Definition of signs of labor:
Women who have been pregnant for more than 37 weeks will experience signs of labor before it begins.
 
Signs of labor: 
  1. Abdominal lightening: Approximately 2 weeks before a woman gives birth , the fetus’ head will moves into the pelvis to get ready to be born. This makes the upper abdomen feel “light”,  that is more obvious in primiparas.
  2. False labor pain: In the days or weeks prior to birth a woman may experience abdominal contractions at irregular intervals, which is not the beginning of labor pain and is thus called false labor pain.
  3. Cervical dilation: The cervix will become soft, thin, and slightly dilated a few days before delivery. Doctors can confirm the degree of cervical dilation by performing a vaginal examination.
  4. Bloody show: One to two days before delivery, the vagina will have mucus secretions containing blood, similar to menstruation.
  5. Water breaking (Rupture of membranes): The amniotic membrane will rupture, and the amniotic fluid will flow out from the vagina. The amniotic fluid is colorless, odorless, and clear, flowing out and unable to be controlled by pregnant women.
  6. abor pain: Uncomfortable or painful feeling when the uterus is contracting. At the beginning, the uterus will contract every 15~30 minutes, lasting for 15~20 seconds each. As labor progresses, the contractions will become more and more frequent, and the intensity will also increase. If pregnant women do not meet the requirements for hospital admission then the lower back can be gently heated to relieve discomfort, or they may be advised to walk around to increase the release of Oxytocin to promote the progress of labor.
 
When should a pregnant woman check-in to a hospital?
  1. Regular labor pain: When a primipara is experiencing contractions every 3-5 minutes ,which last for 30 minutes to 1 hour, or a multipara experiencing labor pains every 5 minutes, they must be admitted to a hospital.
  2. Vaginal Bleeding: The color is dark brown at the beginning and can be further observed. If the secretion is bright red and similar in amount to the 2nd day of a  menstrual  period, go to a hospital immediately.
  3. Water breaking (Rupture of membranes): No matter whether there is pain in the case of rupture of membranes, she must seek medical attention immediately to prevent complications, such as umbilical cord  prolapse or intrauterine infection.
  4. Fetal movement increases or decreases: Fetal movement measurement can be counted 30 minutes after three meals a day and before going to bed, and the number of fetal movements must be greater than 10 times within 12 hours.
  5. Every pregnant woman needs to know that the natural birth process is the healthiest and safest for the fetus and mother. When a pregnant woman needs to go home for observation, she should remember what the healthcare per-sonnel has mentioned about the signs, and check for her signs of childbirth during inspection at a hospital.
 
Things to prepare when a pregnant woman goes to a hospital:
  1. Personal ID card (Alien Resident Card), National Health Insurance (NHI) card. 
  2. The pregnant woman’s health manual (hospital notes) and test data from prenatal examinations.
  3. General toiletries, maternity bed mats, a few pairs of underwear, and slippers.
  4. During hospitalization, the hospital provides pregnant woman with pajamas, baby clothes, and diapers.
  5. Please bring a baby blanket and clothes for the baby to wear when going home.
 
Reference
  1. 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.  doi:10.1590/1983-1447.2019.20190026
  2. Lee, L., Dy, J., & Azzam, H. (2016). Management of Spontaneous Labour at Term in Healthy Women. Journal of Obstetrics and Gynaecology Canada, 38(9), 843-865. doi:10.1016/j.jogc.2016.04.093
  3. Petrovska, K., Watts, N. P., Catling, C., Bisits, A., & Homer, C. S. (2017). ''Stress, anger, fear and injustice'': An international qualitative survey of women''s experiences planning a vaginal breech birth. Midwifery, 44, 41-47. doi:10.1016/j.midw.2016.11.005
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