Signs of Labor: True vs False Labor and When to Go to the Hospital

Signs labor may be getting close

• The baby drops lower (easier breathing, more pressure and peeing).
• Losing the mucus plug, or bloody show: thick mucus streaked pink, red or brown, hours to days before labor. A little is normal; bleeding like a period is not.
• Loose stools, a burst of energy, low backache, or more Braxton Hicks.

True labor or false labor?

• False (practice) contractions: irregular, don't get closer together, often felt in front, and ease when you rest, drink water, walk or change position.
• True labor: contractions come at regular intervals, get longer, stronger and closer together, and keep going whatever you do. Pain often starts in the back and wraps to the front.
• Back labor: strong, constant low back pain, often when the baby faces up. Hands-and-knees, counter-pressure on the low back and warm packs help.

Timing contractions

• Time from the start of one contraction to the start of the next, and how long each lasts.
• A common guide for first babies is 5-1-1: contractions every 5 minutes, each lasting 1 minute, for 1 hour. Some providers use 4-1-1. If you've given birth before, live far away or labored fast last time, you'll often be told to come sooner. Use the rule your provider gave you.

Early labor at home

• Early labor can last many hours, especially the first time. Home is often the most comfortable place for it.
• Rest or sleep between contractions if you can, eat light food and sip fluids, pee often.
• Try a warm shower, walking, a birth ball, slow breathing, massage, music and changing positions.
• Get the car seat in, bag by the door, and a plan for older kids and pets.

Water breaking

• It can be a gush or a steady trickle you can't stop, unlike urine or discharge.
• Note the time, the color and any smell, and put on a pad (no tampons or baths).
• Call your provider whenever your water breaks, even with no contractions. Many will want to see you, sooner if you tested positive for group B strep.
• Clear or pale pink is expected. Green, brown, bloody or foul-smelling fluid means call right away.

When to go

• When you reach your provider's contraction rule, your water breaks (or as they told you), or you can't talk or walk through contractions.
• When something just feels wrong. You'll never be in trouble for coming in to be checked.

Preterm labor (before 37 weeks)

• Contractions or tightening every 10 minutes or more often, menstrual-like cramps, a dull low backache, pelvic pressure, a change in discharge (watery, mucus or bloody), or fluid leaking.
• Don't wait it out: call your provider or go to labor and delivery. Treatment can sometimes delay birth or help the baby's lungs.

When to check in

Call 911 now if:

• You see or feel the umbilical cord in your vagina: call 911, get on your knees with your chest down and hips higher than your head (or lie on your side with hips raised on pillows), stay that way until help arrives, and don't push the cord back.
• Heavy bleeding (soaking a pad in an hour or less), fainting, chest pain, trouble breathing or a seizure.

Call your provider or labor and delivery now if: - Any bleeding more than spotting or bloody show. - Fluid that is green, brown or foul-smelling, or your water breaks before 37 weeks. - The baby is moving less than usual. - Severe belly pain that doesn't ease between contractions, or a belly that stays hard. - Regular contractions or other preterm labor signs before 37 weeks. - A fever of 100.4°F (38°C) or higher. - A headache that won't go away, vision changes or sudden swelling of the face or hands. See the pregnancy warning signs guide for the full list.