How Do I Know I Am In Labor? – Contractions

Knowing when you’re in labor can be tricky. Labor is different for every woman. Even when and how it starts varies. But there are common signs you can look out for that indicate your baby is about to arrive.

Path to better well-being

When you’re pregnant, you have all kinds of feelings and sensations. The upcoming labor will add more. Some signs indicate that labor will probably start soon. Other signs mean labor has already begun. Labor is a process. Even after it starts, it may take several hours or several days until your baby is born.

Here are some signs that labor might start soon.

  • The sensation that the baby has “dropped” or moved down in the uterus. This is called “lightening.” Some of the effects of lightening include:
    • Pressure in the pelvis
    • Feeling lighter in the rib cage because the baby is lower
    • Being able to breathe better because the baby is not putting pressure on your lungs.
    • Need to urinate more frequently as the baby puts pressure on the bladder.
    • Heartburn relief
  • Increased vaginal discharge. A thick mucus plug covers the opening of the cervix throughout pregnancy. When the cervix begins to dilate, it pushes this mucus into the vagina. The discharge, called “vaginal discharge” or “bloody vaginal discharge,” may be clear, pink, brown, or slightly bloody.

You’ll know you’re in labor when you experience one or more of these signs:

  • Strong and regular contractions. Contractions are when the muscles in your uterus tighten (expand) to push the baby out. If your contractions feel like this, you’re in labor:
    • Contractions occur every 5 to 10 minutes and tend to become stronger and occur at shorter intervals as time goes on.
    • The contractions are so strong that you can’t walk or talk during them.
    • Contractions cause pain in the lower back and abdomen. Moving or changing position does not help relieve the pain.
  • Your water breaks. The baby is surrounded by a “bag of waters,” or sac of amniotic fluid. When this sac breaks, fluid leaks out of the vagina. Some women feel only a trickle, while others feel a gush of fluid. It can be hard to tell if your bag of waters has broken. Many pregnant women leak urine, and this can be mistaken for your bag of waters breaking. Call your doctor if you think your bag of waters has broken. There is a simple test they can do to tell if the fluid is amniotic. The risk of infection increases after your bag of waters breaks. It is important to talk to your doctor.
  • Changes in vaginal discharge. You may see the “bloody mucus” days before labor begins. Some women see it as soon as labor begins. Anything other than bloody mucus could be a sign of a problem. Call your doctor right away if your discharge contains large amounts of blood.

Things to keep in mind

It can be difficult to tell if you’re actually in labor. Sometimes your uterus contracts, but labor hasn’t started yet. This is called “false labor contractions.” These contractions are called Braxton Hicks contractions. They can occur as early as the second trimester. However, they are most often felt in the third trimester, if at all.

Below are some ways to tell the difference between true labor and false labor.

Time of contractions

  • True labor: These occur at regular intervals (every 5 to 20 minutes). They become more frequent as time goes on. They can last between 30 seconds and 1 minute.
  • False labor: Contractions are irregular and do not occur more closely together.

Strength of contractions

  • Real Work: They steadily increase their strength over time.
  • False births: They tend to be weak and do not strengthen progressively.

Pain from contractions

  • True labor: The pain usually starts in the lower back and moves toward the abdomen.
  • False labor: Pain or discomfort is usually felt only in the abdomen.

Contractions change with movement.

  • True labor: It comes and goes no matter what position you’re in or what you’re doing.
  • False labor: Contractions may stop when changing position.

If you don’t know whether you’re in true or false labor, call your doctor. Sometimes checking your cervix and monitoring contractions is the only way your doctor can tell for sure.

Questions to ask your doctor

  • What should I do if I have Braxton Hicks contractions?
  • What are the chances of my waters breaking before I go into labor?
  • How long after the baby is born will I go into labor?
  • There is some blood in my discharge. Do I need to see my doctor?
  • Where in my body will the pain of contractions be?
  • When should I go to the hospital?

Resources

Eunice Kennedy Shriver National Institute of Child Health and Human Development: About Labor and Birth

U.S. Department of Health and Human Services, womenshealth.gov: Labor and Birth

Copyright © American Academy of Family Physicians

This information is intended to be a general overview and may not apply to everyone. Talk to your GP to find out if this information applies to you and to learn more about this topic.

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