Latter Pregnancy

Physicians: Russell L. Wavrin, M.D., Mary Anne Jacob, M.D., Juan C. Angelats, M.D., Daniel T. Chow, M.D., Jennifer L. Schwab, M.D., Paige E. Persch, M.D.

Certified Nurse Practitioners: Jaimi L. Anderson, APRN, CNP, Vicki I. Buth, APRN, CNP, Heidi Helleck-Sprang, APRN, CNP, Shirley J. Jarcho, APRN, CNP

Instructions for the latter part of pregnancy and information about going to the hospital

Your baby may come a week or two later than the expected date, without anything “being wrong”, or you may go into labor a week or two early, without harm to either you or the baby.

Tub baths may be taken throughout pregnancy if care is used in getting in and out of the tub. Avoid prolonged exposure to high temperatures, as in hot tubs or saunas. Douches should be omitted during the last months of pregnancy. Intercourse need be avoided only if it is followed by pain or bleeding.

False labor contractions may occur during the last month of pregnancy. Usually the contractions are irregular as to interval (varying from 5 to 20 minutes apart). They are short in duration, lasting less than 30 seconds. Usually they begin in the front of the abdomen, not low in the back as true labor contractions usually do, and the contractions will go away after 1-3 hours. They do not get stronger or closer together, as do true labor contractions.

The labor contractions almost always begin low in the back and come around to the front of the abdomen. Sometimes the contractions are preceded by a slight spotting of blood from the vagina. If you have had a recent office vaginal examination, you may have some vaginal bleeding because of slight irritation to the cervix and this should not be mistaken for the “bloody show”. True labor contractions are regular as to time, usually starting out 15 to 20 minutes apart, but may start as close as every 3 minutes. They usually last between 30 and 60 seconds.

When labor contractions are coming 10 minutes apart or less, lasting 30 seconds or more, you may be in labor. Call the doctor’s office at this time and they will instruct you as to when to get to the hospital.

Sometimes before labor begins, the membranes rupture (The “Bag of Waters” breaks), and there is a small or large gush of colorless fluid from the vagina. When this happens, call the doctor immediately. You may continue to lose fluid, especially when you move about, and labor contractions often follow soon afterward. You will probably be instructed to go to the hospital when this happens, but call first.

Do not eat solid foods after going into labor. Take clear liquids only. Call the doctor before going to the hospital. The nurses at the hospital will call the doctor as soon as you are admitted and inform him/her as to your condition. You will be seen during your labor, according to how it is progressing. You may reach the doctor by calling either office number, day or night.

Information about losing your mucous plug

What is the mucous plug?

The mucous plug is a collection of cervical mucus that seals the opening of the cervix. It keeps bacteria and infection from entering into the cervix, providing a protective barrier for the developing baby.

What does the mucous plug look like?

Some women describe the mucous plug as looking more like the mucous in your nose. It may look like a thick glob of stringy mucous, thicker than what you would see with normal vaginal secretions. If you are close to going into labor you may see pink, brown or red blood around the edges of the mucous plug. This is called “bloody show.”

When do you lose your mucous plug?

Some women will lose their mucous plug, or part of their mucous plug, weeks before they go into labor. Losing your mucous plug does not always mean labor will begin shortly. Keep in mind that even if a woman has begun to dilate it may be weeks before she actually goes into labor. However, if you notice blood tinged mucous before your thirty-sixth week of pregnancy notify your doctor. As your body prepares for labor your cervix will begin to dilate and thin. As your cervix opens up, your mucous plug may fall out. Losing your mucous plug is a good sign that labor is on its way. Though, it could be days or even weeks after you lose your mucous plug before labor actually starts. Many women do not lose their mucous plug at one time; instead, they lose it more gradually. They may notice an increase in vaginal secretions weeks before they go into labor.

Should I call my doctor if I lose my mucous plug?

If you are full term and have lost your mucous plug, there is usually no need to call your doctor. You may lose your mucous plug weeks before labor starts. If you have a history of preterm labor and you suspect you have lost your mucous plug, call your doctor. If you notice blood tinged mucous and are earlier than thirty-six weeks call your doctor.