True Labor Signs vs. False Labor Signs

Updated September 29, 2022
Pregnant woman feeling pain while sitting in living room

Once you have 2-4 weeks left of pregnancy, you become highly sensitive to every muscle twinge and gas bubble. Your heart leaps and your pulse races. Is this it?Differentiating between true and false labor becomes a challenge at this stage. Braxton Hicks contractions, or 'practice contractions,' can offer a confusing glimpse of hope to the parents-to-be, and then diffuse into nothing.

You'll see a wide range of products, including various teas and spices, that claim to help get that baby moving. But studies are distinctly non-committal on their actual effect. Every parent wants to know when they can start getting excited about impending birth, so let's take a look at some early labor signs.

Common Signs of Impending Labor

You may experience labor symptoms as your body prepares 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 people start to notice an increase in pressure or an achy feeling in their lower abdomen and pelvis, similar to menstrual cramps. 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. Is that even possible? (Sorry, it is.)

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. If labor is truly on its way, you'll be thankful you did.

Pregnant Woman Sleeping In Bed With Pillows

Vaginal Discharge/Bloody Show

You may notice an increase in vaginal discharge, which is related to the shifting of hormones that help 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 mucus 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. Your baby can scootch out of there when your cervix gets 10 centimeters, and not before. 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 read all about Braxton-Hicks contractions, which are irregular in length, come and go, and are easily calmed. True labor, on the other hand, persists despite changing activities and positions. The contractions feel more intense, regular, and strong as time passes.

Young Pregnant Woman Having Contractions

Choose an app that can help you track your contractions. At the very least it can give you information and ease some anxiety. 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.

Vaginal Discharge and Bowel Changes

You may notice an increase in bloody mucus discharge, which suggests that your cervix is opening. This can look identical to discharge associated with pre-labor so you cannot know that you are in labor from this symptom alone. If you are having a lot of bright red bleeding, call your OB provider immediately.

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.

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.

True labor vs false labor infographic

What Is 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.

  • Braxton Hicks contractions typically are not too painful.
  • In true labor, the contractions won't subside but will continue and become more frequent.
  • Labor and false labor can occur at any time of the day or night.
  • 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 your back.

Braxton-Hicks Contractions

Pre-labor contractions, called Braxton-Hicks contractions, can occur as part of your body's preparation for real labor. You may experience a feeling of tightness in your abdomen, as well as pain in your lower back or belly and sometimes in your legs. These practice contractions will usually go away if you change positions, eat, drink or empty your bladder. If you've been resting, get up and walk. If you've been nesting, sit down and rest with a glass of water or a cup of tea. You should notice the contractions easing.

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.

Bleeding After 36 Weeks

What is the difference between bleeding and spotting at 37 weeks gestational age?

Spotting

If you see spotting or pink, brown or blood-tinged discharge, this could be normal at this stage of pregnancy. The discharge that you pass 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.

Bleeding

If you are passing bright red blood 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.

Placenta previa occurs 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.

When To Call Your OB

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

Woman sitting on sofa having online video chat with obstetrician doctor
  • A large gush of greenish or bluish fluid.
  • Baby isn't moving or hasn't been moving very much.
  • Bright red bleeding.
  • Excessive pain that does not go away, this might suggest something is wrong.
  • Tightening/contractions or fever in conjunction with bleeding.
  • True labor signs when you are less than 37 weeks.
  • You feel something coming from your vagina. This could be the umbilical cord coming out around the baby, which is a medical emergency.

Any time you have a concern or something doesn't feel right to you, follow through on it and have things checked out.

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

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True Labor Signs vs. False Labor Signs