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Contractions and signs of labor

Learning the signs of labor before your due date can help you feel ready for your baby’s birth.

Signs of labor include strong and regular contractions, pain in your belly and lower back, a bloody mucus discharge and your water breaking.

If you think you’re in labor, call your health care provider.

Not all contractions mean you're in true labor. Learning the difference between true and false labor can help you know when it’s the real thing.

What is labor?

Labor (also called childbirth) is the process of your baby leaving the uterus (womb). You’re in labor when you have regular contractions that cause your cervix to change. Contractions are when the muscles of your uterus get tight and then relax. Contractions help push your baby out of your uterus. Your cervix is the opening to the uterus that sits at the top of the vagina. When labor starts, your cervix dilates (opens up).

As you get closer to your due date, learning the signs of labor can help you feel ready for labor and birth. If you have any signs of labor, call your health care provider.

What are the signs of labor?

You know you’re in true labor when:

• You have strong and regular contractions. A contraction is when the muscles of your uterus tighten up like a fist and then relax. Contractions help push your baby out. When you’re in true labor, your contractions last about 30 to 70 seconds and come about 5 to 10 minutes apart. They’re so strong that you can’t walk or talk during them. They get stronger and closer together over time.
• You feel pain in your belly and lower back. This pain doesn't go away when you move or change positions.
• You have an increase in vaginal discharge that can be clear, pink or slightly bloody (brownish or reddish). This is called bloody show. It can happen a few days before labor or at the beginning of labor. If you have bright red bleeding or if the bleeding is heavy, tell your provider right away.
• Your water breaks. Your baby has been growing in amniotic fluid (the bag of waters) in your uterus. When the bag of waters breaks, you may feel a big rush of water. Or you may feel just a trickle. 

If you think you’re in labor, call your health care provider, no matter what time of day or night. Your provider can tell you if it’s time to head for the hospital. To see for sure that you’re in labor, your health care provider measures your cervix.

What are signs that you may be close to starting labor?

You may be close to starting labor if:

• Your baby drops or moves lower into your pelvis. This is called lightening. It means that your baby is getting ready to move into position for birth. It can happen a few weeks or even just a few hours before your labor begins.
• You have an increase in vaginal discharge that’s clear, pink or slightly bloody. This is called show or bloody show. It can happen a few days before labor starts or at the beginning of labor.
• At a prenatal checkup, your health care provider tells you that your cervix has begun to efface (thin) and dilate (open). Before labor, your cervix is about 3.5 to 4 centimeters long. When it’s fully dilated (open) for labor, it’s 10 centimeters. Once labor starts, contractions help open your cervix.
• You have the nesting instinct. This is when you want to get things organized in your home to get ready for your baby. You may want to do things like cook meals or get the baby’s clothes and room ready. Doing these things is fine as long as you’re careful not to overdo it. You need your energy for labor and birth.

If you have any of these signs, you may start labor soon. Learn the signs of labor so you know when to call your provider.

What are false labor and Braxton-Hicks contractions?

Not all contractions mean you’re in labor. You may have contractions on and off before true labor starts. These contractions are called false labor or Braxton-Hicks contractions. They soften and thin the cervix to help your body get ready for labor and birth. You may feel them in the weeks right before your due date. Learning the differences between true labor contractions and false labor contractions can help you know when you’re really in labor.

It can be hard to tell the difference between true labor and false labor. When you first feel contractions, time them. Write down how much time it takes from the start of one contraction to the start of the next. Make a note of how strong the contractions feel. Keep a record of your contractions for 1 hour. Walk or move around to see if the contractions stop when you change positions.

What is preterm labor?

Preterm labor is labor that begins too early, before 37 weeks of pregnancy. Premature babies (born before 37 weeks of pregnancy) can have health problems at birth and later in life. If you’re not to 37 weeks of pregnancy and you have signs or symptoms of preterm labor, call your provider. Getting help quickly is the best thing you can do. Learn about risk factors for preterm labor and what you can do to help reduce your risk.

What are stages of labor?

Stages of labor include the whole process of labor, from your first contractions (stage 1) to pushing (stage 2) to delivery of the placenta (stage 3) after your baby is born. Learning about the stages of labor can help you know what to expect during labor and birth.

