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5 Signs of Labor That Are Not False Alarms

When you’re nearing the end of your pregnancy, every twinge, cramp, and hiccup can make you think you're about to go into labor. And with so much misinformation about the signs of labor just a Google search away, it’s easy to get confused about what you're experiencing and go into a panic.

“I counsel women all the time about labor, and it wasn’t until I went into labor of my own that I finally understood what it was really like,” says Melissa R. Peskin-Stolze, MD, generalist ob-gyn and assistant professor of obstetrics & gynecology and women's health at Montefiore Health System and Albert Einstein College of Medicine in New York. “Labor is a process…but every woman’s process is different."

That said, labor does have a very clear definition characterized by some specific signs, Andrea Campaigne, MD, an ob-gyn who practices at St. David's Women's Center of Texas, tells Health. These are the 5 earliest signs that labor is imminent—and your baby is on the way.

Contractions are painful

You’re not going to know without medical assistance whether or not your cervix is dilating. So pay attention to the pain. Are the contractions irregular, mild, and don't get stronger or closer together as time progresses? These are likely to be Braxton-Hicks contractions. Named for the British doctor who first studied them, these false labor contractions that often happen in the third trimester are thought to be your body's way of warming up for the real contractions that open up your cervix and launch your little one into the world.

Real contractions, however, feel different; they become stronger, more frequent, and more painful. While Braxton-Hicks contractions feel like a sudden tightening, then release, of your uterus, "labor pains move from front to back,” says Dr. Campaigne.

Shifting positions doesn’t ease the pain

Another sign your contractions are the real deal? When you sit, stand, lie on your back, or otherwise change body position, they won't feel any better. Same goes for going on a walk, taking a bath or shower, or curling up on the couch to rest—if the contractions ease up after doing any of these, they probably were false labor. If they don't, you're about to become a parent. “If you can modify [the pain], it’s not worth worrying about,” says Dr. Campaigne.

Contractions wake you in the middle of the night

If you spent the day running around (#nestingproblems) and you’re having weak contractions now that you've settled down to relax, it’s more likely to be false labor, says Dr. Campaigne. However, if the pain of contractions starts up in the middle of the night when you’re in a relaxed state and they’re bad enough to wake you, well, you may want to start looking for the hospital bag you packed. Or, you know, finish packing it.

Your water broke 

Remember in Sex and the City when Charlotte’s water broke while yelling at Big, and she knew she had to hightail it to the hospital? Her instincts were on the mark. When a pregnant woman's water breaks, it means the fluid-filled membranes of the amniotic sac have ruptured, so the baby can make its way out of the uterus and into the birth canal. While a gush of liquid is an obvious sign that your water broke, it can also feel like a small leak, Dr. Peskin-Stolze tells Health.

“The leaking would be constant, not something that would start and stop like urine,” she says. It also has a distinct odor, like—how do we say this?—well, some women say it smells like semen. “Odor is not how you should tell if you ruptured your membranes. A continuous leak is more telling,” she says. It’s not always the sign that you need to rush to the hospital though, but most women go into labor within a few hours, according to the American College of Obstetricians and Gynecologists. 

Your instinct tells you it's time

This one might sound strange, but it's what the ob-gyns tell us. “If you call us and your story [about your symptoms] is too long, you’re probably not in labor,” says Dr. Campaigne. On the other hand, if you call and all you can manage to spit out is “I’m in labor, I’m coming to the hospital,” you probably really are, she says, adding, “Labor is a straightforward process.”

3 signs you think mean you’re going into labor—but really don’t

It’s totally natural that in this wait-and-see period (when you’re so ready to give your baby an eviction notice), you might put too much stock in signs that can happen a few weeks before labor, like these.

You lost your mucous plug—and it’s streaked with blood. A little vaginal bleeding, or seeing long strings of mucous (aka your mucous plug) coming from your vagina, could suggest that your cervix is dilating. However, both of these can happen as much as a week or two before labor, as your cervix goes from completely closed to a bit open, says Dr. Peskin-Stolze. Your body needs to dislodge that mucus plug from your cervix to deliver the baby, of course. But it's not always a surefire sign of labor. Just think of it as your body gearing up for the main event.

Your baby dropped. If this is your first baby, Dr. Peskin-Stolze says that the baby may "drop," in your uterus, leading to an increase in vaginal pressure. Again, it’s something that happens sometime before labor, but it doesn't kick it off. 

Your little one isn't moving as much. All pregnant women pay attention to how much—or how little—their baby is moving in there, even if those kicks to the ribs are totally uncomfortable. However, less movement is not a sign labor is impending, according to Dr. Campaigne. “There’s the idea that the baby will start to slow down their movements as they’re getting lined up in labor. We don’t consider that normal. In fact, as OBs, we think that’s a concerning sign,” she says. If you’re worried that your bambino is not moving around as much, call your doctor.

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