Many women, near the end of their pregnancy, start wandering how they will know if labor has started and what contractions will feel like. Do they really hurt and how will they handle the pain of contractions and childbirth.

Labor contractions are the periodic tightening and relaxing of the uterine muscle. They are often described as a cramping or a tightening sensation that starts in the back and moves around to the front in a wave-like manner. Some women report that contractions feel like pressure in the back. During a contraction, the abdomen becomes hard to the touch.

Many expecting mothers describe early labor contractions as similar to menstrual cramps or as severe gas pains, which may be confused with flu symptoms or intestinal disorders. Imagine your contractions as a wave. Each contraction will gradually increase in intensity until the contraction peaks, then slowly subside and disappear. As your body does the work, during labor, the time between contractions will decrease.

As the strength of each contraction increases, the peaks will happen sooner and last longer. There should be some regularity or pattern when you time your contractions. Persistent contractions that have no rhythm, but are five-to-seven minutes apart or less should be reported to your physician or midwife.

A typical labor for a first time mother is eight-to-fourteen hours, and is usually shorter for a second or subsequent birth. For many women, rocking in a chair or swaying back and forth, during a contraction, assists them with this relaxation.

You can check for contractions by feeling your uterus tightening and softening. Lie down and use your fingertips to feel the uterus. During a contraction your abdomen harden, then become soft again.

In this day and age, with medicine taking over the miracle of childbirth, a woman giving birth may feel secondary in the process. After all, the doctors know better, so do the nurses, they are all more experienced. And the expecting mother finds herself following directions rather than listening to her instincts.

The process of childbirth is a natural one and until the 1900’s it was done with midwives at home. It has only been in the last century that childbirth has found its way into the hospitals. Even now, many women around the world still choose a natural childbirth, even in the western world. After all, hospitals are for the sick and they are healthy.

Before you decide to dive into this amazing experience of natural birth, it is important to ask yourself why you want a natural birth and how far you are willing to go for it. It is not for everyone and you need to consider whether it is the right thing, for you. Childbirth may not go as you planned, at home or the hospital. While in the past everyone gave birth at home, you cannot ignore the fact that some women died giving birth. Sometimes the wonders of modern technology and advanced medicine should not be overlooked. There is no guarantee that one way is better than the other, therefore your own intuition is important – listen to it!

If you choose to pursue a natural birth, take the time to learn the process and make sure you understand it and that it is indeed right for you. Listen to yourself, your beliefs, and your inner wishes. Do not hesitate to ask questions and consult everyone you can. Knowledge is power and will help you to prepare for the experience.

First and foremost you should embrace the fact that this experience is the realization of something that is natural to your body. The birth does not have to take place at home, it can be anywhere you feel comfortable. The birthing process is natural, with no foreign intervention.

In a natural birth, you choose who will be present and where you will give birth, as opposed to a hospital birth, where the staff cannot be handpicked. A natural birth should revolve around the desires of the expecting mother, who can choose what environment her baby will be born into. What will be the first sights, smells and sounds her baby will be exposed to at birth.

While pregnancy is a time of excitement and anticipation, it can sometimes also be filled with unknowns, worries and concerns. While pregnant, you are more aware of your body as you follow the changes it is going through.  If this is your first pregnancy, you may be wondering how you will know when labor has begun. You may also wonder what, of all the new symptoms you are experiencing, is normal. You may wonder how your baby is developing, is he doing well or is there a reason to be concerned.

A healthy, low risk pregnancy lasts about 40 weeks. If you go into labor after the 37^th week, it is considered a full term pregnancy and there is no reason to be alarmed. However, if you go into labor before the 37 week mark, it is considered a preterm labor.  A baby born before 37 weeks of pregnancy is considered premature and can be at risk with regard to health problems.

Preterm labor is usually common in pregnancies with multiples, women with previous premature birth experience and women with certain uterine or cervical abnormalities.

Warning signs that you may be experiencing premature labor include 6 or more contractions an hour, leakage from your vagina indicating your water broke, cramps in your lower abdomen, back pain that comes and goes, pelvic pressure and/or an increase in vaginal discharge.

If you think you may be experiencing preterm labor call your healthcare provider immediately. To help prevent preterm labor, take these precautionary actions – lie on your left side, avoid lying on your back (it can cause contractions to increase), empty your bladder, drink plenty of water (dehydration can cause contractions) and count your contractions per hour.

If symptoms continue or worsen, go to triage. At the hospital you will be checked for the frequency of the contractions and your cervix will be examined to see if it is dilated. If your cervix is opening premature labor could be starting.

