The unpredictability of labor pops up a myriad of questions in your mind. “Are those cramps contractions, or just an upset tummy? Would the waters break, and if yes, when would they? And what if I get into labor at the wrong place and the wrong time?”
Your fears are understandable but you don’t have to worry because all you have to do is to watch the signs of labor.
MomJunction tells you about the various signs and symptoms of labor that you may experience. They will help you know if you are nearing labor or still have some time.
When Does Labor Start?
In most cases, labor starts between the 37th and 42nd week of pregnancy. Labor that occurs before the 37th week is called preterm or early term; labor between 39th and 40th weeks is a full term; labor after the 42nd week is a late term. About 60% of women go into labor on or before their estimated due date (1). If you go beyond 41 weeks, your practitioner may recommend induction (2).
You may begin checking for the signs of labor around your due date. However, note that the process of labor might begin way before your due date.
Signs And Symptoms Of Labor Pain
Labor comes only after giving you enough alerts about its arrival. Here are some signs your body gives before labor.
1. The baby “drops” (lightening)
When the body prepares for labor, the baby may settle deeper into the pelvis, making you feel lighter. There will be reduced pressure in the chest and abdomen, thus, making you breathe easily and eat a full meal (3).
However, it does not mean that labor is close. It will take a few more weeks. Moreover, first-time moms have baby dropping earlier than experienced moms.
As the name suggests, nesting is the motherly instinct to build a haven for the baby. Amid those days of breathlessness and weakness, you might suddenly feel energetic to get up and set the house in order, paint your baby’s room, or keep the things ready for them. It is scientifically proven that nesting happens not only in other mammal species but also in humans (4).
In spite of your energy spurt, don’t give in to your urge. Take rest as labor might be just around the corner.
3. Contractions get intense
One of the major signs of true labor is contractions. They will become longer and stronger as you get closer to labor. It is hard to figure out if they are real or false (Braxton Hicks) contractions. Here is how you can understand the difference:
|Real Contractions (True labor)||Braxton Hicks Contractions (False labor)|
|They start after the 37th week of pregnancy, and if they come earlier, they are the signs of preterm labor.||They start from the second trimester itself and appear frequently in the third trimester.|
|They are regular and follow a pattern.||They are irregular and do not follow any pattern.|
|They progress with time; become more frequent, stronger and longer.||They do not progress over time.|
|They begin from the lower back and radiate towards the groin region.||They are a generalized abdominal tightening.|
|Any activity or movement will not stop or lessen the contractions.||They disappear with any activity or movement.|
|Your waters may break.||Your waters will not break.|
|The bloody show happens.||The bloody show will not take place.|
|Cervical changes occur.||No cervical changes.|
There is yet another kind of real contractions called prodromal labor. These contractions do not get longer, stronger, and closer but change your cervix. Your doctor will guide you in the case of such a development (5).
4. Cervical changes during labor
The cervix is the opening of the uterus through which the baby is born. All through the pregnancy, this opening is thick (not effaced), closed (not dilated), pointed towards the back (posterior end of the mother), and has a layer of mucus (mucus plug) to protect the baby. The below changes to the cervix signal labor:
- Thinning of the cervix (effacement): The cervix begins to thin and widen, indicating that the lower part of the uterus is ready for labor.
- Opening of the cervix during labor (dilation): The cervix opens to about 10cm, but the maximum dilation occurs just before labor. Only the health practitioner can tell you the extent of dilation (6).
5. Bloody show
As the changes occur in the cervix, you will shed the mucus plug. It drops out in a lump or discharge for a few days. It is tinged with brown, pink, or red blood and therefore referred to as “bloody show”. This indicates that labor is close (7). But note that not every pregnant woman will have this symptom. If you notice the bloody show between 32 and 34 weeks, you should call your doctor as it can be a sign of preterm labor.
6. Water breaking
Spontaneous rupture of the membranes or “breaking of the waters” is a strong symptom of labor. It happens when the amniotic sac ruptures and the fluid gushes out from the vagina. Once the waters break, you should immediately contact your doctor who would ask for the consistency and color of the fluid.
