Early signs of labor and childbirth

autumnleaf

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My character is in the late stages of pregnancy and realizes she's going into labor. What does this typically feel like? How does she know the baby is definitely on the way?

Some important points:
- Setting is a small village in a pre-industrial era.
- No doctor, just a local midwife (who is good at her job, but restricted by the knowledge and superstitions of the era).
- It's the character's fourth pregnancy, so she should know what to expect.
- She has a good idea when conception occurred, so presumably that gives her a reasonably good notion about when the baby is due.
- Pregnancy is full term and so far uncomplicated.
- I'm not planning to do a birth scene; the story will cut away after she sends her young daughter to fetch the midwife.

Many times in fiction, the first sign is the waters breaking, but I'd like to avoid that cliché as it seems less common in real life.

First-hand experience and medical or historical knowledge welcome!
 

waylander

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According to Mrs Waylander (retired midwife) - backache and contractions.
 

lizmonster

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I had mild contractions off and on for several weeks - one or two a day, sometimes a few more. One evening I had an unusually upset stomach after dinner, and they started getting more regular. I started timing them. When they were reliably about 20 minutes apart, we called the midwife. Daughter was born about 5 hours later. From talking to other women, this progression isn't uncommon, although I was a little fast.

I did have a backache, but I'd had one for weeks. Vanished the moment she was born.

(And I've no idea when my water broke, but it was long after labor started in earnest.)
 

Marissa D

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It sounds kinda weird, but one of early labor is the passing of a lot of mucus, which has been plugging the cervix; as dilation reaches a certain point, that mucus plug comes out.

Also, an odd sort of restlessness and need to move around. And nausea and vomiting.
 

Professor Yaffle

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Ooh! One I can help with! Similar to Marissa D, loss of mucus, and an odd restless feeling. I didn't have the nausea though, thank goodness. Also, stomach muscles getting very hard and rigid over the bump, and this eventually becoming uncomfortable, then painful as full labour kicked in.
 

Masel

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In retrospect the first sign of labor with my daughter was not being able to bend over. I had to bend from my knees to get ice out of the ice maker at the office, not something that had bothered me even the day before. There was also light spotting. My water didn't break until well into labor at the hospital a couple of days later.

With my son, I had almost no early labor symptoms. I slept well, got up at 6, took a shower at 7, my water broke at 7:32 and he was caught by EMTs in my living room at 7:47am. Surprise.

The restlessness is a good observation and wasn't something I had anticipated. I also had an altered perception of the space around me. After the shower, still thinking I'd have all day, walking across my bedroom from the bathroom door to my dresser seemed like miles. I could not parse what clothing I should put on. I wanted to be covered but able to nurse and cute enough clothes for pictures but not something I minded getting blood on. If I was going to be pacing at the hospital for hours on end making me feet hurt should I put my good sneakers on but what if my water breaks.

ETA - I shared this yesterday in another forum and thought you might find it interesting. It is a medieval notary report about a woman giving birth. Notaries were not usually present at birth but her husband had died and she needed to prove that the baby was her's to maintain access to more of the inheritance.
https://the-orb.arlima.net/birthrecord.html
 
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Coddiwomple

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Spotting and a brutal backache with my first. Will your character's delivery be normal? We found out later that the intense backache I had was due to his unusual presentation (not breech, but flipped, so he was facing the wrong way).

Second one was normal -- and yes, it started with water breaking and intense contractions. Cliche? Maybe. But it's cliche because it actually happens. If you want to present it as non-cliche, maybe add details. For instance, I was in bed next to my husband, enjoying a Saturday morning sleeping in. Our three-year old son was cuddled between us. I felt a dull "thunk" deep inside, and then the swift gush of liquid between my thighs. The first contraction rippled as I nudged my husband awake. And then comes the thought process, because it wasn't my first. A quick calculation: How close are the contractions? Do I have enough time for a load of laundry? How about a shower, before we leave? Time to set our plans in motion, call my mother-in-law to watch our son. I was trying to fold one last piece of laundry as my husband gently ushered me to the door.