To stop or prevent premature labor, magnesium sulfate is given, via IV, at the hospital. If birth is unavoidable or seems to be near, corticosteroid is given to help mature the baby’s lungs and brain. While it is usually better for the baby to stay in the womb longer, birth is sometimes unavoidable. In these cases the baby may be admitted to the NICU (neonatal intensive care unit) for special care.

With your first pregnancy, everything is new and exciting. Nevertheless, it can also be scary!  Worrying about what you do not know or what to expect ahead is common. It is normal to fear the unknown and that is why there are birth preparation classes. Knowledge is power, as they say, rightfully so.

When you start your third trimester, your healthcare provider will explain some signs of early / preterm labor and when you should call, or go to triage. It is important to know these signs because it will help you recognize when you need to go to the hospital. Some labor signs (a few weeks or even days away), include:

It is said that Nesting is a good sign that your baby is on its way, but it is not a clinical sign.  Those who experience nesting have sudden bursts of energy toward the end of their pregnancy.  After a long period of fighting the fatigue that can take over with pregnancy, you will find yourself full of energy and excited to start cleaning, organizing and getting ready for your newborn.

After long weeks of feeling heavy, and rightfully so, you can suddenly breathe again. Lightening is an indication that baby has dropped, settling deeper into your pelvis. While the pressure is off your diaphragm, your bladder is the next victim in line, which means frequent visits to the restroom. All in all, it is a sign that your baby is getting ready to start its way out, which is cause for celebration in itself, even if it is spent going to the bathroom every five minutes.

It is said that the loss of mucus plug is often the first sign that labor is approaching. This thick plug of mucus protects your cervical opening from bacteria enters the uterus during your pregnancy. When your cervix begins to thin and relax, this plug is expelled. The mucus plug may be clear, pink or blood tinged and can appear minutes, hours or even days before labor begins.

Possibly the most famous sign of labor is the rupture of membranes, or more commonly referred to as your water breaking. You should know that only 1 in 10 women experience this dramatic gush of amniotic fluid and can break before labor begins. If you experience rupture of membranes, first you need to determine if it is urine or amniotic fluid. The difference is in the odor. The amniotic fluid is odorless. Once you know it is not urine, contact your healthcare provider for future instructions.

When you begin to experience regular uterine contractions, you are in labor. This is a good time to start timing your contractions and see how long they are and how far apart. Contractions may feel like menstrual cramps or a lower backache that comes and goes, and during early labor, they may be as far apart as 20 to 30 minutes. Over the course of several hours,your contractions will begin to occur at shorter intervals; and you may notice themto start happening every 10-15 minutes or less. When your contractions are consistently 5 minutes apart, it is time to call your health care provider.

Contractions are:

• Regular
• They follow a predictable pattern
• They become progressively closer
• They last progressively longer
• They become progressively stronger
• Each contraction is felt first in the lower back and then radiates around to the front or visa versa
• A change in activity or position will not slow down or stop contractions
• Blood may appear
• Membranes may rupture
• Your health care provider will notice cervical changes, ie. effacement (thinning) or dilation

Keep calm and remember, knowledge is power!

“Birth preparation course” sounds like the most impossible combination of words, doesn’t it?! In other words, how can you prepare for something when you have no idea what to expect? How can you prepare for an event you can’t control, or foresee how it will start and develop? And if it is such a natural process then all you need to do is listen to your body, right?  What else is there to prepare for?

Well, even though you really cannot foresee how and what your birth experience will be like, learning about your options and possibilities is the greatest variable in the mystery of what is to come. Simply stated, knowledge is power.

When you conceive, there is an excitement of anticipation and not much thought is given to the child birth experience that is unavoidably to come. However with time, thoughts, wonders and fears may start to creep in.

If you have already researched your options, you are ahead of the game. Otherwise you may find it helpful to know what types of childbirth methods are available to you today.

No matter what type of birth experience you are planning, you should know the basic facts about other options in case you will be forced to abandon your original plan for medical reasons such as risk to the health of yourself or your baby. Try to stay open minded about the possibility that your birth plan will not be executed as you dreamed. If you remain flexible, the disappointment you may experience could be lessened.

Birth preparation courses usually take place at the hospital where you plan to give birth. In most courses, you will take a tour of the hospital and get familiarized with procedures and facilities available to you.

You will learn about types of childbirth and techniques to help yourself handle labor and the process of childbirth. Most courses should cover: signs of labor, the normal progress of labor and birth, techniques for coping with pain, ways your partner can help you during labor and recognizing when to call your doctor or midwife.

