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How to tell when you're in labor

Updated November 23, 2015.

By Janice Neumann

After 40 long weeks of pregnancy, your precious newborn is almost here. Your due date is fast approaching, and you’re on the lookout for the first signs that labor is under way. Yet the final weeks and days of pregnancy can bring on bouts of abdominal tightening, gas and other discomforts that can feel like contractions — but aren’t. So, how can you tell the difference? Here are seven signs your baby’s on the way.

1. Lightening

As you near the end of your pregnancy, your baby settles lower into your pelvis — this process is called lightening. Lightening occurs in the last few weeks before delivery. Because lightening causes the uterus to weigh on the bladder, you may feel the need to urinate more frequently after lightening has occurred.

2. Nesting

While you’ve probably spent a lot of your pregnancy resting more often than you did before (and maybe even napping), you might start feeling more energetic as labor nears. You may make urgent to-do lists to prepare for the baby — things that need to be bought or things that need to be cleaned, for example. This feeling can occur a few months before childbirth, but is strongest as you get closer to delivery. Despite this sudden urge to take action, try to remember that you’ll need all the rest you can get before the baby arrives.

3. Ripening of the Cervix

During the final couple months of pregnancy, effacement occurs — your cervix gets shorter and begins to thin out in preparation for childbirth. Effacement is measured as a percentage ranging from 0% (no change to the cervix) to 100% (the cervix is completely thinned and ready for vaginal delivery). Contractions help to spur these changes to your cervix. During this time, you won't be able to feel any changes to your cervix; your percentage of effacement can only be determined by your healthcare provider.

4. Opening of the Cervix

While you won't be able to feel it, in the days or weeks ahead of labor, your cervix gradually begins to open or dilate. This opening increases as you start to experience contractions. Dilation is measured in centimeters. You're fully dilated and ready to give birth when your cervix has opened to 10 centimeters.

5. Contractions

For the majority of women, contractions are a sure sign that labor has begun. While every woman experiences contractions differently, they most often feel like especially painful menstrual cramps or dull aches in your lower back or abdomen. Early contractions may occur 20 to 30 minutes apart, and will last for more than 30 seconds each. As labor progresses, your contractions should last longer and occur more frequently, eventually lasting up to 90 seconds and coming about 5 minutes apart. This is advanced labor and the time when you’ll want to be at the hospital.

Many women in the late stages of pregnancy experience Braxton Hicks contractions, sometimes called “practice” contractions, which are early, tamer versions of the contractions that will eventually bring baby to you. It’s important to know the difference between these contractions and those that signal that labor is imminent. Braxton Hicks contractions feel more like tightening in the abdominal area or a mild menstrual cramp. They’re usually uncomfortable, but not painful, and they tend to be irregular, taper off and disappear, rather than increase in intensity or frequency. If you’re less than 37 weeks pregnant and any abdominal tightening does seem to become more frequent or regular, call your provider.   

To help ease the pain from Braxton Hicks contractions, you can try several things: changing positions (sit, if you’ve been standing, or take a walk, if you’ve been sitting); taking a short, warm bath (30 minutes or less); drinking water (Braxton Hicks contractions can be triggered by dehydration); or drinking a cup of warm tea or milk.

6. Increase in Vaginal Discharge

During pregnancy, a plug of mucous blocks the cervical opening, helping to block bacteria from entering the uterus. As your cervix begins to thin in preparation for childbirth, the plug is often expelled as a clear, pink or blood-tinged discharge. For some women, this discharge occurs hours before labor; for others, it can happen days or weeks before labor begins. Some women don’t even recognize the mucous plug as having passed.

7. Your Water Breaks

The rupture of the amniotic membrane (the fluid-filled sac that surrounds the baby during pregnancy) is another signal that labor is underway. While a noticeable gush of water is often a signal of the start of labor in movies and on TV shows, the truth is most women don’t experience a dramatic gush of amniotic fluid, but rather a steady trickle of clear, odorless fluid. After your water breaks, it still may take up to 24 hours for delivery to occur — but you should head to the hospital immediately. 

And, if you’re experiencing other symptoms of labor (like intense, frequent contractions), don’t wait for your water to break to head to the hospital. Not all women have their water break as they begin labor; often, the doctor will rupture the amniotic membrane before delivery.

When to Head to the Hospital

If you’re more than 37 weeks pregnant and your contractions have been coming every 5 minutes for an hour, you should go to the hospital. You should also head to the hospital if your water has broken; even though delivery could still be hours away. Be sure to call to let them know you’re on your way! 

Published July 17, 2012. 

Janice Neumann is a Chicago-based health and wellness writer.