A lot of women want to know when it's time to go to the hospital when they're contracting and they're full term, or their due date is only a couple of weeks away. Technically speaking, full term is 37 weeks and beyond. So you need to start watching out for regular contractions, and if they become regular, time them. Write down the time that each one starts. And let's say that one started at 9:45, and then you had another one at 9:49, you would know that those are 4 minutes apart, so it goes from start to start. Once they are consistently 4 to 5 minutes apart, and that's been going on for at least 2 hours, then it's time to go to the hospital. And what we're looking for is cervical change, so when you get there, the first thing we're going to do is check your cervix. And unless you're like 5, 6, 7 centimeters, then we're going to watch you for an hour, and unfortunately, all we can do at that point is cross our fingers, tell you to work hard, shut the door, and then come back in an hour and re-check you to see if your cervix has changed, meaning it's dilated.
Cervical dilation from hour to hour is actually the true definition of labor. Women can contract for days leading up to the actual delivery of their baby, but they're only in labor for the hours leading up to delivery when their cervix is actively changing. And also know that it's okay to get sent home from the hospital at least once before you deliver, especially if it's your first baby, because you don't know exactly how contractions are going to feel. It takes regular and intense contractions for your cervix to change, and a lot of people don't expect it to hurt as bad as it does, and so they go in maybe a little bit prematurely and get sent home - that's okay.
Now a lot of women want to know what contractions actually feel like. If you've never had one before, that's a very valid question. And even women who have had babies before sometimes don't exactly know, because maybe they were induced with previous babies and got their epidurals early, so going into spontaneous labor is a new thing for them. Contractions are felt in a few different ways, and everyone feels them differently, but generally speaking, most women describe it as lower abdominal cramping, lower back ache - kind of where the dimples are on your lower back, where your back meets your butt cheek - it aches. And you also feel abdominal tightening, you experience pressure, and sometimes you can have shooting pains down your thighs associated with all of those other sensations.
Sounds fun, right? So one helpful thing to ask yourself is how bad your contractions are actually hurting on a scale from 0 to 10. 10 is like surgery without anesthesia, 0 is no pain. So when you start having regular contractions, remember there's 2 pieces to the puzzle - regularity and intensity. So once they're regular, ask yourself how intense they are. Sometimes we get women who come into the hospital and they rate their pain at a 10, and then we check their cervix, and they're only 1cm, and that's so discouraging for them. And we still watch them for an hour and see if their cervix changes. And sometimes it does, and they get to stay. And sometimes it doesn't, and then you go home, and come back later when they're more intense. So asking yourself how intense your contractions are is helpful, because it puts it in perspective for you. It also helps you to have a discussion with your caregivers about your pain so that we can understand what you're going through.
For example, if you walked into the hospital and told me that your pain was at a 4, and then an hour later, your pain was a 7 or an 8, then I know you've crossed that threshold - you're really hurting. It helps to turn it into an objective conversation. It's also helpful, because then if you end up going home, and I tell you to just come back when they're more regular and more intense, then you can be realistic about it and say, "Okay maybe I'm really only like a 5 or a 6." And then hours later, days later, weeks later, whatever the case may be, you're contractions are now like a 7, 8, 9 on that pain scale, then you know it's time to go back and get checked to see if your cervix is actually changing this time. Good luck, I hope you have an amazing labor and delivery experience, and that things go well for you and your baby. And if you have any other questions for me in the future, feel free to ask them on our Facebook page at http://www.facebook.com/IntermountainMoms, and recommend us to your friends and family too.