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Life with a bump can be uncertain and unpredictable and during the last few days or weeks you are likely to be on tenterhooks; each twinge could be a nothing or a something, so how do you know when your baby is gearing up to get out?

Show time

You have a mucus plug that seals the entrance to your cervix. Towards the end of your pregnancy the cervix softens and dilates and the plug comes away; this is called ‘the show’.

Not all women notice it but ‘the show’ is a bit like a blob of jelly, a pink or blood-stained mucus discharge which can happen up to ten days before labour starts.

Contractions

You know your bump days are nigh when contractions kick in! These are a sure fire sign that baby is on the way, especially once contractions last more than 40 seconds and come just minutes apart.

Things start slowly and build up, call the hospital and let them know how frequent your contractions are and they will advise you whether to head to the hospital or stay in the comfort of your home for a little while longer.

Braxton-Hicks contractions are irregular pain-free contractions where your bump hardens; think of it as your body’s dress rehearsals. They happen from early on in pregnancy but you may become more aware of them in the latter stages.

Water breaking

Your waters can break at the onset of labour or much later on and could be a gush or a trickle. Your waters break when the membranes rupture and release the amniotic fluid that has surrounded your baby.

You should head to the hospital, if you are not already there, as once the membrane has ruptured there is a risk of bacteria entering and causing an infection. There is a risk that the umbilical cord, no longer suspended in water, could prolapse into the cervix. This is a rare but potentially life threatening situation and your medical team will want to keep an eye on baby.

Stages of labour

As with all the best stories, the tale of your labour has three parts; a beginning, middle and end.

The beginning (first stage) is the dilation of the cervix, which goes from tiny to a 10cm opening with the help of the muscles in the uterus and contractions. The middle (second stage) is the delivery of your baby’s head, quickly followed by the body. The end (third stage) is when you deliver your placenta.

Your delivery

Once your cervix is fully dilated you will need to push with each contraction. Depending on how you and baby are doing you will be able to move around to find a position that suits you. It can take an hour or two for baby’s head to appear and after that things usually progress quickly, and you finally get to meet the person that you grew.

Pain relief

You don’t get a medal for doing it all totally au natural so don’t be ashamed to ask for help. The following options may be available to you;

TENS – (transcutaneous electrical nerve stimulation) are popular in early labour, mild electrical currents block pain.

Gas and air – officially known as entonox; 50 per cent nitrous oxide and 50 per cent oxygen. You’re unlikely to care about its composition, more the fact that you can control it yourself to alleviate some of the discomfort. It can make you feel a little nauseous or sick.

The strong stuff – pethidine, diamorphine and fentanyl have a more pronounced pain relieving and calming effect but don’t kick in for at least twenty minutes. A dreamy drug-induced state might sound like the best option but they can make you and your baby less alert.

Epidural and spinal block – these are always carried out by an anesthetist. A spinal block is a one off injection of anesthetic without a tube. In an epidural a very fine tube is inserted in to your lower back with a needle, anesthetic drugs are administered through the tube, which is left in place so more drugs can be given later on. It can take around 40 minutes to be set up.

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