What Is Labor?

Labor is a different experience for every woman and every birth. Many first-time mothers make the mistake of thinking they have entered labor prematurely, and may end making unnecessary trips to the hospital. To be fully prepared for labor, it's important to understand exactly what happens during this time.

The changes taking place in your body, placenta, and baby during the last three months of pregnancy accelerate at the end, culminating in labor. As the placenta ages and gradually loses its ability to maintain the pregnancy, the baby becomes strong and capable enough to survive outside the mother's body; the uterus begins to let go and expel the baby; and the mother becomes ready to give birth and to feed and nurture her baby.

Labor consists of rhythmic uterine contractions, which open the cervix and press the baby down through the birth canal and out of your body. The uterus is a big, strong, hollow muscle; when it contracts, it tightens and hardens. This may happen anywhere from 25 to 300 times during labor, which may take anywhere from a few hours to more than a day. The process involves not only your uterus but your entire body and mind; all your energy is devoted toward the one goal of giving birth to your baby.

How will you know when you are in labor? As basic as this question is, it is one of the most difficult to answer. It usually takes hours or even days to figure out whether your sensations are labor or something else (prelabor, or false labor). This is because labor does not begin suddenly. It evolves gradually. At some point, you or your doctor will recognize these sensations are true labor, meaning they are accompanied by increasing dilation of the cervix. This section describes the signs and sensations of labor to help you recognize it. It also describes the birth process, the emotions that accompany labor, and how your partner can help you the most.

If you are within a week or two of your due date, you generally may wait until you have an absolutely clear sign of labor before going to the hospital, although your caregiver may ask you to let him or her know if your bag of waters (amniotic sac surrounding the baby) seems to be leaking. If your pregnancy has been complicated by diabetes, high blood pressure, or other medical conditions, or if you have twins, your doctor may advise you to go to the hospital with the onset of preliminary signs. If you are several weeks before your due date, you should notify your doctor if you have any preliminary signs because they could indicate early or premature labor. Premature labor can often be stopped if treatment is begun early enough.

To determine whether your contractions are progressing (that is, becoming longer, stronger, and closer together), you need to time them. On a sheet of paper, list the times contractions begin and how long the contractions last. Time them in this way for an hour or two. If they are not progressing, stop for a while until the contractions seem different, then try timing them again.

You should call your caregiver or your hospital's labor and delivery ward to tell them you are in labor or to ask for advice. Be sure to report the status of your bag of waters; whether you have a bloody discharge (called bloody show, which you continue to pass throughout labor); how long and how many minutes apart your contractions are; and how strong or painful they feel to you.

Labor varies from woman to woman; even in the same woman each labor is different. Some labors are very fast, lasting only a few hours; some are average in length (about 15 or 16 hours for first-time mothers and 7 or 8 hours for women who have had babies before); some are very long, lasting a day or two. Some start slowly and then speed up unexpectedly; others start rapidly and then slow down. The amount of pain and fatigue varies also. It is best not to have definite expectations but to prepare yourself for the wide range of possibilities.