Understanding Labor: Key Signs and Preparing for Your Big Moment

Expecting the arrival of your baby is an exciting milestone, but it can also be filled with questions and uncertainty. One of the most common concerns for expecting parents is knowing when labor actually begins. Recognizing the signs of early labor, understanding what contractions feel like, and knowing when to head to the hospital or birth center can help you feel more prepared for this incredible journey.

How Do I Know If I Am in Labor?

Regardless if it’s your first time or your fifth, many women wonder, "How do I know if I am in labor?" While experiences vary, there are several key early labor signs to watch for:

• Lightening: Your baby drops lower into your pelvis, which may make breathing easier but increase pressure in the pelvic area.

• Increased Pelvic Pressure: Feeling a sensation of heaviness or pressure in your pelvis and rectal area.

• Bloody Show: A small amount of blood-tinged mucus (called the mucus plug) passing from your cervix.

• Nesting Instinct: A burst of energy and a strong urge to prepare your space for the baby's arrival. While some may experience nesting as folding laundry and doing more dishes, others may feel the sudden urge to organize their garage, paint their trim, wash curtains, or scrub grout! 

• Loose stool: Hormonal changes may trigger more frequent or loose BMs in the preparation phase of labor

• Loss of Amniotic Fluid: If your water breaks, you’ll notice a sudden gush or a steady trickle of fluid.

Early-labor Signs

Early labor, also known as prodromal or latent labor, involves various signs that your body is gearing up for the real deal:

• Early Labor Contractions or Braxton Hicks Contractions: These are irregular, often painless contractions that can start weeks before labor. They help prepare your uterus but do not indicate active labor.

• Cramping or Lower Backache: Persistent (or increased) discomfort or dull aches in your lower back or abdomen.

• Cervical Dilation and Effacement: Your healthcare provider may perform check-ups to see how your cervix is opening and thinning.

What Are Contractions?

Contractions are the rhythmic tightening and relaxing of your uterine muscles that help efface and dilate the cervix, leading to childbirth. Many women prefer terms like “waves” or “surges”to describe contractions. This helps with the recognition that contractions come and go, like waves in the ocean. Each wave will crest over the top, go down over the other side and let go into a calm peaceful rest before the next wave begins to build. Consider that more time in labor is spent in the restful floating between contractions than in the actual contractions.

What Do Contractions Feel Like?

Early Labor Contractions

Early labor contractions often feel mild and resemble menstrual cramps. Some women are able to ignore or like to be distracted by other activities with early labor contractions.  They often start as irregular mild contractions, allowing most women to continue their daily activities. These contractions may come and go, serving as a gentle message that your body is preparing for labor. During early labor, effacement or thinning of the cervix is happening. For women having their first baby cervical thinning typically occurs before the cervix begins to dilate or open.

Active Labor Contractions

As labor progresses, your body creates stronger contractions and they occur more consistently. They may be felt as tightening waves across your abdomen or in your lower back, lasting about 60 seconds. During this phase, contractions occur closer together, usually every 3 to 5 minutes, signaling that active labor is underway. Many women find this stage considerably more intense and may need to focus on breathing and relaxation techniques during contractions. Strong, regular uterine contractions begin to open or dilate the cervix during the active phase of labor. Women will often stop “walking” and “talking” during contractions as they focus and breathe through contractions.

Transition Phase

This is often the most intense part of labor, like the steep climb before you reach the summit of a mountain. Contractions come very frequently, every 2-3  minutes, and can last 60-90 seconds. Many women describe this phase as the most challenging. Hormone changes may cause shakiness, nausea, feeling hot or cold and needing to change positions or coping methods more frequently. During this phase the cervix is making a final stretch over the baby's head from 7-10 centimeters in preparation for birth. Many women express self doubt in this phase. Surround yourself with support people who are familiar with birth and can help encourage you as you navigate through this amazing effort.

Contractions vs Braxton Hicks

A common question is how to distinguish between early  labor contractions (Braxton Hicks) and active labor contractions. Understanding the differences is crucial for knowing when to head to your birthing location.

Here is a comparison chart to quickly help you determine what you may be experiencing:

Feature	Active Labor Contractions	Early Labor Contractions
Regularity	Yes, regular, with increasing strength	Irregular, unpredictable
Timing	Closer together, about every 5 minutes or less	Inconsistent, may come and go
Intensity	Stronger and more intense	Gentle tightening or menstrual cramp sensation.
Duration	Last about 60 seconds	Inconsistent timing lasting 30-120 seconds
Response to Movement	Continue or intensify with activity	Tend to go away with movement or hydration
Progression	Become stronger and closer together	Remain consistent or fade
Indication of labor	Yes, signs that active labor is starting	Early labor
What to do?	Call your provider	Rest! Continue daily activities.

What to Do When You Start Feeling Contractions

Once you notice consistent contractions, here are the steps to take:

• Track the frequency and duration of your contractions for 2-3 contractions every hour if you are not able to sleep through them.

• Hydrate and rest if they are mild.

• Change your position or walk around to see if contractions intensify or change.

• If contractions are about 3-5 minutes apart, lasting a minute each, and have been consistent for at least an hour, it’s time to contact your healthcare provider or head to your birth center or hospital.

