How To Tell Labor is Beginning

You're officially in active labor when your cervix is four centimeters dilated. Some women can stay just shy of this stage of dilatation for days or a week or two before they experience consistently regular, hard contractions. So we will arbitrarily say your labor has begun when your contractions become regular and increasingly intense, and you are likely to see your baby within a day.

We do not find the terms "true" and "false" labor helpful, nor accurate, since there is no such thing as a "false" labor contraction. As discussed, all those prelabor Braxton-Hicks contractions you've had for weeks and months have been toning the uterus, adjusting baby's position, and effacing your cervix, all preparing for the day you're going to labor a baby out. Instead, we find it helpful to divide contractions into preparing-the-passage-for-baby contractions (prelabor contractions) and delivering-baby contractions (labor contractions). Many women, especially first-timers, can't pinpoint the exact moment labor contractions begin. Labor contractions can seem like prelabor ones at first. After the fact, of course, mothers can look back and say, "Oh yes, that was when they started." Once active labor is well underway, you'll no longer doubt that this will end except with the delivery of your baby. Here's how to tell the difference.

Prelabor contractions (also called "false" contractions):

• Are irregular, following no discernable pattern for more than a few hours.
• Are non-progressive: don't become stronger, longer, or more frequent.
• Are felt most in front, in the lower abdomen.
• Vary from painless to mildly uncomfortable; feel more like pressure than pain.
• Become less intense and less uncomfortable if you change position or walk, lie down, or take a hot bath or shower.
• Make your uterus feel like a hard ball.

Labor contractions (also called "real" or "true" contractions):

• Follow a regular pattern. (Timing is seldom precise to the minute.)
• Are progressive: become stronger, longer, and more frequent. The contractions get longer and the intervals between them shorter.
• Are felt most in the lower abdomen and radiate around to the lower back.
• Vary from uncomfortable pressure to a grabbing, pulling pain, which can usually be managed, even lessened, by conscious release of tension in the rest of your muscles.
• Don't change if you lie down or change position; may be intensified by walking.
• Are usually accompanied by a "bloody show."