Lightening During pregnancy, the uterus grows gradually out of the pelvis and into the abdomen. By the 34th to 36th week it will be right under your ribs. About two weeks before you deliver, the baby's head settles down into the pelvic area. You'll know this has happened because breathing will seem easier, but the increased pressure in the pelvic area may cause leg pains and more frequent urination. False Labor The uterus is a large muscle which has been contracting and relaxing periodically throughout your pregnancy. These contractions, which may have been barely noticeable until now, may become more painful at times during your last month of pregnancy and you might become confused about whether or not you are actually in labor. The best way to tell "false" labor from "true" is to time how long the contractions last and the rest period in between each contraction. Unless the contractions are regular, getting closer together and becoming stronger over several hours, you are not in labor. Walk around if you have been resting, sit down if you have been on your feet. Regular Contractions In the beginning, cramp-like labor pains are far apart (every 15-20 minutes) and short (30 seconds or less). You will feel them first in the small of your back, and after a few hours they will radiate to the front. As labor progresses, the contractions will be increasingly more uncomfortable. The length of the contractions (timed from the beginning of one contraction to the end of the same contraction) will increase. The interval between contractions (timed from the beginning of one contraction to the beginning of the next) will decrease. You should talk with your physician about when you should go to the hospital. In general, if your contractions last 45 seconds or longer and are every 3-4 minutes, you should go to the hospital. If this is not your first baby and you have a history of rapid labors, you may be asked to go to the hospital when your contractions are less frequent than every 3-4 minutes, but you should discuss this with your physician. If you have any questions about whether or not you should go to the hospital, call the Family Birth Center at (360) 514-4000. Bag of Waters Breaking A slow trickle or a gush of water from the vagina indicates the rupture of the bag which contains the baby. This can occur at any time during the pregnancy. If your bag of waters has broken, you should go to the Family Birth Center at the hospital whether or not labor has started. If you have any questions, call the Family Birth Center at (360) 514-4000. Bleeding Any bleeding as heavy or heavier than menstual flow may be of concern. Should this happen, go to the hospital. You may have the passage of blood-tinged mucous from the vagina. This is commonly referred to as "bloody show", and is not a cause for concern. Unremitting Pain Should you have severe abdominal pain, that is unremitting, or severe uterine contractions that you cannot tolerate, you should go to the Family Birth Center at the hospital. Decreased Fetal Movement During the last weeks of pregnancy it is common to feel some decrease in fetal movement. If you notice a decrease in your baby's movement, you should do the following: •  Lie on your side and count the baby's movements during one hour. You should feel at least four movements. Do this twice daily. If you do not feel four movements in an hour or don't feel the baby move over any consecutive 12 hours, call your physician. Urinary Traction Infection Urinary tract infections represent one of the most common infections in women. Symptoms of a urinary tract infection may be frequency of urination, discomfort voiding, urgency, fever, back pain or bloody urine. Should you have these symptoms, please call your physician. Urinary tract infections may be associated with intercourse, and it is a good idea for women to empty their bladder completely after intercourse. Going To The Hospital Once labor has begun, a light diet is permitted. Tea with sugar, Jello and broth will help keep your energy up. Carry on quiet activities during the day, rest at night and be sure to time your contractions. If you have already pre-registered at the hospital, go to the birthing center when your contractions are 5 minutes apart. If you have not pre-registered, go to patient registration. An I.V. may be started when labor begins. An I.V. is a bag of sugar solution connected to tubing which is placed in your arm or hand. An I.V. is an efficient method of giving you fluids, and insures a route for medication if needed. Medication is available upon request. Things To Do •  Your doctor encourages you to participate in childbirth classes. The knowledge gained from the classes should allow for a more comfortable labor and delivery with less fear. •  During this month before delivery, we suggest you pre-register at the hospital. Pre-registering prevents you from having to do so at the time that you are in labor. •  If you have not chosen a physician for your baby, we urge you to do so now. Your baby will need to be examined by a General Practitioner or a Pediatrician before he/she can be discharged from the hospital.