Am I in Labor?

It sometimes can be difficult to tell when you’re in labor. Braxton Hicks contractions can occur for many weeks before labor actually begins. These “practice” contractions can be very painful and can make you think you are in labor when you really are not. But painless contractions don’t always mean that you’re not in labor, either. Each woman feels pain differently, and it can differ from one pregnancy to another. Nevertheless, there are certain changes in your body that signal labor is near:

• Lightening—You feel as if the baby has dropped lower. Because the baby isn’t pressing on your diaphragm, you may feel “lighter”. The baby’s head has settled deep into your pelvis. Lightening can occur anywhere from a few weeks to a few hours before labor begins.
• Loss of the mucus plug—A thick mucus plug has accumulated at the cervix during pregnancy. When the cervix begins to dilate (several days before labor begins or at the onset of labor), the plug is pushed into the vagina. You may notice an increase in vaginal discharge that’s clear, pink, or slightly bloody. Some women expel the entire mucus plug.
• Rupture of membranes—The fluid-filled sac that surrounded the baby during pregnancy breaks (your “water breaks”). You may experience this as a discharge of watery fluid from your vagina in a trickle or gush. Your membranes can rupture from several hours before labor to any time during labor.
• Contractions—As your uterus contracts, you may feel pain in your back or pelvis that’s similar to menstrual cramps. Contractions occur in a regular pattern and get closer together over time.

How can you tell the difference between “real” labor contractions and Braxton Hicks contractions? One good way to tell the difference is to time the contractions and to note whether the contractions go away with movement. True labor contractions may be irregular at first but usually become regular, longer, closer together and stronger. Lying down does not make them go away and they are usually felt in the lower back and radiate to the front.

False labor contractions are usually irregular and short. They do not get stronger or more frequent and lying down typically makes them go away. These contractions are usually felt in the groin and the upper section of the uterus. 

If you have doubts about whether you are in labor, call your health care provider. There also are other signs that should prompt you to call your healthcare provider or go to the hospital:

• Your membranes have ruptured and you are not having contractions.
• You are bleeding from the vagina (other bloody mucus).
• You have constant, severe pain with no relief between contractions.
• You notice the baby is moving less often

When to Go to the Hospital

During the final weeks, you and your partner will no doubt spend anxious moments wondering when it is the right time to go to the hospital. It will depend mostly on the timing and intensity of your contractions or whether your water breaks. Your health care provider will give you clear instructions as you approach your due date, so follow them exactly. You be able to call and talk with your health care provider or the staff to discuss the signs and symptoms of labor that you are experiencing.

Stages of Labor:

Stage 1: Dilation & Effacement of Cervix

Early Phase: Contractions are mild and last about 30-45 seconds with 5-30 minutes between each. Your water might break during this phase. The Early Phase may last between 8-12 hours

Active Phase: Typically, you are at the hospital at this phase. Contractions are stronger, longer, and more painful. They last between 45-60 seconds with 3-5 minutes between each. If desired an epidural will be administered at this time. The Active Phase may last between 3-5 hours.

Transition Phase: This is the stage at which the cervix is 7cm until fully dilated (10 cm). At this time, contractions last 60-90 seconds and have 30 seconds-2 minutes rest period between. It is common to feel fatigued, shakiness, hot flashes and nausea during this phase.

Stage 2: Pushing & Birthing

The cervix is now fully dilated and pushing can begin with your doctor’s go-ahead. Your doctor will tell you when to push, and when to relax. The length of this process differs for all moms.

Stage 3: Delivery of the Placenta

This is the final phase and sometimes referred to as “the afterbirth”. During this stage, your placenta is separating from the uterine wall and is delivered. Applying pressure to uterus, gently pulling the umbilical cord, and/or pushing will help deliver the placenta. This stage lasts a few minutes and is surely the easiest of them all.