- Beginning Labor
- False Labor
- Cesarean (C-section)
- Fetal Heart Rate Monitoring
- Labor Induction
- Preterm Birth and Labor
When labor begins, what happens?
When labor begins, the cervix dilates (opens) and the muscles in the uterus start contracting at regular intervals. These muscle contractions cause the abdomen to harden; between these contractions, the uterus relaxes and softens.
Are there changes that signal labor is beginning?
There are certain changes you may or may not notice before labor begins, including:
- The physical sensation that the baby has lowered or dropped. This may happen anywhere from a few weeks to a few hours before labor begins, and occurs when the baby’s head settles deep into the pelvis.
- Increased vaginal discharge which can begin several days before, or at the onset of, labor. What is false labor?
What is false labor?
You may have contractions of the uterus before labor “truly” begins. These sporadic contractions are known as false labor, or Braxton Hicks contractions, and you may notice that they occur more at the end of the day. Although they can be painful at times, they are normal.
How can you tell the difference between false labor vs. true labor?
Here are some ways that may help you differentiate between false labor and true labor:
- Timing of contractions. False labor contractions are often irregular and don’t get closer together; true labor contractions come at regular intervals and happen more frequently as time passes. True labor contractions may last between 30-70 seconds each.
- Changes with movement. False labor contractions may subside if you walk, rest, or even change positions; true labor contractions continue, despite any change in movement.
- Contraction strength. False labor contractions are usually weak and do not get much stronger; true labor contractions will steadily increase in strength.
- Location of pain. False labor contractions are normally only felt in the front; true labor contractions normally begin in the back and move to the front.
Sometimes the only way to tell if you are truly in labor is to be examined by your physician.
If you are experiencing any type of contractions during your pregnancy, contact Women's Institute for Specialized Health to schedule an appointment with one of our experienced gynecologists in Chattanooga.
Disclaimer: This information is not intended to take the place of the doctor-patient relationship and any email is not appropriate for emergency care. To schedule an appointment, please call your doctor's primary office, listed on our Locations page. In case of emergency, we are available 24 hours a day.
Cesarean Birth (C-section)
Cesarean birth is a method of delivering a baby baby through incisions made in the abdomen and uterus of the mother. Depending on your reason for needing a cesarean birth, and how your body recovers afterwards, impacts the length of time you will stay in the hospital. Normally, the hospital stay is between 2-4 days after having a cesarean birth.
What situations may result in cesarean birth?
There are a variety of reasons and situations that make a cesarean birth necessary, including:
- Number of babies carried or size of the baby. When a woman is carrying twins, it may be necessary to perform a cesarean birth if the babies are going to be born prematurely, are not positioned well inside of the uterus, or other related multiple birth complications. Likewise, in larger babies, most obstetricians will recommend scheduling a cesarean section for the safest delivery possible.
- Labor failing to progress. The cervix may not open enough to move the baby far enough down for delivery during contractions.
- Concerns for the baby’s health. There are multiple reasons for cesarean birth if the baby’s health is at risk. Reasons often include: a pinched or compressed umbilical cord, detection of an abnormal heart rate, the baby is in breech position, and maternal medical conditions or infections.
What complications are associated with a cesarean birth?
Most complications that occur are usually only in a small number of mothers and can be treated easily:
- Loss of blood
- Blood clotting in the lungs, legs, or pelvic organs
- Negative reaction to anesthesia or medications used during the procedure
What should be expected during recovery?
After a cesarean birth, the following may occur during recovery:
- Pain at or in the site of the incision
- Mild cramps, especially for women breastfeeding
- Bleeding that lasts around 4-6 weeks
Can a cesarean birth be requested?
Even when vaginal delivery is an option, there are some women who may request a cesarean birth. This should be a decision that is discussed with your physician and weighed carefully, as there are risks and complications associated with any type of surgery. Additionally, multiple cesarean births may increase the risk of medical problems and complications with future pregnancies. Women who want to have more children may determine that this is not a good option for them.
During labor and delivery, special equipment is used in order to check your baby’s heart rate – this process is referred to as fetal heart rate monitoring.
