Signs of labor: Know what to expect
Do you know the typical signs of labor? Understand the changes your body will go through as you prepare to give birth.By Mayo Clinic Staff
In the movies, babies are often born quickly and in dramatic fashion. Mothers double over from the pain of a single contraction and suddenly babies appear. In reality, however, labor usually takes time — and the early signs of labor can be subtle. Here's what you need to know about the common signs of labor.
Thinning of the cervix (effacement)
The lower part of the uterus is called the cervix. Before labor, the cervix is typically 3.5 to 4 centimeters long. As labor begins, the cervix starts to soften, shorten and thin (efface). You might feel mild, irregular contractions or nothing at all.
Effacement is often expressed in percentages. At 0% effacement, the cervix is at least 2 centimeters long, or very thick. Your cervix must be 100% effaced, or completely thinned out, before a vaginal delivery.
Opening of the cervix (dilation)
Another sign of labor is the cervix beginning to open (dilate). Your health care provider will measure the dilation in centimeters from zero (no dilation) to 10 (fully dilated).
At first, these cervical changes can be very slow. Once you're in active labor, expect to dilate more quickly.
Increase in vaginal discharge
During pregnancy, a thick plug of mucus blocks the cervical opening to prevent bacteria from entering the uterus. During the late third trimester, this plug might push into your vagina. You might notice an increase in vaginal discharge that's clear, pink or slightly bloody. This might happen several days before labor begins or at the start of labor.
However, if you have vaginal bleeding that is as heavy as a typical menstrual period, contact your health care provider immediately. Heavy vaginal bleeding could be a sign of a problem.
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 the nesting instinct.
Nesting can begin at any time during pregnancy, but for some women it's a sign that labor is approaching. Do what you must, but don't wear yourself out. Save your energy for the harder work of labor ahead.
Feeling the baby has dropped lower (lightening)
Lightening is the term used to describe when the baby's head settles deep into your pelvis. This might cause a change in the shape of your abdomen. This change can happen anywhere from a few weeks to a few hours before labor begins.
Your water breaks (rupture of membranes)
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 irregular or continuous trickle of small amounts of fluid from your vagina or a more obvious gush of fluid. 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. You and your baby will be evaluated to determine the next steps.
Once your amniotic sac is no longer intact, timing becomes important. The longer it takes for labor to start after your water breaks — if it hasn't started already — 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).
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.
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 closer together. Active labor contractions generally occur 2 to 5 minutes apart. False labor contractions will remain irregular.
- How long do they last? Time how long each contraction lasts. True contractions last about 60 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.
- Are the contractions getting stronger? True contractions progressively become stronger. False labor contractions are typically weak, or they may be intense at first and then weaken.
Expect false alarms
Remember, no one knows for sure what triggers labor, and your 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 37 weeks — especially if you also experience vaginal spotting — consult your health care provider.
If you arrive at the hospital in false labor, don't feel embarrassed or frustrated. Think of it as a practice run.
Dec. 16, 2021
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See more In-depth
- Labor and birth. Office on Women's Health. https://www.womenshealth.gov/pregnancy/childbirth-and-beyond/labor-and-birth. Accessed Nov. 2, 2021.
- Landon MB, et al. Normal labor and delivery. In: Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed Nov. 2, 2021.
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