Pain and contractions before, during and after labour – tips and facts

Pre-labour pains and contractions 
It is normal for your belly to alternately contract and relax during the pre-labour contractions. Your uterus is a muscle, and will start preparing for labour by intermittently contracting. It is highly individual how you experience these contractions and how frequent they are.

Pre-labour pains are irregular. They do not grow in intensity or frequency and they do not last very long. However, they can be quite painful. Try to rest. Take a warm bath or use a heat pad to ease the pain and help you relax.

Many women experience pains early in the pregnancy. Some get no early pains at all, some get them all through the pregnancy and others only get them at the end. Sometimes they come frequently and may cause discomfort. In most cases, these pains are completely normal and are the body's way of preparing for labour.

Contact your health care centre if you start bleeding
Speak to your midwife or doctor if you have trouble distinguishing between normal and abnormal contractions. If the contractions become more frequent or are accompanied by bleeding, contact a health care centre immediately.

Factors that can cause pre-labour contractions:
• They often get worse in the evening if you are stressed. Rest for a while every day if possible.

• It is also common to get pre-labour contractions if you are constipated. Although they are usually nothing to worry about, they could be a sign that you should take it easier at work and at home.

• A urinary tract infection can sometimes cause contractions. Have a urine test if the problem recurs frequently.

• Having an orgasm can also cause slight contractions during pregnancy. This is nothing to worry about. However, if you have pain and/or any bleeding after having intercourse or an orgasm, speak to your midwife.

When labour starts - when should you go to hospital? 
The most common sign that labour is starting is when the pains come at regular intervals and increase in strength and duration. They will take on a regular rhythm. A rule of thumb is three contractions every ten minutes. When the real contractions start, contact your midwife or the maternity clinic to find out when you should go to hospital. Further reading: At the maternity ward - meeting your midwife

In films, labour starts when the waters break. In reality, the waters do not always break before you go into labour. In fact, it is usually the opposite. It can be hard to determine whether your waters have broken. All the waters do not flow out at the same time. Because the baby's head is blocking the birth canal, the waters usually trickle rather than gush out.
Read more about: 
Contractions and the three stages of labour
Breaking of the waters
Pain management during labour

Tips for relieving and managing pain during labour
• Getting the right amount of exercise increases your strength and energy during pregnancy. This benefits both you and the baby. Exercise can also make your labour easier.
Read more about exercise and physical activity during pregnancy

• Relaxation and breathing exercises are also important. You don't have to do them alone. See them as an opportunity to do something together with your partner or a friend. You can use them to relax during contractions. There are a wide range of courses and many books available on the subject.

• Massage creates intimacy and relieves pain. But use a slightly softer touch than usual. Giving a massage also makes your partner feel that he or she is doing something practical to help and support you.

When labour is late starting
The baby decides when it's time to come out. Research shows that the duration of pregnancy is genetically determined and something we inherit from our parents.
Most clinics wait for 24 to 48 hours after the waters break before inducing labour. The decision largely depends on the baby's health and the colour of the amniotic fluid.

If the fluid is greenish, it means the baby has defecated which may be a sign of stress. A CTG is performed to check the baby's condition. If the contractions does not start within 24 to 48 hours, labour will be induced.
Read more about planned induced labour.

Afterpains
Contractions after giving birth are called afterpains. They are usually stronger after a subsequent birth than a first-time birth. They are more likely to happen during breastfeeding, since lactation causes the uterine muscles to contract.

Although the contractions may be painful, they are harmless and natural. Many maternity wards offer acupuncture for afterpains these days. Sometimes it is enough to take an over-the-counter painkiller. It is normal for a little extra bleeding to occur during afterpains.

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