How to Tell If You're Really in Labor

There are a few telltale signs that let every pregnant woman know that labor is beginning. Here's how to know if what you feel is really it, or just a false alarm.

How to Tell if You're Really in Labor

Almost every pregnant woman portrayed on television wakes up in the middle of the night and says, "It's time!" And within 20 minutes (on a half-hour show), she delivers the baby.

The frustrating truth is that the onset of labor is rarely predictable. But there are signs that it has started—or soon will. Here are a few of them.

Lightening This term is defined as descent of the baby into the pelvis, which can happen as early as two to four weeks prior to labor. If it happens, it's typically accompanied by increased frequency of urination, as well as pelvic and rectal pressure. On a more positive note, you'll likely experience less shortness of breath as the baby settles down and away from your diaphragm.

Loss of the mucous plug This can occur anywhere from one to two weeks or just hours before labor — or not at all. And it's not really a plug, but a glob of thick mucus expelled through the cervical canal and vagina. When tinged with blood, this glob is called "bloody show." Sometimes this loss is followed by mild contractions.

"I began to have bad cramping and then this need to urinate," says Lorraine Sheridan of Port Washington, N.Y., of her first pregnancy. "I went to the bathroom, and then this plug popped out of me!"

Braxton Hicks Otherwise known as false contractions, Braxton Hicks contractions often start three to four weeks or more before delivery. The irregular, mild tightness or cramping, usually felt in the lower abdomen, lasts a few seconds and may increase during the night and while exercising. Unlike true labor contractions, Braxton Hicks do not progress in frequency.

Water breaking The amniotic fluid sac, also known as the "bag of waters" that surrounds the baby, spontaneously ruptures before labor for some women. When it happens, they report, a gush of warm fluid runs down their legs. Labor began this way for Yolanda Kolinski of Boston. "It felt like a balloon with warm water that suddenly popped," she says.

The "rupture" can also begin as a slow trickle. But recognizing the difference between slowly leaking amniotic f fluid and leaking urine isn't always easy. "Amniotic fluid should be clear, with a slightly musty odor," says Robert H. Hayashi, M.D., director and professor of maternal-fetal medicine at the University of Michigan, Ann Arbor. Call your doctor if you think your water might have broken.

True contractions One sure sign of labor is the onset of contractions that progress in intensity, frequency and duration. Unlike some false contractions, no shifting in position or walking will stop the real ones. Hayashi says that the simplest distinction between true contractions and false labor pains is this: "True contractions cause such significant discomfort in the low back or abdomen that you can't talk." Many women describe true contractions as extremely painful menstrual cramps.

Kolinski knew the difference. After her water broke, contractions began — and the sensation was like no other she'd ever felt. "They came around from my back," she says. True contractions gradually increase in frequency to every 1 1/2 to three minutes, each lasting 60 or even 90 seconds.

The prelude to labor varies for each woman and each pregnancy. Some experience all of these signs, others one or none. Some encounter less common signs such as a burst of energy or weight loss a day or two before delivery.

Exactly how and when will you deliver? For your answer, Hayashi recommends using this essential medical instrument: a crystal ball.