Signs of Labor

HOW TO TELL WHEN LABOR BEGINS

Delivery of a baby is a major event in any woman’s life. The day that you have been waiting for -- the day your baby will be born -- will soon arrive. No doubt you are excited, a little tired or waiting, and maybe a little nervous. What you should probably like to know most is exactly when labor will start and when your baby will be born. But for each pregnant women the answer is different. It may also be different each time you have a baby.

This handout will give you an idea of what signs you can look for to help you recognize the onset of labor. It will also help you to tell the difference between labor and what is called “false labor.” The tables at the end are designed to be hung on a wall or bulletin board so that you can refer to them as the time approaches.

YOUR DUE DATE

The most important thing to remember about a due date is that it is only a guideline -- there is nothing “magic” about it that will help labor begin. Women often do not give birth on their due dates. In fact, you may not even want to tell relatives and friends an exact date so that you do not feel disappointed or upset by phone calls and questions if the date comes and goes and labor has not started. The beginning of labor is unpredictable and often happens a little early or late. This is no cause for anxiety or alarm. In fact, labor may begin as early as three weeks before or two weeks after your due date and still be considered normal.

MAKE PLANS TO GO TO THE HOSPITAL:

There are a few basic things to think about before it is time to go to the hospital. They include some of the following:

  • Distance. How far away are you? If you live a significant distance from the hospital you may want to consider moving in temporarily with a family member or friend who lives closer.
  • Transportation. Is someone available to take you, or do you have to call and find someone?
  • Time of Day. Depending on where you live, it may take longer during rush hours than at other times of the day or night.
  • Home arrangements. Do you have other children to take to a babysitter’s home, or must other special arrangements be made?

CAUSES OF LABOR

It is not certain exactly what causes labor to begin. Hormones produced by the fetus, hormones produced by the mother, and changes in the cervix and in the uterine muscles all play a role.

WHAT HAPPENS DURING LABOR

Although labor is different for each birth, the basic process is the same. Labor occurs in three stages:

  • Stage 1. The cervix (the lower portion of the uterus) thins out and opens enough to permit the fetus to move from the uterus into the vagina.
  • Stage 2. The mother bears down, or pushes, while the muscles of the uterus contract to move the fetus through the birth canal. This stage ends when the baby is born.
  • Stage 3. The placenta, or afterbirth, comes out of the uterus through the birth canal.

HOW TO TELL WHEN LABOR IS APPROACHING

Some changes take place that may signal the approach of labor. These changes are listed in Table 1. Except for the contractions, you may or may not notice some of these signs before labor begins.

TRUE LABOR VS. FALSE LABOR

In the last several weeks of pregnancy, you may notice that your abdomen gets hard and then gets soft again. As you get closer to your delivery date, you may find that this process becomes uncomfortable or even painful. These irregular cramps are called Braxton-Hicks contractions, or false labor pains. They occur more frequently when you are physically active.

False labor can occur just at the time when labor is expected to start. Thus, it is sometimes difficult to tell this from true labor. Do not be upset or embarrassed if you react by thinking labor is beginning. Sometimes the difference between true and false labor can only be determined by a vaginal exam. Progressive changes in your cervix unequivocally diagnose the onset of labor. Other times there are ways that might help you to tell the difference between true and false labor.

One good way to tell is to time the contractions. Time how long each cramping period lasts and the length of time in between each contraction. Keep a record for an hour. During true labor...

  • the contractions last about 30-70 seconds.
  • they occur at regular intervals.
  • they do not space out when you rest or lie down.

Table 2 gives you easy reference to some of the differences between labor and false labor. Keep in mind, though, that it can be hard to time labor pains accurately if the contractions are slight. It is best to be cautious -- do not wait too long to call if you think you are going into labor.

We will discuss with you when to call us regarding your contractions. Generally, this will vary from patient to patient. It depends on your cervical exam in the office, your individual labor history, the baby’s estimated size, and your gestational age. Our job is to let you know when to bring you to the hospital. Your job is to let us know when you think the time is near or if you are not sure.

OTHER REASONS TO CALL

There are other signs that should prompt you to call the office. Call if:

  • your membranes rupture (your “water breaks”), even if you are not having any contractions.
  • you are bleeding from the vagina (but not if it is just the “show” mentioned in Table 1).
  • you have constant severe pain in your abdomen.
  • if you notice a decrease in fetal movements.

FINALLY...

You are approaching a special, exciting time. Although it is impossible to know exactly when labor will begin, you can be ready by knowing what to look for and what to expect. We encourage you to ask questions. Being prepared will help make your labor experience the best it can be.

TABLE 1: SIGNS THAT YOU ARE APPROACHING LABOR

SIGN

WHAT IT IS

WHEN IT HAPPENS

Feeling as if the baby dropped lower

Lightening. This is commonly referred to as the “baby dropping.” The baby’s head has settled deep into your pelvis.

From a few weeks (especially with the first baby) to a few hours before labor begins.

Discharging a thick plug of mucous or having an increase in vaginal discharge (clear, pink, or slightly bloody)

Show. A thick mucous plug has accumulated at the cervix during pregnancy. When the cervix begins to open wider, the plug is pushed into the vagina.

Several days before labor begins or at the onset of labor.

Discharging a continuous trickle or a gush of watery fluid from your vagina.

Rupture of membranes. The fluid-filled sac that surrounded the baby during pregnancy breaks (your water breaks).

From several hours before labor begins to any time during labor.

Feeling a regular pattern of cramps or what may feel like a bad backache or menstrual cramps.

Contractions. Your uterus is a muscle that tightens and relaxes. The hardness you feel is from your uterus contracting. These contractions may cause pain as the cervix opens and the baby moves through the birth canal.

Usually at the onset of labor See Table 2 to compare contractions at labor to false labor pains.

 

TABLE 2: DIFFERENCES BETWEEN FALSE LABOR AND LABOR

TYPE OF CHANGE

FALSE LABOR

LABOR

Timing of contractions

Often are irregular and do not consistently get closer together (called Braxton-Hicks contractions)

Come at regular intervals, and as time goes on, get closer and closer together.

Change with movement

Contractions may stop when you walk or rest, or may even stop with a change of position.

Contractions continue despite movement.

Location of contractions

Often felt in the abdomen.

Usually felt in the back coming around to the front.