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1) Your contractions are not coming at regular intervals, or are not consistent in their intensity or length. If one contraction has you doubled over in pain, but the next one is more of a mild twinge, and then the next one is really long but somewhere in between the first two on the pain scale, it’s probably not active labor.
2) You don’t notice any progression in the timing or pain of your contractions. My doctor told me flat-out that he wouldn’t consider sending me to the hospital unless I was having contractions at three minutes apart for at least an hour. (Your doctor might have a different standard — be sure to ASK if you don’t know.) So even though my contractions started at five minutes apart, I waited. And waited. And they remained steady at five minutes apart, and they were not getting more painful or intense as the hours went by. In “real” labor, contractions get steadily closer together and more painful as your cervix dilates. Holding-pattern contractions generally mean there’s nothing going on with your cervix, so just stay home and ride it out.
3) Your contractions stop and start, or change depending on what you’re doing. The first rule of Braxton-Hicks contractions is to LIE DOWN, PUT YOUR FEET UP, DRINK WATER. This usually causes things to settle down. I continued to contract while lying down for awhile, but eventually I did get a brief 20-minute reprieve. They started up again and were more painful once I started walking around, which also told me that, no matter how nice it would be to have a baby already, it wasn’t gonna happen that night.
4) You haven’t passed the mucus plug or noticed any bloody show. At some point — usually right before labor begins or at the onset of actual active labor — you’ll notice a fairly substantial amount of pink or blood-tinged mucus come out your vagina, often times after using the bathroom. It’s…uh…hard to miss. I lost most of the mucus plug about 24 hours before going into labor last time, and then continued to lose more and more of it once labor really got going. (This is what gets called bloody show, which is just…exactly what it sounds like, and one of the many reasons you may notice that us mom types tend to lose most of our sense of shame after giving birth. I mean, once you’ve left a trail of THAT across a clean hospital floor in front of your husband and family members and God and everybody else, it’s hard to imagine caring about a silly thing like DIGNITY anymore.)
5) Your water hasn’t broken. This one is probably the least useful, however, because contrary to what the movies show, only about 10% of women actually experience the dramatic gush of fluid before labor begins. Usually you’ll know you’re in labor by the time it happens, or your practitioner will break your water for you with a big crochet-hook-like thing. So…this one is more of an indication that you ARE in real, active labor. (Although…GAH. I have also spent a lot of time Googling “how can i tell if my water has broken or if this is just more assorted pregnancy fluids of mystery?”) (Surprise! Just more assorted pregnancy fluids of mystery.)