Before Labor Begins
by Amy B. Tuteur, MD Ask Dr. Amy.comHas the baby dropped yet? Friends and complete strangers are asking the same question. What are they talking about? How will you know?
By the end of pregnancy, the baby is likely to take a position that will be favorable for the coming journey. Over 95% of all babies will be facing head down, with their chins tucked on to their chest. Some babies, particularly those of first time mothers, will literally drop into the pelvic opening. The cervix may not have dilated, and the baby is still totally within the uterus, but the head is now nestled within the pelvic opening instead of abovdrop, e it. Doctors and midwives refer to this process as engagement.
Engagement is also known as lightening, probably because it provides some relief from common pregnancy symptoms. When your baby drops, pressure on your stomach and diaphragm drops, too. You will probably have less heartburn and shortness of breath. Of course, these symptoms may merely be exchanged for new ones. You may feel increased pelvic pressure, and some women complain that it’s hard to walk because it feels like the baby’s head is between their legs. However, it’s important to remember that many women have no change in their symptoms and never even notice when the baby’s head engages. It is also possible that the baby will not drop until labor begins.
There are other signs that the time for labor may be drawing near. For example, the mucous plug, which has kept the inside of the uterus sealed off from the vagina, falls out as the cervix begins to to soften and thin in preparation for labor. The mucous plug may fall out hours or even days before labor begins. Sometimes the membranes of the amniotic sac rupture (“breaking your water”) minutes or hours before labor begins. If your membranes rupture, you should call your practitioner. Some doctors and midwives prefer that you come in for examination right away. Others will advise you to wait at home to see if labor begins spontaneously.
Many women have other physical symptoms that signal labor is approaching, including diarrhea, low backache, or abdominal cramping. It seems that impending labor may cause psychological changes as well. A few women are seized with the nesting instinct in the hours and days before labor begins. They are suddenly consumed by the urge to clean and arrange things, when just a few days before they were too exhausted to move.
Can you do anything to deliberately start your own labor? There are a lot of old (and new) wives’ tales that you can consider. Some women insist that spicy food started their labors, and others claim it was because they dosed themselves with castor oil. Then there are those who swear by sex, reasoning that even if it doesn’t work, at least they’ll have a good time. Unfortunately, it’s not likely that any of these home remedies are effective. Labor starts when the baby is ready and not one second before.
About the Author
This article was adapted from the book How Your Baby is Born, by Amy B. Tuteur, MD. Dr. Tuteur runs the website Ask Dr. Amy.com where you can ask her your questions.
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