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”.