal near term, and may precede labor by several days. If you have any question whether you have broken your water, call your doctor or midwife for advice. Often an examination can answer the question.

More commonly, though, labor starts with contractions. At first these may feel like menstrual cramps, or like the baby is balling up. Your whole uterus will become hard to the touch for 30-60 seconds, and then relax and become soft again. I usually tell my patients having a first baby not to time contractions until they are so intense that they need to change activities in order to get through them, or intense enough that someone with them could tell something was up by their change in facial expression and breathing. Strong contractions coming five minutes apart or closer for an hour usually mean labor has begun and it’s time to bust out all those breathing techniques you learned when you were preparing for labor. Your doctor or midwife can give you specific recommendations for when to call, and when to head in to the hospital or birth center.

Answered by Dr. Marjorie Greenfield