Pre- and Early Labor Signals

• Initiation of labor, progression and signals of labor

Parents face two common challenges during late pregnancy.
1) Impatience to end the pregnancy due to discomfort, fatigue and eagerness to hold their baby
2) The possibility of a long, discouraging pre-labor phase.

These challenges make parents more accepting of induction or vulnerable to the belief that there is something wrong. Parents need to understand that labor normally begins only when all of the following occur:
• The fetus is ready to thrive outside the uterus (breathing, suckling, maintaining body temperature, and more).
• The placenta has reached the point where it can no longer sustain the pregnancy.
• The uterus is ready to contract, open and expel the baby.
• The mother is ready to nourish and nurture her baby.

If parents understand that fetal maturity is essential in initiating the chain of events leading to labor, they may be more patient with the discomforts of late pregnancy, and less willing or anxious to induce labor without a medical reason.

Natural induction methods are a viable options to assist and allow for the above criteria to be met and for labor to commence. However, they are not meant to coax the baby out but rather to encourage the process along. I will blog about natural induction methods coming up but for now, please see one delicious way by checking out my Labor Cookies Recipe.

The ways to progress to a vaginal birth
Progress before and during labor and birth occurs in many ways, not simply cervical dilation and descent, which is what most people focus on. Labor unfolds gradually, which begin weeks before labor and involve the cervix. The cervix moves forward, ripens, effaces and then dilates. When parents understand that a long pre- or early labor is accomplishing necessary progress – preparing the cervix to dilate – they are less likely to become anxious or discouraged that nothing seems to be happening. The other steps involve the fetus: the fetal head repositions during labor by flexing, rotating, and moulding to fit into the pelvis; and lastly, the fetus descends and is born.

Possible signs of labor

• Nesting urge
• Soft bowel movements
• Abdominal cramping
• Backache that causes restlessness

These may or may not continue to the clearer signs of labor and may be associated with early cervical changes.

Pre-labor signs
The most important of these is the first one:

• Continuing ‘non-progressing’ contractions (that is, over time, the pattern remains the same; they do not become longer, stronger or closer together)
  
• Possible leaking of fluid from the vagina
  
• Possible ‘show’ – bloody mucus discharge from the vagina

With these signs, the cervix is probably not dilating significantly, but is likely to be ripening and effacing.

​Positive signs of labor
The most important of these is the first one:

• Continuing, progressing contractions, i.e. contractions that become longer, stronger, and closer together (or at least two of those signs). These progressing contractions cause cervical dilation, which is the clinical definition of labor.
  
• Spontaneous rupture of the membranes (SRM), especially with a gush of fluid. This happens before or at the onset of labor in about 8% of women at term. It most often happens late in labor. SRM is only a positive sign of labor in conjunction with continuing progressing contractions.

Positive Notes
Staying positive amidst pre- and early labor is important in the process of delivering your baby. Women progress in many different ways and your journey is your own pathway to forge for you and your baby. The hard work put into the process is well worth it. Just knowing the signs above can and will help in understanding when it is a good time to bring in your birth team, call your midwife, go to the hospital (or stay at home), and move forward in a positive and healthy manner.

Stayed tuned for more progression through labor and delivery, as well as some natural induction methods!