by Lauren Zielenski, CNM
How will I know when I’m in labor? How do I manage early labor at home? How long do I stay home? Will I be able to figure this out if I’ve never done it before? I’ve only been induced before, so will I know I’m in labor?
You’re reading a handful of the most common questions we get at the birth center about how to know when you may be transitioning from “early” to “active labor” and how to time coming to Dar a Luz for evaluation and hopefully, admission! These are complicated questions and there isn’t one straightforward answer for each laboring person… so hey, we feel you if you’re confused or anxious about what, how, and when it will happen. Let’s turn your anxiety into empowered excitement! This beautiful transcendent time in your pregnancy and life will unfold exactly as it should, and knowing the basics of how your body will take care of you and work with you to bring your baby into your arms will help you enjoy the process rather than be fearful of it. Take a deep breath, breathing birthing power in… hold it at the top, and exhale out the fear. Okay, we’re set! My hopes are that this article empowers you with the right information and tools on how to manage early labor at home, and gives you a clear picture of what things will look like when it’s actually time to come to Dar a Lu. You got this, mama! Let’s dig in!
Also remember: no body complies to a text book and each labor is very different — therefore it’s very much expected that your labor won’t match this description exactly. Keep your mind open and follow the general gist when its happening for you. You are in tune and intuitive, so listen to the signs your unique body gives you. If this is not your first baby, read the article and pay close attention to the paragraph called “This is not my first baby” for supplemental information.
What is early labor?
The sweet beginnings of your birth have arrived. The day you will meet your babe is here (or close to it). This is when that light bulb in your pregnant-get-this-baby-out-of-me-brain flicks on, and you realize that something is happening in your body. YAY! If you want to get technical, early labor is when your body begins having contractions that open the mouth of the uterus (a.k.a the cervix — this is what your babe’s head is against). This opening of the cervix from centimeters 1 through 6 is the “early stage” of labor (active phase is centimeters 6-10 and I will discuss that below).
Some distinguishing key points about early labor:
- Early labor is different from the warm up contractions that occur as your body prepares for birth.
- It’s common to have warm up contractions, otherwise known as Braxton-Hicks contractions, throughout the third trimester. They often feel like mild period cramping and are irregular, in no particular pattern, and not increasing in intensity.
- The distinctive difference between warm up contractions and early labor is that early labor contractions begin and continue (typically for many hours), getting stronger and closer together as time passes. They don’t stop or go away.
- Similar to warm up contractions, early labor oftentimes begins with contractions that come in irregular time intervals and are mild. The difference is that labor contractions stick around and get more intense when it turns into active labor… more on how it feels below.
- A tip to help distinguish early labor from warm up contractions: if you’re not sure, keep waiting — your body will tell your story.
- It will feel different over time when it’s really labor. Think of your labor over time climbing rungs of an intensity ladder. The more time passes, the more the intensity increases.
Signs of early labor in your body:
- Increased vaginal discharge; menstrual or period cramps low in the belly; back pain or back cramping; vaginal, pelvic, or mild rectal pressure; and/or diarrhea.
- Irregular, mild contractions that then begin to come more regularly in a pattern you can time.
- In the early labor phase, pregnant people can usually talk or walk through their contractions.
- You may still be able to smile, laugh and chat.
- Your belly may become tight or hard with contractions, increasingly so as time goes on.
- You may feel contractions beginning to wrap up and around the belly as time increases.
- You can likely still pay attention to the outside world, text messages, and phone calls; and maybe you’re even still working or getting things ready around the house.
- If you’re truly in early labor, it will continue to intensify and change with time. It will not stop when you lie down or rest.
When do I come to Dar a Luz? What is active labor?
For context, our hope at Dar a Luz is that you manage well with early labor at home and present for admission at the center as you’re reaching the “active phase” of labor. The active phase of labor is when your contractions are coming regularly and strongly, and opening your cervix from 6-10 centimeters; some people can be active sooner and some later. It’s really about intensity, frequency, and the rate at which your cervix dilates: Active labor is when the cervix is changing the fastest and why you often hear of someone who went from 7 cm to having a baby in just an hour or two. With first babies especially, it may take many hours of strong contractions for your cervix to dilate and efface (open, thin, and soften). You will be past the “early phase” of labor (where it tends to feel more manageable) and will probably have been in an active labor pattern for a few hours or so before coming to Dar a Luz — sometimes less, especially if it’s not your first baby.
Signs of Active Labor in Your Body
- Contractions have moved from being a mild or moderate sensation to being strong and regular. They wrap around your belly each time.