The fact that a seasoned mom has plans in place and is weighing time and options with a calm anticipation could add realism. She knows labor is unpredictable, but she's been there before and knows it's going to be tough work.
 

Silva

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My symptoms were:

-more white, thick mucus discharge than usual (which indicated that I was dilating slightly over the course of a couple weeks and the mucus plug was continually regenerating, which is normal, I didn't "lose" mine fully until well into labor and at that point it was more yellow than white and streaky with blood)

-braxton hicks, which I didn't feel but were apparently visible to my midwife--she could see my belly tensing up and then relaxing.

-contractions, which to me felt like having a blood pressure cuff inside my abdomen (relatively fast increase of pressure to the point of discomfort, then slow release).

The waters didn't break until the baby's head was crowning in my first birth. In fact, for a minute we thought my daughter would be born in the caul. There was bulging sac in front of her head and when it broke it was a audible, surprisingly loud pop despite being underwater (in a birthing tub) at the time. With my second, it broke exactly as I transitioned from dilating to pushing.

With my second labor I woke up at midnight and avoided waking my husband because my prior labor had taken 24 hours and there was no point in him being up and fussing around. It was more irritating than exciting or scary because I would rather have been sleeping. I could also tell after a few hours that the baby wasn't positioned optimally because something didn't feel "right" about the labor compared to the last one--I couldn't and still can't describe how I knew or what precisely was telling me this, but I knew (and I was right). Nevertheless, at 12 hours it was a much faster birth than the previous one.
 
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MaeZe

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I...With my son, I had almost no early labor symptoms. I slept well, got up at 6, took a shower at 7, my water broke at 7:32 and he was caught by EMTs in my living room at 7:47am. Surprise.

Just to illustrate the wide variation: I started having regular contractions on Friday. I waited much of the day, went walking all those things. Went in and they said I wasn't dilating yet, go back home. My regular contractions continued all night so I went back the next day and still was only barely dilated. The nurses didn't believe I could be in real labor but before sending me home again they put the contraction monitor on. "Oh these are good contractions," the nurse said so they decided I should stay. Sunday morning the doc came in and assumed my contractions must have stopped. They hadn't.

This continued until my son was born Monday afternoon. I was too exhausted to push, they should have done a damn C-section but such procedures were out of favor at the time. They needed forceps, he had trouble breathing, but he was okay after a couple days with no further problems.


Sigh, my mom's three kids were all born with three hour labors.
 
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Harlequin

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As a general trend, water breaks very late for most. Almost never do you get WATER BROKEN HOLLYWOOD BIRTH (but you probably know that).

I had "slow labour" for a week with both children, meaning contractions that stopped and started. Then jumped straight to stage 2 with almost no warning, except sudden cramps and throwing up. (yay!)

How the birth will go depends on many factors, but position of baby is one. My daughter was back-to-back, which usually means a long and miserable labour as the baby slow turns around.

She didn't turn--she was just born facing the wrong way up. instead of a long, miserable labour, I had a (relatively) short and excruciating one.

Early labour and active labour are often confused, for some reason.
 

autumnleaf

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Thanks everyone for sharing your experiences. Rep points all around!

I don't have kids but my youngest brother was born when I was eleven and I remember his birth well. My mother seemed unhurried, "the baby is on its way, your aunt will be coming over to mind you tonight while your Dad drives me to the hospital, and yes you still have to do your homework". I thought she was cleaning the house because we would be having visitors, but maybe that was the restlessness you guys are talking about. So the OMG WATER BROKEN HURRY TO HOSPITAL BABY ARRIVING NOW always seemed unrealistic to me, but I understand that experiences differ and that does happen to some women. It's also possible my mother was putting on a calm face for the rest of us and she was more impatient than she let on!

It seems that birth experiences do differ greatly so there's a certain amount of variation I can get away with. So maybe she's rubbing her back, moving about the house restlessly, noticing her tight belly. And when she gets another contraction, she realizes they're getting closer and she should let the midwife know her services will be needed soon. She is scared because she's living in a time of when childbirth was one of the most dangerous things a woman could do, but at least she has a good idea what to expect so it's not as bad as the first time. Also she's staying calm for the sake of her other kids.

