Nesting: Spurt of energy

You might wake up one morning feeling energetic, eager to fill the freezer with prepared meals, set up the crib and arrange your baby's outfits according to color. This urge is commonly known as nesting. No one knows for sure, but it could be a primal instinct that hearkens back to a time when physical preparation was necessary for a safer childbirth.

Nesting might begin months before your due date, but the instinct is usually strongest just before delivery. Do what you must, but don't wear yourself out. Save your energy for the harder work of labor ahead.

Rupture of membranes: Your water breaks

The amniotic sac is a fluid-filled membrane that cushions your baby in the uterus. At the beginning of or during labor, your membranes will rupture — also known as your water breaking.

When your water breaks you might experience an intermittent or continuous trickle of small amounts of watery fluid from your vagina or a more obvious gush.

If your water breaks — or if you're uncertain whether the fluid is amniotic fluid, urine or something else — consult your health care provider or head to your delivery facility right away. You and your baby will be evaluated to determine the next steps.

If the amniotic sac is no longer intact, timing becomes important. The longer it takes for labor to start after your water breaks, the greater your or your baby's risk of developing an infection. Your health care provider might stimulate uterine contractions before labor begins on its own (labor induction). In the meantime, avoid doing anything that could introduce bacteria into your vagina, such as having sex.

Contractions: When labor pains begin

During the last few months of pregnancy, you might experience occasional, sometimes painful, contractions — a sensation that your uterus is tightening and relaxing. These are called Braxton Hicks contractions. They're your body's way of warming up for labor.

To tell the difference between Braxton Hicks contractions and the real thing, consider these questions:

  • Are the contractions regular? Time your contractions from the beginning of one to the beginning of the next. Look for a regular pattern of contractions that get progressively stronger and closer together. False labor contractions will remain irregular.
  • How long do they last? Time how long each contraction lasts. True contractions last 30 to 90 seconds.
  • Do the contractions stop? True contractions continue regardless of your activity level or position. With false labor, the contractions might stop when you walk, rest or change position.

Expect false alarms

Remember, no one knows for sure what triggers labor, and every woman's experience is unique. Sometimes it's hard to tell when labor begins.

Don't hesitate to call your health care provider if you're confused about whether you're in labor. Preterm labor can be especially sneaky. If you have any signs of labor before 36 weeks — especially if you also experience vaginal spotting — consult your health care provider.

At term, labor will nearly always make itself apparent. If you arrive at the hospital in false labor, don't feel embarrassed or frustrated. Think of it as a practice run. The real thing is sure to be on its way!

Jul. 18, 2013 See more In-depth