Why is fetal heart rate monitoring performed during labor and delivery?
Changes in your baby’s normal heart rate pattern during labor may be detected through fetal heart monitoring. This allows steps to be taken in order to treat underlying issues, if certain changes are detected. Additionally, fetal heart rate monitoring can help prevent unnecessary treatments. If there aren’t any other problems present, a normal fetal heart rate reassures you and your physician that it is safe to continue labor.
What are the types of monitoring?
There are 2 ways to monitor fetal heart rate during labor:
- Auscultation – this method is used to periodically monitor the fetal heartbeat
- Electronic fetal monitoring – this procedure uses instruments to continually record the fetal heartbeat, along with the contractions of the uterus
Your physician will determine the method used to monitor the fetal heart rate depending on a variety of factors, including individual risk of problems, complications, and how labor is progressing.
What happens if there is an abnormal fetal heart rate pattern?
If an abnormal heart rate pattern is detected, the first thing your health care provider will do is try to determine the cause. There are steps that can be taken in order to get more oxygen to the baby, such as asking you to change positions.
However, an abnormal fetal heart rate pattern does not necessarily mean that there is a problem, and your physician may perform additional tests to determine what is happening with your baby.
There are certain situations when medications or alternative methods are used to bring on, or induce, labor. This process will stimulate contractions of the uterus in effort to have a vaginal birth.
Why is labor induced?
If the health of the mother or fetus is at risk, labor induction might be recommended by your physician. In other special situations, labor may be induced for nonmedical purposes (e.g. living too far from the hospital), which is often referred to as elective induction. Elective induction shouldn’t happen prior to 39 weeks of pregnancy.
What risks are associated with induced labor?
Some methods of labor induction may cause overstimulation of the uterus, which causes it to contract too frequently. Having too many contractions may lead to fetal heart rate changes or problems with the umbilical cord.
Additional risks include:
- Infection in the baby or the mother
- Higher risk of cesarean birth
- Rupturing of the uterus
- Fetal death
Medical issues that arose before pregnancy, or occurred during pregnancy, may also contribute to complications associated with induced labor.
Is labor induction consistently effective?
There are times when labor induction does not work, which may mean that a cesarean delivery, or another attempt to induce labor, is needed. In addition, the chance of induced labor resulting in a cesarean delivery greatly increases for first-time mothers.
What is preterm (premature) labor?
When regular contractions of the uterus begin before 37 weeks of pregnancy and result in changes to the cervix, this is defined as preterm labor.
What is preterm birth?
Preterm birth is the term used for when birth occurs between 20 and 37 weeks of pregnancy.
Why is preterm birth a concern?
When a baby is born premature, there is a concern that the baby may not be fully developed, and could also be born with serious health complications. Some health deficiencies may last a lifetime, while others may present later in childhood or even as an adult.
What are risk factors associated with preterm birth?
- Previously having a premature birth
- Having a shorter cervix
- Brief intervals between pregnancies
- History of certain surgical procedures to the cervix or uterus
- Specific pregnancy complications (e.g. multiple pregnancy)
- Lifestyle factors such as substance abuse or smoking during pregnancy, or having a low pre-pregnancy weight
Can preterm birth be prevented for high risk women?
If a preterm birth has occurred previously and another pregnancy is being planned, schedule a preconception care checkup in order to be in the best possible health before becoming pregnant. Once pregnancy happens, make sure to start prenatal care early. There may be additional treatment recommendations, depending on individual circumstances and risk factors for preterm birth. Consult with your doctor for the personalized treatment options.
What are signs and symptoms associated with preterm labor?
- Changes or increase in vaginal discharge
- Lower abdominal or pelvic pressure
- Continual dull, lower back pain
- Mild cramping of the abdomen
- Frequent or regular uterine contractions, which are often painless
If any of these signs or symptoms are being experienced, contact your WISH health care physician right away.
According to The American Congress of Obstetricians and Gynecologists, only about 10% of women who experience preterm labor will have a preterm birth within the 7 days that follow. Additionally, for about 30% of women, preterm labor ends on its own.