Some of the early signs and symptoms of labor include painful contractions that usually last longer than 30-60 or more seconds for over 1 hour, come in a regular, measurable interval, usually less than every 3-5 minutes, and worsen as time goes on.
According to Dr. Grunebaum a sign of a regular early labor contraction is that it is so painful that it takes your breath away and makes you unable to finish singing your favorite song.
What is labor in pregnancy
Labor is usually defined as contractions of the uterus that are strong enough to makes the cervix change, make it shorter (effacement) and softer and open it up (dilatation). Labor is the act of baby moving from the womb to the outside world through contractions and changes in the cervix. The female body has precisely planned out the entire 40 weeks of gestation and when the body says the time has come for baby to leave the womb, the process of active labor will begin. Labor can be spontaneous or it can be induced.
Here are some early signs and symptoms of labor
- You have more contractions of the uterus. These may be Braxton-Hicks contractions, or practice contractions that have no effect on the cervix. Or they may be increasingly strong labor contractions which are painful, closer together, last longer and can change the cervix.
- The baby has dropped. This is also called engagement of the baby when it enters the pelvis closer to the cervix. You could see this happening when the shape of your abdomen changes and the baby moves lower.
- The cervix has changed. The cervix becomes softer, shorter (effacement), and most importantly it starts opening up (dilatation). These changes, especially softening and shortening of the cervix can happen without labor. In women who have delivered before, the cervix can also open up a little prior to labor.
- The cervical mucus plug passes or you see "bloody show". The mucus plug is inside the cervix, the lower part of the uterus, and it forms soon after the fertilized egg implants in the uterus. The plug blocks the opening of the cervix until it passes. As the body prepares for labor, it shrinks away and falls out of the cervical opening. It has antimicrobrial properties, which means it protects against infections.
- Rupture of fetal membranes, your water breaks. When the fetal membranes surrounding the fetus rupture, amniotic fluid from inside the membranes leak out through the cervix and the vagina. When fetal membranes rupture after 37 weeks but before labor that's called premature (before labor) rupture of membranes. If this happens prior to 37 weeks that's called "preterm premature rupture of membranes". Most women will go into labor within 24 hours after the water breaks.
How can I tell if I am in labor
The symptoms of labor may not be the exact same for all women and telling if you are in labor is not always easy and can be different from one woman to the other. And even if you have these signs, you may actually not always be in active labor and it may be weeks away.
Can I tell when I will be going into labor
It's very difficult to predict ahead of time when labor will start and exactly when you will be in labor. As the pregnancy gets closer to the due date, there are early signs and symptoms mom will need to look for in order to recognize the beginning of labor. During the last trimester of the pregnancy, the changes in the body of both mom and baby are happening at a lightning pace. Baby is gaining more weight every day and mom is feeling that weight gain paired with the body preparing for the birth of the new baby.
WARNING: Labor is normal after the 37th week of the pregnancy. Labor before the 37th week is called preterm or premature labor. If you experience premature labor, you should let your doctor know right away or go directly to the hospital.
In order to prepare for labor, the uterus will take some time to practice the art of the contraction. These contractions are often mild and do not mark the start of active labor. These early contractions are called Braxton Hicks contractions and some can be felt while others are simply lost in the aches and pains of being in the latest weeks of pregnancy. Braxton Hicks contractions after 37 weeks of pregnancy are normal, but if they happen before 37 weeks, more than 3 weeks before your due date, then you should immediately call your doctor because they may signal premature labor.
The early labor signs rules: The 5-1-1 rule versus 4-1-1 versus 3-1-1 rule
The 5-1-1 rule means that contractions come every 5 minutes, each lasting a full minute, and have been that way for an hour:
- 5 = Every 5 minutes
- 1 = Lasting a full minute or more
- 1 = Lasting for at least 1 hour
However, this rule may not apply to everybody and may be different for women who have their first pregnancy versus those who have had a baby before. More recently, recommendations especially for those who have their first baby are 4-1-1 (four minutes apart) or even 3-1-1 (three minutes apart).
From Training to Active Labor
After weeks or months of training, the female body will be ready to kick those contractions into full gear and labor will begin. In order to recognize these new pains and active labor, there are a few labor specific body changes to watch out for.
Here are some early labor symptoms and signs to let you know you are in active labor:
- When contractions are painful
- Contractions last longer than 30 seconds
- Contractions are coming in a regular, measurable interval, usually less than every 3 minutes.
- Contractions worsen as time goes on.
