When you are pregnant for the first time, or even in subsequent pregnancies, a really big question that comes up is “How will I know when I am in labor?” and “How will I know when to go to the hospital? Or Birth Center? Or Call my midwife?”

What you need to know and do.

Truly I do think this is a VERY important topic because that part is the time when you set the energy for the whole labor and birth experience.

We know that women experience all different kinds of signs that labor might be starting soon:

  • Losing extra mucus, especially blood-tinged mucus.
  • Having multiple bowel movements in a short period of time.
  • Having either of the above, combined with a feeling of tightening over the whole uterus.
  • Having any of the above, along with a feeling of cramping, like menstrual cramping down low.
  • Having any of the above, along with tightening or aching feeling that extends around to the lower back or extends down the thighs.
  • Having a really deep down feeling that this is it.

Having said all that, the truth is that the early signs of labor are different for each woman. For my first baby I had regularly timed cramping sensations, so that was fairly easy. For my last baby, I had a feeling of “becoming unraveled” energetically as I noticed with surprise that I was dropping tears into my cereal bowl and didn’t know why! Surges came later on, but seeing those unusual tears was my first inkling that things were changing, and this could be the birthing day. Of course if we have any of those signs combined with a leak of fluid or a gush of fluid, we know we are about to start labor.

The important thing to remember is what we talk about and teach over and over again: breathe, surrender, relax, breathe, surrender, relax more.

Use the long slow abdominal breath from the very beginning during every surge. Put on your relaxation audio or favorite affirmations. Don’t wait until later to begin your relaxation.

Often in the latent phase or “prodromal phase” as you might expect, we have different or unusual sensations that we hadn’t noticed before. (i.e. “This is not how I felt yesterday!”) It is not uncommon for this period to last a day or more. However, some women don’t even notice it, or they sleep through it. I always tell women to touch their abdomen during unusual or crampy sensations and see if it feels much tighter and harder than usual. That is one way to know that you are having a surge during that sensation. Eventually you will just KNOW, because you will need to stop everything, breathe, sink in and relax.

Mothers have told me it helped them to remember that the energy of each surge will be just as perfectly big and strong as it needs to be, and you can allow it to be that big. Your relaxation practice now during pregnancy, combined with your deep slow breathing during surges in labor, will move you into that deeper place of surrender and relaxation. No matter what occurs, that place of relaxation, breath and surrender will always be available to you. This is the reason and the benefit of your relaxation practice! This is why you have been breathing your belly up with that long slow breath practice a few times a day. Your companion’s voice, and presence while offering reminder prompts, can help you even more during this early part. Connection with your baby happens at the same time.

You are all in this together!

In the early labor part, the prodromal part, surges are often inconsistent in length and regularity. 15 seconds to 3 minutes long, changeable, erratic. By surges here, I mean uterine tightenings. They can be regular and then not regular, come and go. The strength and the pattern can change according to your activity as well. They can be tricksters that get your attention. The important thing is to stick with what I mentioned above: breathe, relax, and during all of this STAY NORMAL. By this I mean EAT, DRINK, SLEEP. Take naps if it is during the day and an erratic surge pattern interrupted your sleep the night before. Perhaps take extra cal/mag, or try the Nervous System Tonic. Trust your body’s process. Use forward leaning postures or other spinning babies techniques to help keep the baby in best position for labor and birth. I do not think it is helpful to be focused on timing surges in general because this can just be a distraction from your relaxed focus.

signs of labor

However, later on, as your birthing companion or partner observes that the process is deepening for you, it is fine for him/her to do some timing to “check in.” As things are getting stronger for you and you are moving into a phase when you are so focused on relaxing and breathing that talking during a surge is not possible, that is a critical time for the birth companion to remember to “hold a space” for you in a loving way, be totally available and encouraging. You can think of it as cocooning the birthing person. Use your birth and relaxation prompts or any deepening desired. The intention here is to set the tone of love, joy and trust in the process. This will amplify the oxytocin and endorphin hormones that are so vital to the process and it will keep the birthing person in the “healing room.” There is NO place for fear here, so you will want to make sure that you have done that clearing before labor begins. If there is anyone fearful around (a relative perhaps?) kindly and lovingly usher them out of the space.

3-2-1 Guide

Here is a simple kind of guide for you – When you have all of these happening and you cannot talk through a surge (3 min apart, for 2 hours, lasting 1 min) you are likely moving into active labor. (Cervix has responded to uterine tightenings/surges by thinning and opening to 6 cm if you had a cervical check). This means you have already done a LOT of work. Good job! We normally view labor as TRUE LABOR or ACTIVE LABOR when for the last 2 hours…

  1. Surges are increasing in strength from hour to hour.
  2. Surges are consistently about 60 seconds long from beginning to end.
  3. Surges are consistently 3 minutes apart from beginning of one to beginning of another
    and getting closer together, over the hours.
  4. You cannot talk during a surge.

(NOTE – this is geared toward someone having their first baby. For subsequent babies, 4-2-1 might be more relevant.)

Sometimes birthing people spend their initial early or prodromal labor time trying to “get away” from the sensations or distract themselves. This is counterproductive and I do not advise it! You could be wasting time that could be used to initiate a deep and effective relaxation practice during the surges. You could be buying into your anxiety brain instead of staying in your healing room. Instead, just sink into relaxation, trust your body, let go and enjoy the ride of your ecstatic birthing hormones. You can trust! You can surrender!

Another guide I share with people we work with about “How to know if you are in labor” is this: If you become confused about the pattern of your surges, they seem super strong to you but you can’t tell what’s happening, just lie down on your left side for at least 30 minutes and have your partner or birth companion time them. Timing means include the duration from beginning to end of each surge and also the length of time from beginning of one to beginning of another. Your left side lying will give you an accurate picture of your pattern. Then you can compare that to the 3-2-1 guide above.

Always trust your deep instincts with this!

As you invest in deepening your relaxation, and in trusting your instincts, you will KNOW when it is time to travel to your birthing place or call your midwife! Always trust your deep instincts with this! In our coaching and courses we teach you how to become familiar with your deeper wisdom, urges and clarity. You will have everything ready ahead of time and the travel time can just be enjoyed as you relax with your affirmations or relaxations and do your long slow abdominal breathing with your surges.

I am going to repeat one more time what I said above:

  1. Use your long slow abdominal breath with every surge.
  2. Enjoy your relaxation.
  3. STAY NORMAL! By this I mean EAT, DRINK, SLEEP.
  4. Take naps if it is daytime and an erratic surge pattern interrupted your sleep the night before.
  5. Consider taking extra cal/mag (if you experience and irritating contracting uterus that is not really in labor yet but is keeping you from sleeping). You could also try the Nervous System Tonic.
  6. Trust your body’s process.
  7. Use forward leaning postures or other spinning babies techniques to help keep the baby in best positions for labor and birth.
  8. Stay connected with your baby and your joy that they are coming soon!

labor tips

Going through this “early” phase is some of the most important work you will do as a birthing person. By relaxing and breathing and taking super good care of yourself in all the ways, you set the tone and environment to optimize the flow of your natural birthing hormones. By the time your “active labor” is truly underway, you will be an expert at tuning in, breathing, and trusting your body. And then you get to breathe your baby down and meet your beautiful little one for the first time.

You continue to be on our hearts and minds as you navigate the changes the pandemic has brought. As midwives and mothers we have gathered immune support suggestions over the years that we follow and also recommend to our clients. We wanted to reach out to offer these suggestions, some additional resources we trust that you can access here, to help you in supporting healthy choices around your pregnancy and upcoming birth.