Full-term labor

• Labor begins when the cervix opens or dilates. The uterus contracts and the abdomen becomes hard at regular intervals.
• False labor (Braxton-Hicks) contractions may be confused with true labor. Braxton-Hicks contractions are usually irregular, occur in the afternoon or evening when you are tired, and often go away after you lie down.
• True labor usually occurs when contractions are 4-5 minutes apart or closer, last 45-60 seconds, and continue for at least one hour. You should call your doctor if labor has begun, your “water breaks” (a sudden gush of fluid or trickling fluid from the vagina), or you have constant severe pain with no relief between contractions. We then recommend going to the hospital for labor and delivery.
• There is no need to call if you lost your mucus plug (pinkish tinged mucus). This can happen several weeks before delivery. It is common for this to occur after a cervical exam. If you experience vaginal bleeding at any time during your pregnancy, you should call the office.
• Barring any serious issues that would warrant an early delivery recommendation, labor will not be induced prior to 39 weeks gestation. To optimize the best care and outcome for both mother and baby, the recommendation to continue the pregnancy will often extend to 41 weeks gestation if natural labor has not occurred on its own. After 41 weeks, fetal surveillance will likely be recommended if the patient desires to avoid an induction and wait for natural labor. No pregnancies should continue past 42 weeks of gestation.

Pre-term labor

Pre-term labor is labor that begins before 37 weeks. Some warning signs are:

• Four or more uterine contractions per hour—these may be painless.
• Menstrual-like cramps felt low in the abdomen. These may be constant or may come and go.
• Dull, low backache that radiates to the sides or the front and is not relieved by change of position.
• Pelvic pressure that feels like the baby is pushing down.
• Stomach cramps or the feeling of “gas pains” with or without diarrhea.
• Increase or change in vaginal discharge—may become pink or brown-tinged, mucous-like or watery.
• A general feeling that something is not right. You may just not feel well, even without a specific cause.

 Call the office immediately if you are experiencing any of these symptoms.