True Labor Signs vs. False Labor Signs

Reviewed by Terri Forehand RN
Pregnancy pain

As you approach the end of your pregnancy, you may be wondering when to watch for signs of labor. You may actually experience these signs at any time towards the end of the third trimester and once your baby has reached 37 weeks, he or she is mature enough to be born.

Common Signs of Impending Labor

You may experience labor symptoms as your body is preparing itself for your baby's arrival. In the last four to six weeks before you give birth, you might notice some changes that may eventually lead to active labor. You should be in tune with these signs early in the third trimester in the event you experience preterm labor, which is when labor starts before a baby is fully developed.

You should also discuss with your OB care provider when they want to be called or what you should do if you think you are having symptoms of labor.

Increased Pelvic Pressure

Many women start to notice an increase in pressure in their lower abdomen and pelvis, similar to menstrual cramps. This may be an achy feeling. You may also discover you are no longer short of breath because your lungs have more room to expand. Called lightening, this simply means the baby has snuggled further down into your pelvic bones. Instead, you will notice more pressure down near your bladder, which means you will feel like you need to urinate more often.

Increased or Decreased Energy Levels

Some women notice a significant change in energy--either decreased or increased. Known as "nesting," you may experience a burst of energy as you prepare to get everything ready for the baby. On the other hand, you may just feel more tired than usual. Take this opportunity to get extra rest by napping.

Vaginal Discharge/Bloody Show

According to eMedicine Health, you may notice an increase in vaginal discharge, which is related to the shifting of hormones that helps prepare your body for labor. Some women notice a light, bloody mucus that usually indicates that the cervix, the lower section of the uterus, is opening and thinning out. Small capillaries burst, which becomes a pink or brownish vaginal discharge. Women may notice this pink or brown discharge at 38 weeks of pregnancy or beyond. The mucous plug, which has sealed the cervix throughout the pregnancy, dislodges. It will look like pink or blood-tinged stringy mucus.

Pink or brownish discharge in the third trimester could also be indicative of cervical irritation due to sexual intercourse, a routine pelvic exam by your doctor, cervical polyps or an infection. Regardless, if you experience brown, pinkish-brown, or pink discharge during pregnancy in the third trimester discharge, it is typically not a cause for alarm, but you should still make sure your doctor is aware of these symptoms. However, if you pass bright red blood or clots, this could be a sign of a serious problem and you should contact your doctor or go to the hospital immediately.

Cervical Changes

Effacement of the cervix is another positive pregnancy labor sign. In the final appointments with your doctor, he or she will conduct manual internal exams and tell you how much the cervix has thinned by percentage, with a goal of 100 percent. Once the cervix is fully effaced, it will begin to dilate, or expand, by centimeters. The magic number is 10 centimeters. Some mothers will hover at 3-4 centimeters for days or weeks, but dilation will rapidly increase as actual labor approaches.

Common Signs of True Labor

Have a plan of action, so that when you begin to experience actual labor, things will go smoothly. Remember, each labor is different. If you are confused or don't understand what is happening, call your OB health care provider and discuss your situation with them.

Contractions

You may experience a feeling of tightness in your abdomen, as well as pain in your lower back or belly and sometimes into your legs. Pre-labor contractions, called Braxton-Hicks contractions, can occur as part of your body's preparation for real labor. These practice contractions will usually go away if you lie down, eat or drink, or move around.

True labor, on the other hand, persists despite changing activities and positions. The contractions feel more intense, regular, and strong as time passes. You should call your OB provider when the contractions become regular and are about four to five minutes apart. Always discuss your labor plan with your doctor.

Discharge

Some women notice an increase in a bloody mucous discharge, which suggests that your cervix is opening. If you are having a lot of bright red bleeding, call your OB provider immediately as this is something about which to be concerned.

Ruptured Membranes

You may notice a leaking or large gush of fluid. This means that your membranes have released and the sac containing the amniotic fluid has burst. To use the more familiar term, your water broke. This sometimes happens when you least expect it; however, only one in ten women experience it. The fluid should be clear, without odor. Sometimes it's easy to confuse the amniotic fluid with urine, but a spot check and sniff will help you tell the difference.

