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Congratulations! You are now approaching the Big Day! If this is your first pregnancy, there must be so many doubts regarding the delivery going through your mind. Foremost amongst them will be, "How do I know whether I'm in labour or not?" Well, this is where we come in. We are going to help you identify and recognise the different types of pain you might experience.
During the last eight weeks of your pregnancy, you may experience some irregular contractions or tightening of your uterus. This is fairly common. It is the uterus warming up and doing a 'trial run' before the grand finale—the arrival of your baby!
The contractions begin at the top and slowly spread downwards. They can last from 30 seconds to over two minutes. If you walk about or change your position, these contractions may decrease and even disappear altogether. That's why these are known as 'false' labour or Braxton-Hicks contractions.
Remember, in true labour, the pain does not disappear by changing position; instead the contractions become more intense and occur more frequently.
As the mouth of the cervix begins to open in readiness for the delivery, the mucous plug that seals the opening of the uterus slides out through the vagina. You may notice a blood-tinged mucous discharge. This is sometimes referred to as "bloody show". This may happen a couple of days before the onset of labour and indicates that the cervix is dilating and getting ready for labour.
All through your pregnancy, your baby has been floating in a sac containing amniotic fluid. When the baby is ready to be born, the membranes holding the amniotic sac start to rupture. This can happen suddenly, making the waters gush out, or it can happen slowly, allowing the waters to trickle out. This is referred to as the "breaking of waters". The first contractions normally start a few hours after the waters break, although this is not a hard and fast rule.
Labour begins when the uterus starts contracting regularly. Usually, labour pains start at the lower back, move forwards towards the top of the uterus and embrace the rest of the abdomen. If the contractions are coming more frequently, and if they are getting progressively more intense, then it is true labour. You must time your contractions. If your contractions are over 40 seconds long and are coming 3 in every 10 minutes, then it is true labour. True labour pains cannot be relieved by a change in position.
If this is your first pregnancy, contractions can last many hours. For subsequent pregnancies, the time is shorter.
The initial contractions may not be very noticeable but will gradually increase in intensity. They usually last for 30-45 seconds, are mild and irregular, ranging anywhere between 5-20 minutes apart. You can minimise discomfort by walking around and sitting across a chair. Walking assists the baby's head to descend and increases efficiency of contractions.
Sitting upright and leaning forward on a firm chair is comfortable and allows back massage. Kneeling, squatting, and going down on all fours may also help. Avoid lying on your back as this may reduce blood supply to your baby.
Prepare to come to the hospital. You can eat a light snack if hungry, but avoid a heavy meal.
Regardless of the status of your contractions, you MUST come to the hospital immediately for any concerning symptoms.
Please come to the hospital immediately if you notice any of the following:
You are never alone — we are always available. If you are unsure or worried, please call the hospital once and start towards us. Informing us early helps us prepare and be ready for you when you arrive.
When you come to the hospital, please bring your ID card and all relevant medical papers. You may also carry a small bag with your toiletries and essentials, in case admission is required.
You will be warmly received and escorted to the Labour Ward. The doctor on duty will examine you and assess whether admission is needed. This decision will be made in consultation with the doctor who has been following you during your antenatal visits.
Your comfort and safety are our priority. You and your baby will be carefully monitored, and every step of your labour will be clearly explained to you. Our team is here to support you throughout this journey, ensuring a safe and positive birth experience.
