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Getting Ready for the Big Day

by Dr. Preeti Bhandari | Mom To Be

Preparation helps you feel confident and ready when labor begins.

When Will Labor Start?

The honest answer: Nobody knows exactly!

Due dates are estimates:

  • Only 5% of babies arrive on due date
  • Normal to deliver 2 weeks before or after
  • First babies often come later (average 40 weeks 5 days)
  • Subsequent babies may come earlier

Full term: 37-42 weeks (but 39-40 weeks is ideal)

Your body and baby decide when it’s time.

Signs Labor Is Near (Days to Weeks Before)

Lightening (Baby Drops)

Baby settles lower into pelvis:

  • Usually 2-4 weeks before labor (first babies)
  • May happen at start of labor (subsequent babies)
  • Breathing easier (less pressure on lungs)
  • More pelvic pressure
  • Need to pee even more frequently

Cervical Changes

Detected at pelvic exam (after 38 weeks):

  • Dilation (opening): 0-10 cm
  • Effacement (thinning): 0-100%
  • Softening of cervix
  • Cervix moving forward

Some women walk around dilated for weeks! Not reliable predictor.

Nesting Instinct

Sudden burst of energy:

  • Urge to clean and organize
  • Preparing baby’s space
  • Can happen days before labor
  • Don’t exhaust yourself!

Loose Bowels

Diarrhea a day or two before:

  • Body’s natural preparation
  • Hormones relaxing intestines
  • Clears out system

True Signs of Labor

1. Regular Contractions

Real labor contractions:

  • Regular pattern
  • Get closer together (5-10 minutes apart)
  • Get stronger (can’t talk through them)
  • Get longer (lasting 30-60 seconds each)
  • Don’t stop with movement or position change

Time your contractions:

  • From start of one to start of next
  • Note how long each lasts
  • Track pattern

2. Water Breaking (Rupture of Membranes)

Amniotic sac ruptures:

  • Gush of fluid or steady trickle
  • Clear, pale yellow, or pink-tinged
  • Odorless or slightly sweet smell
  • Continues leaking

Happens before labor starts in 10% of women

If your water breaks:

  • Note time it happened
  • Color and smell of fluid
  • Call your healthcare provider immediately
  • Don’t put anything in vagina
  • Wear pad (not tampon)
  • Infection risk increases after 24 hours

Go to hospital even if no contractions yet.

3. Bloody Show

Mucus plug releases:

  • Thick, pinkish or blood-tinged mucus
  • May happen all at once or gradually
  • Can be days before labor or at start
  • Means cervix is changing

Normal and expected. Not an emergency.

When to Go to Hospital

The 5-1-1 Rule (For First-Time Moms)

Contractions:

  • 5 minutes apart
  • 1 minute long
  • For at least 1 hour

For Subsequent Babies

May progress faster!

  • Use 5-1-1 rule or
  • Earlier if you live far away
  • Earlier if previous fast labor

Go Immediately If:

🚨 Water breaks (especially if fluid is green, brown, or foul-smelling)

🚨 Bright red bleeding (more than period)

🚨 Severe pain (different from contractions)

🚨 Decreased fetal movement

🚨 Intense pressure (feeling like you need to push)

Trust your instincts! If something feels wrong, go.

Better to be checked and sent home than to deliver in the car.

Hospital Bag Essentials

Pack around 36 weeks – just in case!

For Labor

Must-haves:

  • Insurance card and ID
  • Birth plan (copies for nurses)
  • Phone and charger
  • Snacks for partner (you won’t eat)
  • Music or relaxation aids
  • Massage tools (tennis ball for back labor)
  • Lip balm (breathing dries lips)
  • Hair tie
  • Glasses (if you wear contacts)

Consider:

  • Birth ball (check if hospital provides)
  • Aromatherapy oils
  • Focal point object
  • Camera

For After Delivery

Clothing:

  • Comfortable clothes for going home
  • Nursing-friendly if breastfeeding
  • Underwear (bring old ones – they’ll get bloody)
  • Comfortable bra (nursing bras if breastfeeding)
  • Socks and slippers (non-slip)
  • Loose, comfortable outfit (you’ll still look pregnant)

Toiletries:

  • Toothbrush and toothpaste
  • Shampoo and conditioner
  • Body wash
  • Deodorant
  • Face wash and moisturizer
  • Hairbrush
  • Any medications you take

Hospital usually provides:

  • Pads (bring extra)
  • Mesh underwear
  • Peri bottle
  • Sitz bath supplies
  • Basic toiletries

But bring your favorites for comfort.

For Baby

Hospital provides most supplies, but bring:

Outfit to go home:

  • Onesie
  • Sleeper
  • Hat and socks
  • Blanket
  • Outfit in two sizes (newborn and 0-3 months)

Car seat:

  • Installed and inspected
  • Can’t leave hospital without one
  • Practice installation before labor

Optional:

  • Pacifiers (if you want to use)
  • Special blanket

Creating a Birth Plan

Document your preferences for labor and delivery

What to Include

Pain management preferences:

  • Epidural, natural, or decide in moment?
  • Other pain relief methods (water, position changes)

Labor preferences:

  • Freedom to move and change positions
  • Intermittent vs. continuous monitoring
  • Who you want in room
  • Music, lighting preferences
  • Use of mirror to see baby being born

Delivery preferences:

  • Delayed cord clamping?
  • Who cuts cord?
  • Immediate skin-to-skin?
  • Vitamin K and eye ointment timing

Feeding:

  • Breastfeeding or formula
  • No bottles or pacifiers (if breastfeeding)

Postpartum:

  • Rooming in with baby
  • Circumcision (if having boy)
  • Visitors

Keep It Flexible

Plans change!

