How will I Know I'm in Labor?
by Stacy Caldarera

As the big day nears, you will most likely become nervous about going into labor. I know I was! I began asking all the mom's I knew about contractions. How will I know if I have one? Trust me, you will know.   After a few hours of contractions, I arrived at the hospital, and the monitor confirmed - I was having contractions. In my case, this ended up being false labor. After an IV of fluids, the contractions stopped only to start again two days later. This time it was the real deal. Everyone is different though, so how will you know?

Here are some common signs:
• Lightening or adjusting the pressure
• Effacement or ripening of the cervix
• Dilation or opening of the cervix
• Bloody show or loss of mucus plug
• Nesting or spurt of energy
• Rupture of membranes or breaking of water
• Contractions or when labor begins

Lightening or adjusting the pressure is one of the first signs of labor. You may feel as if the baby is settling deeper into your pelvis or you may feel increasing pelvic pressure.   A few days before I went into labor, I had the sensation that the baby had "dropped" and I was feeling a lot of pressure that sent me on frequent bathroom runs.

Effacement is the shortening, or thinning, of the cervix before or during early labor. Prior to effacement, the cervix is like a long bottleneck, usually about four centimeters in length. You will not be able to feel this sign of labor but is one of the signs your doctor will check for as near your due date.  Some women will dilate weeks prior to giving birth and others dilate more quickly.

Throughout pregnancy, the cervix is tightly closed and protected by a plug of mucus. When the cervix effaces, the mucus plug is loosened. The mucus may be tinged with blood and the passage of the mucus plug is called bloody show. A bloody show does not mean you are in labor.   You may still not start into labor for a week or more.

Nesting or a spurt of energy is another sign of labor.  I'm not sure if it was panic or "nesting" but just days before going into labor I organized all the baby clothes and the baby's room.   Signs of nesting include sudden spurts of energy to clean and organize. Nesting may begin months before your due date, but may be the strongest just before delivery.

Rupture of membranes or water breaking is a well known sign that you may be in labor.  You may notice a gush or just a trickle. If this happens at home, call your doctor right away. Timing becomes very important if the amniotic sac is no longer intact. The longer the membranes are ruptured, the greater the risk of an infection. If labor does not begin on its own at this point, your doctor may need to induce labor. During this time be careful about introducing bacteria into your vagina. Sex is not a good idea if you are leaking amniotic fluid.

Contractions are when labor pains begin.  How can you tell if the pains are true contractions?
• 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 stronger and closer together. Real contractions are most likely those that come about every five minutes.
• How long do they last? Measure the length of each contraction by timing when it begins and when it ends. A true contraction last more than 30 seconds at first and gets progressively longer, up to 75 seconds, and stronger. If you are in a false labor, the contractions vary in length and intensity.
• Can you stop the contractions?  True contractions continue regardless of what you are doing, or which position you turn to. They often grow stronger with increased activity. In false labor, you may be able to stop the contractions by changing your activity or position, lying down or even taking a walk.
• When do you feel the contractions? True contractions tend to begin high in the abdomen, radiate throughout the abdomen and lower back. False labor pains are often concentrated in the lower abdomen.
Do not hesitate to call your doctor if you wonder whether or not you are in labor. If you experience symptoms of labor before 36 weeks and especially if the symptoms are accompanied by vaginal spotting, see your doctor for an exam.

Source: Mayo Foundation for Medical Education and Research

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