The first symptoms of labor tend to present themselves well in advance of the time of delivery. Usually, therefore, the woman has plenty of time to evaluate these symptoms together with the healthcare professional and understand whether or not it is a false alarm.
The most important signs that herald the actual onset of labor (prodromal phase) are:
the release of the cervical plug;
the onset of regular and worsening contractions over time;
spontaneous rupture of the membranes (water rupture).
Release of the cervical plug
During pregnancy, the cervix is occupied by an accumulation of mucous material, which prevents pathogenic microorganisms from rising into the uterus, protecting it from the aggressions of the outside world. At the beginning of labor, when the cervix begins to dilate in preparation for childbirth, this plug slips off and is ejected. On this occasion, the pregnant woman feels the release of a white, dense, odorless and mucilaginous substance, streaked with blood and sometimes followed by a small blood loss.
Breaking of the waters
The "water bag" is the "sack" that contains the fetus and the amniotic fluid in which it is immersed.
In its classic presentation, the breaking of the water results in the descent into the vagina of a "large quantity of hot liquid, normally odorless and colorless. These characteristics help to differentiate it from urine and common vaginal discharge, which is more viscous, non-continuous and sometimes mixed. to blood. The amount of amniotic fluid that escapes from the vagina is however variable; for example, if the bag pierces in one point only instead of breaking completely, the loss is modest and not constant; nevertheless, it is repeated throughout the day and is generally associated with the mother's movements.
Membranes can rupture at the onset of labor or without contractions having begun; in most cases the waters rupture during labor and if uterine contractions do not occur within the next 24 hours, they are usually medically stimulated.
Uterine contractions
In the last period of pregnancy, uterine contractions represent a rather faithful company. False labor pains, or more technically Braxton-Hicks contractions, tend to increase in intensity and frequency. one's contractions preparatory to childbirth are characterized by a stable and continuous rhythm, and do not disappear when walking, lying down or changing position. On the contrary, they become more and more frequent and painful, so much so that when they arrive the woman needs to stop and lean on someone During this event, the pregnant woman feels an internal compression of the belly, which in true contractions is often associated with a painful sensation in the upper abdomen or loins (at the height of the kidneys) and hips.
Sometimes accompanied by the loss of amniotic fluid, at first the true uterine contractions occur every 15-30 minutes, with a duration that can go from 15 to 20 seconds. Once labor begins, the contractions become more and more close, more intense and longer, occurring 3-5 times every 10 minutes, for a duration of 40-60 seconds each. Given the importance of the intensity and frequency of this symptom, pregnant women generally receive precise instructions from healthcare professionals to note the frequency and duration of contractions. The important fact, however, is not so much the distance between one contraction and the next, but the regularity with which they follow each other.
Another symptom that can announce the imminent arrival of labor is represented by diarrhea, sustained by the release of endocrine and paracrine hormones that prepare the body of the pregnant woman for the happy event.
Generally, subjective symptoms alone are not sufficient to diagnose labor. In order for the healthcare staff to confirm that the long-awaited and planned moment is now upon us, it is necessary to perform a vaginal examination. If over time the uterine cervix dilates and thins, labor has now begun: active or dilating phase, also called I stage).
