How Do I Know I’m in Labor?

Knowing when you’re in labor can be tricky. Every woman’s labor is different. Even when and how it starts varies. But there are common signs you can look for that signal your little one is about to arrive.

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You have all kinds of feelings and sensations when you’re pregnant. Your upcoming labor will add more. Some signs indicate your labor will probably start soon. Other signs mean your labor has started. Labor is a process. Even after it starts, it could take several hours to several days to deliver your baby.

Here are some signs that labor might start soon.

• The feeling the baby has “dropped,” or moved down in your uterus. This is called lightening. Some of the effects of lightening include:
  • Pressure in your pelvis
  • Feeling lighter in your rib cage because the baby is lower
  • Being able to breathe easier because the baby isn’t putting pressure on your lungs
  • Need to urinate more frequently, as the baby presses on the bladder
  • Relief from heartburn

• Increase in vaginal discharge. A thick mucus plug covers the opening of the cervix throughout your pregnancy. When the cervix begins to dilate, it pushes this mucus into the vagina. Called “show” or “bloody show,” the discharge can be clear, pink, brown, or slightly bloody.

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

• Strong and regular contractions. Contractions are when the muscles of your uterus contract (expand). They do this to push the baby out. If your contractions feel like this, you are in labor:
  • Contractions are 5 to 10 minutes apart. They tend to get stronger and come in shorter intervals as time passes.
  • The contractions are so strong, you can’t walk or talk during them.
  • The contractions cause pain in your lower back and your abdomen. Moving or changing positions doesn’t help relieve the pain.

• Your water breaks. The baby is surrounded by a “bag of water,” or a sac of amniotic fluid. When this sac breaks, the fluid comes out the vagina. Some women feel just a trickle. Others feel a large gush of fluid. It can be hard to tell if your water has broken. Many pregnant women leak urine, and it can be mistaken for water breaking. Call your doctor if you think your water has broken. There is an easy test they can do to know if the fluid is amniotic fluid. Your risk of infection goes up after your water has broken. It’s important to talk to your doctor.

• Changes in vaginal discharge. You may see your “bloody show” days before labor begins. For some women, they see it when labor first starts. Anything more 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 consider

It can be hard to know if you’re really in labor. Sometimes your uterus contracts, but labor hasn’t started yet. This is called “false labor.” 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.

Here are some ways you can tell the difference between true labor and false labor.

Timing of the contractions

• True labor: They come at regular intervals (every 5-20 minutes). They get closer together as time goes on. They can last anywhere from 30 seconds to 1 minute.
• False labor: Contractions are irregular and don’t get closer together.

Strength of contractions

• True labor: They steadily increase in strength over time.
• False labor: They are usually weak and don’t get progressively stronger.

Pain of contractions

• True labor: Pain usually starts in the lower back and works its way around to the belly.
• False labor: Pain or discomfort is usually felt only in the abdomen.

Contractions change with movement

• True labor: They come and go no matter what position you are in or what you are doing.
• False labor: Contractions might stop when you change positions.

If you don’t know if you’re in true labor or false labor, call your doctor. Sometimes checking the 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 experience Braxton Hicks contractions?
• What are the chances that my water will break before I go into labor?
• How long after the baby drops will I go into labor?
• There is some blood in my discharge. Do I need to see my doctor?
• Where is the pain of the contractions going to be in my body?
• At what point should I come to the hospital?

Resources

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

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