Medically Reviewed by Jabeen Begum, MD on December 28, 2023
Written by Katie CameronLabor is another word for your body’s natural process of childbirth. It starts with your first steady contractions and goes through the delivery of both your baby and placenta.
Some have very distinct signs of labor, while others don’t. No one knows what causes labor to start or when it will start, but several hormonal and physical changes help indicate the beginning of labor.
Lightening during labor
The process of your baby settling or lowering into your pelvis just before labor is called lightening. It’s also referred to as the baby “dropping.”
Passing of the mucus plug
The mucus plug accumulates at the cervix during pregnancy. When the cervix begins to open wider, the mucus is discharged into the vagina. It may be clear, pink, or slightly bloody. This is also known as “show” or “bloody show.” Labor may begin soon after the mucus plug is discharged or 1 to 2 weeks later.
Labor contractions
Contractions are the tightening of the muscles of the uterus. During contractions, the abdomen becomes hard. Between contractions, the uterus relaxes and the abdomen becomes soft. The way a contraction feels is different for each person, and it may feel different from one pregnancy to the next.
Diarrhea
You may notice your stools are loose or watery. While it may seem weird, this may be a sign that labor is 24-48 hours away.
Back pain
It's common to have back pain during pregnancy. It could be due to the extra strain on your back and belly muscles or just changes in posture. Heat or cold packs and massages often help.
During labor , you may have lower back pain and cramps that don't get better or go away. It can also be part of your contractions. The pain usually starts in your back and then moves around to the front of your body.
Weight loss
While you’re pregnant, it may seem like you’re never going to stop gaining weight. But many pregnant people actually lose a few pounds in the days leading up to labor.
Nesting instinct
Some find themselves with an urge to get ready shortly before their baby’s arrival. That’s known as the nesting instinct.
Activity of the baby
Your baby may move less as you get closer to the start of labor, but let your doctor know. It can sometimes be a sign of a problem, not an early sign of labor.
Cramps and back pain
It may be hard to recognize a contraction, especially with your first baby. Many pregnant people have what feels like menstrual cramps in the lower abdomen. They may stay the same or may come and go. You might also have pain in your lower back that either stays or comes and goes.
Looser joints
If you find yourself “waddling” as your pregnancy winds down, that’s just your body getting ready for the job ahead. A hormone called relaxin loosens up the ligaments around your pelvis to make it easier for the baby to pass through.
Water breaking
The rupture of the amniotic membrane (the fluid-filled sac that surrounds the baby during pregnancy) may happen before you get to the hospital.
Effacement
During labor, your cervix gets shorter and thins out in order to stretch and open around your baby's head. The shortening and thinning of the cervix is called effacement. Your health care provider will be able to tell you if there are changes to the cervix during a pelvic exam.
Effacement is measured in percentages from 0% to 100%. If there are no changes to the cervix, it is described as 0% effaced. When the cervix is half the normal thickness, it is 50% effaced. When the cervix is completely thinned out, it is 100% effaced.
Dilation
The stretching and opening of your cervix is called dilation and is measured in centimeters, with complete dilation being at 10 centimeters.
Effacement and dilation are a direct result of effective uterine contractions . The progress in labor is measured by how much the cervix has opened and thinned to allow your baby to pass through the vagina.
In addition to physical signs, you may experience emotional symptoms that could be signals you're going into labor, including:
Before “true” labor begins, you may have “false” labor pains, also known as Braxton Hicks contractions. These irregular uterine contractions are perfectly normal and may start to occur in your second trimester, although more commonly in your third trimester of pregnancy. They are your body's way of getting ready for the “real thing.”
What do Braxton Hicks contractions feel like?
Braxton Hicks contractions can be described as a tightening in the abdomen that comes and goes. Unlike true labor contractions, these do not get closer together, do not increase with walking, do not increase in duration, and do not feel stronger over time.
How do I know when I am in true labor?
To figure out if the contractions you are feeling are the real thing, ask yourself the following questions.
| Contraction Characteristics | False Labor | True Labor |
| How often do the contractions occur? | Contractions are often irregular and do not get closer together. | Contractions come at regular intervals and last about 30-70 seconds. As time progresses, they get closer together. |
| Do they change with movement? | Contractions may stop when you walk or rest. They may even stop if you change positions. | Contractions continue despite movement or changing positions. |
| How strong are they? | Contractions are usually weak and do not get much stronger. Or they may be strong at first and then get weaker. | Contractions steadily increase in strength. |
| Where do you feel the pain? | Contractions are usually only felt in the front of the abdomen or pelvic region. | Contractions usually start in the lower back and move to the front of the abdomen. |
When you think you are in true labor, start timing your contractions. To do this, write down the time each contraction starts and stops or have someone do it for you. The time between contractions includes the length or duration of the contraction and the minutes in between the contractions (called the interval). Some people use a contractions timer app to keep track of their contractions.
Mild contractions generally begin 15-20 minutes apart and last 60-90 seconds. The contractions become more regular until they are less than 5 minutes apart. Active labor (the time you should come into the hospital) is usually characterized by strong contractions that last 45-60 seconds and occur 3-4 minutes apart.
How to ease labor pain
It’s best to go through the first stage of labor (called the latent phase) in the comfort of your home. Here are some tips that might help:
When you suspect you are in true labor, call your health care provider. Also, call:
Your health care provider will give you specific guidelines about when you should get ready to come to the hospital.
You may experience a wide range of physical and emotional symptoms during the early stages of labor. Early on, make yourself as comfortable as you can at home and continue timing your contractions. Once you begin having contractions lasting 45-60 seconds every 3-4 minutes, it's time to head to the hospital.
