Hesperian Health Guides

Chapter 9: Getting ready for labor and birth

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HealthWiki > A Book for Midwives > Chapter 9: Getting ready for labor and birth

Get ready for the birth as soon as the mother has signs that labor will start soon.

Signs that labor will start soon

There is no way to be sure when a woman’s labor will begin, but there are some signs that it will start soon.

In the weeks before birth, the baby may drop lower, the mother may feel more contractions, or the mother may just feel different. Other signs may happen only a day or 2 before labor starts. The mother’s stool may change, or a little show (bloody mucus) may come out of the vagina. Sometimes, the bag of waters breaks.

2 women, 1 with a baby high up in the womb, just under her breasts, and another whose baby has dropped lower.

The baby drops lower in the belly

Babies often drop lower in the mother’s belly about 2 weeks before birth. But if a mother has had babies before, this baby may not drop until labor begins.

Contractions get stronger or come more often

During labor the womb squeezes up and becomes hard. This is called a contraction because the womb contracts, or tightens.

To understand how contractions work, think about what happens when you wring water out of a thick cloth. It gets tight and hard. The womb contracts in the same way during labor. You can see it bunch up, like this:
MW Ch9 Page 149-2.png
a woman thinking while she watches and feels her belly.
Now it is soft.
MW Ch9 Page 149-4.png
Now it is hard!

There are two kinds of contractions: practice contractions and labor contractions. Practice contractions happen throughout pregnancy. They are usually felt high in the belly (or all over the belly), and are mild and irregular. Many women do not even notice them. Practice contractions may start and stop several times. They will often go away if the mother changes what she is doing. For example, if the mother is walking when the practice contractions start, they may stop when she sits down.

Practice contractions may get stronger and start to come more often a few days before labor begins.

Labor contractions begin closer to the time the baby is born. They are usually felt lower in the belly or back and get much stronger than practice contractions. Labor contractions usually become more and more strong and can be very painful or intense.

a man speaking to a pregnant woman who is sweeping the floor at night.
It's late. Let me take care of that so you can get some rest.

The mother feels different

Sometimes a woman can feel that labor is near. She may feel dreamy, very quiet, and aware of her body. Or she may simply feel a strong urge to stay home and wait. All these feelings are normal.

Some women want to clean and rearrange their homes before labor starts. This desire is normal — but the woman should not work too hard. Her labor may start at any time, and she needs to save her strength. Her family can help her do chores and get rest.

Stool changes

Many mothers get loose stool (diarrhea) before they go into labor. This helps clean out the body so the woman will be more comfortable during labor and birth.

a baby in the womb when labor is near

Show appears

During most of pregnancy, the tiny opening in the cervix is plugged with mucus.

In the last few days of pregnancy, the cervix may begin to open. Sometimes the mucus and a little bit of blood drip out of the cervix and out of the vagina. This is called show.

MW Ch9 Page 150-3.png

Show may come out all at once, like a plug, or it may leak slowly for several days. When you see show, you know that the cervix is softening, thinning, and beginning to open. Labor will probably start in a day or 2.

Be careful not to confuse show with the discharge (wetness from the vagina) that many women have in the 2 weeks before labor begins. That discharge is mostly clear mucus and is not tinged with blood.

The bag of waters breaks

MW Ch9 Page 151-1.png

When the bag of waters breaks, there can be a big gush of fluid or a slow leak. Most of the time, the bag of waters breaks during labor. When the bag breaks before labor, labor usually starts within a few hours.

If labor does not start within 6 hours after the bag breaks, there is a risk of infection. As more time goes by after the water breaks, the risk of infection gets stronger. You may choose to do something to get labor started. If labor has not started in 24 hours (1 day and 1 night) after the water breaks, bring the woman to a medical center.

If medical help is very far away, you should start on your way there earlier.

This page was updated:11 Sep 2019