False Labor or the Real Deal? How to Know if You Are in Labor

As their due dates approach, many expectant moms are fooled by “false labor.” They can get contractions that seem like the real thing—occurring closer together and appearing to grow more intense or painful. But, if the contractions do not cause dilation of the cervix, then they are false.

So, how can you tell if you are in false labor or real labor? Here are some questions to ask yourself—along with cues to help you decide:

Tips for Recognizing False Labor

While contractions typically signal the start of real labor, they could be practice contractions—also called Braxton Hicks. These contractions hardly ever get too strong, nor do they come at regular intervals. They usually go away on their own—and can be triggered by dehydration or even hunger.

Quick checklist for false labor:

  • Are your contractions coming at irregular intervals?

  • Are they remaining irregular?

  • Do your contractions get shorter and become less painful over time?

  • Do they get weaker when you start walking, and

  • Do the contractions get shorter even if they continue for a while?

What kind of contractions are you having?

If you’re having true contractions, then your labor would not slow up or become less painful before delivering the baby. True labor can be described as a tight band of pressure that may begin in your lower back and spread across the front of your pregnancy bump. Contractions may start out feeling like cramps and then become regular as labor progresses.

Quick checklist for true labor:

  • Are your contractions intense and regular—about 10 minutes apart (or about six contractions per hour?

  • Do the contractions feel stronger over time and last longer?

  • As labor progresses, are your contractions coming closer together—at eight, five, and three minutes apart?

  • Are you having extreme, continual pain in your lower back or abdomen?

  • Do you feel mounting pressure in your vagina or pelvic area?

  • Are you experiencing symptoms like diarrhea or nausea?

Does your lower back hurt more?

If you notice very sharp pains in your back—it may be a symptom of “back labor,” which occurs in over 30 percent of pregnant women. (Keep in mind that many women experience back pain in the latter part of the pregnancy.)

The more forceful pain could occur near the end of the pregnancy. This happens when the infant’s head hits against the mother’s spine as the baby travels down the birth canal. Should your back pain become too intense, it could indicate the start of labor.

False or true? It depends…

Sometimes there is a grey area where it may be difficult to determine whether you are in labor or not. This is the case if you notice a mucus discharge.

During your pregnancy, the cervix is protected with a mucus plug. This plug is your body's natural way of preventing infection in the developing fetus. When you get closer to delivery, the cervix starts to dilate—releasing this mucus plug. The plug then may become tinted with blood when vessels near the dilating cervix begin to tear. This could mean that delivery is imminent. Or, it could be days or weeks away, so you'll need a consult with your doctor to determine if baby is on the way.

Steps to Take at Home

If it’s close to your due date, you can try waiting out the contractions at home to see how they develop—unless your ob-gyn, midwife or doula has given you other instructions.

If you’re not sure whether you’re experiencing false or true labor, here are some things you can do:

See if the contractions change (stop or persist) with movement – try walking or changing your position. If they stop, then they’re false.

Determine how strong they are. If the contractions are weak, then they usually are false.

Figure out where you feel pain. False contractions are typically in the front of the baby bump or in your pelvis.

Rest if you’re dizzy or nauseous. Try to relax, eat crackers and/or drink water—it’s important to stay hydrated, get enough rest, and maintain good nutrition.

When to Call Your Care Provider

If you have a high-risk pregnancy or can’t determine the signs of true or false labor, don’t take chances. If you think you could be in true labor (especially if it’s before 37 weeks and you’re in preterm labor), then call your ob-gyn immediately. Here are some more tips on when to make the call:

  • You have any of the symptoms in the “quick checklist for true labor.”

  • Labor pains are strong, regular, close together and last approximately 30 to 70 seconds.

  • Your water breaks. (This means the amniotic sac ruptures. This only happens in a small fraction of cases before the start of labor. For most women, the water doesn’t break until their labor is well established.)

  • You notice a “bloody show” discharge (mucus plug or runny, blood-tinged discharge)

  • If lower back pain becomes especially severe, it could mean that you’re getting close to giving birth!

Once you’ve made the call, what can you expect? Your care provider can offer support and advice—she or he can assess any symptoms or changes you report, and help you decide if you need to be examined or go to the birthing center or hospital. Remember to be prepared to describe your symptoms, the duration and strength of your contractions, and how far apart they are.

Once labor has begun, find out how soon you should go to the delivery center. Every pregnancy is unique, so be sure to talk with your care provider ahead of time so you have a plan. When you call your care provider on the day your true labor has begun, you'll know what to look for and

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