- You will likely be pausing, breathing, making noise and unable to walk or talk through any of your contractions now.
- You will no longer be able to participate in conversation or interaction with the outside world during a contraction, you tend to turn inwards and focus on the beautiful work you’re doing.
- You won’t be smiling, laughing, or texting; you will be working hard to get your little one earth side.
- For a visual representation for both you and your partner of what birth often looks like, check out this gorgeous video of fellow midwife Naoli Vinaver’s birth. You can watch her birth day and her progress through early and active labor. I think it does a good job of showing the progress through the day. If you don’t speak Spanish, click the gear icon at the bottom to translate the subtitles. They’re not perfect, but you will get the idea.
Why must I wait until active labor to come to Dar a Luz?
Labor is extremely primal. It may sound wild or even feel a little anxiety-provoking to know that, while in throws of labor, your animal brain takes over, and instincts and reflexes guide you on your way to bringing your baby to you. It’s a pivotal life opportunity to let go and get out of your brain, and follow your body. This all being said, our primal brains need to feel safe, secure, and super comfortable for labor to work with our bodies best. Where does that happen most naturally? At home! Your home is your den, where you body can relax the most, sink in to this amazing work you’re doing the most, and open the best! You don’t have to take my word for it either. There are some impressive research studies (see HERE and HERE) that show that when women stay at home through early labor, no matter the setting of their birth, whether a birth center or hospital, their labors progress more quickly, efficiently, and effectively. Additionally, the data shows that keeping women out of birth facilities — even birth centers — until active labor means they experience less interventions overall, and lower rates of cesarean section. Wow! We want the best outcome for each of our clients, and we pay close attention to evidence when it comes to birth and admitting you to the center. Rest assured it works well like this for the majority of our clients. Also know that labor progress and admission is considered on a case-by-case basis. It’s certainly not all about the numbers, and if you really need us, we’re always here for you. We hope you can see the benefits in laboring in the comfort of your own cozy den during the slower early phase of your birth!
What can I do at home to help support and cope with early labor?
Laboring at home in the early phase of labor can look however you want it to. Some people rest in one position on their bed and try to doze between contractions. Others must be standing, have to sit on a birth ball, or have no choice but to move from one place to the next to cope with the growing intensity of labor. The important thing is that you listen to your body and follow its cues. There is probably a reason your body is telling you to do what you’re doing. That being said, having a good understanding of common positions, tips and tricks that help in early labor are great tools to add to your tool box. You will learn so many more in your birth classes, but here’s a short list of suggestions.
- First and foremost — consider hiring a doula! There’s excellent data that show women who use a doula have faster and less complicated births, feel more supported in labor, and have lower rates of cesarean section. As you will be laboring for a good portion of your birth at home, hiring a doula is an excellent tool to help guide and support you through this process. Doulas should come to your home in early labor to help and support you there. It’s also a lot less pressure on your partner in terms of “knowing” exactly what to do for you and when. A doula is an excellent choice for your entire family. We love and welcome any doula in our center, and additionally have a wonderful relationship with a group called New Life Birth Services. They’ve written a message for this article to all clients considering hiring a doula:
“The birth doulas of New Life Birth Services take pride in our relationship with Dar a Luz! Doulas are the perfect complement to your medical birth team, providing physical comfort, emotional empathy, and informational care prenatally, during your labor, and postpartum.
“One of the greatest benefits we repeatedly see is helping you decide during labor the best time to go to Dar a Luz. Laboring with you in the comfort of your home is one of the joys of our care for you. We are in contact with your midwife and can be her eyes and ears, looking out for physical and emotional signs that you are in active labor. We are here for you, wherever you are!”
~ Judy Key, New Life Birth Doula
- Stay hydrated and nourished. Often, the last thing you want to do in really active labor is eat food… but it’s really important your body has calories and energy to support all the hard work you’re doing. Eating a good meal and regular snacks in early labor and continuously sipping on water and electrolyte drinks will ensure your body is nutritionally balanced before you run the (hypothetical) marathon of labor.
- Change positions. Switch it up! Movement in early labor can be extremely helpful to cope with regular contractions and pain. Whenever a position is no longer working for you, move! Here are some ideas of different positions that may help.
- Water is your friend! Standing in the shower, sitting, or hanging out on hands and knees in the tub at your home are excellent tools for decreasing the intensity of labor and assisting with pain control. Consider buying a shower head that detaches. Holding a steady stream of warm water over your belly or lower back can feel really helpful.
- Heat! Try the good old heating pad to the lower belly or back. This time-tested trick is an excellent tool in labor.
