What Are the Signs of Labor?

Everyone experiences pregnancy and labor in different ways, and it's difficult to know when labor will begin. However, knowing the signs of labor can alleviate the anxiety surrounding the process and help you prepare when it's time to give birth. Typical signs of labor include contractions, changes in your vaginal discharge, and water breaking. Timing your contractions is the best way to find out if you are in labor. When your contractions are happening every five minutes and are so strong that you can’t walk or talk, it's time to call your healthcare provider.

Stages of Labor

There are three stages of labor. The first stage consists of early and active labor, the second stage is where the baby is delivered, and the third stage is where your body pushes out the placenta. The second stage is commonly the most difficult and painful because this is the phase where the cervix is fully dilated and the person has to push the baby out of the vagina.

No one is really sure what prompts the process of labor, but researchers have proposed many theories. Hormonal shifts and changes in the composition of the uterus are measurable changes that occur as labor begins, but the process is believed to be triggered by the baby itself, who releases signals through DNA changes when it is ready to be born.

Signs of Labor

There are other signs that indicate labor is near or has begun:

• Contractions: You may have contractions that get stronger and more painful instead of weaker. You’ll feel them throughout your whole uterus. Contractions that are regular, happening about every five to 10 minutes, and are getting closer together are a sign that labor has begun.
• Lightening: You may have the sensation that your baby has "dropped," or moved lower in your pelvis. Your baby will change position in the uterus and begin to move down the pelvis, nestling between the pubic bones. This may be a sign of labor, but it can also happen weeks before delivery.
• Loss of the mucous plug: Throughout pregnancy, a mucous plug forms at the opening of the cervix to help seal the uterus. As the cervix dilates, or opens, during labor, you may notice vaginal discharge that ranges from clear to cloudy or even slightly bloody. You may even lose the entire plug all at once. This may be a sign that labor is starting.
• Membrane rupture: Sometimes referred to as water breaking, this rupture of the amniotic sac, a fluid-filled membrane that cushions your baby in the uterus, and a rush of fluid may appear at the beginning of labor. You may feel a gush or trickle of fluid when this happens. You should call your healthcare provider when your water breaks and follow their instructions from there.

False Labor

Contractions are seen as the quintessential sign that labor has begun. In reality, contractions can occur for weeks before pregnancy as the body prepares for labor. Braxton Hicks contractions are "practice" contractions that may be very painful. During these contractions, the cervix softens and the muscles that control the uterus prepare for delivery. These contractions actually begin as early as the first trimester, but most people don't feel them until the end of their pregnancies.

The presence of Braxton Hicks contractions may cause false labor. During false labor, you may feel contractions with increasing frequency even though you aren't ready to give birth. False labor transitions to true labor when:

• Contractions become more regular, occurring at regular intervals.
• Contractions follow a pattern.
• You experience contractions regardless of your movement or position.
• Your contractions gradually increase in intensity.
• Pain starts in the back and moves to the front of your body (pain is usually only felt in the front during false labor).

Complications

Maternal mortality, or death rates, have dropped by 98% in the past century—from 850 deaths per 100,000 people immediately after delivery compared to 14 per 100,000 by 2015.

Unfortunately, maternal mortality rates have been increasing recently in the United States, and they are significantly higher for Blacks and Native Americans or Alaskan natives. Multiple organizations including the government have recognized the problems and taken measures to address it.

Modern medicine has changed the way babies are delivered and made the labor process safer, but there are still some complications that may arise, including:

• Labor that does not progress: Sometimes contractions weaken, the cervix does not dilate enough or fast enough, or the infant's descent in the birth canal does not proceed smoothly. If labor is not progressing, a healthcare provider may give medications to increase contractions and speed up labor, or the person may need a cesarean delivery.
• Perineal tears: The vagina and surrounding tissues often tear during the delivery process. Sometimes these tears heal on their own. If a tear is more serious or the person has had an episiotomy (a surgical cut between the vagina and anus), her provider will help repair the tear using stitches.
• Water breaking early: Labor usually starts on its own within 24 hours of the water breaking. However, the healthcare provider often does not wait that long to offer induction of labor since this can reduce the rates of infection and the likelihood of the baby being admitted to the neonatal intensive care unit. If a pregnant person's water breaks before 34 weeks of pregnancy, they will be monitored in the hospital.
• Excessive bleeding: If delivery results in tears to the uterus, or if the uterus does not contract to deliver the placenta, heavy bleeding can occur.
• Abnormal heart rate of the baby: An abnormal heart rate during labor is not usually a problem. A healthcare provider will likely ask the person to switch positions to help the infant get more blood flow. In some cases, delivery may have to happen right away through an emergency cesarean delivery, or the healthcare provider may need to do an episiotomy to widen the vaginal opening for delivery.
• Perinatal asphyxia: This condition occurs when the fetus does not get enough oxygen in the uterus or the infant does not get enough oxygen during labor, delivery, or just after birth.

Many of these complications can be prevented through adequate prenatal care, education, giving birth in a hospital setting, and medications like antibiotics.

A Word From Verywell

Pregnancy can be an exciting time, but it can also be a scary one. Especially for first-time parents, the unexpected nature of labor and delivery can be a major source of anxiety. When it's time, your body will give you signs that it is time to deliver your baby. Your healthcare provider should create a plan with you so you know when you need to go to the hospital and when it's okay to remain at home. Complications and other risks during pregnancy, labor, and delivery can be prevented, at least in part, with good prenatal care.