Patient education: How to tell when labor starts (The Basics)

What is labor? — When a person is pregnant, labor is the process that leads to birth of the baby. Contractions of the uterus are the main sign of labor.

Labor usually starts on its own between 37 and 42 weeks of pregnancy. Your "due date" is at 40 weeks.

A pregnancy that lasts 37 to 42 weeks is called a "term" pregnancy. When labor starts before 37 weeks, doctors call it "preterm" labor.

What are the signs that labor is starting? — The signs that labor is starting, or about to start, can include the following:

●The baby moves lower (or "drops") in your belly.

●You have increased vaginal discharge that is thick, mucus-like, or slightly bloody. ("Vaginal discharge" is the term doctors use to describe the fluid that comes out of the vagina.) The increased vaginal discharge is sometimes called a "mucus plug" or a "bloody show."

●Your "water breaks." During pregnancy, your baby is in a sac in your uterus and surrounded by a fluid called "amniotic fluid." This sac typically breaks open sometime before your baby is born. When it breaks open, the fluid inside comes out of your vagina. This can feel like a big gush or just a trickle of fluid.

●You have low back pain or belly cramps.

●You start having contractions. During a contraction, the uterus tightens. This can be painful and make your belly feel hard. After a contraction, the uterus relaxes and the pain goes away. Some people have "Braxton-Hicks contractions" or "false-labor contractions." These feel like contractions, but they are not true contractions. They do not mean that you are in labor.

How can I tell if I'm having true contractions? — It can be hard to tell if you are having true contractions or Braxton-Hicks contractions. But here are some ways to help tell the difference:

●True contractions come every few minutes and get more frequent over time. Braxton-Hicks contractions can come every few minutes, but they don't get more frequent over time.

●True contractions don't go away, even when you rest. Braxton-Hicks contractions usually go away when you rest.

●True contractions get stronger and more painful over time. Braxton-Hicks contractions usually don't get stronger or more painful over time.

●True contractions might be felt in your back and front. Braxton-Hicks contractions are usually only in front.

If you are still not sure whether you are having true contractions, call your doctor or midwife.

What should I do if I start having contractions? — If you start having contractions, time them to see how far apart they are. That way, you can tell if they get more frequent.

You can time your contractions by keeping track of the time when each contraction starts. If you have a clock with a second hand or a timer on your smartphone, you can also time how long each contraction lasts. Your doctor or midwife will want to know how far apart your contractions are and how long they last.

When should I call my doctor or midwife? — Call your doctor or midwife if you think that you are in labor. You should also call if any of the following things happen:

●You have blood, mucus, or fluid leaking from your vagina.

●You have 6 or more contractions in 1 hour. (This means that your contractions are 10 minutes apart or less.)

●Your contractions are getting stronger and are painful.

Your doctor or midwife will probably want to see you to do an exam. To tell if you are in labor, they will check your cervix to see if it is opening ("dilated") and thinning out. They will see how frequent your contractions are. They might also do other tests.

What if my labor starts too soon? — If you start having any symptoms of labor before 37 weeks, call your doctor right away. They might want to give you medicine to try to stop your labor or help the baby if it is born early.

What if my labor doesn't start on its own? — If your labor doesn't start on its own, your doctor will talk to you about your options. They might try to start your labor with medicines. This is called "inducing labor."

How long will my labor last? — If it's your first baby, your labor will probably last for many hours. If it's not your first baby, your labor will probably be shorter.

More on this topic

Patient education: Managing pain during labor and childbirth (The Basics)
Patient education: Labor and childbirth (The Basics)
Patient education: Preterm labor (The Basics)
Patient education: Preterm prelabor rupture of membranes (The Basics)
Patient education: Prenatal care (The Basics)

Patient education: Preterm labor (Beyond the Basics)