Labor, Delivery, and Postpartum Care
FAQ004, May 2011



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How to Tell When Labor Begins

What happens when labor begins?

Signs That You Are Approaching Labor
Sign What It is When It Happens
Feeling as if the baby has dropped lower Lightening. This is known as the “baby dropping.” The baby’s head has settled deep into your pelvis. From a few weeks to a few hours before labor begins
Increase in vaginal discharge (clear, pink, or slightly bloody) Show. A thick mucus plug has accumulated at the cervix during pregnancy. When the cervix begins to dilate, the plug is pushed into the vagina. Several days before labor begins or at the onset of labor

As labor begins, the cervix opens (dilates). The uterus, which contains muscle, contracts at regular intervals. When it contracts, the abdomen becomes hard. Between the contractions, the uterus relaxes and becomes soft. Up to the start of labor and during early labor, the baby will continue to move.

Certain changes also may signal that labor is beginning. You may or may not notice some of them before labor begins:

What is false labor?

Your uterus may contract off and on before "true" labor begins. These irregular contractions are called false labor or Braxton Hicks contractions. They are normal but can be painful at times. You might notice them more at the end of the day.

How can I tell the difference between true labor and false labor?

Differences Between False Labor and True Labor
Type of Change False Labor True Labor
Timing of contractions Often are irregular and do not get closer together (called Braxton Hicks contractions) Come at regular intervals and, as time goes on, get closer together. Each lasts about 30–70 seconds.
Change with movement Contractions may stop when you walk or rest, or may even stop with a change of position Contractions continue, despite movement
Strength of contractions Usually weak and do not get much stronger (may be strong and then weak) Increase in strength steadily
Pain of contractions Usually felt only in the front Usually starts in the back and moves to the front

Usually, false labor contractions are less regular and not as strong as true labor. Sometimes the only way to tell the difference is by having a vaginal exam to look for changes in your cervix that signal the onset of labor.

One good way to tell the difference is to time the contractions. Note how long it is from the start of one contraction to the start of the next one. Keep a record for an hour. It may be hard to time labor pains accurately if the contractions are slight. Listed as follows are some differences between true labor and false labor:

If you have further questions, contact your obstetrician–gynecologist.

FAQ004: Designed as an aid to patients, this document sets forth current information and opinions related to women’s health. The information does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations, taking into account the needs of the individual patient, resources, and limitations unique to institution or type of practice, may be appropriate.

Copyright May 2011 by the American College of Obstetricians and Gynecologists. No part of this publication may be reproduced, stored in a retrieval system, posted on the Internet, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.