- Consider hiring an acupuncturist to perform at-home treatments while in labor. Some acupuncturists will perform house calls once you get to know them, if they have the training, and specialize in women’s health and birth.
- Pressure points and aromatherapy: Here is an excellent article and video where you can learn about pressure points in labor. You and your birthing partner may consider practicing these prior to birth. Additionally, here’s another educational video on aromatherapy in labor.
- Practice breathwork as a tool to relax and decrease anxiety now. Do this now, so by the time you are in labor, breathing in a pattern is something you’re comfortable with and used to, and your brain and body respond accordingly. Here’s another great video to help introduce you and teach you about breathing in labor for pain relief.
When do I call the midwife in labor?
This is situation-dependent always, but I will touch on the basics:
- If you’ve hired a doula, they will help you determine this. It’s a nice item to take off your plate and get good advice on, in real time during your labor.
- First-time moms are usually in active labor when contractions are 2-3 minutes apart (the time from the beginning of one contraction to the beginning of the next); as well as lasting an entire minute for at least one hour.
- Second-time moms are usually in active labor when contractions are 5 minutes apart, lasting an entire minute for at least one hour.
- Call the midwife at any point if your bag of water breaks or you are or think you might be leaking fluid (note the time it started and color).
- Call right when labor begins if you carry group beta strep (GBS) infection and would like antibiotic treatment.
What happens if I get sent home from Dar a Luz in early labor?
While coming to the birth center for evaluation on the early side is not uncommon, admitting you on the early side is! We try our hardest to give you the best care, and this includes not admitting you too early, so we don’t hesitate to send you back to your cozy home to labor if your cervical evaluation is roughly between 1-4 centimeters and it’s not quite time. Usually, the timing is right in a matter of hours from when we send you home to when you return, and things usually look wayyyyyy different when you come back! Riding in the car in labor can be difficult, so we would love to help talk you through the timing of things as carefully as possible to avoid trips back and forth for your own sake. We are pretty good at knowing what active labor sounds like, and may ask to hear a few contractions on the phone. We will also time your contractions while we’re speaking with you and consider things such as how long you’ve been in labor, what number baby you are birthing, your group beta strep status, and how far away you live from Dar a Luz. It can feel like a lot of pressure to time things all on your own well, so rest assured we will help you figure it out! Remember, please never head to the birth center or anticipate coming in for sure without speaking to a midwife first. You can rely on our expertise!
This is not my first baby
If your upcoming birth is for baby 2, 3, 4, 5, 6 or more, you probably have a good idea of what labor looks and feels like. Trust your gut. Sometimes things can go pretty quickly for a mom who’s birthed vaginally before, so you’re really looking out for regular painful contractions for about an hour. Here are a few key points to remember:
- Sometimes strong regular contractions only need to be every 8-10 minutes apart to make change. The important thing is to pay attention to the intensity and how it ramps up. If it’s ramping up quickly, find your way to Dar a Luz on the faster side.
- If you have had a fast birth before, the likelihood of this birth also being fast is higher. Your second labor is often roughly ½ the length of your first birth.
- If your water breaks, call the midwife ASAP. In some instances, after your bag of waters opens, things can go pretty fast.
- Make a plan for childcare well in advance so you’re not stringing something together while in labor. Have a plan B and plan C lined up as well!
- If your labor is progressing quickly, have your childcare meet you at Dar a Luz for a kiddo hand off in the parking lot.
Closing Thoughts
Labor is a fluid situation (ba dum ching! Get the pun?). Things can change quickly and each body is so unique! You don’t have to know everything that is going on — and your midwife will help you figure it out — but having a good idea of the big picture and what is required of you in terms of communication and timing will help give you the confidence and understanding you need for birth center birth. You got this!
I recommend forwarding this article to your birthing team and familiarizing yourself with the information by the 3rd trimester, or no later than 37 weeks.
If you have any outstanding questions about when to come to Dar a Luz in labor, you will be seen weekly after 36 weeks. These final appointments are a perfect time to solidify plans and ask questions about birth.
Wishing you all beautiful births and powerful pushes — whatever it ends up looking like. We are here for you!
Lauren was born and raised in Dallas, Texas. She graduated with a BSN in 2010 from Texas A&M University, Corpus Christi. Completing a Masters of Science in Nursing with a focus in Midwifery from University of Colorado, Denver remains her proudest accomplishment. She deeply cherishes travel and learning about women’s health through a global and international lens. She loves building connections with clients, and making people laugh and feel at ease in this journey. She also writes a monthly women’s & sexual health column for a lifestyle blog and occasionally speaks at or organize events focused on women’s health, fertility and sexual health empowerment.