During the early stage of labor, the body releases prostaglandins, which soften the cervix and contract the uterus. They also stimulate bowel movement, naturally emptying the bowel to make way for the baby. This is a good sign as it helps clean out your tummy and avoid any discomfort during labor (5).
Back pain is normal throughout pregnancy, but if it gets severe then it could be a sign of “back labor”. The baby usually faces the mother’s spine while descending the birth canal. However, in some cases, the baby’s skull may hit the mother’s spine while descending and cause excruciating lower back pain (7).
9. Loose joints
During pregnancy, relaxin hormone helps soften and loosen the ligaments. This is why you will have episodes of clumsiness starting from 29 weeks. However, this is a natural way of opening the pelvis to make way for your baby.
10. Losing weight
Towards the end of pregnancy, you will not gain weight. Some women may lose weight. However, this is normal and does not affect your baby. Your baby continues to gain weight but you will lose weight due to lower amniotic fluid levels, increasing bowel movements, and restlessness (8).
Symptoms such as diarrhea and backache are generic and might happen anytime during pregnancy. Therefore, you do not have to panic about them but let the doctor know during your regular check-up. But water breaking or bloody show might be the exclusive signs of labor.
Can You Tell If Labor Is About To Happen Soon?
You may or may not since there is an overlap of the symptoms of advanced pregnancy (the period between 28 weeks and birth) and pre-labor (the body’s way of preparing for real labor). However, the following symptoms might tell you about the impending labor (5):
- When the lightening occurs, your breathing gets heavier, you tend to eat more, pee frequently and find it difficult to walk.
- Braxton Hicks contractions become more noticeable.
- Vaginal discharge might increase.
- You might have intense mood swings such as excitement, uncertainty, anticipation, and anxiety.
All of the above symptoms are normal, and there is nothing to worry about. You should relax as much as possible to save your strength for the later stages of labor.
How Will You Know If You Are In Active Labor?
Your contractions will become regular, stronger and more prolonged. They typically last for 40 to 60 seconds as the cervix dilates from 4cm to 7cm. By now, you will be at the birth center, or if delivering at home, your midwife will be helping you. You might also have the following symptoms (9):
- Increasing discomfort
- Heaviness in the legs
- Increasing backache
- Bloody show
- Rupture of amniotic membranes
You will become more aware of the contractions, and start sighing with the start of each contraction. You will feel hot and anxious.
What To Do In Early Labor?
Stay calm and focused when you are in labor. It is natural to be overwhelmed with apprehension or disbelief. Have your partner or family member along if you think labor is close. Here’s what you can do (7).
- Lie down and relax: Find some quiet place, lie down and relax. Try to breathe normally. It helps you to cope with contractions and also stimulates your body to release oxytocin that is required for labor progression.
- Stay hydrated: Drink enough water or have juices to ease labor symptoms and prevent cramps that may occur due to dehydration.
- Eat well: You might feel hungry. Eat and drink whenever you feel like. Have small amounts of high-energy foods as it comforts you and also helps in the smooth progression of labor.
- Rest and wait: Alternate between resting and walking, or take a warm bath to ease pains and aches.
You can try breathing techniques or visual imagery to cope with contractions. Check if your partner or anyone else could track the symptoms you are experiencing. Call the doctor, explain the symptoms and ask them if the time has come.
When Should You Go To Hospital?
Your doctor would have told you about what’s to be done if you have contractions. If you think that the contractions are consistent and you may be in labor, you should immediately check with your doctor or midwife (10).
Call your doctor if you notice the following:
- Bright red bleeding or discharge that is not dark brown or pale pink.
- Having a headache, changes in vision, tenderness in the upper abdomen, or sudden swelling (symptoms of pregnancy-induced hypertension or preeclampsia).
- Less active baby.
- Back pain.
- Contractions before 37 weeks or any other signs of preterm labor.
