Signs of Labor


Possible signs: Without other signs, these are not enough to signify labor. They may be due to something else, such as indigestion, fatigue, or physical overexertion.

  • Vague nagging backache causing restlessness and a need to keep changing positions
    • different from “normal” backache felt during pregnancy; may be associated with early contractions
  • Several soft bowel movements, sometimes accompanied by flu-like “sick” feelings
    • probably associated with increases in prostaglandin levels, which ripens and effaces the cervix
  • Intermittent or continuous cramps, similar to menstrual cramps; discomfort may extend to thighs
    • may be associated with prostaglandin action and early labor contractions
  • Unusual burst of energy resulting in great activity; the “nesting instinct”
    • ensures that the mother will have strength and energy to handle labor, so try to avoid overexertion

Preliminary signs:  These are more important than the “possible signs,” but it could still be hours or even days before labor is really underway.

  • Blood-tinged mucous discharge (“bloody show” or mucous plug)
    • associated with thinning and softening of the cervix
    • may occur days before other signs, or not until after progressing contractions have begun
    • a discharge, mistaken for show, may appear after a pelvic exam; this tends to be brownish, whereas show is pink or red
  • Bag of water leaks, resulting in a trickle of fluid from the vagina, but no contractions occur
    • ALWAYS call the office, even if no contractions present
    • not necessarily associated with labor
    • occurs before labor only about 10-12% of the time
  • Continuing, non-progressive contractions; they do NOT become longer, stronger, and closer over time. Sometimes called “false” labor, pre-labor, or Braxton-Hicks
    • accomplishes softening and thinning of cervix, allowing cervix to begin dilating; should not be perceived as unproductive

Positive signs:  These are the only certain signs that the mother is progressing or in true labor.

  • Progressive contractions, meaning that they become longer, stronger, and closer together over time.
    • It is a clear sign that the cervix is opening if contractions are 5 or fewer minutes apart, and they feel painful, usually in lower abdomen and/or back
    • May be accompanied by bloody show
    • mother cannot be distracted from these contractions
  • Spontaneous rupture of membranes (“water breaks”) with a gush of fluid; may feel a “pop”; along with progressive contractions
    • often associated with rapid cervical dilation
    • usually happens in late labor