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When labor Begins
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Obstetrics/Gynecology
White-Wilson Medical Center -- The Center for Women's Health

When Labor Begins

When Labor BeginsAwaiting the birth of a baby is an exciting and anxious time. Most women give birth between 38 and 42 weeks of pregnancy. However, there is no way to know exactly when you will go into labor. Birth often occurs within 2 weeks before or after your expected due date.

Making Plans

As you plan for the birth of your baby, you can take steps to help your labor go more smoothly. It is best to discuss your questions about labor with your health care team before the time comes:

  • When should I call my doctor?
  • How can I reach the doctor or
    nurse after office hours?
  • Should I go directly to the hospital or call the office first?
  • Are there any special steps I should follow when I think I'm in labor?

Before it's time to go to the hospital, there are many things to think about. You may not have time to think about them once labor begins, so it is best to consider them ahead of time:

  • Distance—how far do you live from the hospital?
  • Transportation—is there someone who can take you at any time, or do you have to call and find someone?
  • Time of day—depending on where you live, may it take longer during rush hours than at other times of the day or night?
  • Home arrangements—do you have other children to take to a babysitter's home, or do you have to make any other special arrangements?
  • Work arrangements—do you have a plan for how your workload will be covered and for letting your coworkers know when you have had the baby?

It may be a good idea to rehearse going to the hospital to get a sense of how long it could take. Plan a different route you can follow to the hospital if there are delays on the regular route.

How Labor Begins

No one knows exactly what causes labor to start, although changes in hormones may play a role. Most women can tell when they are in labor. Sometimes, it is hard to tell when labor begins.

As labor begins, the cervix opens (dilates). The uterus, which is a muscle, contracts at regular intervals. When it contracts, the abdomen becomes hard. Between the contractions, the uterus relaxes and becomes soft. Even up to the start of labor and during early labor, the baby will continue to move.

Certain changes may also signal that labor is beginning. You may or may not notice some of them before labor begins.

Signs That You Are Approaching Labor

Sign

What It Is

When It Happens

Feeling as if the baby has dropped lower

Lightening. This is known as the “baby dropping.” The baby's head has settled deep into your pelvis.

From a few weeks to a few hours before labor begins

Increase in vaginal discharge (clear, pink, or slightly bloody)

Show. A thick mucus plug has accumulated at the cervix during pregnancy. When the cervix begins to dilate, the plug is pushed into the vagina.

Several days before labor begins or at the onset of labor

Discharge of watery fluid from your vagina in a trickle or gush

Rupture of membranes. The fluid-filled sac that surrounded the baby during pregnancy breaks (your “water breaks”)

From several hours before labor begins to any time during labor

A regular pattern of cramps that may feel like a bad backache or menstrual cramps

Contractions. Your uterus is tightening and relaxing. These contractions increase as labor begins and may cause pain as the cervix opens and the baby moves through the birth canal.

At the onset of labor

True Versus False Labor

It can be hard to tell false labor from true labor. Usually, false contractions are less regular and not as strong as true labor. Sometimes the only way to tell the difference is by having a vaginal exam to find changes in your cervix that signal the onset of labor.

One good way to tell the difference is to time the contractions. Note how long it is from the start of one contraction to the start of the next one. Keep a record for an hour. It may be hard to time labor pains accurately if the contractions are slight. If you think you're in labor, call your doctor's office or hospital.

Differences Between False Labor and True Labor

Type of Change

False Labor

True Labor

Timing of contractions

Often are irregular and do not get closer together (called Braxton Hicks contractions)

Come at regular intervals and, as time goes on, get closer together. Lasts about 30–70 seconds

Change with movement

Contractions may stop when you walk or rest, or may even stop with a change of position

Contractions continue, despite movement

Strength of contractions

Usually weak and do not get much stronger (may be strong and then weak)

Increase in strength steadily

Pain of contractions

Usually felt only in the front

Usually starts in the back and moves to the front

The following are other signs that should prompt you to call or go to the hospital:

  • Your membranes rupture (your “water breaks”), even if you are not having any contractions
  • You are bleeding from the vagina (other than bloody mucus)
  • You have constant, severe pain with no relief between contractions
  • You notice the baby is moving less often


CervixFinally...

You are nearing a special, exciting time. Although it's not possible to know exactly when labor will begin, you can be ready by knowing what to expect. Being prepared can make it easier for you to relax and focus on the arrival of your baby when the time comes.


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