Prior to or during labor the following can happen:
- Lower back pain will appear and be persistent enough to make mom feel uncomfortable. This lower back pain may feel as though you are about to start a menstrual cycle.
- The mucus plug blocking the cervical opening will pass out through the vagina. The plug may appear as a white spot on the underwear when using the bathroom. Passing the mucus plug can happen hours, days, or weeks before labor. Or it can happen during labor.
- A brown discharge may appear in the underwear. This brown liquid may appear to be mixed with a mucus consistency matter.
- The amniotic sac breaks, also known as the breaking of the bag of waters.
These signs are all visible to mom at the later stages of the pregnancy and the earliest stages of labor. The obstetrician, on the other hand, will be able to recognize changes happening to the cervix that may also mark the onset of labor. Upon a vaginal exam, the cervix will feel thin and the plug will be gone. The cervix may be dilating in preparation for the baby to move through the cervix and into the vaginal opening. Cervix dilation is measured on a scale of 1 to 10 with 10 meaning it is time to push.
Labor is a unique experience where the body prepares for the birth of a child. When labor starts early, there are medications that can help to calm the muscles of the uterus when paired with rest and relaxation.
Early signs of labor and symptoms
The most tell tale sign of pregnancy are regular and strong contractions. Labor contractions last usually more than 30 seconds and come regularly and more frequently than every 4-5 minutes. If these contractions increase or charge to a more patterned set of contractions, labor could be starting. (WARNING: If you are under 37 weeks pregnant do NOT wait for regular contractions to start but let your doctor know right away if you have ANY contractions, usually more than 4-5 per hour).
While back pain is normal during pregnancy, when labor begins this pain will be more pronounced and could pulse with the contractions. Any change in back pain during the pregnancy needs to be talked over with the obstetrician.
Feeling of Fullness / Pressure
There is a very clear feeling of pressure when baby is ready to be born. This pressure often feels like mom needs to have a bowel movement.
Drop of the Pregnant Tummy
The tummy will clearly drop when the last days of pregnancy arrive. This drop will relieve some of the pressure on the stomach and the lungs so mom may be able to eat more and breathe more easily.
Loss of Cervical Mucus Plug
The plug that blocks the end of the cervix will fall out before labor but not always. Losing the cervical plug may mean that you are going into labor soon, though it can happen many days prior to labor. This plug will appear the same as ovulation only thicker. Most of the time the plug is lost during a trip to the bathroom, but can fall out and appear in the panties.
Leaking of Fluid or Breaking the Bag of Waters
The amniotic sac will leak or break when labor is about to begin. If there is any fluid leaking from the vagina, the obstetrician needs to be notified immediately. Once this sac is broken, birth is the only option. If there is a green or brown color to the fluid, go to the emergency room as baby may have had a bowel movement in utero.
Cramping or Bloody Discharge
The first labor pains may feel like menstrual cramps. If there is a slight bloody discharge this could also be associated with the loss of the cervical plug.
Increase in Blood Pressure
When the body kicks into labor, the blood pressure will rise a bit.
Commonly women who are about to go into labor will lose between one and three pounds. This weight is pure water weight.
Nausea and / or Vomiting
The female body is one smart thing. Right before labor begins, the body will "feel" something about to happen and may decide to empty all stomach contents. This emptying may appear as diarrhea or vomiting.
For women who have given birth before, the signs of labor may be less hectic than first time mothers. If mom waits too long, the baby may actually crown on the way to the hospital to diagnose labor. Crowning is preceded by dilation and the breaking of the bag of waters.
Sudden Burst of Energy
The body will lose a bit of weight right before labor begins, the tummy falls a bit and mom may feel like she has more energy than ever before. This increase in energy is often associated with the nesting instinct.
Can I tell the difference between true labor and false labor
False labor and true labor can overlap because they are usually associated with contractions that are more or less strong. Thge single most important information you must be aware of is that any strong and reular contractions or pain prior to 37 weeks of the pregnancy *more than 3 weeks before the due date* is not normal. Labor is only normal after the 37th week of the pregnancy. Labor before the 37th week is called preterm or premature labor. If you experience premature labor, you should let your doctor know right away or go directly to the hospital. Do not try to guess if you pain or contractions before 37 weeks are true or false labor. They are true labor and therefore of concern until you get checked out and find out what the pain or contractions are coming from.
After 37 weeks, true labor is usually identified by contractions that come closer together, are stronger and more painful, and most imprortantly lead to cervical opening (dilatation).