Awaiting the birth of a baby is an exciting and anxious time. Most women give birth between 38 and 42 weeks of pregnancy. However, there is no way to know exactly when you will go into labor. Birth often occurs within 2 weeks before or after your expected due date.

No one knows exactly what causes labor to start, although changes in hormones may play a role. Most women can tell when they are in labor. Sometimes, it is hard to tell when labor begins. As labor begins, the cervix opens (dilates). The uterus, which is a muscle, contracts at regular intervals. When it contracts, the abdomen becomes hard. Between the contractions, the uterus relaxes and becomes soft. Even up to the start of labor and during early labor, the baby will continue to move.

Signs That You Are Approaching Labor

You may have periods of “false” labor, or irregular contractions of your uterus, before “true” labor begins. These are called Braxton Hicks contractions. They are normal but can be painful at times. You might notice them more at the end of the day.

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
Discharge of watery fluid from your vagina in a trickle or gush 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
A regular pattern of cramps that may feel like a bad backache or menstrual cramps Contractions. Your uterus is tightening and relaxing. These contractions increase as labor begins and may cause pain as the cervix opens and the baby moves through the birth canal. At the onset of labor

It can be hard to tell false labor from true labor. Table 2 lists some differences between true labor and false labor. Usually, false 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 find 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. If you think you are in labor, call your doctor’s office or go to the hospital.

Differences Between False 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

 

For more detailed information on how to tell when labor begins, please visit The American College of Obstetricians and Gynecologists.