-------------------------------------------------------------------------------- What's below: • What are Braxton Hicks contractions?
• How can I tell the difference between Braxton Hicks and true labor contractions?
• What if the Braxton Hicks contractions become painful?
• How can I minimize them if they're uncomfortable?
• When should I call my doctor or midwife?
• See also --------------------------------------------------------------------------------
What are Braxton Hicks contractions? Sometime toward the middle of your pregnancy (or even earlier), you may notice the muscles of your uterus tightening for anywhere from 30 to 60 seconds. Not all women feel these random, usually painless contractions, which get their quirky name from John Braxton Hicks, an English doctor who first described them in 1872.
How can I tell the difference between Braxton Hicks and true labor contractions? Most women pregnant for the first time will ask their practitioner or friends this question often, and the answer is maddeningly vague: 'You'll know real labor when it begins.' Truth is, they're right. Labor contractions are noticeably longer as well as more regular, frequent, and painful than Braxton Hicks. Also, labor pains will increase in frequency, duration, and intensity as time goes on, while Braxton Hicks remain unpredictable and nonrhythmic.
What if the Braxton Hicks contractions become painful? As your pregnancy progresses, these contractions may become more intense and even painful at times; when they start to become more intense and frequent, they're referred to as false labor. False labor may feel like the real thing, but the contractions will still be irregular in intensity, frequency, and duration and can taper off and then disappear altogether. In other words, if you ever notice that your contractions are easing up in any way, they are most likely Braxton Hicks. Doctors and midwives believe that Braxton Hicks contractions are part of prelabor and essentially get the process of effacement and dilation going in preparation for delivery. (This is called 'ripening.') In fact, some healthcare providers recommend you use Braxton Hicks contractions as an opportunity to practice the breathing exercises you'll learn in your childbirth class.
How can I minimize them if they're uncomfortable? Many women notice that the contractions come more frequently when they do even light physical activity, such as lugging groceries from the car. If you feel discomfort, it sometimes helps to lie down, or, conversely, to get up and take a walk, both of which can ease any pain you feel. A warm bath sometimes helps, too. Some healthcare practitioners recommend drinking a couple of glasses of water if the contractions bother you as they can sometimes be brought on by dehydration. In general, a lack of adequate fluids tends to make your uterus more irritable — another of the many reasons to drink plenty of fluids while you're pregnant.
When should I call my doctor or midwife? Call anytime your contractions are accompanied by watery or bloody ******l discharge. And until you reach term (37 weeks gestation), call your provider if contractions are accompanied by lower back pain, if you feel more than four contractions an hour, or if they're coming at regular intervals; these are signs of premature labor. If you're past 37 weeks, there's no need to call your provider until your contractions last 60 seconds each and are five minutes apart
shamma
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Signs of labor
Signs of labor Approved by the BabyCenter Medical Advisory Board
-------------------------------------------------------------------------------- What's below: • What are the signs of labor?
• When should I call my doctor or midwife?
• What should I do early on in labor?
• Can I have contractions and not be in labor?
• Can I tell if labor is about to happen soon?
• See also --------------------------------------------------------------------------------
What are the signs of labor? Labor is different for every woman, and pinpointing when it begins is not really possible. It's more a process than a single event, when a number of physiological changes in your body work together to help deliver a baby. If you're truly in labor, one or more of the following five things will happen: • The cervix becomes progressively thinner and softer (also called effacement) and dilated (up to 10 centimeters).
• Contractions occur at regular and increasingly shorter intervals, and become longer and stronger in intensity.
• Persistent lower back pain, especially if it's accompanied by crampy, premenstrual feeling.
• The appearance of bloody show (a brownish or blood-tinged mucus discharge). If you pass the mucus plug that blocks the cervix, labor could be imminent--or it could be several days away. Still, it's a sign that things are moving along.
• Breaking of the bag of waters, but only if it's accompanied by contractions.