Last reviewed: December, 2018

Increased tone of the uterus during pregnancy

Nicotine constricts the blood vessels of the expectant mother, as well as the vessels of the placenta and umbilical cord, through which the fetus is nourished. Of course, smoking by itself is unlikely to lead to hypertonicity, but in combination with other factors, it may well

If the work is associated with constant stress, it has harmful effects or it is physically difficult, give it up as soon as possible. If this is not possible, use your rights, which are enshrined in the labor legislation of the Russian Federation

Hypertonicity must be distinguished from Braxton-Hicks contractions: it lasts much longer than these training contractions and usually does not go away on its own (or goes away only after a long time)

what is hypertonicity

, - muscle, and according to the laws of physiology, muscle tissue is reduced under the influence of any factor. Slightly the uterus contracts in women every month during menstruation, much stronger during labor pains. The uterus can also contract during pregnancy, doctors call this condition hypertonicity. What it looks like: suddenly, at some point, a woman feels that her stomach is tense, becomes hard, as if “hardening”. This state lasts for a long time - half an hour, an hour, half a day or even all day. Additionally, discomfort (or pain) in the lower back or sacrum may also appear. It is clear that such tension in the abdomen worries the mother, because since the uterus is contracting, then perhaps there is a threat of termination of pregnancy. But here it all depends on how much and how often the stomach tenses. nine0003

Braxton-Hicks contractions

It turns out that the stomach can tense up not only when there is a threat of miscarriage. Starting from the end of the second trimester, the expectant mother can feel the so-called training contractions (Brexton-Hicks contractions) - the stomach also tenses with them for a while, as if “hardening”, - in general, the sensations are the same as with hypertonicity. But the main difference between such contractions and hypertonicity is that they last for a very short time (a few seconds - a couple of minutes) and pass by themselves, as well as if you change the position of the body or take a shower. Braxton-Hicks contractions occur up to about ten times a day, and by the end of pregnancy they appear even more often. These contractions are completely normal during pregnancy, and they do not indicate any threat of interruption. It’s just that with their help, the uterus, as it were, prepares (trains) for childbirth. nine0003

where does hypertonicity come from

Hypertonicity can appear in any trimester of pregnancy. In the early stages, it occurs more often due to the fact that there is not enough progesterone, a hormone that is needed for the normal course of pregnancy. Another cause of hypertonicity is some changes in the uterine wall, for example, fibroids (a knot of uterine muscle tissue), endometriosis (growth of the uterine mucosa into the thickness of the wall), and inflammatory diseases. In these situations, the wall of the uterus is not able to stretch as it should. At later dates, hypertonicity can develop, on the contrary, with overstretching of the uterus (with polyhydramnios, large fetuses, multiple pregnancies). Very often, hypertonicity is provoked by some kind of physical activity too strong for a woman, for example, if, in a fit of “nesting”, the mother suddenly began to move and rearrange something in the apartment herself, or she simply moved for a very long time without resting. Someone hypertonicity occurs after psychological overstrain. nine0003

how to recognize hypertonicity

Hypertonicity must be distinguished from Braxton-Hicks contractions - as mentioned earlier, it lasts much longer than these training contractions and usually does not go away on its own (or goes away only after some long time). But if the mother cannot understand whether she has hypertension or not, you should consult a doctor. If there is still an increased tone of the uterus, the doctor, simply by placing his hand on his stomach, will feel a seal, tension, up to the feeling of a stone at hand. In addition, you can always do an ultrasound, on which, with hypertonicity, areas of local thickening of the muscular layer of the uterus are visible, and also look at the cervix, by the state of which you can also judge whether there is a threat of abortion or not. nine0003

what to do in case of hypertonicity

If it appears, the first thing you need to do is:

1. Calm down and lie down if possible. Do not panic, extra stress will not bring any benefits, especially since without consulting a doctor it is still not clear whether there is hypertonicity and how pronounced it is. Or maybe it's a false alarm? In addition, you can use relaxation techniques (breathing, auto-training, etc.).

2. Call your doctor. Of course, the doctor will not make a diagnosis in absentia, but since he knows the history of the expectant mother, her real or possible problems, he will be able to give the right direction for further action. nine0003

3. If it is not possible to contact your doctor, you can contact any clinic or antenatal clinic where pregnant women are treated. If medical institutions are already closed (late evening, at night), you can call an ambulance - she will take you to the nearest hospital or maternity hospital (you can also get there by taxi).

4. Hypertonicity is well eliminated by special medicines that relax the uterus (tocolytics), and if the doctor has prescribed them, then you should not be afraid to take them: they help quickly enough and do not harm the child. nine0003

how to prevent hypertonicity

There are simple rules that can prevent hypertonicity or reduce the risk of its occurrence:

1. Quit smoking, watch your weight, do not eat surrogate foods. No matter how trite it may sound, but it is a healthy lifestyle that is the basis of our well-being.