When your membranes have ruptured, your contractions will probably become more intense and closer together. Call your OB provider and let them know you think your membranes have ruptured and that you are in labor.

Bowel Changes

Sometimes women in labor experience diarrhea. This is nature's way of helping to clear out your bowel to make room for your baby to come through the birth canal.

What Is False Labor?

False Labor

According to the American Pregnancy Association, false labor, or warm-up labor, is the experience of recognizable uterine tightening, but with inconsistent timing. This is not active labor, but a pre-labor phenomenon.

  • Labor and false labor can occur at any time of the day or night.
  • Braxton Hicks contractions typically are not too painful.
  • Soaking in a warm bath, listening to peaceful music, using aromatherapy, eating something you like, and trying to get some rest can all help them to calm down. These contractions usually fade when you change positions and activities.
  • Your discomfort might be in the lower abdomen or in your back.
  • If this is really labor, the contractions won't subside but will continue and become more frequent.

If it's relatively close to your due date and you have rapid, regular contractions for an extended period, don't hesitate to go to the hospital. At the very least, you'll discover how long it takes to get there, and receive peace of mind if it's false labor. The hospital staff deals with this all the time, and there's absolutely no harm in looking out for the health and safety of your child and yourself.

What If I Experience Bleeding at 37 Weeks?

There is a significant difference between bleeding and spotting at 37 weeks gestational age.

Bleeding

If you are bleeding and the blood is bright red, heavy or you are passing clots, this is typically cause for concern and you should contact your doctor immediately. This could be due to problems with your placenta that could put you and your baby at risk, such as, placenta previa which is when the placenta attaches and grows low enough in the uterus to partially or completely cover the cervix. Another potential issue could be placenta abruption. This is when the placenta partially or completely separates from the uterine wall due to trauma (car accident or a fall) or a quick decrease in your amniotic fluid which can cause heavy bleeding and pain.

Spotting

If you are having spotting or pink, brown or blood-tinged discharge, this could actually be normal at this stage of pregnancy. The brown, pink or blood-tinged discharge that you have passed or are in the process of passing is most likely your mucus plug which could indicate that labor may be starting soon. It is typically best for your baby to be delivered as close to 40 weeks as possible, however, if you do go into labor at 37 weeks, this is considered full term and your doctor will allow your labor to progress until you deliver your baby.

When Should I Call My OB Provider Right Away?

Call your doctor immediately if you notice any of the following:

  • Bright red bleeding could be a concern with the placenta. It is especially important to call if you experience tightening/contractions or a fever in conjunction with the spotting.
  • If you have a large gush of greenish or bluish fluid, or if you feel something coming from your vagina, this could be a medical emergency where the cord slips down next to the baby.
  • If you are having excessive pain that does not go away, this might suggest something is wrong. Any time you have a concern or something doesn't feel right to you, sort of a mother's sixth sense, follow through on it and have things checked out.
  • If you feel the baby isn't moving or hasn't been moving very much, this is another reason to take action.
  • If you are less than 37 weeks and experiencing any of the pre-term labor signs mentioned above, don't hesitate to call.

If you are on your way to the hospital and faced with a fast birth, the important thing is to keep your baby and yourself safe and warm. Stay calm. Allow the baby to be born peacefully and cover yourself with warm blankets. Keep the cord to the placenta attached and stimulate the baby by rubbing its body to help it breathe. Talk to your baby and reassure it that everything is fine. Once the baby is born, continue to the hospital for medical attention.

Talk to Your Doctor

If you are concerned about recognizing labor, talk with your doctor, midwife, or healthcare provider. Whether you are experiencing brown discharge during last week of pregnancy, increased pelvic pressure, or other labor sigs, he or she can help you understand the changes that your body will go through when your baby is ready to arrive.

True Labor Signs vs. False Labor Signs