Am I in labor?
False labor; Braxton Hicks contractions; Prodromal labor; Latent labor; Pregnancy - labor
After the membranes rupture and the water breaks, a woman may begin to experience the First Phase of labor, or Early labor. The average time of early labor is extremely variable, lasting anywhere from 2 to 6 hours. In rare cases, it can last up to 24 hours. During this time, the pressure of repeated regular contractions causes the cervix, which had been closed when labor began, to open up to a diameter of 3 centimeters, and at the same time, become much thinner. Various techniques can be used to help alleviate the discomfort a woman may experience during the first phase of labor such as back-rubs and breathing exercises.
False Labor (Braxton Hicks Contractions)
Most pregnant women feel mild contractions before true labor begins. These are called Braxton Hicks contractions, which:
- May occur at any time after the first trimester of pregnancy
- Are typically short
- Are not painful
- Do not come at regular intervals
- Are not accompanied by bleeding, leaking fluid, or decreased fetal movement
- Do not result in cervical changes that suggest the onset of true labor
This stage is called "prodromal" or "latent" labor.
Other Signs That Labor is Near
Lightening. This happens when your baby's head "drops" down into your pelvis.
- Your belly will look lower. It will be easier for you to breathe because the baby is not putting pressure on your lungs.
- You may need to urinate more often because the baby is pressing on your bladder.
- For first-time mothers, lightening often happens a few weeks before birth. For women who have had babies before, it may not happen until labor has begun.
Bloody show. If you have bloody or brownish discharge from your vagina, it may mean your cervix has begun to dilate. The mucous plug that sealed your cervix during your pregnancy may be visible. This is a good sign. But active labor may still be days away.
Your baby moves less. If you feel less movement, contact your health care provider, as sometimes decreased movement can mean that the baby is in trouble.
Your water breaks. When the amniotic sac (bag of fluid around the baby) breaks, you will feel fluid leak from your vagina. It may come out in a trickle or a gush.
- For most women, contractions come within 24 hours after the bag of water breaks.
- Even if contractions do not begin, let your provider know as soon as you think your water has broken.
Diarrhea. Some women have the urge to go to the bathroom often to empty their bowels. If this happens and your stools are looser than normal, you may be going into labor.
Nesting. There is no science behind the theory, but plenty of women feel the sudden urge to "nest" right before labor starts. If you feel the need to vacuum the entire house at 3 a.m., or finish your work in the baby's nursery, you may be getting ready for labor.
True Labor
In true labor, your contractions will:
- Come regularly and get closer together (about 5 to 10 minutes apart)
- Last from 30 to 70 seconds, and will get longer
- Not stop, no matter what you do
- Radiate (reach) into your lower back and upper belly
- Get stronger or become more intense as time goes on
- Make you unable to talk to other people or laugh at a joke
When to Call the Doctor or Midwife
Contact your provider right away if you have:
- Leaking amniotic fluid
- Decreased fetal movement
- Any vaginal bleeding other than light spotting
- Regular, painful contractions every 5 to 10 minutes for 60 minutes
- Contractions lasting 60 to 90 seconds
Also make contact for any other reason if you are unsure what to do.
References
Kilatrick S, Garrison E, Fairbrother E. Normal labor and delivery. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 11.
Thorp JM, Grantz KL. Clinical aspects of normal and abnormal labor. In: Lockwood CJ, Copel JA, Dugoff L, et al, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 40.
Version Info
Last reviewed on: 5/14/2024
Reviewed by: John D. Jacobson, MD, Professor Emeritus, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
