You are, step by step, working your way up to labor, though you may not even realize it. You may feel quite different now. Perhaps it seems as though the baby’s head is pressing against your pelvic floor more than it did before. You might begin to have more frequent Braxton-Hicks contractions. Your midwife or doctor may tell you that your cervix is ripe, or even that it is slightly dilated.
A woman is not considered to be in true labor, though, until she is dilated to around three centimeters and is having contractions that are regularly spaced apart. Labor itself is divided into three stages.
During stage one, regular contractions are slowly opening the cervix. In stage two, the cervix is fully dilated, and the contractions are pushing the baby down the birth canal until it is born. In stage three, the placenta and other membranes are expelled.
Before labor begins in earnest, you may experience some, or all, of these early signs that it is likely to happen soon:
- The nesting instinct. You may find yourself compulsively cleaning the house. You may feel a real urgency to make sure that everything is prepared and ready for the baby.
- “Lightening” or “engagement.” As the baby’s position changes, you might find it easier to breathe, but the head’s contact with your pelvic floor will bring new sensations. You may need to urinate more frequently. Some people also say that the baby has engaged or “dropped” into a position that prepares him for birth.
- Weight loss. Women will sometimes lose two or three pounds right before they are going to go into labor.
- Malar flush. This is a rosy-colored flush over the cheeks and chin that often happens shortly before a woman goes into labor.
- Light contractions. You may have experienced Braxton-Hicks contractions throughout your third trimester, or you may not have felt any at all until now. These contractions generally feel like a thick elastic band is stretching around your midsection and pulling tight for a few seconds. They are not usually strong enough to interfere with your daily life, though you may pause for a moment while you are actually having one. They can become more and more frequent as time goes by, or you may have them for a couple of days and then stop altogether. Some women never experience them at all. These contractions are helping your cervix to ripen.
- Cervical ripening. This sometimes happens gradually over a period of several days, or it can happen quite quickly. The ripening, or effacement, of the cervix is often likened to the difference between pursing the lips of your mouth up tight and then allowing them to relax and become soft. The cervix must become soft so that it can begin to dilate.
- Cervical dilation. When your cervix has dilated one or two centimeters, labor may be close, or it could still be many days away.
- A bloody show. The mucus plug that has sealed your cervix off until now is expelled. It will look like a bit of bloodstained mucus. This often means labor is imminent.
- Cramps. You may feel a low, indefinite crampy sensation. It may feel like you are about to have a menstrual period.
- Low backache. The crampy sensation described above may be more centered in the area of your lower back.
- Breaking or leaking of the bag of water. This may happen all at once. You’ll find yourself, all of a sudden, standing over a small puddle of clear liquid. Or you may notice just a bit of it in your underwear. If you are leaking, and your due date is three weeks or less away, try to just go about your business, but call your physician or midwife and let him or her know. If the water bag breaks all at once, you should let your care provider know, but you are still not in active labor until you are having regular contractions.
If your water has broken, there is an increased chance of infection as time goes by. For this reason, many physicians and midwives do not want you to wait.