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Loving Life as a Foreign Service Family – Current Parallel 6° 27' North- Lagos, Nigeria

How do I know when I am going to go into labor?

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Volunteering at the medical clinic and providing classes for the nurses and midwives means I have birth on my mind much of the time. A three year break meant that I only thought about birth a couple of times a day, but once a midwife always a midwife. Thank heavens for Ben who listens to me often describe what I have observed about the birth culture here in Nigeria, how resourceful and ready to learn the doctors and midwives are that I work with, how frustrating the corruption is here, how I can’t wait to share a piece of knowledge with the midwives, but most of all he listens to how frustrating it is that I am only allowed to go once or twice a week on their busiest days so I almost never get to be there for births!!! Oh it is so hard for this midwife heart to not see a woman at next weeks antenatal clinic and know she had her baby and not know if I will see her again. I do feel like I am starting to figure out how to teach and talk and most importantly ask the right questions. I always have so many questions.
On that note this is a repost from 2013. It was posted on my old childbirth blog. I found myself giving this advice over and over yesterday at the clinic.

Oh how I wish I could answer this question for all of you. If I had a crystal ball and could I would be rich! This is such a common question in my practice. Women in the United States and in many other parts of the world under US influence have been lulled into a false sense of planning by the medical community making them believe they can detect when they go into labor.

Here are a few things that will not detect that you will go into labor soon:

1. You are dilating. But but but. Nope. Doesn’t matter. I have seen women walk around at 7 cm for a couple weeks then go on to have a normal length labor. I have seen women go from 1 cm to baby in one hour. It is not a good assessment of when you will have your baby.

2. It is your due date. See #1 below.

3. Your baby has dropped. This can happen in labor.

4. Your previous baby was born at 39 weeks (or 40, or 37). Your previous gestation amounts can play into the equation but based on 15 years of birth work I would never put money on it.

For those of you (like me) who appreciate a good check list here are a few signs that labor may be on it’s way in the next week or less:
1. You are over your estimated due date. I tell every first time parent to add 8 days to their EDD based on their last period and count on baby coming no sooner than that. Make sure you share your new EDD with everyone. But what if the baby comes early you ask? You have your baby a few weeks early and no one raises an eyebrow, but go over your due date and the texts and phone calls won’t stop until the baby is out. Even mom’s who have had a baby before often hit their due date.
2. You have had a seriously good cry. This usually occurs as a prenatal appointment after you come in puffy and glaring at your care provider that you are still pregnant. The cry often occurs from the build up of hormones in your body preparing you for labor.
3. It has been one week since you have had a night of contractions where you were “Sure this is it.”  and you almost called(or did call) your midwife or go to the hospital.
4. You have loose bowels. You have spent most of your pregnancy more blocked up than usual thanks to iron supplements and slowed down digestion which helps with greater absorption of nutrients that is typical in pregnancy. Suddenly things change the other direction. Emptying becomes the word of the week.
5. You have lost your mucous plug although these regrow all the time and it is not uncommon to loose them a couple of times before baby comes or to never notice that you loose them at all.
6. You get up in the middle of the night to fold baby clothes. Nesting anyone?
7. Everyone in the family has gotten a really nasty cold, flu, or stomach virus and it now starting to feel better. It sounds crazy but  this almost always happens. Every one gets sick about a week before baby comes. Mom is super stressed about being sick or having sick kids while in labor. Everyone gets better and then the baby is born.
8. Your toddler has decided s/he is ready to toilet train. Completely serious. You wanted to do it all your first trimester but didn’t have the stomach for it. You tried to do it your second trimester but the child wasn’t ready. You had given up hope the third trimester and were sure that they would be in diapers in college. Week before the baby comes and wamo they want to use the potty and you spend a week washing pee soaked underwear.
9. Your mother-in-law who came into town to be here for the birth just caught their flight back home. Your body has a way of waiting to go into labor until it can be a private event. This can also be the sister, best friend, mother etc. I really do not have a vendetta against mother-in-laws.
10. Baby is moving less. It is very important to pay attention to baby’s movements in utero as this is a positive warning sign that baby is doing well. Often right before labor there is a moment of calmness from your little one as s/he prepares for birth. They have just plain run out of room and their head is wedging deeper into your pelvis. This comment usually comes up during a prenatal appointment, but more than a handful of times I have gone to a clients home to check on things because mom was concerned that the baby wasn’t moving and there was something wrong only to arrive assure her everything is fine and she is in early labor.
11. You are having sporadic contractions. They come and go. They are not regular. I always told my pregnant mamas and now find myself saying the same thing at the clinic that the contractions have to come regularly to be effective and end in a baby in the next day. This doesn’t mean the pains you are feeling are for nothing. These early contractions help to move the cervix in front of the baby’s head. They help to push the baby further into the pelvis into an optimal position for birth. They help to thin the cervix.

Regardless of everything above your baby will come when it is the right time for him or her. Keep attending your antenatal appointments where your doctor or midwife will assess things to be sure that you and your baby are still showing signs of health. If there are concerns an induction may be in order but much of the time nature takes its course.There is a point when almost every woman meets a point of surrender. She will be pregnant forever and she is ok with that. For now she will enjoy the joy of the baby growing with in her. Then the baby will come.

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