For more information about birth preparation courses, contact your hospital for scheduling.

A cesarean section delivery may be unavoidable in certain situations, especially when there is a real threat to the wellbeing of the baby or mother or both. In such cases, it is a blessing to have the option of such a procedure. But in other cases, when it may not be necessary or can be avoided, you may want to consider the possibility to pass up this invasive surgery.

Like any other medical procedure where you are being cut open, a cesarean section is a major surgery. This means there is a recovery time, about 2 to 4 times longer than the recovery time needed after a vaginal birth. There is also the risk of infection around the incision area, as well as the possibility that future births will result in another cesarean section.

Elective cesarean section is becoming more accepted these days. Some expecting mothers get impatient and want to meet their baby rather than wait. Others want to choose their child birth date, or want to avoid the pains of labor and maybe have a tummy tuck along the way.

Nevertheless, there are many women who prefer to give birth vaginally. If you are one of them, start with speaking to your healthcare provider and write a birth plan to better your chances of having things go your way. Make sure your OBGYN is on board with your plans. Also check the cesarean section rate at the hospital you intend to deliver at. If your OBGYN or the hospital do not have the right answers for you, considering switching to another provider.

You can help avoid undergoing a cesarean by taking care of yourself and listening to your provider. Towards the end of the pregnancy, your doctor will monitor the size of the baby and may alert you to change your diet if there is a concern that your baby will be too large to be delivered vaginally. Do not take this advice lightly.

Listen to your body and take care of yourself throughout your pregnancy. Eat healthy, exercise, sleep well and stay safe. If you are at a higher risk for a cesarean or your baby’s position does not allow for a vaginal birth, talk to your OBGYN about what you can do to help change the situation.

Medical science has yet to discover what exactly causes contractions to start and labor to begin.  If your due date has come and passed with no delivery in sight, you may be at a point where you are ready to do anything to get the process started. It is normal to want to meet your little one already, or want the pregnancy to be over because you are uncomfortable.

There are different home remedies to jump starting labor, but you should know that none of them is a sure thing, so don’t get your hopes too high, and cross your fingers when you try them.

You can try Maternity Acupuncture. Certain spots between the thumb and the pointer finger, near the ankle, and on the shoulder are considered by shiatsu practitioners to be linked to the uterus. According to shiatsu practitioners, pressing these points can speed labor up.

Having Sex can help induce labor. Semen contains prostaglandin, a natural fatty acid that helps soften and dilate your cervix. That, as well as an orgasm, can cause your uterus to contract.

Take a Long Walk. Gravity helps lower the baby and the pressure on your cervix can dilate it.

Raspberry tea helps to tone the muscles of the uterus.  To make it – boil water, let it sit for 5 minutes and then, add two to three teaspoons of red raspberry tea leaves. Drink two to three cups a day. Start only after week 35.

Your OBGYN may offer to strip the amniotic membranes to induce labor, if your cervix has started to dilate. This method can cause labor to start within 48 hours. However effective, it may be painful procedure.

Try nipple stimulation. Rubbing your nipples with your fingertips helps release the hormone oxytocin, the natural version of the labor-inducing drug Pitocin, which causes contractions to begin. It’s a slow process that requires breast stimulation for an hour at a time, three times a day. Some practitioners only recommend doing this at a hospital, where you can be monitored, since very strong contractions could affect the baby’s heart rate.

Castor Oil taken with orange juice for example, can stimulate prostaglandin production and in turn cause contractions. However, it is also a known laxative, so you may get terrible diarrhea before or during labor, suffer from vomiting, sever cramping and other unpleasant side effects. So think twice and speak to your doctor before choosing this method.

Consult your health provider before trying any method.

Vaginal birth is the normal biological consequence of pregnancy, regardless of previous births experiences. It is important to know you are not limited to a cesarean section procedure in future pregnancies even if your previous delivery was a cesarean section.

Vaginal Birth after Cesarean is actually quit common. Some 90% of woman who have had a cesarean delivery can deliver vaginally the next time around.

The biggest concern for women who have had a previous cesarean is the risk of a uterine rupture during a vaginal birth. Studies show increased rates of uterine rupture in women who go through labor induction or augmentation. Discuss the possible complications of induction with your OBGYN before you make your decision.