When should I call my doctor or midwife? By your third trimester, you and your provider have probably talked about what to do when you're in labor long before you really are. But, if you think the time has come, don't be embarrassed to call your doctor or midwife. They're used to getting calls from women who are uncertain if they're in labor and who need guidance-it's part of their job. And the truth is, your doctor or midwife can tell a lot by the tone and tenor of your voice, so verbal communication helps. Your provider will want to know how close together your contractions are, whether you can talk through a contraction, and any other symptoms you may have. If your bag of waters break, or if you suspect you're leaking amniotic fluid, call your caregiver. You should also let her know if you suspect a decrease in fetal activity, or if you have any ******l bleeding, unless it's just some bloody show (characterized by a small amount of blood-tinged mucus plug), fever, severe headaches, changes in your vision, or abdominal pain.
What should I do early on in labor? During early labor, it's very important to drink plenty of fluids. Alternate between walking and resting, or try taking a warm bath or shower to ease any aches and pains. And if you can, try to get some rest to prepare you for the work ahead.
Can I have contractions and not be in labor? Absolutely. You're in false labor if your cervix doesn't dilate (your doctor or midwife can confirm this during an examination), contractions are erratic and don't feel increasingly intense, and any pain you may feel in your abdomen or back is easily relieved by a warm bath or massage. Try drinking water to manage irregular and unproductive contractions.
One mother we know had strong contractions for three days before she was officially in labor. The contractions, though painful, were completely irregular and unpredictable, coming at five minutes, then seven, then eight, then five, and eventually at eight minutes. When her water finally broke, she cried with relief, hoping she was finally entering real labor. She was.
Can I tell if labor is about to happen soon? Maybe. Although you're probably blissfully unaware of all that's going on, your body starts preparing for labor up to a month before delivery. By the time true labor begins, some women's cervixes have already started to dilate and thin.
Other signs:
• Lightening when the baby's head begins to drop into position in your pelvis
• An increase in ******l discharge
• The appearance of bloody show (a brownish or blood-tinged mucus discharge
Approved by the BabyCenter Medical Advisory Board
-------------------------------------------------------------------------------- What's below: • What are the signs of labor?
• When should I call my doctor or midwife?
• What should I do early on in labor?
• Can I have contractions and not be in labor?
• Can I tell if labor is about to happen soon?
• See also --------------------------------------------------------------------------------
What are the signs of labor? Labor is different for every woman, and pinpointing when it begins is not really possible. It's more a process than a single event, when a number of physiological changes in your body work together to help deliver a baby. If you're truly in labor, one or more of the following five things will happen: • The cervix becomes progressively thinner and softer (also called effacement) and dilated (up to 10 centimeters).
• Contractions occur at regular and increasingly shorter intervals, and become longer and stronger in intensity.
• Persistent lower back pain, especially if it's accompanied by crampy, premenstrual feeling.
• The appearance of bloody show (a brownish or blood-tinged mucus discharge). If you pass the mucus plug that blocks the cervix, labor could be imminent--or it could be several days away. Still, it's a sign that things are moving along.
• Breaking of the bag of waters, but only if it's accompanied by contractions.
When should I call my doctor or midwife? By your third trimester, you and your provider have probably talked about what to do when you're in labor long before you really are. But, if you think the time has come, don't be embarrassed to call your doctor or midwife. They're used to getting calls from women who are uncertain if they're in labor and who need guidance-it's part of their job. And the truth is, your doctor or midwife can tell a lot by the tone and tenor of your voice, so verbal communication helps. Your provider will want to know how close together your contractions are, whether you can talk through a contraction, and any other symptoms you may have. If your bag of waters break, or if you suspect you're leaking amniotic fluid, call your caregiver. You should also let her know if you suspect a decrease in fetal activity, or if you have any ******l bleeding, unless it's just some bloody show (characterized by a small amount of blood-tinged mucus plug), fever, severe headaches, changes in your vision, or abdominal pain.
What should I do early on in labor? During early labor, it's very important to drink plenty of fluids. Alternate between walking and resting, or try taking a warm bath or shower to ease any aches and pains. And if you can, try to get some rest to prepare you for the work ahead.
Can I have contractions and not be in labor? Parents Talk
Have an opinion about this? Add your comments to the bottom of this page.
