What Are the Signs of Labor?
Labor is another word for your body’s natural process of childbirth. It starts with your first steady contractions and goes through the delivery of both your baby and placenta.
Some women have very distinct signs of labor, while others don’t. No one knows what causes labor to start or when it will start, but several hormonal and physical changes help indicate the beginning of labor.
Lightening during labor
The process of your baby settling or lowering into your pelvis just before labor is called lightening. It’s also referred to as the baby “dropping.”
- Lightening can happen a few weeks or a few hours before labor.
- Because the uterus rests on the bladder more after lightening, you may feel the need to urinate more often.
- But the extra room in your upper abdomen may make it easier to breathe and relieve heartburn.
Passing of the mucus plug
The mucus plug accumulates at the cervix during pregnancy. When the cervix begins to open wider, the mucus is discharged into the vagina. It may be clear, pink, or slightly bloody. This is also known as “show” or “bloody show.” Labor may begin soon after the mucus plug is discharged or one to two weeks later.
Labor contractions
Contractions are the tightening of the muscles of the uterus. During contractions, the abdomen becomes hard. Between contractions, the uterus relaxes and the abdomen becomes soft. The way a contraction feels is different for each woman, and it may feel different from one pregnancy to the next.
- Labor contractions usually cause discomfort or a dull ache in your back and lower abdomen, along with pressure in the pelvis.
- Contractions move in a wave-like motion from the top of the uterus to the bottom.
- Some women describe contractions as strong menstrual cramps.
- Unlike false labor contractions or Braxton Hicks contractions, true labor contractions don’t stop when you change your position or relax.
- Although they may be uncomfortable, you’ll be able to relax in between contractions.
Diarrhea
You may notice your poops are loose or watery. This may mean you are within a day or two of labor beginning.
Weight loss
While you’re pregnant, it may seem like you’re never going to stop gaining weight. But many women actually lose a few pounds in the days leading up to labor.
Nesting instinct
Some women find themselves with an urge to get ready shortly before their baby’s arrival. That’s known as the nesting instinct.
- You may have a sudden burst of energy after weeks of feeling more and more tired.
- You may feel like shopping, cooking, or cleaning the house.
- Be careful not to overdo it. Childbirth will take a lot of energy.
Activity of the baby
Your baby may move less as you get closer to the start of labor, but let your doctor know. It can sometimes be a sign of a problem.
Cramps and back pain
It may be hard to recognize a contraction, especially with your first baby. Many women have what feels like menstrual cramps in the lower abdomen. They may stay the same or they may come and go. You might also have pain in your lower back that either stays or comes and goes.
Looser joints
If you find yourself “waddling” as your pregnancy winds down, that’s just your body getting ready for the job ahead. A hormone called relaxin loosens up the ligaments around your pelvis to make it easier for the baby to pass through.
Water breaking
The rupture of the amniotic membrane (the fluid-filled sac that surrounds the baby during pregnancy) may happen before you get to the hospital.
- It may feel either like a sudden gush of fluid or a trickle of fluid that leaks steadily.
- The fluid is usually odorless and may look clear or straw-colored.
- If your "water breaks," write down the time this happens, how much fluid is released, and what the fluid looks like, then let your health care provider know. They’ll advise you what to do next.
- Not all women have their water break when they’re in labor. Many times the doctor will rupture the amniotic membrane in the hospital.
Effacement
During labor, your cervix gets shorter and thins out in order to stretch and open around your baby's head. The shortening and thinning of the cervix is called effacement. Your health care provider will be able to tell you if there are changes to the cervix during a pelvic exam.
Effacement is measured in percentages from 0% to 100%. If there are no changes to the cervix, it is described as 0% effaced. When the cervix is half the normal thickness, it is 50% effaced. When the cervix is completely thinned out, it is 100% effaced.
Dilation
The stretching and opening of your cervix is called dilation and is measured in centimeters, with complete dilation being at 10 centimeters.
Effacement and dilation are a direct result of effective uterine contractions. Progress in labor is measured by how much the cervix has opened and thinned to allow your baby to pass through the vagina.
What's the Difference Between True Labor and False Labor?
Before "true" labor begins, you may have "false" labor pains, also known as Braxton Hicks contractions. These irregular uterine contractions are perfectly normal and may start to occur in your second trimester, although more commonly in your third trimester of pregnancy. They are your body's way of getting ready for the "real thing."
What do Braxton Hicks contractions feel like?
Braxton Hicks contractions can be described as a tightening in the abdomen that comes and goes. These contractions do not get closer together, do not increase with walking, do not increase in duration, and do not feel stronger over time as they do when you are in true labor.
How do I know when I am in true labor?
To figure out if the contractions you are feeling are the real thing, ask yourself the following questions.
| Contraction Characteristics | False Labor | True Labor |
| How often do the contractions occur? | Contractions are often irregular and do not get closer together. | Contractions come at regular intervals and last about 30-70 seconds. As time progresses, they get closer together. |
| Do they change with movement? | Contractions may stop when you walk or rest, or may even stop if you change positions. | Contractions continue despite movement or changing positions. |
| How strong are they? | Contractions are usually weak and do not get much stronger. Or they may be strong at first and then get weaker. | Contractions steadily increase in strength. |
| Where do you feel the pain? | Contractions are usually only felt in the front of the abdomen or pelvic region. | Contractions usually start in the lower back and move to the front of the abdomen. |
Time Your Contractions
When you think you are in true labor, start timing your contractions. To do this, write down the time each contraction starts and stops or have someone do it for you. The time between contractions includes the length or duration of the contraction and the minutes in between the contractions (called the interval).
Mild contractions generally begin 15 to 20 minutes apart and last 60 to 90 seconds. The contractions become more regular until they are less than 5 minutes apart. Active labor (the time you should come into the hospital) is usually characterized by strong contractions that last 45 to 60 seconds and occur 3 to 4 minutes apart.
Try to Relax
It’s best to go through the first stage of labor (called the Latent Phase) in the comfort of your home. Here are some tips to help you manage:
- Distract yourself -- take a walk, watch a movie.
- Soak in a warm tub or take a warm shower. But, ask your health care provider if you can take a tub bath if your water has broken.
- Rest. Try to sleep or take a nap if it is in the evening. You need to store up your energy for active labor.
When Should I Call My Health Care Provider or Go to the Hospital?
When you suspect you are in true labor, call your health care provider. Also, call:
- If you think your water has broken.
- If you’re bleeding (more than spotting).
- If the baby seems to be moving less than normal.
- When your contractions are very uncomfortable and have been coming every 5 minutes for an hour.
- If you have any of the signs of labor, but you haven’t reached your 37th week of pregnancy. You may be going into labor before your baby is ready and will need medical help right away.
Your health care provider will give you specific guidelines about when you should get ready to come to the hospital.
