Short on time? Then the key things to know are:
- If you experience any kind of abdominal pain and bleeding at the same time, give your local maternity department a call
- If you are at all concerned about baby’s movements, again contact your local maternity department
- Any period like pains that come and then go are perfectly normal when you are 40 weeks pregnant - if the period pains stop, they are simply practice contractions
- If the period like pains don’t stop and just get stronger and more intense, it is likely that you are going into labour
- Sharp shooting pains in the vagina, known as ‘lightning crotch’ are quite normal towards the end of the pregnancy, especially whilst walking or mobilising
- A ‘show’ is cervical mucous that has built up over the pregnancy. As the cervix starts to open slightly this ‘mucous plug’ is then released
When you reach 40 weeks of pregnancy all of a sudden every single pain or niggle gets analysed - could this be it? Could this be the start of labour?
Here we answer the most common questions about what you are feeling at this time, what is normal and when to seek further help.
Why am I feeling period like pains or abdominal pain?
Labour pains will initially feel like period pains - they are exactly that!
When you have your period, your uterus contracts to shed the lining that has built up over your cycle. When you go into labour, your uterus contracts to push the baby out. It is the same muscles doing the same thing, except that a baby is slightly bigger and will require a fair few more of these muscle contractions to get the baby out.
There are times when you can experience a sudden sharp pain in the abdomen or further down in the vagina. These are usually quite intense but quick sharp pains. This is normally down to nerve pain; either the baby has shifted into a certain position and is putting pressure on certain nerves or it’s due to ligaments stretching.
Abdominal pains can be uncomfortable and even breath taking, but as long as they go away quickly they are nothing to worry about. As with any abdominal pain, if it persists, please seek advice from your maternity department, but if it is very fleeting and the baby continues to move normally, rest assured all is well.
I keep feeling lots of pressure on my bum and cervix, what does this mean?
If you feel pressure down below but no contractions then it’s likely almost time! This is a perfectly normal sensation and is usually due to the baby engaging deep down into the pelvis. This is a good sign as it means that the baby is getting into a good position ready for birth.
It can however feel a little uncomfortable, almost like you are carrying a bowling ball around in between your legs, it can also make sitting for too long difficult.
Great positions for relieving this sensation are getting onto all fours, or on your knees leaning over a birthing ball or chair. If it is your second or subsequent baby, it may come and go as the baby is able to bob in and out of the pelvis easier.
Why am I having sharp shooting pains in my vagina?
If you are experiencing sharp shooting pains in the vagina, these too are perfectly normal towards the end of the pregnancy - often referred to as lightning crotch!
It is usually due to the baby putting pressure either on your cervix or nerves towards the bottom of the uterus causing some rather uncomfortable sensations. It could also be due to pelvic instability, or pelvic girdle pain (PGP) which is also perfectly normal towards the end of the pregnancy.
What does it mean when my tummy gets hard?
At 40 weeks pregnant it is perfectly normal for your tummy to get hard occasionally - this is your uterus having a go with practice contractions. These are commonly known as Braxton Hicks and can start much earlier on in the pregnancy.
As long as the tummy softens again after a couple of minutes and there is no bleeding associated with it, then it can be regarded as perfectly normal. If you experience severe pain and a hard tummy or any bleeding, then please seek medical advice from your local maternity department straight away.
What is a show? And how do I know if I’ve had one?
A ‘show’ refers to your mucous plug. This is cervical mucous that has built up over the pregnancy to stop any infectious bacteria getting to the baby from the vagina. It serves a very useful purpose, but when you start to have period like pains and the cervix starts to open a little bit, this cervical mucous can start to discharge itself.
It doesn’t necessarily mean that labour is imminent though, as some women will start to have a bit of a show as early as 28 weeks pregnant. It also does not mean that there is any risk to the baby, or that you’re going to go into premature labour.
What does it mean if I have brown discharge or a spot of blood on wiping?
Your mucous plug or ‘show’ can manifest itself in an array of different colours and can sometimes carry some old blood, which would look like brown discharge.
It can also look like fresh red blood, but if you ever notice any bleeding at all, rather than be in doubt, we recommend that you contact your maternity department straight away for more advice.
How do I know when it’s real labour?
This is the most common question we get asked as midwives. The simple answer to this question, (which infuriates most first time Mums-to-be!) is that ‘you will just know’ - and it is so very true.
There is a significant difference between niggles, period pain and irregular tightenings, and actual contractions. For one thing, when you go into true labour these contractions won’t stop until there is a beautiful baby in your arms. Any other niggles will come and go with large intervals in between them and will usually settle if you lie down or are able to sleep.
What to do when you start having regular contractions?
When your contractions are appearing regularly, it’s the most exciting thing of all - it means that the baby is really on its way! By regularly, we mean having at least two contractions every 10 minutes.
It is at this point that we advise you to contact the midwives or hospital where you are choosing to give birth. Even if you’re not quite ready to go into hospital or have the midwives come to see you at home, it is still advisable to give them a call and let them know what’s happening.
Do baby’s movements slow down before labour starts?
Baby should continue to move around as normal in between your contractions. If at any point you feel that the baby's movements are not normal for you, we would recommend that you contact your own maternity department to discuss this and get checked out.
It is sometimes thought that baby’s movements will slow down towards the end of the pregnancy as they run out of room - this is definitely not the case, babies should stick to their normal pattern of movements right up until they are born.
Want to speak to someone about your pregnancy or birth? Book a midwife appointment at a time that suits you to get specialist advice with any concerns.
Kate, Naytal Midwife
Kate has been a Midwife within the NHS for more than 15 years and supports women to work harmoniously with their bodies and tune into their intuitions.