LABOR INSTRUCTIONS

Although every woman will hour, they may be preterm labor contractions which describe her birth experience can cause the cervix to open. differently, there are specific events that happen prior to FALSE LABOR VS. TRUE LABOR the birth of your baby. After False labor or early labor may have some of the 37 - 40 completed weeks of following symptoms: pregnancy, it is anticipated • Contractions that are irregular and/or more that you will deliver your than five minutes apart infant. Knowing what to • Pelvic pressure which is constant and not expect and how to recognize intermittent or wave-like these events will provide you • Losing your mucous plug does not indicate and your partner an that your labor is starting important reference point for • During false labor, try to distract yourself. when to call NEMS. Watch a movie, take a shower, go on a walk and drink fluids (dehydration can cause

irregular contractions) WHAT IS A CONTRACTION?

When any muscle in your body contracts, it becomes True labor can be distinguished from false labor tight and hard to the touch. As muscles of your because: uterus contract, you will feel your abdomen harden. • Contractions are 5 minutes apart (from start As the contraction goes away, your uterus becomes to start), each contraction lasts at least 1 soft. minute, and this pattern continues for 1-2 hrs It is normal for your uterus to contract during your • The contractions make you stop and catch pregnancy. The muscle layers of the uterus (womb) your breath tighten irregularly from the early weeks and • The contractions do not go away after throughout pregnancy. You may feel them as early drinking some fluids or lying down as four months but many women don't notice them Try to walk and see if the contractions get stronger until seven or eight months. Usually, these and more regular. Call NEMS OB department when you are having contractions every 3-5 minutes that contractions are not painful. You may notice more are lasting 45-60 seconds each for 1 hour. If you contractions when you first lie down, after orgasm, have given birth before, call when the contractions if you have a full bladder, or after you walk up and are every 5-7 minutes apart, lasting 45-60 seconds. down stairs. These normal contractions (sometimes Labor is often more intense and faster with called Braxton-Hicks) are usually irregular and do not subsequent pregnancies and after you break your open the cervix. If these contractions become bag of water. In active labor, your contractions will regular (i.e., every 10-12 minutes for at least one be every 2-3 minutes apart. At this time, you can expect your cervix to start dilating.

NEMS Health Ed.– Rev. 3/2016

LABOR INSTRUCTIONS

BLOODY SHOW PLEASE CALL NEMS… Bloody show is a small amount of blood mixed with • When contractions are 5 minutes apart (from mucous, which is a normal part of labor. After a start to start), each contraction lasts at least cervical exam, you may see some bloody show. The 1 minute, and this pattern continues for 1-2 show is less than a period, so if you soak a pad in hours • When your contractions are every 3-5 less than an hour, please call NEMS OB department. minutes apart lasting 45-60 seconds for 1 Any persistent bright red vaginal bleeding needs to hour. If you have given birth before, please be communicated to the OB doctor immediately. call if you are contracting every 5-7 minutes lasting 45-60 seconds for 1 hour MEMBRANES (BAG OF WATER) • When your bag of water breaks. Please call The amniotic fluid has a distinct smell, which is quite immediately if you are leaking any green or different from the smell of urine. Please note the yellowish fluid color of your amniotic fluid and call NEMS OB • If you are having heavy bright red vaginal department when your water bag breaks. If you bleeding notice a yellowish or greenish fluid, or are Group B • If you are experiencing continuous and Strep (GBS) positive, please make sure you intense abdominal pain communicate this and give the GBS report to the OB • If at any time during false labor or true labor, doctor or nurse. your fetal kick count falls below 10 movements in 2 hours. TIMING CONTRACTIONS If you have been given any other instructions by • Time the frequency of your contractions by the doctor, please follow her/his guidelines. counting the minutes from the beginning of

one contraction to the beginning of the next If you think you need to go to the hospital or ER, • Time the duration (length) of your always call NEMS OB department first. We have contractions by counting the seconds from operators to answer your calls 24 hours a day, 7 the start to the end of several contractions days a week. Measure the strength of your contractions by whether you can walk or talk during a contraction

NEMS Health Ed.– Rev. 3/2016