Deciphering your contractions & other signs of labor.
Most pregnant women who come to the hospital think they are in labor, but only about half of them are. Here are the top seven ways to deterimine if it’s really the big day!
The 5/1 rule.
You have a contraction every 5 minutes or less for at least one hour straight. Contractions will usually intensify and can be felt in your back and/or your lower abdomen. Most women describe the pain at first to be like a strong menstrual cramp. These pains will come and go and you will feel your skin over the baby become tighter with the contraction.
Nursing Tip: If you take your fingertip and touch the tip of your nose, that is what a “mild” contraction feels like from the outside. Your chin – “moderate” and your forehead – “strong”.
Your back HURTS.
You may not feel the “cramping” type contractions as above, you may just have a low back ache that won’t let up. Try a good hot bath or shower, have your honey rub your hips and lower back for you, or put some heat where it hurts. When none of this really helps and the feeling starts to increase in intensity, it might be time to see if you are in labor.
Nursing tip: False labor can look just like labor…except your cervix is not dilating. If you think you might be dehydrated, consider drinking 1-2 liters of water and putting your feet up first (especially if you have spent the day walking the malls or hanging out on the beach). Your body can act like it is going into labor but your symptoms will improve with a little rest and re-hydration.

Your water breaks
I tell my patients that this can be an overly dramatic experience like in the movie Fools Rush In (Selma Hayek & Matthew Perry; circa 1997). Pregnant Selma shouts, “I think my water just broke!” followed by a high pitched scream and ambulance siren as a baby girl is delivered in the middle of the road (highly unlikely, especially if it is your first baby).
OR
More likely you will see a little trickle of liquid that keeps running down your legs, sometimes after experiencing a strange “pop”-like sensation (but not always). Most ladies are highly embarrassed to be seen, thinking they have simply lost all control over their bladders at this stage of pregnancy (this is sometimes the case, and nothing to be embarassed about).
If you notice any fluid leaking from your nether-parts…call your midwife/OB/nurse practitioner for advice. More than likely you will need to come to the hospital or birth center for evaluation even if you do not feel the above mentioned contractions.
Your discharge changes.
Typically in pregnancy you experience various degrees of discharge, appearing as whitish or yellowish that is nothing more than an irritant. But many times when labor begins, that discharge takes on a new consistency. It becomes more mucous-like and can take on a tinge of pink or red. Be on the look-out for changes in your vaginal discharge, it could mean your body is readying itself for the little one to come!
Nursing Tip: While there is much ado about the “mucus plug”, this usually means less about going into labor than you may think. There does in fact exist a mucus barrier that you will see when your cervix starts to dilate and it “falls out”. HOWEVER…this can happen hours, days or even weeks before labor starts. Call your provider first before heading into the hospital!
You notice some bleeding.
While you are told throughout your pregnancy bleeding is a bad thing, when labor begins slight bleeding or spotting can be a great sign! It means whatever braxton-hicks contractions you’ve been having is starting to actually change your cervix (this is the opening from your vagina to your uterus and needs to change from completely closed to about the size of a full-sized bagel)!
Bleeding can also be a normal result after intercourse, (totally normal and okay!), or after your cervix has been “checked” by your doctor or midwife. It may not mean you are in labor but could still be the beginning of things.
NOTE: Notify your provider or go to the ER right away if you are saturating a pad with blood at any time in pregnancy. This could be indicative of an emergency and the sooner you are evaluated the better.
Tummy trouble.
Many times within a day of labor starting, women will go from pretty constipated (all those vitamins!) to suddenly diarrhea-like. It’s almost like your body knows a baby will be coming out from “down below” and it is emptying itself out to make more room!
There is also a tendency to have a big change in appetite. This can swing from a sudden desire to hit all the fast-food places in town, to barely being able to keep down some crackers and ginger-ale. Whatever the case, this could be your body’s way of telling you to get ready!
Something is just different.
While not an actual sign of labor, many women have a sense that something is up. Usually you are nesting like crazy, without a really good reason why. Suddenly you can’t get the toilets clean enough, you are taking curtains down from the high ceilings to steam clean (NOT advisable…) and you have an urgent need to rearrange the family room. This burst of energy is mysteriously common among women just before labor starts.
Or you may just have a “feeling”. This is different than the desperate need to be rid of the extra weight off your bladder; that huge mound you carry which makes sleep (or breathing even) impossible. This is an intuition of sorts that is as unexplainable as the nesting phenomenon, but nonetheless very real. Somehow your psyche just knows this baby is on the way.

The crystal ball.
While these are all very typical signs of labor, every body is different…just like every baby is different. Not a single person follows all the rules of pregnancy and delivery, making it nearly impossible to say when your labor has started or when you might deliver your sweet little one. (I like to tell my patients somebody broke the crystal ball years ago!)
Stay in-tune with your body and keep the lines of communication open with your delivering provider. They will help you decipher when it is finally time to bring that baby bag to the hospital and start your journey to delivery!