Every expectant mother has questions like “When will I give birth? What are the birth signs? When does labor pain start? How will I know when labor pains begin?” in her mind during pregnancy. Every pain is thought to be a labor pain, and there is constant stress. So, what are the signs of labor pains? Here is the answer…
In pregnancy, which is normally 9 months and 10 days, that is, 40 weeks, some signs indicate that the time of birth has come. Sometimes these signs can be confused with daily pains.

So, what is the difference between normal pain and labor pain? What are the signs of impending birth? Yeditepe University Kozyatağı Hospital  Gynecology and Obstetrics Specialist answered all the questions in minds.

When Will I Give Birth?

There are two different ways to answer the question “When will I give birth?”.
The first method: Counting 280 days, starting from the first day of the last menstrual period. The result is accepted as the probable date of birth.
The second method: Going back 3 months from the menstrual period and adding 7 days to the found date. 
For example, if the last menstrual period is August 1st, the estimated date of birth will be calculated as May 7th.

What Are the Birth Symptoms?

Signs of impending birth include:
1.    Uterine contractions
2.    The onset of regular contractions
3.    The baby's head going down into the birth canal and a strong urge to go to the toilet
4.    Water breaking
5.    Relief in the upper abdomen and diaphragm-stomach line due to the baby coming down

How to Know that the Birth Has Begun?

Normally, pregnancy is a process that lasts 9 months and 10 days, i.e., 40 weeks. As the baby grows, the pressure on the mother's diaphragm increases and the mother begins to breathe harder. In the week nearing birth, the baby moves towards the birth canal. This displacement reduces this pressure on the diaphragm, and as the mother approaches to birth, she feels relief and begins to breathe more easily.
Normally there is a mucus plug that closes the cervix. When the birth begins, this mucus plug falls off at the earliest due to the softening of the cervix. A discharge occurs in the mother, which is popularly called a bloody show.

As birth approaches, the small and irregular pains in the mother begin to come regularly and sporadically. These contractions, which are the most well-known among the normal birth signs, are called Braxton-Hicks contractions. These pains, which start from the 35th week, can be seen for a short time during the day. These contractions intensify as birth approaches, and the duration of the pain gets longer.

Although not always with pain, one of the most well-known birth signs, also known as water breaking, is experienced at the last stage. As a result of the contractions, the water in the torn sac is thrown out by the mother's body. Sometimes the sac can be punctured before the contractions begin and there may be constant wetness. You should also pay attention to this. 

The biggest sign that you are about to give birth is the start of regular uterine contractions. Initially, these early contractions feel like menstrual cramps or lower back pain. It occurs at intervals of 20 to 30 minutes.

The pain or cramping becomes more severe and lasts longer. Contractions also become more frequent and begin to happen every three to five minutes. Here, if regular contractions have started, it means that birth is approaching.

With the baby's head going down into the birth canal, a strong urge to go to the toilet comes. If there is this symptom, it means that the birth is approaching.
Especially in the upper abdomen and diaphragm-stomach level, there is relief due to the baby going down. This is a sign that birth is approaching.

When to Go to the Hospital?

During the bloody show or the opening of the cervix, there may be bleeding as much as menstrual blood. When there is more bleeding, it is necessary to go to the hospital very quickly. 
Water breaking always requires going to the hospital until proven otherwise.

In first births, you can stay at home if everything is fine until the contractions come in 10-20 minutes. But if the pains become more frequent, it may be better to act by considering the traffic density of the city you are in and go early if it comes maybe every 30 minutes and if you are in rush hour.

In the second or subsequent births, when the contractions start to become regular, it will be beneficial to go to the hospital immediately. Because from the second, births happen very fast.

If you have had a cesarean section before or if a large number of myomas have been removed from the uterus, it is necessary to go to the hospital from the very beginning, while the pains begin to occur.

If the pregnancy is less than 37 weeks and the contractions have started, you should go to the hospital.
If the partner of the baby, called the placenta, slips through the birth canal or if it is suspected that the placenta is attached to the uterine wall, you should warn the physician and go to the hospital immediately.

What Should a Mother Do with Birth Signs?

First of all, she should be calm and peaceful and look for danger signs (bleeding-severe and constant pain and water breaking). If these are not present, she should act calmly and call her doctor or hospital.
She should take the baby and birth items she prepared before and go to the hospital carefully.
When the pain starts, there is no need for an ambulance to reach the hospital if there is no serious bleeding or severe pain.

What Are the Similar Signs That Are Most Often Confused with Birth Signs?

False pains are very confused with real pains. In real labor pain, contractions are regular and predictable. Contractions become more frequent, longer, and stronger.
Each contraction is felt first in the lower back and then spreads to the front and lower parts and the groin.

Walking-lying or changing position does not cause a decrease or stop in contractions. There may be blood. Membrane rupture may occur. These do not happen in false pains. 
Urine leakage is most often confused with water breaking. Urine leakage is one-time, but water flows constantly. In case of less water in the urine, a large amount of liquid is discharged.

What are the Delivery Types?

Birth happens when the baby and the baby's partner come out of the womb. The ideal and healthiest method is vaginal delivery if there is no problem with the baby or if there is no reason for the mother to put it at risk.
Cesarean section should be seen as a rescue and the last exit before the bridge and should be preferred if there is a risky situation for the mother and the baby and this requires cesarean section. There are basically 2 types of birth methods.
•    Vaginal Birth
•    Abdominal Birth (Cesarean section)
Both births have their own subgroups. Vaginal births are divided into subgroups: episiotomy (incision), non-episiotomy, intervention (forceps-vacuum, etc.), non-intervention, epidural anesthesia (princess birth), and water birth.
Cesarean births are classified according to the type of anesthesia: General, Epidural, Spinal, or Combined anesthesia (Epidural + Spinal). 

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