An Overview of Labor and Birth:

know what to expect and watch for warning signs


Labor and birth are similar to an athletic event in that your body will need to work hard. Like other normal physical experiences, your body will communicate with you when it needs something, such as food or fluids, or deeper or shallower breaths during contractions.

Covered in this labor and birth overview are:
Before Labor Begins
How Do I Know That I'm in Labor?
What Should I Do When My Labor Starts?
Premature Labor Warning Signs

Before Labor Begins

Prior to going into labor, your body will experience some changes.
  • About two or three weeks before labor, your baby's head will settle deeply (engage) into your pelvis. This is called "dropping" or "lightening", and you'll feel a relief of pressure under your diaphragm. Your health care provider can determine whether or not the baby's head has engaged by examining you.
  • Because the baby's head is lower, you'll probably feel the urge to urinate more often. Your legs may also feel achy, since pressure on your arteries (from the uterus) prevents blood from flowing easily to the lower parts of your body.
  • Braxton Hicks contractions occur more often, causing a tightening or pains in your belly and groin areas. These contractions begin the process of effacement, in which your cervix begins to soften, grow thinner, and stretch in preparation for the birth.
  • As the cervix begins to efface, the mucus plug loosens and then passes through your vagina. This can occur up to two weeks before labor begins or just as labor begins. After the mucus plug loosens, you may notice a clear, mucus discharge that is tinged or streaked with pink blood. This is called "show". During effacement, your cervix may begin to dilate (open).
  • You may feel a burst of energy, extreme tiredness, or "flu-ish" (sometimes accompanied by diarrhea) just before labor begins. Some women also lose one to three pounds about two or three days before labor starts.
  • Your amniotic sac may burst; this is also known as the "water breaking". You may lose anywhere from a small trickle to several cupfuls of fluid. Note that some women's water will break before labor begins, while in others, it occurs during labor. Always communicate this event to your health care provider, noting the time your water broke.
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How Do I Know That I'm in Labor?

Two signs tell you that your labor has begun. But keep in mind that when they occur is different for everyone, and the actual beginning of labor can sometimes be very drawn out and tiresome.
  • Your "water breaks" (membranes rupture)
  • You have contractions that get longer, stronger, and closer together

It is sometimes difficult to tell if your water has broken or you are simply leaking urine. Amniotic fluid smells like saltwater, not like urine, and usually the flow is uncontrolled. Sometimes you can tell by emptying your bladder and seeing if you continue to leak fluid. To be sure, check with your health care provider.

Contractions can feel like you have indigestion, a backache, or menstrual cramps. As they become stronger, you may notice that they have a defined beginning and end, and usually "peak" somewhere in the middle. Contractions last no longer than a minute or so, with several pain-free minutes in between contractions. If you're not sure that you're feeling "real" contractions, try changing your position (such as moving from sitting to standing); if they keep coming at fairly regular intervals, they are probably labor contractions.

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What Should I Do When My Labor Starts?

As soon as you notice that you are leaking amniotic fluid, contact your health care provider, especially if this happens before strong and regular contractions begin. Even though contractions can occur before labor truly starts, it's always a good idea to call your health care provider to find out if she wants to see you. If you have ruptured membranes, a vaginal exam is not recommended because it increases the risk of infection.

Note that if your amniotic fluid is a greenish-brown color, you should call your health care provider immediately. This is a sign that meconium, a tar-like substance that comes from your baby's digestive tract, has passed into the fluid. Meconium in amniotic fluid can mean that your baby is having a problem.

When you start the third trimester, it's a good idea to ask your health care provider about the procedure to follow when labor begins. For example:
  • Find out when to call your health care provider.
  • Find out when to go to the birth center or hospital. Or, for a home birth, find out when your health care provider will come to you.
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Premature Labor Warning Signs

The following symptoms may be indications that you are going into premature labor or have a problem that needs medical attention.

Call your health care provider right away if you have any of these symptoms!

Premature labor warning signs:
  • Cramps that are strong
  • A backache
  • A feeling of pressure in the pelvis
  • A pink or brownish discharge from your vagina
  • Water breaking

Warning signs of other conditions:
  • Your baby is moving less than usual or not at all
  • Sudden swelling of your hands, feet, or face
  • Blurred vision or spots in front of your eyes
  • Severe headache that won't go away
  • Fever over 100ºF
  • A sharp or dull stomach ache
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Don't ever be embarrassed to call your care provider if you have any of these symptoms.

Continue to "Labor Stage 1: Active Labor" journey to parenthood

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Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families.
Most recent page update: 9/9/2010