Vanderbilt Center for Women's Health

Labor and Baby's Birth

Knowing when you are in labor

As you approach your due date, you will be looking for any little sign that labor is about to start. You might notice that your baby has "dropped" or moved lower into your pelvis. This is called "lightening." If you have a pelvic exam during your prenatal visit, your healthcare provider might report changes in your cervix that you cannot feel, but that suggest your body is getting ready. For some women, a flurry of energy and the impulse to cook or clean, called "nesting," is a sign that labor is approaching.

Some signs suggest that labor will begin very soon. Call your healthcare provider if you have any of the following signs of labor. Call you healthcare provider even if it's weeks before your due date — you might be going into preterm labor. Your healthcare provider can decide if it's time to go to the hospital or if you should be seen at the office first.

  • You have contractions that become stronger at regular and increasingly shorter intervals.
  • You have lower back pain and cramping that does not go away.
  • Your water breaks (can be a large gush or a continuous trickle).
  • You have a bloody (brownish or red-tinged) mucus discharge. This is probably the mucus plug that blocks the cervix. Losing your mucus plug usually means your cervix is dilating (opening up) and becoming thinner and softer (effacing). Labor could start right away or may still be days away.

True vs. false labor

Many women, especially first-time mothers-to-be, think they are in labor when they're not. This is called false labor. "Practice" contractions called Braxton Hicks contractions are common in the last weeks of pregnancy or earlier. The tightening of your uterus might startle you. Some might even be painful or take your breath away. It's no wonder that many women mistaken Braxton Hicks contractions for the real thing. So don't feel embarrassed if you come to the hospital thinking you're in labor, only to be sent home.

So, how can you tell if your contractions are true labor?

Time them. Use a watch or clock to keep track of the time one contraction starts to the time the next contraction starts, as well as how long each contraction lasts. With true labor, contractions become regular, stronger, and more frequent. Braxton Hicks contractions are not in a regular pattern, and they taper off and go away. Some women find that a change in activity, such as walking or lying down, makes Braxton Hicks contractions go away. This won't happen with true labor. Even with these guidelines, it can be hard to tell if labor is real. If you ever are unsure if contractions are true labor, call your doctor.


Coming to the hospital

Go to Vanderbilt University Hospital located on Medical Center Drive in Nashville. When you arrive at the hospital, come to the Emergency Room entrance. Your support person will need to park in the garage across from the hospital. An Emergency Room nurse will escort you to our labor area, located on the fourth floor.


Hydrotherapy tub

For some low risk pregnancies, the Vanderbilt Center for Women’s Health offers an additional option for distraction during contractions with our hydrotherapy tub room. The hydrotherapy tub is used to help in delaying or lessening the need for medication during labor. Women have the opportunity to use the tub throughout their labor, and will exit the tub for birth.


Inhaled nitrous oxide (laughing gas) for labor

Vanderbilt now offers nitrous oxide for labor.  This epidural alternative is popular in Europe and provides both pain relief and decreases anxiety in labor.  Vanderbilt is the third academic medical center in the U.S. to offer this therapy which is used by about 1 in 6 women laboring at Vanderbilt. For more information on this labor option, view a video by clicking here.


Family-Centered Cesarean Care

Cesarean birth is very common, and in the United States over 30% of women give birth by cesarean section.  Although this surgery is generally very safe, it is often a disappointment to families and an unwanted cesarean can add stress to the birth experience.   Our Family-Centered cesarean birth committee was formed in 2011 to look at our cesarean birth care, and implement changes to make the cesarean birth experience better for our families.  We now offer families the opportunity to view the birth of their baby during a cesarean if they desire.  In addition, a transition nurse in the OR give families the opportunity to hold and bond with their baby in the operating room shortly after birth.  These and other positive changes are being implemented to make the birth experience better for all our patients, particularly those women for whom a cesarean is needed.

For Patients
in Labor

Go to Vanderbilt University Hospital located on Medical Center Drive in Nashville. When you arrive at the hospital, come to the Emergency Room entrance. Your support person will need to park in the garage across from the hospital. An Emergency Room nurse will escort you to our labor area, located on the fourth floor.

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