• A helpful way to tell if you might be in labor is to relax in a warm bath. If your contractions become stronger, closer together, and more consistent while you’re in the water, it’s a good sign that labor may be starting. If they ease up or slow down, it’s likely just Early labor contractions giving you a practice run.

Contraction Myths Debunked

There are many misconceptions about contractions, so let’s clear up some common myths:

Myth: Every contraction means labor is starting.

Fact: Not all contractions indicate labor. Many women experience Early Labor or Braxton Hicks contractions, which are irregular and painless. Active labor contractions are regular, increasingly strong, and closer together, signaling that active labor has begun.

Myth: Contractions should feel like severe pain from the start.

Fact: Contractions usually start as mild cramps or a tightening sensation and gradually become more intense. It’s common for labor to feel manageable, with the strength of contractions increasing as labor progresses.

Myth: Only women in labor experience contractions.

Fact: The uterus contracts, like other muscles in our body, off and on through our lives. For example, orgasm creates contractions of pelvic tissues including the uterus. (Which is, by the way, safe in a normal pregnancy). Notable uterine contractions are often present throughout pregnancy. Early labor contractions can happen weeks before active labor begins. These contractions help prepare your uterus for the process of childbirth and eventually transition to active labor.

Myth: Only women who experience strong pain are in labor.

Fact: The way we experience pain is very individual. You may consider that the way you think about pain can affect the intensity and amount of pain you experience. Not all women feel intense pain during labor. Some may describe sensations like pressure, stretching and strength that comes from within their body. Some women also experience sensations of pleasure during labor and birth. The intensity of contractions varies widely among individuals, and some women, especially those with epidurals or using techniques for natural pain management, may experience little or no pain but are still in active labor.

Myth: Once contractions start, I should expect the baby to arrive soon.

Fact: While contractions indicate that labor has begun, it can still take hours or even days before the baby is born. The duration depends on many factors, including whether this is your first pregnancy and baby’s positioning. It’s important to stay calm, monitor your contractions, and communicate with your healthcare provider.

Myth: You need to labor at home until contractions are very painful.

Fact: Every pregnancy is different. A common recommendation is to stay home until contractions are  3-5 minutes apart, while others may go to the hospital sooner for pain management or other concerns. Having a relaxed environment at home during early labor can help your labor progress and help you conserve energy. Being at home in early labor also decreases the amount of unneeded interventions (epidural, pitocin augmentation, cesarean section) that are more likely to occur if you are admitted in early labor.

When to Head to the Birth Center / Hospital for Labor

Timing is essential. Contact your health care provider and consider heading to your birth center or hospital if you experience:

• Contractions occurring 3-5 minutes apart from the start of one contraction to the start of the next, lasting 60 seconds each, and consistent for at least an hour.

• Leaking fluid, especially if accompanied by strong contractions. 

• Heavy bleeding or other concerning symptoms.

• Persistent lower back pain with contractions.

• Baby moving less than usual

• Any uncertainty about what you’re experiencing—call your healthcare provider to clarify.

When in Doubt, Contact Your Healthcare Provider

If you're unsure about what you're experiencing or whether it's time to head to the hospital or birthing center, don’t hesitate to call your midwife or birthing facility. Sharing detailed information about your symptoms allows them to provide guidance tailored to your situation and help determine if you should come in for a visit. Trust your instincts and communicate openly—your healthcare team is there to support you every step of the way.

Additionally, if you’re interested in a natural birth and looking for personalized, holistic care—or if you’re considering a water birth and want a comfortable, supportive experience—we invite you to explore Haven’s caring team and our birthing services located in Cary, NC. Haven proudly serves families across the Triangle and surrounding areas of North Carolina. Our welcoming birth center is designed to empower you and support your choices every step of the way.

Labor FAQs

How do I know if I am in labor?

Signs include regular contractions, water breaking, or bleeding. The main indicator is that contractions become regular, closer together, and more intense over time, signaling active labor.

Is it true that taking a shower or bath can calm down contractions?

Yes, many women find that taking a warm shower or bath can help you relax. If you are in early labor, this may help reduce the frequency or discomfort of contractions. Hydration and changing positions can also be helpful.

Can you see your belly tighten in a contraction?

Yes, during a contraction, you may notice your belly feeling hard or tight as the uterine muscles contract. This tightening is often visible and can be a helpful way to recognize a contraction.

Can I tell how dilated I am without a healthcare check?

It’s difficult to accurately gauge your dilation without a check-up. While some women may feel changes or pressure, it would be difficult for most women to actually check their own cervix. A healthcare provider can assess how dilated and effaced your cervix is through a physical exam.

How long does it typically take for labor to progress in first-time versus experienced mothers?

For first-time mothers, active labor often lasts between 12 to 24 hours, while women who have given birth before might progress faster, sometimes in as little as a few hours. However, every labor is unique.

Is it normal to feel anxious or unsure about labor?

Yes, it’s very common to feel nervous or uncertain. Preparing ahead by learning about birth, asking questions, and discussing your concerns with your healthcare provider can help ease anxiety and make you feel more confident as you approach labor.