Pregnancy Early Labor
Signs of early labor include:
- Cervical dilation
- Braxton-Hicks contractions
- Ruptured membranes
The fetus drops into the pelvis in a head down position.
During pregnancy, the cervix remains tightly closed. In order for labor to begin, the cervix must begin to open. This is referred to as cervical dilation. Before the cervix begins to open, a plug of mucus that is blocking this channel must be pushed out. If the mucus is stained with blood, passing the plug may be called bloody show. Following the passage of a mucus plug or bloody show, cervical dilation starts. The cervix must open more than 10 centimeters before the baby can pass through it. First time mothers tend to dilate more slowly than mothers who have delivered a baby in the past.
These contractions have been painless for the past several months. At this point, they become stronger and cause pain. The pain seems to come from within the pelvis, groin, or lower back. Many first time mothers are fooled by these contractions. This is why they are often referred to as false labor. False labor contractions have no pattern, change in strength, are located in the lower abdomen, and may change with activities, such as walking or resting. True labor contractions are regular and slowly build in strength. They are often felt in the abdomen and back, and do not go away with walking or resting. Time how long your contractions are from beginning to end, then time how far apart they are from the beginning of one contraction to the beginning of the next one. Write the information down in a logbook, so that you can track your progress.
Rupture of Membranes
A strong membrane makes up the amniotic sac, which contains the fetus and the amniotic fluid that surrounds the fetus. When the membranes rupture, amniotic fluid leaks from the uterus. This may be confused with bloody show and a mucus plug. Your doctor may perform tests to confirm that you have ruptured membranes. The membranes usually rupture after labor contractions have started. In about 1 out of 5 women, the membranes rupture before the onset of labor contractions: this is called premature rupture of membranes. Once the membranes rupture, labor is starting: you need to see your doctor immediately. More than 90% of women go into labor within 24 hours after the membranes rupture.
Continue to Pregnancy Evaluation
- Blenning CE, Paladine H. An approach to the postpartum office visit. Am Fam Physician. 2005 Dec 15;72(12):2491-6. 
- Condous GS, Arulkumaran S. Medical and conservative surgical management of postpartum hemorrhage. J Obstet Gynaecol Can. 2003 Nov;25(11):931-6. 
- Magann EF, Evans S, Hutchinson M, Collins R, Lanneau G, Morrison JC. Postpartum hemorrhage after cesarean delivery: an analysis of risk factors. South Med J. 2005 Jul;98(7):681-5. 
- Malamitsi-Puchner A, Boutsikou T. Adolescent pregnancy and perinatal outcome. Pediatr Endocrinol Rev. 2006 Jan;3 Suppl 1:170-1. 
- Nanda K, Peloggia A, Grimes D, Lopez L, Nanda G. Expectant care versus surgical treatment for miscarriage. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD003518. 
- Ozkaya O, Sezik M, et al. Placebo-controlled randomized comparison of vaginal with rectal misoprostol in the prevention of postpartum hemorrhage. J Obstet Gynaecol Res. 2005 Oct;31(5):389-93. 
- Tierney JP, Welsh J, Owen P; Effective Gynaecology in Glasgow Group. Management of early pregnancy loss--a complete audit cycle. J Obstet Gynaecol. 2006 Apr;26(3):229-32. 
- Vitzthum VJ, Spielvogel H, Thornburg J, West B. A prospective study of early pregnancy loss in humans. Fertil Steril. 2006 Aug;86(2):373-9.