Diagnosis: in labor

And then comes the moment when you think:  my labor has started. You have contractions, maybe your membranes have ruptured, or you have lost your mucus plug. Your midwife or obstetrician have instructed you when to call them.

During your pregnancy your cervix is about as long and as hard as your little finger. See picture (A) It is very stiff connective tissue. When your time has come to give birth the cervix softens and shortens, we call it effaced. (B) 

The midwife or obstetrician will be the one to diagnose ‘labor has started’ The clear definition of the diagnosis is: 

regular painful contractions, a fully effaced cervix and at least 1 cm dilated. 

Observation of the woman and a vaginal exam are nessecary to diagnose labor. 

Your cervix must be completely effaced. (C) We do not know how long it takes for a cervix to efface. Effacing is not part of the labor. Some women will not notice effacing , others will feel it from the first to the last millimeter. 

Because of the painful contractions women in these cases, often have the impression that labor has started. This is known as a false start. That does not mean that you are exaggerating. You do experience pain and discomfort that keep you awake and restless.  It is important to prevent exhaustion.  You need to be fit when labor really kicks in. Your caregiver will discuss with you whether it is wise to take a painkiller and/or something to sleep in this case. 

But if a firm diagnosis is avoided, problems are bound to arise later in the process. The importance of a clear firm diagnosis of ‘ being in labor’  can’t be emphasized enough. Otherwise it will be almost impossible to tell if  contractions are effective. Don’t let yourself be fobbed off with vague terms like “You are in the beginning ,” or “this is the latent phase. 

Latent phase doen’t exist!

You are in labor or not. There is no inbetween.