Signs of Labor - What You Should Know If You're Pregnant


This is a question I get a lot from pregnant moms...How will I know I'm in labor?  That's what this blog is all about, the signs of labor and what you should know if you're pregnant.  

Women who have gone through labor before will always say, "trust me you'll know when you're in labor."  And that's very true.  But if you're a first time mom there's a ton of anxiety surrounding labor.  And a large amount of that anxiety stems from not knowing the actual signs or what to expect during labor.  I don't blame you if "you'll know" isn't a sufficient enough response.  Knowing exactly what to look for can and will help reduce labor related stress. 

So let's dig in.  Labor usually begins between the 37th and 42nd week of pregnancy. 

There is no exact formula to knowing when labor is going to start.  But there are 6 things that need to happen before the baby is born.  These are:  

  1. Cervix softens (ripening)
  2. Cervix thins and shortens (effacement) 
  3. Cervix dilates (0 cm to 10 cm)
  4. Cervix moves from back to front
  5. Baby's rotation, head flexes and molds
  6. The baby descends from - 5 to +5  through the pelvis 

So as you can see labor is a process and a lot of things are happening in order for the baby to be born.  


Getting Ready

It is super important to remember that just because there may be "signs" that labor is approaching doesn't mean that actual labor will happen anytime soon.  I realize that at this point you are way over being pregnant.  You are beyond ready to deliver and meet and hold your little bundle of joy.  But the truth is, you may be in for a long wait.  The baby will come when he or she is ready.  So have patience.  You want to hear something cool?  It's widely believed that the baby and the mother release certain hormones that work dependently on each other to prepare for labor and birth.  For example, "The University of Texus Southwestern researchers found evidence that a substance secreted by the lungs of a developing fetus contains the key signal that initiates labor. The substance, called surfactant, is essential for normal breathing outside the womb."

Keep in mind that some women can show signs and not go into labor for weeks!   Believe me, I've seen it happen many times.  


Possible signs of labor:   

Backache that feels vague, low, nagging, and may cause restlessness. 

  • It feels different, less defined than posture related backache from sitting or standing too long.  The backache may be caused by early contractions.

Menstrual-like cramps. 

  • You may feel them on and off or you may feel them continuously.  These cramps can be  associated with prostaglandin action and early contractions.  Prostigladins helps thin and soften the cervix.  
  • Some women may even experience discomfort in the thighs.

Soft bowel movements.

  •  May be related to increased circulating prostaglandin, which ripens (softens and thins) your cervix.
  • You may also have intestinal cramping or digestive upset.

Nesting urge.  

  • A major urge and burst of energy resulting in great activity and desire to finish all preparations for the baby.
  • Think of this as the body's way of telling you that you'll have the energy, strength and stamina to handle labor.  But try to curb exhausting activities. 

The baby "drops" or whats called "lightening".  

  • This is when the baby gets in a better position for labor.  
  • It happens around 2 - 4 weeks prior to labor for 1st time moms and a few hours before or even during labor for moms who have given birth.  You may feel like you can breathe better and have to urinate more.  You might experience less heartburn.  Some may even  feel like a bowling ball is suddenly between their legs. 

Be patient and go along with your normal activities.  


Preliminary signs: 

Bloody show.  

  • This is the passage of blood tinged mucus from the vagina.  It can be pink or red.
  • Associated with the thinning (effacement) and early opening (dilation) of the cervix.  May occur days before other signs or not until progressing labor contractions have begun.  It will continue to occur throughout labor.  Just be aware that bloody show can also be from sex or a vaginal exam. 

Release of mucus plug.

  •  It's a thick plug of mucus that comes out when the cervix begins to thin (efface) and open (dilate).  
  • It can happen weeks or days before the onset of labor.  You may notice a clear, pink, brown or slightly bloody spotting or a glob of mucus.

Leaking amniotic fluid from the vagina.  

  • Caused by a small release of the membranes (ROM) or what's often called the "leaking of the bag of waters."
  • Sometimes the leak can stop leaking when the membrane (water bag/ amniotic sac) seals.  It can continue to leak on and off for hours or for several days.  It may cause the softening of the cervix to happen more rapidly. 

Non-progressing contractions.  (Braxton-Hicks contractions).

  • These tend to stay about the same length, strength, and frequency.  These pre-labor contractions may last a short time or continue for hours before they go away.   They can stop when you change activity by resting, walking, drinking more water, or taking a warm bath. 
  • Accomplish softening and thinning of the cervix.  Just keep in mind that most of the dilation occurs when you have positive signs of labor.  Think of these like warm up contractions or a mini work out for your uterus so it can be stronger for labor.  You may feel these contractions up high in the front.


Positive signs of labor  (true labor)

Progressing contractions.  

  • Become longer, stronger, and closer together with time.  They eventually tighten the whole uterus.  They can be described as painful or very strong and are felt in the abdomen, back, or both.  Most likely you will start using comfort measure as the contractions begin to get stronger and you can no longer talk through a contraction.  Relaxation is your best friend. 
  • These contractions thin and dilate (open) the cervix.  They will not subside due to change in activity.  In fact, activity will make them stronger.  You may feel the contractions beginning in the back and moving forward.  These contractions are causing your cervix to open (dilate) and thin (efface). 

Gush of Amniotic fluid from vagina.  

  • Caused by a large release of the membranes. (ROM)
  • Usually followed by progressing contractions.   (Pay attention to the color, odor, amount and time because you will be asked these questions by your healthcare provider or someone at the hospital.)


When should you go to the hospital?  

A general rule is 5 -1 -1.  When your contractions are 5 minutes apart, last for 1 minute each (60 seconds),  and have been consistent for 1 hour.   But always follow your health care providers instructions. 


Contact your health care provider or go to the hospital before 5-1-1 if:

  • You vomit with contractions.
  • Feel rectal pressure.
  • Can't walk or talk during contractions (you're probably in active labor). 
  • Think your bag of waters has broken.  (Pay attention to the color, odor, amount and time because you will be asked these questions.)
  • Have vaginal bleeding.
  • Tested positive for Group B Strep and need additional time at the hospital for  administration of antibiotics.
  • Live far from the hospital.
  • Progress quickly (call 911 and get to a side laying position if you're having an extremely fast labor.)

Download this list and put it somewhere so you can refer to it when you think you're in labor. 

Click here for a PDF of the SIGNS OF LABOR.

Trust yourself.  Trust your body.  Trust your baby that he or she will know what to do.  Remember that there will be thousands of moms all over the world going through labor at the same time as you! 

AND if all else fails..."you'll know."  

Make sure to check out my blog for dads... Real Labor Tips for Dads From A Doula - Childbirth Educator.

You may want to consider creating  a postpartum wellness kit for yourself.  Here  is what you'll need. 

If you find this information useful please feel free to share it with your friends and loved ones.   And don't forget to leave a comment down below! 


Adapted from Pregnancy, Childbirth and the Newborn by Penny Simpkin, P.T.: Janet Whaley, R.N., B.S.M.; and Ann Keppler, R.N., M.N.

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Fetal Lungs Provide A Signal Initiating Labor, UT Southwestern Researchers