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To hospital quickly

by Christine Hill
Sometimes when labour starts, you need to head for the maternity ward straight away. Christine Hill explains when to get a move on

Most women get to the end of their pregnancy and just can’t wait to go into labour. Feeling heavy and bulky, tired and breathless, it’s time to have that baby out. If things get going gradually, you can hang on at home until the contractions get stronger and come at regular and shorter intervals. But there are two signs to watch for which mean you must head for hospital or call your midwife, if you’re planning a home birth.

The first is bleeding and the second is if your waters break

Bleeding

This is not to be confused with a ‘show’ – a plug of mucus sometimes streaked with watery blood which often signals the start of labour. If, by contrast, you lose fresh blood – the sort of deep red that comes out when you cut your finger – GO STRAIGHT TO HOSPITAL – EVEN IF YOU’RE PLANNING A HOME BIRTH. There’s a possibility that you may have an APH (antepartum haemorrhage). This occurs when part of the placenta becomes detached from the wall of the uterus. It’s a potential emergency because the baby may not be getting enough oxygen, so it needs to be checked as soon as possible. Don’t worry if it turns out to be a false alarm; no hospital will make you feel foolish for playing safe.

What happens when the waters break

Imagine there’s a balloon (the membranes) within the uterus, which is about a third full of water (the amniotic fluid). Your baby lies in the balloon, surrounded by the fluid. It’s slightly confusing to talk about the ‘waters going’ because, in fact, it’s not the waters that have gone, but the membrane that contains the waters. Hence the medical terminology, spontaneous rupture of membranes, or SRM for short.

Only 5% of labours begin with spontaneous breaking of waters with contractions following. More commonly, the waters break during labour. So if you think your waters have gone, you must go into hospital or call your midwife, even if you can’t feel any contractions.

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