Labor doesn’t usually begin as dramatically as one might expect. In fact, your body starts preparing for labor up to a month before you give birth. You may be blissfully unaware of this process, or you may begin noticing changes as your due date draws near. Either way, the boundary between your body’s preparation for labor and the actual labor process isn’t always clear.
Here are some signs that you are approaching labor:
Your baby drops. As your baby’s head settles deep into your pelvis, you may feel what’s known as “lightening” a few weeks to a few hours before labor begins. When this happens, you may sense heaviness in your pelvis and notice less pressure just below your ribcage.
Your cervix effaces. In the final weeks of pregnancy, your cervix will become softer and thinner, or “effaced,” in preparation for delivery. Although you won’t feel this process, your health care provider may check for signs of cervical change with vaginal exams. The cervix starts out about 4 centimeters long. When you’re 50 percent effaced, your cervix is half of its original thickness, or 2 centimeters. Your cervix must be 100 percent effaced, or completely thinned out, before a vaginal delivery.
Your cervix dilates. Cervical effacement is usually accompanied by cervical dilation, the process in which your cervix begins to open. Your health care provider will measure dilation in centimeters from zero to 10. Some dilation typically occurs days or even weeks before labor begins. As such, it is more of a sign that you’re getting ready for labor than an indicator of when labor actually will begin. Once you’re in active labor, expect to dilate more quickly.
Bloody show. During pregnancy, a thick mucus plug accumulates at the cervical opening to prevent bacteria from entering the uterus. When your cervix begins to thin and open, this plug falls out. As a result, you may notice a clear, pink, brown or slightly bloody vaginal discharge several days before labor begins or at the onset of labor.
Your water breaks. Sometimes the fluid-filled amniotic sac that cushions your baby in the uterus leaks or breaks before labor begins. If this happens, you might notice a slow trickle of fluid or an obvious gush. If your water breaks at home or if the fluid is green, consult your health care provider; green amniotic fluid may be meconium (fetal stool), which can signify fetal distress. If the amniotic sac is no longer intact, timing becomes important. The longer it takes for labor to start after your water breaks, the greater your risk of developing an infection.
Contractions. During the last few months of pregnancy, you might experience occasional, painful contractions — a sensation that your uterus is tightening and relaxing. These irregular Braxton Hicks contractions are your body’s way of warming up for labor. You might notice them more at the end of the day. The best way to tell the difference is to time the contractions from the start of one contraction to the start of the next for one hour. Here are some differences:
- Braxton Hicks contractions are often irregular and do not get closer together. True labor contractions come at regular internals and progressively get closer together, lasting about 30 to 70 seconds.
- Braxton Hicks contractions may stop when you walk, rest or change positions. True labor contractions continue, despite movement.
- Braxton Hicks contractions are usually weak and do not get much stronger. True labor contractions steadily increase in strength.
- Braxton Hicks contractions are usually felt only in the front. True labor contractions usually start in the back and move to the front.
As true labor contractions begin, the uterus contracts at regular intervals. When it contracts, the abdomen becomes hard. Between contractions, the uterus relaxes and becomes soft. Up to the start of labor and during early labor, the baby will continue to move. Call your doctor when your contractions are five minutes apart, lasting one minute each, for one hour.
Preterm labor. Preterm birth can occur if labor starts before 37 weeks. If you experience any signs of labor before 37 weeks, consult your health care provider right away.