Labor Guidelines

For your convenience, a printable copy of the following is available here

These guidelines can be referred to when you have reached at least 36 weeks (four weeks before your due date). Before 36 weeks, you should refer to information about premature labor.

Soon you'll be bringing home your new addition and starting a new life!

During the last few weeks there are different physical experiences that you will have and you will be on the lookout for signs of labor. To assist you in deciding when to call and report what you are feeling, please find below some guidelines to which you can refer.

Contractions

Contractions are a rhythmic tightening of the uterus which is a muscle. When you are having real labor contractions, your belly may feel as hard as your forehead.

Labor is an unpredictable process. Often there are contractions that come and go and don't amount to real labor. You may be in labor if you are experiencing contractions that meet the following criteria:

1. Contractions 5 minutes apart (time them from the beginning of one contraction to the beginning of the next)
2. Contractions are painful. (During real labor contractions, you cannot talk or walk; they will usually cause you to brace yourself and breathe deeply.)
3. Contractions have stayed for at least one hour

If what you are experiencing meets these criteria, call our office (the system will tell you how to reach the provider on call after hours).

If you have had a very quick labor in the past, trust your own judgment to determine when you need to call.

Pressure in the pelvis with no contraction activity is not labor. You can discuss this with your provider at your next office visit.

Rupture of Membranes

In most circumstances, when the membranes rupture (water breaks) it is very obvious. There is a large gush of fluid that soaks through the clothing or bedding. Sometimes, however, there is a slow leak of fluid. You should call to be checked for ruptured membranes if:

1. There is a large gush of fluid from the vagina
2. There is a continuous wetness that persists after changing your underwear

The mucous plug is a clump of thick mucous. It may be blood streaked or clear. It does not have any significance in predicting the timing of labor. It can be reported at your next office visit.

Bleeding

If you see spots of blood with no pain and your baby has been normally active, you can report that at your next visit.

If there is a flow of blood, there is pain accompanying the blood, or if you are concerned that the baby hasn't been moving normally (see below), call.

Fetal Movement

As your baby grows the quality of movements changes but the quantity should not. Earlier in pregnancy, the baby has plenty of space to kick strongly but as the baby gets bigger, there are more squirms, nudges and rolls than there are dramatic kicks. Although these movements are more subtle, they count equally.

If you are concerned about your baby not moving enough:

• Lie on your side
• Have something to eat or drink
• Remove all distractions (don't read or watch TV)
• Count your baby's movements

You should be able to feel 10 movements within 2 hours. If you feel fewer movements, call our office.

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