【Major Points】
  1. The signs of labor are conditions that a pregnant woman will experience before giving birth.
  2. Common signs of labor are bloody show, water breaks, abdominal pain (labor pain), and there is no certain sequence.
  3. You can use hot compresses, showers, changing postures, massage, and deep breathing to relieve the discomfort of labor.
  4. If the number of fetal movements increases or decreases abnormally, a lot of bloody show, water breaks, the frequency of labor pains increases, then you should go to the hospital at any time to confirm whether you need to be hospitalized for labor.

What are labor signs?
Signs of labor are some conditions that will appear before childbirth, indicating that childbirth is imminent, and there is no certain sequence.
 
What are the common signs of labor? 
  1. Bloody show:
    One to two days before childbirth, there will be a menstrual-like mucus discharge from the vagina, which may be brown or dark red.
  2. Water break: 
    Amniotic fluid leaks out of the vagina due to rupture of the amniotic membrane. The difference from urine leakage is that water breaks is uncontrollable, and amniotic fluid is usually a clear, odorless liquid.
  3. Abdominal pain (labor pain):
    A few weeks or days before childbirth, there will be a tight feeling in the lower abdomen, which is usually irregular and does not indicate imminent labor. When it comes to labor, the uterus will initially contract every 15 to 30 minutes, each contraction last 15 to 20 seconds, and the contractions become denser and stronger as labor approaches.
Principles of care:
  1. Bloody show:
    Dark brown at first, you can use pads or sanitary pads, continue to observe the color, consistency and amount. However, if the bleeding is bright red and the amount is like the blood on the second day of your period, you must go to the hospital immediately.
  2. Water break: 
    If the water breaks, whether or not there is labor pain, you should go to the hospital immediately to prevent the following situations, such as umbilical cord prolapse, uterine infection, etc.
  3. Abdominal pain (labor pain):
    When it comes to labor, primitive women have labor pains every 3 to 5 minutes, lasting 30 minutes to 1 hour, while multiparous women have labor pains every 5 minutes and must go to the hospital. When you experience abdominal contractions and lower back pain, here are some things you can try to relieve the discomfort of labor pains.
    1. Hot compress on the waist and lower back: Use a heating pack, warm towels or shower, the temperature is about 40-43 ℃ (105-110℉), and the time is 15-20 minutes. Be careful not to burn yourself.
    2. Change posture:You can lie on your side, sit up, take a walk, try to relax your limbs, and avoid lying on your back on the bed.
    3. Deep breathing:During contractions, inhale through your nose and exhale slowly through your mouth, focusing on your breathing and distracting from the pain.
    4. Massage:Ask a companion or family member massage your body to make you feel comfortable, especially the lower back and waist.     
  4. Sudden increase or decrease in fetal movements:
        Count the number of fetal movements for 30 minutes each day after meals and before bedtime. The number of fetal movements within 12 hours should be more than 10 times; if the fetal movement is not the same as usual and suddenly increases or decreases, you should go to the hospital immediately.
  5. Items to prepare when hospitalized:
        Including ID card (residence card), health insurance card, Maternal Health Booklet and various antenatal reports. General toiletries, nursing pads, underwear, slippers may also be required. During hospitalization, the hospital will provide maternity nursing clothes, baby clothes, and diapers.

Reference
  1. Biana, C. B., Cecagno, D., Porto, A. R., Cecagno, S., Marques, V. D. A., & Soares, M. C. (2021). Non-pharmacological therapies applied in pregnancy and labor: An integrative review. Revista da Escola de Enfermagem da USP, 55, e03681. https://doi.org/10.1590/S1980-220X2019019703681
  2. Cavalcanti, A. C. V., Henrique, A. J., Brasil, C. M, Gabrielloni, M. C., & Barbieri, M. (2019). Complementary therapies in labor: randomized clinical trial. Revista Gaúcha de Enfermagem ,40, 1-9. https://doi.org/10.1590/1983-1447.2019.20190026 
  3. Huang, K. Y., Chen, S. W., & Wan, M. l. (2021). Nursing of Women during Childbirth. In M. L. Gau(Eds.), Practical Obstetric and Gynecologic Nursing (9th ed., pp. 308-310). Farseeing. 
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