You can avoid a cesarean this time around if the reason for your first cesarean delivery is not repeated with this pregnancy, you have no major medical problems, you baby is a normal size, the baby is head-down

To be considered for VBAC you must have had no more than 2 low transverse cesarean deliveries and no additional uterine scars, anomalies or previous ruptures. You will be monitored through labor and may end up undergoing a cesarean if the situation shall call for one.

You may require a cesarean delivery if you are pregnant with twins, have diabetes or high-blood pressure.

If your due date has come and gone and you are still pregnant, with no signs of contractions in sight, your OBGYN will check you and have an ultrasound to estimate the size of the baby and how much amniotic fluid is around him. If the baby is estimated to be in any danger you will be induced soon there after.

If the baby still has room to grow, your doctor may let you wait for another week or two before inducing labor. The longest most practitioners will let you go before inducing is the 42^nd week of pregnancy. After that time the placenta may become less effective and many risks may present themselves to both baby and mom.

Some other reasons you may be induced are if your baby is too big, your water breaks and labor does not start on its own, your placenta no longer functions properly, you have a chronic or acute illness or if you previously had a full-term stillbirth.

Inducing labor means to use medication and other techniques to start or induce contractions. The method in which you will be induced depends on the condition of your cervix at the time. If your cervix hasn’t started to soften, efface (thin out), or dilate (open up), it’s considered “unripe” – or not yet ready for labor.

Methods used to ripen the cervix and induce labor include prostaglandins, Foley catheter, Stripping or sweeping the membranes, Rupturing the membranes and Pitocin.

Prostaglandins are used in situations when you need to be induced but your cervix is not yet dilated or thinned out. Once admitted to the hospital, your healthcare provider will start the induction by inserting medication that contains prostaglandins into your vagina. This medication helps to ripen the cervix and sometimes stimulates enough contractions eliminating the need to use oxytocin.

Foley catheter may be use instead of using medication to ripen your cervix. Your healthcare provider may insert a catheter with a very small uninflated balloon at the end into your cervix. When the balloon is inflated with water, it puts pressure on your cervix, stimulating the release of prostaglandins, which cause the cervix to open and soften. When your cervix begins to dilate, the balloon falls out and the catheter is removed.

Stripping or sweeping the membranes is used if your cervix is already somewhat dilated and there’s no urgent reason to induce. Your health provider will insert her finger through the cervix and manually separate your amniotic sac from the lower part of your uterus. This causes the release of prostaglandins, which may help further ripen your cervix and possibly get contractions going.

This procedure is most commonly done during an office visit. You’ll be sent home to wait for labor to start, usually within the next 48 hours. Many moms-to-be find this procedure uncomfortable or even painful.

Rupturing the membranes is a procedure performed only if you are at least a few centimeters dilated. Your healthcare provider will insert a small, plastic hook tool through the cervix to break your amniotic sac. Once your water has broken, most OBGYNs will want you to deliver within 24 hours because of risk of infection for you and your baby.

oxytocin (Pitocin) is given through an IV pump to start or augment your contractions. Your healthcare provider will adjust the amount you need according to how your labor progresses.

Weather you treat it this way or not, a cesarean section delivery is surgery. Because it is a surgical procedure, it does require a period for both physical and emotional recovery.

With any other surgery, allowing yourself recovery time is logical and usually a relatively easy task. However, other surgeries do not send you home with a child to take care of when you return home.  Having to care for a child while recovering is difficult and it becomes harder to rest and let your body to recuperate. After all, your schedule is now in the hands of a tiny baby with needs he cannot fulfill independently.

What do you do? Ask for help and/or accept any help offered. If you have relatives in town who came especially for the birth or live nearby, take advantage of their presence and let them take some of the weight off your shoulders. You need the help and they will most likely be happy to give a hand.

First, take care of yourself. Drink plenty of water to avoid constipation, which is usually an issue for the first week after delivery. Make sure you get the rest you need, but at the same time make a point to walk around regularly, increasing activity gradually. It will help your healing process and prevent complications such as blood clots.

Secondly, don’t overdo it. Wait until your postpartum checkup (six weeks after delivery) before starting up exercising and/or resume sexual activity. Speak to your OBGYN when you meet about your readiness for these types of activities. Speak to your healthcare provider sooner if you have any questions or concerns.

Finally, cut yourself some slack. Recovery may take longer than you expected, or you may find yourself emotionally recuperated while still physically strained. Try not to let it get to you and certainly don’t be too hard on yourself. You have a newborn to care for, your body is healing, and you may be experiencing the blues – after all your life has changed completely! Keep your chin up and listen to your body. You will be 100% soon!