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Your Birth Plan & Signs of Labour: Getting Ready for the Big Day

Your Birth Plan & Signs of Labour: Getting Ready for the Big Day

What to expect at your healthcare provider’s office in the third trimester

In your third trimester, your visits to the doctor or midwife will increase from once a month to once every other week. Then once you hit your thirty-sixth week, you will likely go every week. Frequency of prenatal visits can vary according to your particular situation.

During these visits, your healthcare provider will:

  • Monitor your weight gain. Depending on your pre-pregnancy Body Mass Index (your doctor can tell you what this is), you should aim to continue to gain 0.4 kg (3/4 pound) a week during your third trimester.
  • Monitor your blood pressure.
  • Screen for gestational diabetes between 24 and 28 weeks.
  • Check your urine sample for sugar and protein.
  • Listen to the baby's heartbeat.
  • Check the size and position of your uterus and the baby by feeling and measuring your abdomen and possibly with the use of ultrasound.

Creating your birth plan

Of course, you want everything to go smoothly once you start labour and begin delivering your baby. Writing a birth plan can help make this special time even more meaningful. A birth plan is an informal agreement that represents an understanding between you, your partner, and your healthcare provider, about your location of labour and delivery, pain management techniques and choice of anaesthesia, whom you want present during delivery and your decisions for infant feeding. Do your research by speaking with your healthcare provider, prenatal/birth educator, friends and family to learn what you can about the different procedures that may accompany your labour and delivery. Ask your healthcare provider if he or she will abide by such a plan, provided your birth is a normal, uncomplicated vaginal delivery.

Many hospitals now offer draft birth plans or you can download the Nestlé Birth Plan.

Where will I have the baby?

By your last month of pregnancy you should know where you plan to deliver the baby through discussions with your healthcare provider. Of course, the decision will likely be affected by whether or not your healthcare provider anticipates a normal, uncomplicated delivery. Your options may include a hospital, a birthing centre or your home.

When will labour start?

It can be difficult to tell when labour begins, particularly if this is your first child. Ask your doctor for advice about how to tell when labour is beginning. Here are some signs of labour your doctor may mention:

  • The mucus plug that has sealed off the opening of the uterus is expelled. You may notice a thick discharge called “show”. This may happen many days before your labour actually begins.
  • Your “water breaks”. This is the breaking of the amniotic fluid that surrounds your baby.
  • Practice or pre-labour contractions. Many women experience contractions all throughout their last trimester. They are spasms felt in the lower abdomen, and last about 30 seconds each. These are not labour pains, but they seem to serve the purpose of "exercising" the uterus, so it is toned up and ready to work hard when the big day arrives. They also are the contractions responsible for "false" labour. So when you feel these are stronger than normal, you may be about to go into labour.

Call your healthcare provider when you notice these signs of labour:

  • You see a "show" or blood-tinged mucus discharge from the vagina
  • Your water breaks, either in a gush or a trickle
  • You feel contractions at regular intervals, and the intervals gradually shorten
  • The intensity of the contractions gradually increases
  • You feel discomfort in your back and abdomen

Your healthcare provider will probably tell you to start for the hospital or birthing centre when your uterine contractions:

  • Are repetitive
  • Are coming less than 5 to 6 minutes apart
  • Have persisted for an hour or more (depending on your distance from the hospital and your previous labour history)

How to tell if it's labour

It is almost your due date and you should be going into labour any day. You feel contractions but they may not be the real thing. As with most of your third trimester, you’re having contractions, which do not gradually get stronger over time, they don’t fall into a pattern and they may weaken or go away for a while. They're real contractions, but they don't have the same effect as the productive contractions you have during labour. Practice or pre-labour contractions also usually stop when you get up and move around.

Labour contractions are a sign of labour.  These are different from practice contractions because will gradually get stronger over time. They will become regular to the point that you can predict them and may last for 30-70 seconds in short intervals of 5 minutes or less. Showing up at the hospital before you’re truly in labour is fairly common for first-time mothers, so don't be embarrassed if you make the trip and then get sent home. Just consider it a practice run!

Before labour begins

When the time comes you’ll want things to go as smoothly as possible. Here are a few things to start thinking about now:

  • How easy is it to reach your labour support person when you go into labour?
  • How do you plan to get to the hospital or birthing centre?
  • Who will drive you? You should not drive yourself.
  • How far is the hospital? How long will it take to get there?
  • Where will you park? Do you need to pre-register at the hospital?
  • Who will take care of your children at home?
  • Do you have pets that need care when you are away?

If you don't find the information you're looking for, please feel free to contact us for additional support.