- Water breaking, especially if it is green or brown or has a foul odor.
Sometimes, waters might break even before the contractions begin.
What Happens If The Waters Break Without Contractions?
If your water breaks but the contractions do not set in, your doctor may induce labor. This is to prevent the baby from infection as the amniotic sac is no more present to protect the baby (11). Also, if you had a positive culture for group B strep (GBS), you and your baby would be at the risk of developing group B streptococcus when the water breaks (12). The doctor will check you to ensure that everything is alright.
Can You Have Contractions And Not Be In Labor?
Yes, you will experience contractions, known as Braxton Hicks, over the last few weeks of pregnancy. They prepare the muscles for delivery. These contractions will not dilate your cervix but cause early changes to it.
Your doctor will confirm the contractions by carrying out the vaginal examination and checking for cervical changes. Follow their advice until your labor gets stronger.
Next, we answer some more queries you might have on the signs of true labor.
Frequently Asked Questions
1. Is loss of appetite a sign of labor?
Yes, during early labor, the bodily changes will drain you of your energy, suppressing hunger and you might lose your appetite. Even if you eat, you may throw it up. So it is advisable to eat easily digestible foods during labor to keep up the energy levels.
2. Are headache and nausea signs of labor?
Headaches and nausea are common a day or two before the labor begins. You may experience a splitting headache and nausea along with uneasiness (13).
3. What are the signs of premature labor at 35 weeks?
Premature labor can happen anytime between the 20th and 37th weeks of pregnancy. It begins with frequent, uncomfortable, and regular contractions. The associated signs include:
- Persistent ache or pressure in the pelvic region, groin or thighs
- Diarrhea and intestinal cramps
- Dull and occasional lower backache
- Pinkish or brownish watery discharge before labor
You should immediately see your doctor if you experience these signs or more than four contractions in an hour (14).
4. Does body temperature change before labor?
The body temperature may rise to a degree or more due to the contractions and hot flashes as the labor nears (15).
5. Is pelvic pressure a sign of labor?
Yes, pelvic pressure that comes and goes can be a sign of labor as it occurs when the baby drops into the pelvis (16). The pressure would be intense, giving a feeling of bowel movement before labor.
It is not necessary for all the women to go through these symptoms; and the signs of labor are not limited to those listed above. You must believe that your body will know the right time of birth. Do not dread the labor nor spend sleepless nights thinking about it. Instead, be prepared and be ready to enjoy the experience of motherhood.
Are you expecting a baby? Share your motherhood experiences with us in the comments section below.
2. Pregnancy and birth: When does labor need to be induced; Institute for Quality and Efficiency in Health Care (IQWiG) (2006)
3. When does labor usually start; NIH (2017)
4. Marla V. Anderson and M.D. Rutherford; Evidence of a nesting psychology during human pregnancy; Evolution and human behavior; Science Direct (2013)
5. Am I in labor; U.S. National Library of Medicine; NIH (2018)
6. Jeremy L. Neal et al.; ‘Active labor’ duration and dilation rates among low-risk, nulliparous women with spontaneous labor onset: a systematic review; J Midwifery Womens Health (2011)
7. Labor and birth; The Office on Women’s Health (OWH) (2018)
8. To avoid early labor and delivery, weight and diet changes not the answer; University of Rochester Medical Center (2012)
9. Labour delivery and care module: 1. recognition of normal labour; The Open University (2019)
10. Pregnancy – labor; Cedars-Senai
11. Thinking about having your labor induced? a guide for pregnant women; Eisenberg Center at Oregon Health & Science University (2009)
12. Group B Streptococcus fact sheet; Maine Center for Disease Control & Prevention
13. When to call your doctor, midwife or labor & delivery; UC San Diego Health
14. Preterm labor; The Children’s Hospital of Philadelphia
15. Diana P. Selvey; Changes in basal body temperature and the onset of labor; College of Nursing The University of Utah (1983)
16. Early labor and preterm birth; Beaumont