1.

Signs of labor
Signs of labor include strong and regular contractions, pain in your belly and lower back, a bloody
mucus discharge and your water breaking. If you think you're in labor, call your health care provider.
Not all contractions mean you're in true labor.

2. Preliminary signs of labor

Before labor, a woman often experiences subtle signs that signal labor is imminent. It is important to
review these with women during the last trimester of pregnancy so they can more easily recognize
beginning signs.
 Lightening - descent of the fetal presenting part into the pelvis, occurs approximately 10 to 14
days before labor begins
o Lightening probably occurs early in primiparas because of tight abdominal muscles. In
multiparas, it is not as dramatic and usually occurs on the day of labor or even after
labor has begun.
A woman may experience shooting leg pains from the increased pressure on her sciatic
nerve, increased amounts of vaginal discharge, and urinary frequency from pressure on
her bladder.
 Increase in Level of Activity - A woman may awaken on the morning of labor full of energy, in
contrast to the feeling of chronic fatigue she felt during the previous month.
o This increase in activity is related to an increase in epinephrine release initiated by a
decrease in progesterone produced by the placenta. This additional epinephrine
prepares a woman’s body for the work of labor ahead.
 Slight Loss of Weight - As progesterone level falls, body fluid is more easily excreted from the
body. This increase in urine production can lead to a weight loss between 1 and 3 pounds.
 Braxton Hicks Contractions - a woman usually notices extremely strong Braxton Hicks
contractions.
 Ripening of the Cervix - is an internal sign seen only on pelvic examination. Throughout
pregnancy, the cervix feels softer than normal to palpation, similar to the consistency of an
earlobe (Goodell’s sign). At term, the cervix becomes still softer (described as “butter-soft”), and
it tips forward. Cervical ripening this way is an internal announcement that labor is very close at
hand.

3. Signs of true labor

Signs of true labor involve uterine and cervical changes. The more a woman knows about these labor
signs, the better she will be able to recognize them. This is helpful both to prevent preterm birth and for
the woman to feel secure knowing what will happen during labor.
  Uterine Contractions - The surest sign that labor has begun is productive uterine contractions.
Because contractions are involuntary and come without warning, their intensity can be
frightening in early labor. Helping a woman appreciate that she can predict when her next one
will occur and therefore can control the degree of discomfort, she feels by using breathing
exercises offers her a sense of well-being.
 Show - As the cervix softens and ripens, the mucus plug that filled the cervical canal during
pregnancy (operculum) is expelled. The exposed cervical capillaries seep blood as a result of
pressure exerted by the fetus. This blood, mixed with mucus, takes on a pink tinge and is
referred to as “show” or “bloody show.” Women need to be aware of this event so that they do
not think they are bleeding abnormally.
 Rupture of the Membranes - Labor may begin with rupture of the membranes, experienced
either as a sudden gush or as scanty, slow seeping of clear fluid from the vagina. Some women
may worry if their labor begins with rupture of the membranes, because they have heard that
labor will then be “dry” and that this will cause it to be difficult and long. Actually, amniotic fluid
continues to be produced until delivery of the membranes after the birth of a fetus, so no labor
is ever “dry.” Early rupture of the membranes can be advantageous as it can cause the fetal
head to settle snugly into the pelvis, actually shortening labor.
o Two risks associated with ruptured membranes are intrauterine infection and prolapse
of the umbilical cord, which could cut off the oxygen supply to the fetus

4. Components of labor and its description

A successful labor depends on four integrated concepts:
1. A woman’s pelvis (the passage) is of adequate size and contour.
2. The passenger (the fetus) is of appropriate size and in an advantageous position and
presentation.
3. The powers of labor (uterine factors) are adequate. (The powers of labor are strongly influenced
by the woman’s position during labor.)
4. A woman’s psychological outlook (psyche)is preserved, so that afterward labor can be viewed.