True Labor

During labor, the uterus repeatedly contracts (tightens and relaxes), causing the cervix to thin (efface) and open up (dilate) so you can push your baby out through the birth canal. It is not always easy to tell when true labor has begun. The due date set by your doctor is just a point of reference. Labor may start as long as three weeks before or two weeks after this date.

Signs that your labor may be approaching:

Lightening: The baby's head drops down into your pelvis, making your belly look lower. It will be easier to breathe but you will have to urinate more often because the baby is now pressing on the bladder. First-time mothers usually experience lightening a few weeks before birth.

Bloody show: A blood-tinged or brownish vaginal discharge means you have lost the mucus plug that sealed the cervix. The cervix is dilating, but active labor may still be days away.

Breaking of the water: When your water breaks (the amniotic sac ruptures), fluid will leak from your vagina in a trickle or a gush. For most women, contractions begin soon after the water breaks.

Diarrhea

Less movement from the baby

Regular Contractions: Labor contractions may be mild at first, but they will gradually build in intensity, starting at the top of your uterus and radiating through your belly and lower back.

Call your caregiver if you have

• Increasing pelvic pressure
• Vaginal bleeding
• Heavy discharge
• Marked decrease in your baby's activity
• Regular contractions

In most cases, you should start for the hospital when contractions are too painful to talk through, last 60 seconds or more, and have been coming three to five minutes apart for at least an hour. Every labor is different, however, and you and your caregiver should develop a plan well ahead of your delivery date.