  • Unexpected complications arise
  • You may change your mind about pain relief
  • Medical necessity overrides preferences

Think of it as preferences, not demands.

Discuss with your healthcare provider to ensure realistic expectations.

Give copies to:

  • Your doctor/midwife
  • Labor and delivery nurses
  • Your partner/support person

Choosing Your Support Team

Who Will Be With You?

Partner:

  • Most common choice
  • Provides emotional support
  • Advocates for you
  • Catches baby (if desired)

Doula:

  • Trained labor support person
  • Continuous support through labor
  • Helps with positioning, pain management
  • Doesn’t replace medical staff
  • Reduces need for interventions

Family member or friend:

  • Can provide support
  • Choose someone calm and supportive
  • Not someone who’ll stress you out!

How many people?

  • Hospital policies vary (especially post-COVID)
  • Most allow 1-2 support people
  • Check hospital policy

Support Person’s Role

During labor:

  • Time contractions
  • Remind you to breathe
  • Help with position changes
  • Apply counter-pressure for back pain
  • Keep you hydrated (ice chips)
  • Advocate for your wishes
  • Provide encouragement

Your support person should:

  • Understand your birth plan
  • Know your pain management preferences
  • Be comfortable in medical settings
  • Put your needs first
  • Stay calm under pressure

Practical Preparations

Home Prep

Before baby arrives:

Meals:

  • Stock freezer with easy meals
  • Accept meal train offers
  • Paper plates reduce dishes

Cleaning:

  • Deep clean house
  • Fresh sheets on bed
  • Stock up on household supplies

Baby basics:

  • Nursery set up
  • Clothes washed and put away
  • Diapers and wipes stocked
  • Safe sleep space ready

Pet care:

  • Arrange care during hospital stay
  • Gradual introduction plan

Work Arrangements

Before leaving:

  • Inform supervisor of leave
  • Complete handover
  • Set up out-of-office message
  • Arrange coverage

Childcare for Older Kids

If you have other children:

  • Arrange care for labor/hospital stay
  • Pack their bag too
  • Prepare them for your absence
  • Plan how/when they’ll meet baby
  • Have backup plan

Transportation

Getting to hospital:

  • Know the route (multiple routes!)
  • Practice drive
  • How long does it take?
  • Where to park?
  • Which entrance to use?
  • Where to check in?

Don’t plan to drive yourself!

Hospital Tour

Schedule tour around 32-36 weeks

What to See and Ask

Labor and delivery:

  • Check-in process
  • Labor rooms
  • What’s provided?
  • Can partner stay overnight?
  • Shower/tub available?

Postpartum rooms:

  • Private vs. shared
  • Amenities
  • Visiting hours
  • Meal service

Nursery:

  • Rooming in policy
  • When baby goes to nursery
  • Security measures

Policies:

  • Parking
  • Visitor restrictions
  • Photography rules
  • Length of stay

Familiarity reduces anxiety when you arrive in labor.

Perineal Massage

May reduce tearing during delivery

What It Is

  • Gentle stretching of perineum (area between vagina and anus)
  • Increases elasticity
  • Start at 34-35 weeks
  • 5-10 minutes, few times per week

How to Do It

  1. Wash hands
  2. Use oil or lubricant (vitamin E, coconut oil)
  3. Insert thumbs into vagina (1-1.5 inches)
  4. Apply gentle pressure downward and outward
  5. Gentle stretching, not painful
  6. Partner can help if more comfortable

Evidence is mixed on effectiveness, but unlikely to hurt.

Mental and Emotional Preparation

Managing Fear and Anxiety

Common worries:

  • Pain during labor
  • Something going wrong
  • Not making it to hospital in time
  • Medical interventions
  • Caring for newborn

Coping strategies:

  • Childbirth education classes
  • Talk to your provider about concerns
  • Read positive birth stories
  • Practice relaxation techniques
  • Know that women do this every day
  • Trust your body

Relaxation Techniques

Practice now, use in labor:

Deep breathing:

  • Slow, deep breaths
  • In through nose, out through mouth
  • Focus on breathing, not pain

Visualization:

  • Imagine peaceful place
  • Visualize cervix opening
  • See yourself holding baby

Meditation and mindfulness:

  • Stay present
  • One contraction at a time

Affirmations:

  • “My body knows what to do”
  • “Each contraction brings me closer to my baby”
  • “I am strong”

Childbirth Classes

Highly recommended, especially for first baby:

  • Understanding labor stages
  • Pain management options
  • Breathing and relaxation techniques
  • Medical interventions
  • Breastfeeding basics
  • Newborn care

When to take: Second or third trimester

Types:

  • Hospital classes
  • Lamaze
  • Bradley Method
  • HypnoBirthing
  • Online classes

Partner should attend too!

Final Weeks Checklist

37-40 weeks:

✓ Hospital bag packed (yours, baby’s, partner’s)

✓ Car seat installed and inspected

✓ Pediatrician chosen

✓ Birth plan written and shared

✓ Hospital tour completed

✓ Childbirth class finished

✓ Support person(s) identified and prepared

✓ Freezer meals prepared

✓ Home cleaned and organized

✓ Childcare arranged (if applicable)

✓ Know signs of labor

✓ Know when to go to hospital

✓ Phone charged, gas tank full

✓ Relaxation techniques practiced

Remember

You can’t plan everything about labor and delivery, but preparation helps you feel more confident and ready.

Trust your body. It was made to do this.

Every labor is unique. Stay flexible.

Soon you’ll meet your baby. The wait is almost over!

You’ve got this, mama.