Absolutely. You're in false labor if your cervix doesn't dilate (your doctor or midwife can confirm this during an examination), contractions are erratic and don't feel increasingly intense, and any pain you may feel in your abdomen or back is easily relieved by a warm bath or massage. Try drinking water to manage irregular and unproductive contractions.
One mother we know had strong contractions for three days before she was officially in labor. The contractions, though painful, were completely irregular and unpredictable, coming at five minutes, then seven, then eight, then five, and eventually at eight minutes. When her water finally broke, she cried with relief, hoping she was finally entering real labor. She was.
Can I tell if labor is about to happen soon? Maybe. Although you're probably blissfully unaware of all that's going on, your body starts preparing for labor up to a month before delivery. By the time true labor begins, some women's cervixes have already started to dilate and thin.
Other signs:
• Lightening when the baby's head begins to drop into position in your pelvis
• An increase in ******l discharge
• The appearance of bloody show (a brownish or blood-tinged mucus discharge
shamma
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Member since
FALSE LABOR
False labor Approved by the BabyCenter Medical Advisory Board
-------------------------------------------------------------------------------- What's below: • What is false labor?
• What should I do?
• See also --------------------------------------------------------------------------------
What is false labor? If you're in false labor, you'll be having contractions that may feel real enough to you but are not strong enough to get your labor started the way real contractions would. That is, they don't cause the cervix to start effacement (thinning out) or dilation (opening up). These contractions are called Braxton Hicks. They may feel like real labor if they suddenly become more intense or frequent, but they tend to be irregular and may eventually ease up or stop altogether. They may occur intermittently for days (or even a few weeks) before the onset of true labor. One mother had strong contractions for 3 days before she was officially in labor. The contractions, though painful, were completely irregular and she would feel them at unpredictable intervals, such as 5 minutes, 7 minutes, 8 minutes, 5 minutes, 4 minutes, and then back to 8. When her water finally broke, she burst into tears of relief, as she hoped this meant she was finally entering real labor. (She was.)
Some signs of false labor include:
• Contractions that are irregular and don't seem to increase in intensity.
• Pain centered on your lower abdomen and groin rather than pain that radiates across your uterus to your lower back.
• Contractions that subside when you move around or take a walk.
What should I do? Even if you're finely attuned to the subtleties of labor, you probably won't be able to determine if you're experiencing false labor until it's over or has progressed into true labor. So, if you're not yet at term (37 weeks) and you notice any signs of labor, true or false, you should see your doctor or midwife right away in order to rule out preterm labor. After 37 weeks, you can sit out signs of false or early labor at home and see what develops. This can be a real drag, interfering with your sleep and making your tired and cranky. Taking warm baths and drinking lots of liquids can sometimes help. You might also be very tense, wondering if true labor will start at any moment. Since this can sometimes happen quickly, particularly if you've had a baby before, you might be constantly wondering if it's time to call the babysitter. Keep a stopwatch nearby to time your contractions — and don't hesitate to call your doctor or midwife to check in (or for a little encouragement) before you get the okay to go to the hospital.
shamma
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Member since
INDUCING LABOR
Inducing labor Approved by the BabyCenter Medical Advisory Board
-------------------------------------------------------------------------------- What's below: • What does it mean to induce labor?
• Why might labor be induced?
• What are some of the ways labor can be induced?
• Are there risks associated with inducing labor?
• See also --------------------------------------------------------------------------------
What does it mean to induce labor? Inducing labor means starting labor by artifical means. Labor can also be augmented, or sped up, if your spontaneous contractions aren't considered adequate to bring you into full labor.
Why might labor be induced? You may need to be induced if the risks of prolonging your pregnancy are higher than the risks of delivering your baby right away. Reasons include (but are not limited to) the following: • You are still pregnant two weeks past an accurate due date.
• Your baby isn't thriving or growing in the uterus.
• Tests indicate that your placenta is no longer functioning optimally and the uterine environment is no longer healthy.
• You have a chronic or acute illness, such as high blood pressure, diabetes, or kidney disease, that threatens your well-being or the health of your baby.
• If your bag of waters breaks and spontaneous labor does not start within a reasonable amount of time.