2. Distribute your forces correctly. Laundry, cooking can wait if the expectant mother suddenly feels that she needs a rest. If any activities require physical or psychological stress, cancel them for a while. Do not attend events or places where you may feel uncomfortable, reduce communication with people that are unpleasant for you. nine0003

3. Follow your doctor's recommendations: if he recommends any examination or treatment, do not neglect them.

Listen to your body, follow the doctor's advice, tune in to the positive - this is the key to a successful pregnancy. And then no hypertonicity is terrible for you!

How can you tell real contractions from training contractions?

Shemyakina Natalya Nikolaevna, head of the obstetric department of the Leleka maternity hospital, will help you figure it out .

Training contractions, or as they are also called, fake, or Braxton-Hicks contractions, are irregular contractions that do not have increasing intensity. The uterus may tone up, but normally, it should pass quickly.

For example, the tone appeared once in half an hour and the uterus relaxed rather quickly. Then the tone reappeared only after two hours and again passed. These are training contractions, they do not increase in intensity and do not become more frequent. nine0003

Training bouts are physiologically provided by our body. So the uterus is preparing to do the hard work in the process of childbirth. Normally, training contractions appear in terms of pregnancy close to childbirth - from the 37th week of pregnancy.

The appearance of training contractions in the early stages of pregnancy is not the norm

The uterus can tone up with an active lifestyle, physical activity, with a change in body position, but this tone should quickly pass. Normally, the uterus should not often come into tone. And even more so, contractions, as such, should not be until the 37th week of pregnancy. nine0077 Braxton Hicks contractions in the early stages are a threat of preterm labor. If a woman has contractions periodically during the day: after an hour, after 2, then again after an hour, (even if they are not regular), for periods up to 37 weeks, such a tone should alert the expectant mother.
Because this is not the norm, but the threat of premature birth. This is an occasion to contact a specialist and change your rhythm of life, put on a bandage. The causes of premature birth are most often internal, caused by hormonal disorders and a violation of the physical health of a woman. But significant physical activity and stress can also cause premature birth. nine0003

Labor pains

Unlike training pains, labor pains are regular. The uterus comes to tone first once every 15 minutes, and after a while - once every 7-10 minutes. Contractions gradually become more frequent, longer and stronger. And already occur every 5 minutes, then 3 and finally every 2 minutes.

True labor pains are contractions every 2 minutes, 40 seconds. If within an hour or two the contractions intensify - pains that begin in the lower abdomen or in the lower back and spread to the stomach - most likely, these are real labor pains. nine0003

Training contractions are NOT so much painful as unusual for a woman. When the expectant mother sees how the stomach comes into tone, its shape changes and it becomes dense, like an inflated ball. This might scare you a little. But a woman must understand that in real, labor pains, there must be a clear periodicity, intensification and acceleration over a certain period of time. Real fights never stop, but practice fights do. The uterus then comes to tone, then relaxes. nine0077 Women often confuse contractions with tone, which is caused by other physiological processes in the body. For example, increased intestinal peristalsis, intestinal infections, colic, etc.

What else should alert a woman?! If within an hour or two the uterus periodically becomes toned and mucous, bloody (streaked with blood or brown) discharge appears, then most likely, there are structural changes in the cervix - it opens. Also an important sign to seek help is the discharge of the mucous plug long before childbirth. Her departure in terms of childbirth, a week or two before childbirth is normal. nine0003

Tracking labor pains

There are several methods for determining the types of contractions. A woman can do this herself, writing down the frequency and duration of contractions on paper or tracking them using special programs for a computer and phone. Or you can contact a doctor at antenatal clinic or at the maternity hospital, where a specialist will conduct fetal monitoring (fetal CTG). With the help of 2 sensors, the fetal heartbeat, uterine contractions are monitored and it is determined whether these are training contractions or labor. nine0003

When should I go to the maternity hospital?

If within an hour or two there is an increase and intensification of pain, its intensity increases, the frequency of contractions is clear and regular, you can go to the maternity hospital. A woman may make a mistake, but it’s better to come and make sure for sure whether these are labor or training contractions.

If the amniotic fluid breaks, you can slowly pack up and go to the maternity hospital. Since, normally, after this labor activity should begin.

The main thing is that a woman should not panic.

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