Masel's link was very interesting. I have read that, in the past, it was more common for women to give birth sitting down, using a birthing chair or sitting on someone's lap. That would seem to make sense with regard to gravity, so I wonder why it fell out of use.
 

Harlequin

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Short answer, patriarchy.

It was more convenient for women to be on their backs with feet in stirrups, for observing male doctors. But it was absolutely worse for the women.

The trend is reversing though and many women are now encouraged to walk around in labour, or to give birth on all fours or while squatting etc.
 

lizmonster

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The trend is reversing though and many women are now encouraged to walk around in labour, or to give birth on all fours or while squatting etc.

I gave birth in a chair (in 2004). I wanted to give birth in the tub, but they told me I was getting lazy and made me get out. Closest I came to swearing the whole time. :)

The worst pain, besides the more serious contractions, was when they had me lie on a hard exam table so they could check my dilation. Anything that gives your tailbone room to flex is likely to be more comfortable. (YMMV, no two labors are alike, etc.)
 

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The EMTs tried to get me to lay on my back but I kept saying "NO". I was on all fours when my son arrived.

I've got lots more about medieval obstetrics if you need it. (I'm loads of fun at parties, let me tell you.)
 

Marissa D

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I was squatting with my husband holding me up for my first delivery and half of my second (twins--unfortunately they had to do a c-section to get daughter #2 out.)

And yes to the cleaning thing! I did a lot of cleaning in the days before my kids were born--it's evidently a thing (nesting instinct?)
 

Anna Spargo-Ryan

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My experiences were vastly different, so may be helpful!

I had one of those 'labour starting with waters breaking' experiences with my first. We rushed to the hospital, clueless, and they sent us home again. I laboured at home for almost a full day before we went back. My early symptoms were lower back pain, period-type pain, a 'bloody show' (mucus plug), and tightening. I was forced to give birth lying on my back while they ran a penicillin line (risk of infection because my waters had been broken for 24+ hours). I pushed for 45 minutes and labour was 28 hours total. Minimal bleeding, a few stitches, threatened retained placenta, three days in hospital.

My second labour started with the same kind of lower back pain, but I was also really sick during. I laboured for a few hours into night, vomiting violently, in lots of pain. When I couldn't hack it anymore, we went to hospital. I don't remember a bloody show, and my waters were intact when we arrived. I was only 4cm dilated, but half an hour later was at 10cm, which seemed miraculous to me at the time! Pushed for 4 minutes, and labour was 6 hours. That daughter was born 30 minutes after we arrived at hospital. I gave birth on my side, with my husband holding my leg so I could push against it. My mum was watching from behind – I think she's scarred for life from seeing the head come out with its face towards her :D Lots of bleeding, no stitches, went home the same day.

Also, in Western countries there were two big turning points with the medicalisation of childbirth. Around 1900, (almost entirely male) doctors started overseeing births alongside – and then instead of – midwives, treating women as patients and prioritising the safety of the baby, and eventually bringing childbirth from the home into hospitals. Then in the 1970s it flipped, and doctors started putting the health of the mother first. The patriarchy, as Harlequin said!
 

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Often the baby will "drop." The head will engage into the pelvis and the baby will sit lower in the abdomen. This is often noticed by other people. Can happen from weeks to hours before birth.
 

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I had the "water broke," race to the hospital. It really does happen! My daughter was 3 days early. Her big sister was 2 weeks late, so I didn't expect anything to happen so fast. At the hospital, I walked around for about 6 hours with contractions, pushed for a bit and the baby was there. 7 hours total. I agree with others who say detail will make the difference, and the mother's attitude toward the moment. Childbirth is still dangerous, of course, we just suppress it more because it's rarer for women with decent health care to die, and our medical knowledge has come along. But after my first daughter, I had an infection that would've killed me 100 years ago, and would've killed me now if I didn't have good health care. So yeah, a certain amount of vigilance and anxiety is always there, and was probably worse in the past.
 
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autumnleaf

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Thanks again for sharing your experiences. All these details will help to make the scene more real.

Short answer, patriarchy.

It was more convenient for women to be on their backs with feet in stirrups, for observing male doctors. But it was absolutely worse for the women.

