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    Labor: What to Do When It Begins

    How Do I Know If I Am Really in Labor?

    Pre-labor can only be differentiated from true labor by an internal examination of the cervix. Generally, if you are able to talk through contractions, the contractions are irregular or are affected when activity is changed and do not last more than 45 seconds, then you are probably experiencing false labor.

    True labor contractions become stronger, difficult to talk through, last longer, and are closer together as labor progresses. These contractions will cause the cervix to thin out and open while encouraging the descent of the baby through the pelvis. Here are some ways to help you distinguish between true and false (or "practice" labor), also known as Braxton-Hicks contractions.

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    True Labor


    • May be irregular at first

    • Usually become regular

    • Get longer, stronger, and closer together as time progresses

    • Walking usually makes them stronger

    • Lying down does not make them go away

    • Often begin in your back and move to the front
    • Changes by becoming thinner and starts to open (dilates)

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    False (or "Practice") Labor


    • Usually are irregular and short

    • Do not get longer, stronger, or closer together

    • Can last several minutes in length

    • Walking does not make them stronger, may even cause them to stop

    • Lying down may make them go away

    • May be felt more in the front area and in the groin area
    • Very little change or no change; does not thin or open

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    Onset of Labor

    Several theories exist as to why labor begins:

    • The physical aging of the placenta may cause insufficient nutrients to reach the fetus.

    • The uterus reaches a crucial point of distension, which may cause tension on muscle fibers and stimulate their activity.

    • Nerve impulses from the uterus to the posterior pituitary gland may bring about release of oxytocin (a hormone which causes the uterus to contract).

    • Changes in the level of hormones may render the uterus irritable. (Progesterone drops).

    • Adrenal glands of the fetus, when mature, may release a substance to stimulate labor.

    • The release of prostaglandin from the wall of the uterus may initiate labor.

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