What are some of the ways labor can be induced? There are natural and synthetic methods of inducing labor. Some of the most common are:
• Artificially rupturing the membranes (bag of waters) that surround the fetus. This procedure causes no more discomfort than a ******l exam. If the cervix is very ripe and ready for labor, this alone might do the trick. In other cases, your doctor or midwife may administer the drug Pitocin as well.
• Stripping the membranes during a pelvic examination. This procedure is thought to stimulate the release of prostaglandin hormones which can help ripen the cervix. It can be done at an office visit and has been shown to reduce your chances of a postterm labor.
• Inserting a gel or suppository containing the hormone prostaglandin into the ****** to ripen the cervix. Often this procedure will stimulate contractions and move a woman into labor; if not, it is followed by intravenous Pitocin (see below).
• Inserting a Foley catheter into the cervix to ripen it. A very small balloon at the end of the catheter is inflated with water, putting pressure on the cervix and causing it to open and soften. When the cervix begins to dilate, the balloon falls out.
• Using Pitocin — a synthetic form of oxytocin — to induce labor. It's given intravenously through a pump to start contractions and used for the duration of labor.
• Stimulating your nipples to release your own natural oxytocin. Massaging the nipples can cause uterine contractions, but this technique would not be used to jump-start labor if it needed to be induced right away. Also, the fetus needs to be monitored during nipple stimulation since it can hyperstimulate the uterus, so don't try this at home.
• Administering an enema or drinking castor oil. Both stimulate the bowels and produce prostaglandins, which might help to induce labor.
Before you take steps to speed up labor, check with your doctor or midwife. Labor should only be induced under the supervision and advisement of your caregiver.
Are there risks associated with inducing labor? Pitocin, prostaglandin gel, and nipple stimulation can cause strong contractions and occasionally hyperstimulate the uterus, thus stressing the fetus, so electronic monitoring is necessary. In most cases you have to lie on your side or sit while being monitored, but some hospitals offer telemetry, which lets you walk around during the process
shamma
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Member since
PAIN MEDICATION FOR LABOR
Labor & Delivery Pain medication for labor Approved by the BabyCenter Medical Advisory Board
-------------------------------------------------------------------------------- What's below: • I'm scared of labor. How will I handle the pain?
• Systemic medications
• Epidural
• Spinal block
• Combined spinal / epidural block
• See also | Other Sources --------------------------------------------------------------------------------
I'm scared of labor. How will I handle the pain? No one finds the experience easy — it isn't called 'labor' for nothing — but the intensity of the discomfort varies from woman to woman and birth to birth. Fortunately, you can do a lot to ease the pain. First be aware that the more you can relax, the less pain you'll feel. Learning breathing methods and other relaxation techniques can be very helpful. However, most women do opt for some kind of anesthetic agent for pain relief. (About 80 percent of births involve the use of drugs, according to the American Society of Anesthesiologists.) David Wlody, director of obstetric anesthesia at Long Island College Hospital, has this advice: 'No woman can predict what sort of pain she will have during labor or how she will cope with it. While some will manage very well with breathing and relaxation techniques, others will not. Try to keep an open mind about what your needs might be and don't second-guess your decision after delivery.' In any case, you'll usually need to make a decision about whether you want drugs while you're still in the first stage of labor; by the time you're pushing it's generally too late. Here are your options.
Systemic medications Systemic painkillers, such as narcotics and sometimes tranquilizers, will dull your pain but not completely eliminate it. They're given through an intravenous (IV) line into your bloodstream or injected into your muscle and affect your entire body rather than concentrating their pain relief on the pelvic area. They'll generally make you feel sleepy, but unlike the general anesthesia that's often given for surgery, they won't make you unconscious.
Pros:
• This kind of pain relief often works well for a woman who can cope with some amount of pain but just needs a little something to help her relax.
• IV medication is less invasive and easier to administer than an epidural or a spinal (see below), and doesn't require an anesthesiologist.
Cons:
• Systemic medications can cause a variety of side effects, such as drowsiness, dizziness, and disorientation, or more rarely, nausea.
• Because of the side effects you'll have to stay in bed after receiving this kind of medication.