Also, in Western countries there were two big turning points with the medicalisation of childbirth. Around 1900, (almost entirely male) doctors started overseeing births alongside – and then instead of – midwives, treating women as patients and prioritising the safety of the baby, and eventually bringing childbirth from the home into hospitals. Then in the 1970s it flipped, and doctors started putting the health of the mother first. The patriarchy, as Harlequin said!

How maddening! Glad to hear things are changing and women are getting more say in their own needs.

I've heard that until the late 19th century, it was safer to be attended by a midwife than by a doctor. The doctors were unknowingly passing on the germs that caused child-bed fever. And yet, when Dr Ignaz Semmelweis brought down death rates at his Vienna clinic by insisting doctors washed their hands, there was a great deal of resentment and disbelief, "how dare he suggest we're killing our patients!" (Poor Semmelweis ended his days in an insane asylum.)

In any case, my character will definitely give birth sitting down and, even though the midwife knows nothing about germs, at least she isn't coming to her straight from the autopsy room!

I've got lots more about medieval obstetrics if you need it. (I'm loads of fun at parties, let me tell you.)

I am both tempted and terrified to read them.
 

Debbie V

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For both of mine, I woke up to urinate at 6 AM and my water broke. I then began having mild contractions. For my first, I called the doctor once he was open. I went in for my regular appointment that day and was sent home. Contractions were too mild and I was still producing fluid. I didn't go into hard labor that day. I went to the hospital the following morning and they induced but without realizing, I pulled the suppository out. The second dose had more effect, but I wasn't dilated, at all. I spent the second night being turned from one side to the other every half hour in order to encourage dilation evenly. My daughter was born at 10:20 in the third morning. I had been 50 hours without real sleep. I too had an IV antibiotic.

For my son, they induced at 7 PM the first night (wasn't making the same mistake twice.) My body reacted to the meds so quickly that they pulled out the suppository. He was born at 11 PM.

Hospital rules here state that they induce if you go in. I knew that up front.
 

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I’m typing this while sitting next to my newborn baby, so this is a timely thread. :D

I had one of those dramatic “my water broke” labor with my first baby. Woke up at 5AM to pee, stepped out of the bed, and felt water trickling down my legs. I thought I’d completely lost control of my bladder and was like, “This is such a low point in my life.” Then I realized it was my water breaking, and promptly woke Mr. Hippo, who leapt out of bed and nearly bashed his head against the wall. It was a hilarious and dramatic moment. Baby hippo 1 was born 11 hrs later. It was an easy labor and I didn’t require any stitches. My doctor was tapping on his phone half the time and the midwives did most of the work. Happy smiles all around!

Baby hippo 2 was expected to be easy as well, but she had other ideas. I woke up at 4AM because I felt wet down there. Realized I was bleeding heavily, so we rushed to the hospital, where they said everything looked fine and sent me home. I continued bleeding for one more week, and had minor contractions the whole time, and then the dr told me the baby had stopped growing and so had to be induced. Was induced at 8AM, started pushing at 4PM, and hooo boy, it was a toughie. Turned out she’d rotated and was sunny side up. My doctor, same guy who delivered the first, was constantly on me this time, no phone or other distractions, which scared the crap out of me. He’s such an easy-going guy, to see him all serious was like... “TELL ME WHAT’S WRONG!!” Midwife had to climb up behind me and push on my belly as I pushed. It was excruciating. Oh, and this may sound weird, but my allergies were acting up and my sinuses were blocked, so each time I pushed, it felt like my face was going to explode. Sounds like a minor thing, but it really affected me at the time. Baby hippo 2 pummeled the crap out of my tailbone as she came out, and ripped me up pretty badly. Before this, I had no idea it mattered which way the baby was facing, as long as her head was down. Oh well. She’s healthy, so we’re happy, except for my poor tailbone. *is sitting on a pack of frozen peas as I type this*
 

Orianna2000

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For those who are interested in such things: Hints to mothers, for the management of health during the period of pregnancy, and in the lying-in room: with an exposure of popular errors in connexion with those subjects, by Thomas Bull. (Yes, that is the book's full title!) It's from the 1870s, I think the first edition was 1871. Not the OP's time period, I know, but still a really fascinating look at what doctors believed and taught about pregnancy and childbirth during the mid-late 19th century.

