Am I in Labor?

Labor is the work that your body does to give birth to your baby. Your uterus contracts, your cervix (the mouth of the uterus) opens, and you push your baby out into the world. Experiences of labor are as unique and varied as the nearly 4 million women who give birth every year in the United States. Familiarizing yourself with some of the common experiences of many laboring women can help you feel more prepared and ready to take action in the face of what probably feels like a huge unknown.

 

Recognizing the Early Signs of Labor

As you and your baby gear up for labor, you may experience several signs that labor is on the way. Nobody knows exactly when you will start labor and no one body sign can tell you what to expect. Some of the things you may experience as you get closer to labor and birth are:

• Lightening (or your baby “dropping”): If you’re a first-time mom, your baby will start to move down into your pelvis a few weeks before labor begins. You may notice that walking is even more difficult than usual, but you’ll also notice more breathing room since your baby has moved away from your lungs. In future pregnancies, lightening doesn’t typically happen until you are actually in labor.
• Cervical changes: As labor approaches, the cervix begins to open (dilate) and thin (efface). For some women, this process happens over the course of a few weeks or a month. Other women experience these changes very quickly during labor.
• Cramps and lower back pain: As your body prepares for the birth of your baby, your joints will loosen and expand thanks to the hormone relaxin. While this makes more room for your baby to move through your pelvis, it can lead to cramps and aches in your groin and lower back.
• Increased vaginal discharge: As labor approaches, you’ll notice that your vaginal discharge thickens and changes color. You may notice when you lose your mucus plug that protects your uterus from the outside world. It may come out all at once or over time. Because it is usually thick and pink, it is often referred to as bloody show. It’s usually a pretty good sign that labor can occur in a matter of days. If you have watery discharge, check with your health care provider to make sure your bag of water is not leaking.
• Diarrhea: The muscles in your rectum will also relax, which can lead to loose bowel movements.
• Contractions: Braxton-Hicks contractions, which are painless tightenings of the uterus, may happen up to months before labor. But real contractions can be a sign of impending labor. As opposed to practice or “false labor,” effective contractions tend to start in your lower back and move to your lower abdomen (and maybe your legs), get stronger and more frequent over time, do not go away when you change positions, and sometimes fall into a regular pattern.
• Your water breaks: In less than 15% of women, the bag of waters will break as a first sign of labor. This could be experienced as a gush of water or just a trickle depending on how your baby is positioned. More frequently, the water will break after active labor is well underway. In some cases, the bag of waters may remain intact until the baby is born! If you suspect your bag of waters has broken, call your health care provider.

 

Labor Action Steps

Health care providers tend to have their clients stay at home during early labor. If you go into labor at night, do your best to sleep and rest for the hard work ahead. If you can’t sleep or you go into labor during the day, here are some things you can do to take care of yourself at home:*

• Walk. If the pains you are having are real labor, walking will make the contractions come faster and harder. If the contractions are not going to continue into active labor, walking will make the contractions slow down.
• Take a shower or bath. This will help you relax, but will not slow down active labor.
• Eat. Labor is an active workout that takes a lot of energy.
• Drink water. Not drinking enough water can cause false labor (contractions that hurt but do not open your cervix). If this is true labor, drinking water will help you have strength to get through your labor.
• If you are able, take a nap. Get all the rest you can.
• Get a massage. If your labor is in your back, a strong massage on your lower back may feel very good. Getting a foot massage is always good.
• Don’t panic. You can do this. Your body was made for this. You are strong!
• Don’t hesitate to ask for support if you need it.

 

Talk to your health care provider for specific guidance on when to call or go to the place where you plan to give birth. In general, when a woman is nearing the end of pregnancy, midwives recommend that you call when:

• Your contractions have been 5 minutes apart or less for at least 1 hour.
• You experience several contractions that are so painful you cannot walk or talk during them.
• Your bag of waters breaks. (You may have a big gush of water or just water that runs down your legs when you walk.)
• You experience bleeding. Some bloody show is normal, but heavy bleeding can be a sign of trouble.
• You have not felt your baby move within the past hour or two. Baby’s activity may increase or decrease during labor, but you should still feel some movement from time to time.

 

More about Labor

The more you know about labor, the better prepared you will be to navigate your way through the experience. Our Bodies, Ourselves has an excellent overview of what happens in labor. The Journal of Midwifery & Women’s Health also has a Share With Women handout titled The Second Stage of Labor: Pushing Your Baby Out.

*Tips adapted from “Am I in Labor?” a Share With Women handout by the Journal of Midwifery & Women’s Health.

 

The contents of this page have been developed and reviewed by certified nurse-midwives.