Category: 39 Weeks

Care providers might suggest methods you can try yourself at home or you could explore alternative or complementary practices that have been thought to start labour. There is limited evidence to support any of these practices

***Key Points***

Physiological onset of labour is different to a labour that is started using methods of induction.

Some midwives or doctors might say there are ‘natural methods of induction’ however there is limited evidence to support any of these methods.

***Key Points***

***Natural methods of induction***

In the weeks before you go into labour your body is producing hormones in preparation for labour. Spontaneous labour means that your baby has sent signals to your body and brain that you are ready to go into labour. Your brain then produces oxytocin to begin and continue the labour process.

An induced labour involves medical interventions to start and keep the labour going, when your body or baby are not ready to go into labour.

On or around the due date some women may try some things to try and go into labour, or some care providers may suggest some things to try. Women will usually try these methods to avoid a medical induction of labour.

You may have heard of eating spicy food or certain fruits to help go into labour, there is no evidence to support this. However, maintaining a nutritious diet is beneficial to you and your baby. There is limited evidence to support the consumption of raspberry leaf either in tea or capsule form but research has found no harm in having it.

Having sex, and especially having an orgasm releases oxytocin and semen has prostaglandins in it which are present naturally when the cervix is softening. It is not known whether having sex has any influence on the start of labour. However avoid having sex if your waters have released.

Sometimes gentle nipple or breast stimulation is recommended to try to start labour. Limited research shows that an increased number of women might go into labour within three days as this method stimulates the body’s release of oxytocin.

Walking or gentle exercise can be good for maintaining fitness near the end of your pregnancy but there have been no studies to explore whether or not it can influence the start of labour.

Complementary therapies such as acupuncture, aromatherapy, reflexology and massage are often suggested as ways to ‘naturally’ influence the start of labour, limited studies have not demonstrated the effectiveness in starting labour. However, if you see a therapist trained in pregnancy you may find it a relaxing thing to do as you get closer to the time of birth.

***Natural methods of induction***

Sara Wickham – let’s be clear labour onset is spontaneous or induced

Pregnancy, birth & beyond – interview Rachel Reed

Induction of labour – what are the risks of being induced?

Cochrane – acupuncture or acupressure for induction of labour

Regular antenatal care is a key component of a healthy pregnancy and provides an opportunity to receive advice, information and support, while engaging in shared decision making about your  pregnancy that is designed to suit your individual pregnancy needs.

KEY POINTS

Antenatal care should be woman centred acknowledging pregnancy is a normal life event for most.

Antenatal care improves pregnancy outcomes for both mother and baby by recognising potential problems in pregnancy early.

The range of routine antenatal care visits range from 7 – 12 throughout the course of pregnancy with the average being around 10 visits.

During each visit your midwife or doctor will discuss screening test and arrange these as required.

It’s good if your partner, a friend or a family member can go with you to antenatal appointments.

Antenatal appointments keep track of your health and your baby’s health and are a great time to ask questions, discuss concerns and get health and lifestyle support throughout your pregnancy.  All antenatal visits require a directed clinical assessment at each visit, with a focus on general wellbeing and early diagnosis of pregnancy complications.

The clinical assessment should include a –

• blood pressure check
• urine dip stick, usually you do this yourself
• weight and how you can achieve a healthy weight gain
• measure your tummy, otherwise called a symphysis-fundal height (SFH) measurement
• listen to your baby’s heartbeat using a handheld doppler, this is always lovely to hear
• and ask about your baby’s movements from approximately 20 weeks of pregnancy onwards.

The midwife or doctor may also

• recommend blood tests, screening tests and other tests when appropriate and talk about test results.
• discuss healthy eating options and foods that aren’t recommended in pregnancy.
• ask about your lifestyle and help you get support for lifestyle changes like quitting smoking, or giving up alcohol or other drugs
• ask about your work and home environment and your family situation and support throughout your pregnancy.

Many women attend antenatal visits every 4-6 weeks until 28 weeks of pregnancy, then every 2-3 weeks until 36 weeks of pregnancy. After this, you’ll probably have weekly or fortnightly visits until birth.  The number and timing of pregnancy appointments could be more or less than this, depending on your health and your baby’s health. For example, if you have a high-risk pregnancy you might have more pregnancy appointments. Your midwife or doctor will talk with you about the appointments you need and why.

Having access to maternity care that is culturally appropriate and personally acceptable is important throughout antenatal care. Your midwife or doctor will ideally provide informed choice, and where possible include you in both the planning and monitoring of your pregnancy care.

Choice in pregnancy care is important and your midwife or doctor will provide access to appropriate information about the benefits and potential risks of each and every option of your pregnancy care as it applies to yours and your baby’s individual needs at each antenatal visit appointment. Be sure to ask questions at each visit too.

Most babies are born between 37 and 42 weeks of pregnancy, often referred to as ‘term’.

Your body will go through some changes to let you know that labour might be starting.

***Key Points***

If your labour is starting before 37 weeks that means your baby might be born prematurely.

Take some time each day to feel what is happening in your body and connect with your baby so you will know when your body is starting to show signs of going into labour.

***Key Points***

***Signs of early labour***

Some of the changes in your body that may indicate the start of labour include:

• Increasing pressure in your pelvic area
• A mucousy discharge called a show or the mucous plug that has been released from the cervix, there might be some streaks of blood in it
• You might be experiencing cramping like period cramps
• your water might release – take note of the colour, odour, amount and time (use the acronym COAT) and put a pad on.
• you might feel nauseous or have some diarrhoea; you might feel emotional, grumpy, short tempered or excited.

When your body is getting ready for labour these are the signs that things are starting to happen. Your cervix is starting to soften and get ready to start opening, the baby will move into position and the hormones of labour will be produced and increase slowly.

This early phase of labour may take a few days before strong, regular, rhythmic contractions begin and active labour starts. There might be times where you are having some regular contractions, which might be a bit like strong period pain, then they will space out again.

***Signs of early labour***

***What can I do?***

If you can, stay home as long as possible during this early phase of labour. You can do things to distract yourself like preparing food, listening to music, taking a bath or shower, reading a book or watching a movie. If it is night time, try resting or sleeping if you can.

If you have other children that will be taken care of by other people you can start to make those arrangements. You can call the hospital to let them know what is happening if you need to.

If you do go into the hospital and they find that everything is okay, be prepared for them to send you home. If you feel more comfortable or safe with someone around, ask them to be with you.

While your body is preparing to go into labour it is important to

• rest as much as you can.
• Try not to expend any energy on this early stage.
• Eat and drink as normal or try frequent nutritious snacks.
• Go to the toilet as needed, open your bowels if you feel the need.
• Try gentle, rocking movement if during the day, or
• try to sleep if it night time, use lots of pillows to help you get in a comfortable position.
• Try to stay home as long as you can.

***What can I do?***

***When to call your midwife or doctor***

Call your care provider if

• your water breaks (put a pad on so the Midwife can check the fluid)
• you have any bleeding (put a pad on so the Midwife can check the fluid)
• your baby isn’t moving as normal

Make sure you put a pad on so the midwife can check the fluid or blood coming from your vagina. If you feel that your baby’s movements aren’t the normal pattern you should also call your midwife or hospital.

When your contractions are strong and regular lasting about one minute and come every 5 minutes and have been coming in that pattern for a couple of hours, active labour may have started. Call your care provider for advice.

***When to call your midwife or doctor***

Resources

Pregnancy Birth Baby – stages and signs of labour

Better Health Channel – labour

Raising Children Network – labour and birth what to expect