Welcome back, everybody to parently. This is Dr. Boyd, and I'm talking today about probably the most important topic throughout your entire pregnancy. When am I in labor? Obviously, the purpose of labor is to allow you to deliver through the vagina, your baby, and to do it in a successful, healthy manner for both you and your baby. But patients oftentimes don't know what labor is and when to go to the hospital and that is our goal today to help you know when that time period is. Now, labor by definition means that your uterus, the organ that's carrying your baby contracts, that means it tightens And when that happens, it causes pain.

For most women, now there is false labor. And there is true labor or active labor. False labor is when your uterus becomes firm. It may cause a little bit of cramping and discomfort. But it's different from active labor because it does not change your cervix. So false labor occurs oftentimes before your 37th week.

It's contraction of your uterus, but it's done in an irregular fashion. So you can have contractions that occur every two minutes every 10 minutes every 20 minutes. That is normal part of pregnancy. False labor, though should never take you to the hospital. You can have true labor in the preterm labor, period. In other words, the gestational age before your 37th week when you can go into labor and that is called preterm labor.

So I'm going to quantify labor, whether you're in your pre term period, or whether you're in your term period under the same umbrella. So it's regular painful contractions. That's the definition of labor. Now, what do I mean by regular, that interval occurs from the end of one contraction to the beginning of the next contraction, and when that interval is regular, that would be defined as the start of labor. So we're going to give you a scenario. So you start contracting right early, and you're noticing your contractions are every 20 minutes apart, and then they go to every 10 minutes apart, and then they become every six minutes apart, and then four minutes apart and then two minutes apart.

When that happens, that's defined as regular contractions. And again, it's a contraction, the contraction last typically 60 to 90 seconds, it ends and then when the Next contraction begins that period of time is called a regular interval when it happens from one contraction to the next contraction to the next contraction. So the first part of labor is having regular contractions. The second part of it, and this is the most difficult for women is the pain part of it. How do you know when I'm having painful contractions that make you go to the hospital? And oftentimes women end up at the hospital.

What what with what they're defining is painful contractions, but it's not true labor. So how do you know if it is true labor based on the definition of pain? What is pain, a scale of 10 out of 10 if you've never had a 10 out of 10 pain, and it's hard to even imagine what a 10 out of 10 pain means, because when you come into the hospital, the nurse will ask you what's the score of your pain and they want a score of zero to 10 If you've never had a 10, how can you give a level of 10? So I'm going to use an analogy that I've used on my own patients for years and years. It's the two by four analogy. If I asked you as a patient, have you ever been hitting the head with a two by four?

Most patients laugh, and then they say, No, I've never been hitting the head with a two by four. But let's assume that you were, would you ever doubt that you were hit in the head with a two by four? In other words, if you weren't knocked out, or even if you were knocked out, when you woke up, and somebody says, were you just hitting the head with a two by four you it's a well of course, you would know it. Labor is exactly the same way from a pain standpoint. You don't have to ask yourself, are they going to send me home? Because your pain is so severe that you know they will keep you?

You do not have to ask your husband or your mother or your sister. Do you think they're going to keep me because you will know You won't have to say, are they going to send me home? Because just based on that analogy of the two by four, I just got hit in the head. I know what that pain feels like. Labor is exactly the same scenario. So what is the definition of labor, it's regular contractions, that interval needs to be two to four minutes for a period of two hours.

If you go one hour and 45 minutes, and then your contractions start spacing out, that is not the definition of active labor. Again, whether it's in your pre term period, or your term period, if the regularity increases, then that is not active labor, active labor will stay regular every two to four minutes. The same equation works with the pain. If the pain is so severe, that you're crying through your contraction. You can't talk through your contraction. You can't listen to your husband through your contraction.

When that pain reaches to the reaches the pinnacle, where you can't do anything, but sit there and breathe through your contraction, then you know that is a painful contraction. Again, the same time period needs to exist, you need to have that pain for a minimum of two hours. The important part of this process is identifying when labor started. that's a that's a necessary time period. When you get to the hospital, your nurse will ask you when did your contractions become regular and painful. Now the reason we do that as healthcare providers that kind of sets the clock on when we think you should be delivered.

So if you start your contraction at this point, there's a certain period of time where we want you to deliver through the natural process of delivery. And if you extend past that natural process, then you may be a candidate for a system intersection. So knowing when your labor started, when the contractions were regular and painful is extremely important for your health care provider. Most important thing to remember if you have to ask yourself, Am I in labor, then you're not. You will know. When your labor God gave you that intuition, so that you will know.

And if you have to ask your husband, ask your mother, ask yourself, Am I in labor, you're not. Very important topic. I hope we can keep you out of the hospital until that true event of when you're in active labor. I hope this was helpful today. Labor on