• Sometimes, especially if given too early in labor, narcotics can slow your progress.
• Since these drugs cross the placenta, they may make your baby a little sleepier too and may affect his ability to nurse for a short time after birth.
• In rare cases, narcotics can make it harder for a baby to begin breathing after birth, particularly if the mother is given a large dose just before delivery. Should this happen to your baby, he will be given medication to counteract the effects of the narcotic.
Epidural An epidural is a regional anesthetic that decreases the sensation in the lower areas of your body while allowing you to remain fully conscious. Medication is delivered through a catheter (a very thin, flexible hollow tube) inserted into the space just outside the dura (the membrane that surrounds your spine). You lie curled on your side or sit on the edge of the bed while the anesthesiologist injects a needle into your lower back, passes the catheter through it, then withdraws the needle and tapes the catheter in place so she can administer medication through it as needed.
Pros:
• The pain relief can last throughout your labor.
• The anesthesiologist can control the effects by adjusting the type, amount, and strength of the medication.
• You will be awake and alert during labor and can rest during dilation, which means you may have more energy when it comes time to push the baby out.
• The medication generally doesn't affect the fetus directly.
• Once the epidural is in place, it can be used to provide anesthesia if you need a cesarean.
Cons:
• You have to stay in an awkward position for about ten minutes while the epidural is inserted, then wait another ten to 20 minutes before the medication takes full effect.
• Depending on the type of medication you're receiving, you may not be able to stand up and move about with an epidural.
• Both you and the baby will require more monitoring devices once you have an epidural.
• An epidural could cause your contractions to become less frequent and intense, in which case you may be given the drug Pitocin to get your labor back on track. For many women, though, the slowdown is temporary and once the pain relief has made them more comfortable and relaxed, their labor may actually progress faster.
• The loss of sensation may make it harder to push the baby out. However, in this case, you may choose to have the epidural dose decreased during the second stage of labor so you can be a more active participant and push more effectively.
• In rare cases, you may get spotty pain relief.
• Shivering is a common reaction, although this often happens during labor even without anesthetic and will usually subside if you're covered with a blanket.
• The drug may temporarily lower your blood pressure, resulting in decreased blood flow to your baby, slowing his heart rate. (This is treated with fluids and sometimes medication.) In rare cases, the medication may affect the chest muscles, making it harder to breathe. Should this happen to you, you may be given oxygen.
• In less than 2 percent of cases, an epidural results in a bad headache. (You can decrease the risk of headache by lying as still as possible during needle placement.) In extremely rare instances, it can cause nerve injury or infection.
shamma
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Member since
Re: PAIN MEDICATION FOR LABOR/CONT'D
Spinal block A spinal block is another option for regional pain relief. An anesthesiologist injects medication directly into the dura, where it then enters the fluid surrounding the spinal cord and eliminates all feeling from the waist down. Spinals differ from epidurals in that no catheter is used, so the medication can be given only once. Relief is rapid and complete, but lasts only a few hours. Occasionally doctors order a spinal block late in labor and sometimes just before a forceps delivery.
Pros:
• Pain relief is rapid.
• The medication generally doesn't affect the fetus directly.
Cons:
• You have to hold an awkward position for five to ten minutes during the procedure.
• The loss of sensation may make it harder to push the baby out.
• The drug may temporarily lower your blood pressure, resulting in decreased blood flow to your baby, slowing his heart rate. (This is treated with fluids and sometimes medication.)
• In about 1 percent of cases, getting a spinal can result in a bad headache. In extremely rare instances, it can cause nerve injury or infection.
Combined spinal / epidural block A combined spinal / epidural block is a relatively new technique that offers the rapid pain relief of a spinal combined with the continuous relief of the epidural. In early labor this technique allows you to stand more easily than with either a spinal block or an epidural alone. That's because the medication used is mostly narcotic, so you're less weak or numb than with an anesthetic. For this reason, a combined spinal/epidural block is sometimes known as a walking epidural.
Pros:
• You can get up and walk around during the early part of labor.
• You get all the benefits mentioned above for both the epidural and the spinal.
Cons:
• This option has all the disadvantages mentioned above for both the epidural and the spinal.
