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$Unique_ID{PAR00432}
$Pretitle{}
$Title{Pregnancy: The Seventh Month: Ask the Doctor}
$Subtitle{}
$Author{
Editors of Consumer Guide
Ellis, Jeffrey W
Ellis, Maria}
$Subject{Seventh Month Ask Doctor recognize labor placenta uterus muscles
contraction cervix birth canal prelabor false Prodromes Lightening lungs
breathing bladder frequent urination Mucous Plug Passage Bloody Show dilate
dilates dilation Increase Vaginal Secretion Secretions Nesting Urge Increased
Braxton Hicks Contractions tightening abdomen cramping pain lower back bag
waters amniotic fluid sac breaks leaks Visit}
$Log{}
Miracle of Birth
The Seventh Month: Ask the Doctor
How Will I Know When It's Time?
Nearly every first-time expectant mother wonders and even worries about
whether she'll recognize labor when it begins. You may feel quite helpless,
since no conscious action on your part can start labor.
No one really knows exactly what causes labor to begin. As far as we
know, it is neither you nor your baby who decides the time of delivery, but
rather the placenta and the muscles of the uterus. When conditions are right,
the uterus begins contractions that will open the cervix and press the baby
down through the birth canal.
How will you know when you are in labor? As basic as this question is,
it is often one of the most difficult to answer. It may take hours or even
days to figure out whether the sensations you are feeling are labor or
something else (prelabor or false labor, for instance). This is because, in
most women, labor does not begin suddenly but rather evolves gradually. At
some point, you and your doctor will recognize that what you are feeling is
true labor.
In this section, you'll find descriptions of prelabor symptoms, false
labor symptoms, and signs of labor to help you recognize labor when it begins.
Prelabor Symptoms (Prodromes of Labor)
As your body is preparing for labor, you may experience the following
signs and symptoms, called prodromes of labor. The appearance of these
symptoms does not mean that labor will start immediately--it may still be
several days before you go into true labor.
Lightening
This is the settling or "dropping" of the lowest part of the baby (head
or buttocks--whichever is facing downward) into the pelvis. You can often
tell that lightening has occurred because the bulge in your abdomen is lower.
As the top of the uterus drops lower, the pressure on your lungs will be
relieved and breathing will be easier. At the same time, however, increased
pressure on your bladder will cause frequent urination.
If this is your first pregnancy, lightening will probably take place
about two to four weeks before labor begins. If you have already had a baby,
lightening may not begin until you are in labor.
Passage of the Mucous Plug ("Bloody Show")
As the cervix begins to dilate (open), the plug of mucus that filled the
canal of the cervix is expelled into the vagina. Sometimes, this mucous plug
is pink or blood tinged and is commonly called "bloody show."
Increased Vaginal Secretions
Your normal vaginal secretions may increase about two weeks before labor.
The "Nesting Urge"
Many women feel a sudden burst of energy a few days before labor begins.
You may feel a nearly uncontrollable urge to scrub floors, prepare the baby's
room, clean out closets, straighten cabinets, and do other household work.
Increased Braxton Hicks Contractions
During the last month of pregnancy, Braxton Hicks contractions normally
increase in frequency and strength. There may be periods in which they become
quite strong, making you think that you are in labor. However, Braxton Hicks
contractions are usually felt as a "tightening" in the abdomen without much
associated pain. Doing something active--walking, for example--usually causes
them to stop.
"False Labor"
Sometimes, a woman will experience what is commonly called "false labor."
Although she may be experiencing mildly painful contractions, the pain or
discomfort is felt in the lower abdomen rather than in the lower back, and
the contractions occur irregularly. Indeed, these false labor contractions,
which generally last for less than 30 seconds, may actually start and stop
over a period of several days. Also, they usually disappear with activity.
Labor Sensations
When labor actually begins, the contractions are often felt as a
cramping pain that begins in the lower back and spreads to the lower abdomen.
If you put your hands on your abdomen when you feel this sensation, you will
find that your entire uterus is hard.
Generally, labor contractions initially last about 30 to 45 seconds and
occur about 15 minutes apart. Over a period of a few hours, the contractions
will become stronger and more painful, they will last longer, and they will
occur more frequently. They will not stop with activity like Braxton Hicks
contractions do.
During one of your prenatal office visits, ask your doctor when you
should call him if you suspect that labor is beginning (he may, for instance,
advise you to call him when the contractions last for at least 30 seconds and
have been coming at five-minute intervals for an hour). Do not be afraid to
call your doctor if you are unsure. Call the doctor immediately if your bag
of waters breaks or leaks, whether or not you have other signs of labor. Make
sure that you have your doctor's 24-hour phone number and the phone number of
the hospital.
This Month's Visit
During this month's office visit, your doctor will probably:
- Check your weight. By now, you will have gained about 18 to 20 pounds.
- Check your blood pressure. This will rise slightly to a normal,
prepregnancy level.
- Check your urine for sugar and protein. You should still have neither in
your urine.
- Ask about symptoms of pregnancy. By now, you may have developed varicose
veins, hemorrhoids, swelling of your feet, and pain in the hips and
vagina.
- Ask how you are feeling.
- Ask about the baby's movements. The baby's kicking should be noticeable
throughout the day.
- Check the growth of your uterus with a tape measure. The top of your
uterus should be about two inches higher than it was last month.
- Listen for the baby's heartbeat with a doppler instrument or a
stethoscope. The baby's heart should be beating at about 140 to 160
beats per minute.
- Describe what you may feel when you go into labor. He may also arrange
for you and your partner to tour the labor and delivery section of the
hospital.
- Perform no new blood tests.