How to identify the onset of delivery? A response by Dr Filip Dąbrowski

We invite you to read the series of articles entitled “Delivery seen by a gynaecologist” (Polish title: “Poród oczami ginekologa”), in which Dr Filip Dąbrowski demystifies the issues related to childbirth by addressing the most frequent questions asked by female patients.



How to identify the onset of delivery?

For many people, the only perception about labour is that from movies, when a woman is hurriedly transported by an ambulance to the admissions department and barely makes it into the Delivery Room. Fortunately, the truth is a little bit different.


The first uterine contractions may be experienced as early as after the 20th week of pregnancy. It should be remembered that the uterus is made of muscle tissue which contracts naturally in response to stretching. In the second half of pregnancy, along with a considerable increase in uterine volume, the contractions may be more frequent and intense. It is particularly common for patients to be afraid that the onset of labour starts around the 32nd–34th week of pregnancy. Luckily, these contractions are not strong and regular enough to lead to shortening of the cervix. On the contrary, they are quite natural – a specific training session for the uterus before the task it is going to perform soon. The real labour contractions last for at least 20–30 seconds and appear more often than once every 10 minutes. Moreover, they often radiate to the back and the sacral bone. If they do not subside after at least one hour and after taking a diastolic agent, it really means that you should go to hospital. However, in the case of the first childbirth, it is not necessary to speed through the red light on a busy road or hurriedly call an ambulance. Such contractions are only the starting point on your way to give birth.

Discharge (escape) of the amniotic fluid

In around 10% of cases, the first symptom of approaching labour is not the contractions but the discharge of the amniotic fluid. This may happen without a single abdominal tension and does not have to be a spectacular spurt as seen on TV.

Whenever a woman suspects her amniotic fluid has been discharged, she should report to hospital for confirmation and verification of her baby’s condition. Physiologically, in the majority of cases, the amniotic sac bursts upon complete effacement of the cervix, with cervical opening of 5–8 cm. Sometimes, it happens even later and then we can speak about babies born “with a silver spoon in their mouth”.

Antenatal (parent craft) classes – 100% YES.

Even though the knowledge about the perinatal period, baby care and the labour itself can be partially found in different books, journals or websites, it also seems essential to consult specialists with in-depth expertise.

An ideal place for broadening one’s knowledge and practical skills is offered by antenatal (parent craft) classes. Attending such classes helps to dispel the doubts that are often harboured by parents-to-be, especially those who have never been in this role before. Besides the typical issues, such as pregnancy, delivery or perinatal period, the subjects discussed often concern a healthy lifestyle, physical activity during pregnancy, the menu or the role of partner in this special period for each woman.

What do we learn during antenatal (parent craft) classes?

The issues covered at antenatal (parent craft) classes include:

  • the physiological foundations for pregnancy development;
  • the information about the course of delivery and how to actively participate in it, about the possibilities of family delivery or labour in water immersion, as well as about how to increase one’s pain threshold and cope with it.
  • the postpartum period and methods of quick recovery after childbirth.
  • the necessary knowledge concerning newborn and infant care as well as information about breastfeeding.

Besides the typical issues, such as pregnancy, delivery or perinatal period, the subjects discussed often concern a healthy and more hygienic lifestyle. This includes the daily care, proper nutrition, supplementation, convenient and comfortable solutions for the mother-to-be (adequate clothes, cushions or pillows to facilitate sleep during advanced pregnancy, etc.). Great emphasis during antenatal classes is also placed on the role of physical activity during pregnancy. Pregnant women become familiar with a series of exercises that will facilitate their labour. Specialists also show the partners how to actively participate in the labour and support their women during pregnancy.

Do you know that …?

  • The first Antenatal School was established in 1957 by Prof. Włodzimierz Fijałkowski at the II Clinic of Obstetrics and Gynaecology of the Łódź Academy of Medicine.
  • Research shows that women attending antenatal (parent craft) classes are better at reading their bodies’ signals during labour and cooperate more efficiently with the midwife and the doctor. As a result, the labour is shorter by 2–4 hours and labour complications are less common, which makes the postpartum recovery much quicker.

The man during delivery – a boon or a bane?

Delivery (childbirth) is not merely a physiological but also a psychological process. A very important role, for both the parents and the baby, is played by the atmosphere and mood. The most comfortable conditions are when there is a feeling of safety and mutual trust between the parents and the baby.

The World Health Organisation (WHO) promotes family delivery and indicates the advantages of the partner’s presence during childbirth. In Poland, the turning point in terms of father support during labour was marked by the international congress held in Warsaw in 1993, entitled “Quality of Birth – Quality of Life”. But is it really a good idea for your partner to be present during delivery?

Specialists say: YES.

According to Professor Fijałkowski, paternity and maternity should go hand in hand from the beginning stages of the baby’s life. It often happens, however, that both the mum and the dad must get well prepared for their new roles, because each of the stages from pregnancy through to labour and childbirth is a new experience for them. Comprehensive assistance in this regard is provided by antenatal (parent craft) classes. During classes with specialists in the field of obstetric and perinatal care, we develop awareness of childbirth as a unique physiological and psychological process.

Women and their partners say: YES

The ongoing research suggests that the motivation for a woman to give birth in her partner’s presence is the psychological support she receives, the willingness to be with a person that is close to her and the greater feeling of safety. The motivation for the men who have been surveyed, besides the psychological support, is the willingness to experience an unforgettable adventure. But it is not the “motivator” that plays the crucial role here, yet the assistance obtained from the partner during labour.

Women see a lot of benefits in this joint act. Obviously, the fundamental and basic one is the motivation and support in difficult moments, but the partner is also helpful for changing the woman’s position during labour or remind her about proper breathing. Sometimes, mere holding by the hand becomes exceptional.

It therefore seems that the presence of a man during labour is highly advantageous, according to experts, healthcare professionals, women and their partners. However, it should be borne in mind that the decision about family delivery must result from a joint resolution made between the mother and the father.