One tidbit I found shocking . . . unless something went wrong, the doctor would often deliver the baby by feel only, keeping the mother covered with a sheet or blanket, because it was "improper" to view a woman's private area. Bear in mind, this is from the same time period where doctors would use vibrators to cure female patients of hysteria, so I'm not entirely sure they were all sane.
 

lonestarlibrarian

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I had two. The first, I had been eating very healthily all throughout my pregnancy (avocados and pineapple were the things I ate regularly), but all of a sudden, I wanted mint chocolate chip ice cream for some reason. Around 7:30 p.m., I started having contractions. I timed them with a nifty contraction-timer on the computer, and messaged my midwife with my times. We got in the car around 11:30 p.m. or so, and arrived at the birth center a bit before 1 a.m. I had chosen it because I wanted a waterbirth, and I labored in the tub. Up until that point, I hadn't had any contractions at all-- no Braxton-Hicks, although some other ladies on my birth board had been experiencing BH for a week or two prior to actual delivery. It was a long time before my water broke (in the tub). Eventually, I had to get up and go to the birthing chair, because he was presenting with his arms up. (She knew how he was presenting, even without scans and stuff. She also mentioned about previous babies in her care who were readying themselves in a breech position who she had successfully compelled to flip and reposition themselves via rebozo techniques.) I tried a ball and a couple of styles of chair before he was born, around 5:45 a.m. It took a while afterwards to deliver the placenta, but those contractions weren't anything like the delivery itself-- that was a walk in the park. It was nice that when it was over, it was over-- and I got to concentrate 100% on my little guy.

When I had his little brother, I didn't take my contractions very seriously. I started noticing them around 9:45 a.m. The pest control guy came, and I'm in labor and wandering around talking to him. I figured he'd wait until nightfall before he was born. But things were getting more intense, and I may have had some spotting. So I called DH to come home from work around 10:30, just so we could make the drive to the birth center, because I knew I could handle it then--- but I wasn't so sure I could handle it in a few hours. So he got home a bit after 11 a.m., we made the drive, and we got there a bit after 1 p.m. I felt like I had to go to the bathroom, so I went and labored on the toilet for a while-- goshdarnit, that was the most comfortable toilet in the world! --and they finally coaxed me into the birth tub. (I knew in my head that childbirth would trigger your "I-gotta-go" feelings, but I was still thinking I had a ton of labor left, so I didn't think much of it.) She was shocked that I was as far along as I was. Once I realized I had permission, and that it was okay to push, I cooperated with the contractions-- and he was born at 1:34, probably within 20 minutes of our arrival. I remember feeling like my water broke earlier with this one, since it happened right after getting in the tub, but perhaps it was just a matter of all the events being more condensed into a shorter timeframe.

So for me, for my first, the only early warning sign was "I want to eat mint chocolate chip ice cream". It was me unconsciously starting to feel the early signs of labor, and wanting to eat something cold and minty and gentle to settle my stomach, before I actually consciously felt the contractions. But only an hour passed between "please go to the store, dear" and "oh, wait, these must be contractions" and there were about 10-11 hours between "oh, these must be contractions" and actual birth. For my second, I didn't have any early warning signs that I can think of-- I was consciously thinking, "I'm sure he won't be born for another 12 hours!" when, in fact, we went from first contractions to birth in under four hours.

I was also told that it makes a difference as to how many pregnancies that you've had-- that your subsequent labors tend to go much more quickly than your first. I don't know if that's true or not; it's just what my midwife told me.

Although I'd experienced a lot of fatigue during the first trimester, the rest of the pregnancy went along just fine. I worked until a week or two of my EDD-- I'd expected to work more, but I was more tired than I realized. I'd planned on taking one of my off days waiting for the baby to go catch the Tutankhamun exhibit in a nearby city, since it had been 30 years since the last US tour, but I ended up just lying on the couch... so that shows how unmotivated I was to do anything towards the very end! :p