Overview

Braxton Hicks contractions

During the second and third trimesters of your pregnancy, you may notice times when your belly tightens and becomes firm to the touch and then relaxes. These are called Braxton Hicks contractions. Think of them as "warm-up" exercises for your uterus.

These contractions may be so mild that you rarely notice them. Or they may be strong enough to make you stop what you are doing.

You may begin to feel Braxton Hicks contractions between the 28th and 30th weeks of your pregnancy. But sometimes they start as early as the 20th week. You most likely will have more of these contractions during your ninth month.

It is often hard to tell the difference between true labour pains and Braxton Hicks contractions, especially in your first pregnancy. Braxton Hicks contractions:

• Tend to be irregular and vary in strength. They do not become more regular or stronger.
• Go away when you're active. (True labour pains may continue or increase during activity.)
• Are more noticeable when you rest.

True labour pains tend to last longer, become stronger, and occur closer together than Braxton Hicks contractions.

If you are not sure what type of contractions you're having, talk to your doctor or midwife.

Preterm labour

Preterm labour is labour that comes too early—between 20 and 37 weeks of pregnancy. In labour, the uterus contracts to open the cervix. This is the first stage of childbirth. In most pregnancies, this happens at 37 to 42 weeks. Preterm labour is also called premature labour.

It can be hard to tell if preterm labour starts. You may have regular contractions. This means about 6 or more contractions in 1 hour, even after you've had a glass of water and are resting. You may have other symptoms, such as menstrual-like cramps or leaking or gushing of fluid from your vagina.

Call your doctor or midwife if you have any of these signs of preterm labour.

First stage of labour and delivery

The first stage of labour is divided into three phases: early labour, active labour, and transition.

Early labour

Early labour is often the longest part of the birthing process, sometimes lasting 2 to 3 days. Contractions:

• Are mild to moderate (you can talk while they are happening) and last about 30 to 45 seconds.
• May be irregular (5 to 20 minutes apart) and may even stop for a while.
• Open (dilate) the cervix to about 4 cm (1.5 in.) to 6 cm (2.5 in.). Women who are delivering for the first time can have many hours of early labour without the cervix dilating.

It's common for women to go to the hospital during early labour and be sent home until they are in active labour or until their "water" (amniotic sac) breaks.

Active labour

Active labour starts when the cervix is about 5 cm (2 in.) to 6 cm (2.5 in.) dilated. This stage is complete when the cervix is fully effaced and dilated and the baby is ready to be pushed out.

During this phase, contractions get stronger, are more frequent (every 2 to 3 minutes), and last longer (50 to 70 seconds). Now is the time to be at or go to the hospital or birthing centre. If your amniotic sac hasn't broken before this, it may now.

You may be restless and excited, and you may feel the need to shift positions often. This is good because it improves your circulation.

As your contractions get stronger:

Transition

Transition is the end of active labour. As the baby moves down, contractions become more intense and longer and come even closer together. Delivery isn't far off.

During transition, you may be self-absorbed, focused on what your body is doing. You may want others nearby for support but be annoyed or distracted by their attempts to help. You may feel more and more anxious, nauseated, exhausted, or fearful.

A woman who's delivering for the first time may take up to 3 hours in transition. A mother who has had a vaginal birth before will usually take no more than an hour. Some women have a very short and intense transition.