How to know labour is about to start
Is it time yet? Here are a few signs that you're getting ready for labour, and some facts about induction.
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Author Vicki Iovine in her book entitled The Girlfriends Guide To Pregnancy writes that there are 2 universal concerns about labour among pregnant women:

  1. Will it hurt?
  2. How will I know when it is happening?

How labour gets started

Understanding how labour gets started or if there is any way to gently prod nature into action, remains a mystery. Try as we may to calculate the precise sequence of events, or whether labour is initiated by a “hungry baby”, an overstretched womb, exhausted mother or a realignment of hormones is, quite honestly at this point, pure speculation.

According to an anthropologist many primitive cultures believe that a baby is born when it is ready

Anthropologist Margaret Mead, who studied human behaviour amongst primitive cultures of Samoa and other Pacific Islands, wrote that the people of Arapesh “say the baby sleeps until ready for birth, and then dives out”.

The Iatmul believe an unborn child can hurry or delay, as it wishes. “Why do you rail at me?” said Tchamwole to her husband. “This baby will be born when it likes. It is a human being, and it chooses its own time of birth”.

But as any very overdue mother will tell you, wondering what triggers labour becomes a fulltime obsession when you’re sitting on week 42. And while many moms report that when they finally were in labour, they didn’t really notice it (the first stages!), there are ways to recognise your body’s amazing preparations for this special event.

Nature prepares to bring on labour when:

Lightening happens

This means that baby’s head has slipped into the “basin” of the pelvis. Good news for your rib cage, lungs and the top of your womb already stretched to burning point is that they will get some welcome relief. Bad news for your bladder though, it has to vie for space in the pelvis.

Your nesting instincts become more obvious

Builders and painters, furnishers and decorators love it when this instinct kicks in! Women, who have been complacent and placid, practical and thrifty, suddenly throw caution to the wind in a malady of frantic preparations for the arrival of her baby.

Everything must be done, and done now! Old carpets, faded curtains and dull walls just won’t do. The nursery must be spick and span, no matter the budget. She will go to great lengths to “build the nest” for her baby and that includes climbing ladders, hauling concrete and assembling scaffolding.

Crankiness

By the end of her pregnancy, many women feel unrewarded for their patience over the past 9 months. By this stage you are unbearably uncomfortable, especially at night if you’re not getting much sleep. You are also tired of being pregnant, sore and irritable (it’s not only your bladder that’s annoying you) and everybody is getting in your way.

A sudden energy boost after weeks of laziness

An old-wives tale is that when pregnant women get a burst of explosive energy, it’s time to light the fire and boil the water. Pregnant women who re-discover lost energy and begin to scrub the house, clean out the garage, defrost and refill the deep-freeze (with home-cooked meals) are getting ready to go into labour.

This instinct is thought to be progesterone driven and a boost of this chemical is said to delay the start of labour so that baby’s lungs can mature. Once surfactant has lined the alveoli, baby can breathe independently, and will be ready to be born.

Subtle withdrawal from society

Ever noticed how pregnant women become “glassy-eyed” with a vacant stare in the middle of a sentence? She may be watching the news, giving advice or taking minutes at a meeting. Her physical being is there, but her heart and soul have diverted to “mommy-land”. She’s really calculating the cost of disposable nappies, rethinking the baby-bathing routine she learned at antenatal classes or memorising the signs of labour.

This subtle withdrawal from society is perfectly natural and acts as a protective mechanism, sparing women the stress of what’s happening in the world around her so that she can focus on what’s important in her life right now – and that is to have a baby.

Diarrhoea

A runny tummy the day before you start your period is always a good warning that something is about to happen. Going into labour is no different to starting your period – in fact, many of the symptoms are identical, only (a whole lot) more intense. Nature seems to give your body a good “clean out” in preparation for labour. The good news is that you certainly don’t need that dreaded enema!

When your body is ready to initiate labour

The text books confess that to date, although we understand the mechanisms of labour, we still have a lot to learn about what triggers the start of it. But a few of the known causes so far include:

Overstretched womb

It is thought that when the womb muscles have been stretched to their limit, their protest initiates labour. This could explain why it is that a woman carrying twins or more than one baby or too much amniotic fluid is at risk for going into premature labour. However, this theory does not explain other causes of premature labour.

Hormones

As the baby’s head is pushed deeply into the pelvis, it’s thought that the pressure on the bottom half of the womb triggers the release of another hormone called oxytocin. This hormone stimulates the womb to contract but only in the final stages of pregnancy when the cervix (mouth of the womb) has softened and is ready to begin opening.

Other hormones, namely oestrogen and progesterone, usually kept in good supply by the placenta throughout the pregnancy begin to diminish, and the lack of these hormones also aid in triggering labour.

Placenta

After 40 weeks of pregnancy, the placenta which has been nourishing your baby all this time is considered “old”. The catch-22 is a diminished blood supply caused by ageing and ageing that decreases blood (and hormone) supply. When the placenta is not making enough hormones, it’s thought that new hormones, oxytocin and prostaglandin will bring on labour.

The baby

In the last few weeks leading to labour, the baby not only has less space to move, but his movement becomes even more restricted when the head engages into the pelvis. This means that babies are usually quieter at this stage of the pregnancy (warning: this does not mean that baby isn’t moving at all, it just means it has less room to move).

FAQs

So what about inducing labour?

A coerced kick-start to labour (or fiddling dates to match a family birthday or to convenience the doctor over a long week-end) is out of the question. A reality check is that inducing labour when it’s more than 10 days earlier than the due date can be dangerous for mom and baby.

If you’re waddling 10 days beyond b-day, you and your partner could give nature a gentle nudge with a few indulgences in orgasmic sex (if you could be bothered). Your grandmother will probably suggest a bottle of castor oil, but that can get a bit messy. Obviously, don’t even think of combining these methods!

But when is it absolutely necessary to induce labour?

Although as just stated, inducing labour too early is never ideal, sometimes it is unfortunately unavoidable. Getting labour started with drugs and drips, in a controlled environment, may be necessary when a high blood pressure persists and threatens pre-eclampsia or pregnancy induced toxaemia.

A diabetic mother whose sugar is not well controlled may be induced and for women whose waters have broken spontaneously without other symptoms of labour, an induction (to prevent infections) may be unavoidable. When there is a known blood group incompatibility between the parents, labour may be started early and also when a pregnancy has gone on for longer than 42 weeks.

When is it dangerous to induce labour?

Inductions are not recommended when women have had a previous c-section, if the placenta is in the bottom half of the womb, if it’s her third or fourth baby, if she is carrying more than one baby or too much amniotic fluid.

An induction is a medical procedure that can carry potential risks to mother and baby. This means that careful monitoring during labour is absolutely essential to avoid any problems.

What can you do while you’re waiting for labour to begin?

Many women work to the very end so that they can enjoy as much time with their baby as possible. Although there is some risk in this so most companies discourage it and may ask for a letter from your caregiver giving you the go-ahead to carry on working.

Working until you go into labour though is not ideal, especially if your job entails long periods of standing or activity. If you’re at home, the days can drag. Now’s a good chance to practice breathing and relaxation and make yourself familiar with birthing positions.

During these “practice” sessions, play music, picturing and even willing yourself to go into labour. Allowing your body to relax will enhance the blood supply to your womb, relax the perineal muscles and “open” your body to birth while gearing your brain into birth mode.

And if you’re a first-time mom, it’s hard to imagine longing for these days again but in those first few sleep-deprived weeks you will. So make the most of this time by resting as much as possible.

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