Am I in Labor?

Did you know you can experience contractions and not be in labor? Knowing the difference between prelabor and true labor contractions is going to come in handy at some point in pregnancy. Maybe you’re 36 weeks, experiencing some increasingly intense tightening sensations, and it’s a little too early for labor to start. Or maybe you’re 41 weeks and wondering if this is finally it?!?

The word, “contraction”, which is the tightening and relaxing of the muscular uterus, is frequently used to describe the hard work the uterus is doing during labor and birth. I like using this term, because it helped me to think of it as simply a muscle contraction when I was going through the birth process. But not everyone likes to call them this. Some people prefer to call contractions surges or waves instead. You can choose whatever sounds best to you!

Prelabor vs True Labor Contractions

True labor contractions work to thin (efface) and open (dilate) the cervix. I like to think of these contractions as “progressing”. Labor begins when you’re experiencing true labor contractions.

Many pregnant people experience what are commonly called Braxton Hicks contractions throughout the second and third trimester. You will feel a tightening sensation with these prelabor or “practice” contractions, but they aren’t causing any significant change to the cervix.

Trying to tell the difference between prelabor and true labor contractions isn’t always easy. If someone has been experiencing some more noticeable and intense Braxton Hicks, it can be a little fuzzy as they start to transition over to the early, more mild labor contractions. So, I’m going to list the characteristics of “practice” prelabor contractions and “progressing” true labor contractions to help you understand the differences. Even if it’s initially hard to tell whether or not you’re in labor, it will eventually become increasingly clear!

Prelabor contractions:

• They are typically irregular and unpredictable, varying in frequency and duration.
• They are typically mild and not painful, although they can sometimes be uncomfortable.
• While Braxton-Hicks toward the end of pregnancy may feel more intense, in general, than in earlier pregnancy, they won’t have a steady and predictable increase in intensity over time. And they’ll eventually slow down or stop.
• They are usually felt right in the front of your belly or in one particular spot. Sometimes they are felt more on one side of your belly than the other.
• And you can usually get them to slow down or stop with a change in activity or position. If you’ve been active, try resting and relaxing. If you’ve been sitting for awhile, try moving around. A full bladder can bring these on, so try going to the bathroom. Drinking water can also help, because they can be caused by dehydration. 

True labor contractions:

• Labor contractions are usually regular and predictable. So, for example, let’s say contractions last for about 30 seconds, and the time from the start of one contraction to the start of another is about 20 minutes. This pattern should stay consistent, increasing in duration and frequency over time.
• Labor contractions usually feel intense. Birthing people often experience sensations of tightening, cramping, aching, and pressure in the pelvic area.
• They may start out as simply uncomfortable, but the intensity will increase over time, requiring increased focus and attention.
• They are felt all through the abdomen and may extend to the lower back and into the thighs.
• Contractions will not stop or slow down with a change in activity. So if you were sitting for awhile and tried some movement, they will continue. Or if you were active and then tried resting, again, they aren’t going to stop or slow.

❗️Important: When true labor contractions begin earlier than 37 weeks, this is called preterm labor. This will require immediate medical attention. Even if you’re not sure but have concerns, make sure to give your care provider a call right away.

It's not always easy to tell when you're truly in labor. If you think you might be, try doing something else. If you're lying down, go for a walk. If you've been active, sit down and rest. If the contractions aren't going away, you can try timing them.

Timing Contractions

Timing contractions can help you determine whether or not they are following a regular pattern and if they are getting longer and closer together over time. It’s also a tool you can use to help you decide when to it’s time to call your care provider or head to your birthing location, if you’re not birthing at home.

Start timing when it feels like the uterus is beginning to contract. Contractions increase in intensity, peak, then decrease in intensity. The total time the uterus is contracting is the duration of the contraction. There is then a rest period between contractions. Note the time from the BEGINNING of one contraction to the BEGINNING of the next. This is the frequency of the contractions.

This diagram shows a contraction that lasts for one minute, which is the duration. And the time from the start of one contraction to the start of the next is five minutes, which is the frequency. Another way to say this is that the contractions are five minutes apart. So, in this example, this birthing person is experiencing one minute of contraction and four minutes of rest before the pattern beings again.

Your care provider will give you guidance on when to contact them or head to your birthing location. Many will use the 5-1-1 rule for first labors. Different guidance may be given for those who have had a prior vaginal birth. There may also be other factors to consider, like your distance from your birth location. The 5-1-1 rule means your contractions are at least 5 minutes apart (frequency), are lasting for at least 1 minute (duration), and this has been going on for at least 1 hour. 

When timing your contractions, it can be helpful to log them. This makes it easier to determine whether or not they are following a regular and predictable pattern and whether or not they are increasing in frequency and duration. Just write down the time when a contraction starts, as well as when it stops. This is the duration. Once the next contraction starts, you can determine the frequency and write that down.

There are also websites and smart phone apps that make this really simple. Here’s one example:

🔗 Contraction Master

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Understanding the difference between prelabor and true labor contractions can be really helpful for decision-making. 

There are other clues, as well, when it comes to assessing whether or not you’re in labor and how it’s progressing. Check out my blog post below more info:

🧭 Searching for Clues: Five Alternative Methods for Assessing Labor Progress