How to know when you're in labor

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It may seem like a silly question, but many pregnant women, especially first-timers, have a hard time telling the difference between false labor and the real thing. Obstetrician Dr. Keith Eddleman explains how to know whether it's time to head for the hospital or not.

How to know when you're in labor

When you move into the final month of your pregnancy be sure you know when labor is really starting and when it is a false alarm. Here are a few tips to help you distinguish between the two.

Contractions

  • When you are in labor you will start to have contractions that get progressively closer together.
  • These contractions last about 30-45 seconds apiece and become increasingly stronger the further along they get.
  • Once you have progressively stronger contractions getting closer and closer together it is time to call your doctor.
Other signs of labor
  • Other indicators include the discharge of a little bit of blood mixed with mucus that comes from the cervix—called a ‘bloody show.’
  • Or, the mucus plug (which covers the cervix) itself might come out.
  • Some women also feel increased pressure in their lower pelvis, which means the baby’s head is descending down into the pelvis.
Dilation
  • Once you get into your 36th week your doctor will start doing internal exams of the cervix, which will let you know if your cervix is beginning to dilate.
  • As your contractions start to become more regular the cervix will begin to dilate more rapidly.
Other reasons to call your doctor
  • When you reach the final week or so of your pregnancy there are three major things that you should look out for that would require an immediate trip to the hospital.
  1. Excessive bleeding: if there is an abnormal amount of bleeding go to the hospital.
  2. If you don’t feel the baby moving you should go to the hospital.
  3. If you have pain that persists between contractions you should go to the hospital.
Induction and epidurals
  • Induced labor is not a harder labor than regular labor. The medicines administered are designed to kick-start and manage labor, which can then follow its normal, natural progression.
  • There are only a few instances where a doctor would not recommend an epidural. For example, if you have a coagulation disorder or a severely low platelet count.
Transcript LISA:  I’m Lisa Birnbach for howdini.com Any woman whose been pregnant will tell you that those nine months of pregnancy, actually ten months can really start to drag in the final days. But suddenly the excitement begins and you’re going into labor. Or are you? How do you know when labor is really starting, and its not a false alarm? We’re here with Dr Keith Eddleman, Director of Obstetrics for Mount Sinai hospital in New York. Where I had at least three kids that I can remember and author of two books about pregnancy including Pregnancy for Dummies. Dr. Eddleman thanks for being here.

KEITH:  Thanks for having me.

LISA:  How do you know when you’re in labor? I’m sorry to ask but some people may not know.

KEITH:  That’s an extremely common question, especially for first time moms. One of the things is you start to have contractions, and they get closer and closer together. They last about thirty to forty seconds a piece, and they become increasingly stronger the further along they get. And sometimes its not easy to tell in the very beginning, but if you have progressively stronger contractions, getting closer and closer together, then its time to call your doctor.

LISA:  Now there are other indicators that you’re going into labor that might perceive of follow contractions, right?

KEITH:  Yeah, there are a couple of hints; the thing is they don’t tell you when you’re going to go into labor. It tells you things might be gearing up-

LISA:  Right.

KEITH:  Things like the bloody show, a little bit of blood mixed with mucus that comes from the cervix. Also a lot of women have an increase in the amount of mucus coming out of the cervix, its sometimes called a mucus clog. And some women feel a sudden increase in the pressure in their lower pelvis which means the baby’s head is descending down the pelvis. Those are three signs that are sort of warning signs if you will.

LISA:  If you’re being seen by a doctor regularly, none of this would be a mystery.

KEITH:  Well in your last few prenatal visits starting at about thirty-six weeks, your doctor is going to start doing internal exams to check the cervix every week. And you’ll get an idea based on those exams whether or not your cervix is starting to dilate. Cause a lot of women it slowly dilates a little bit toward the last few weeks of pregnancy. Then when you start to have regular contractions, that dilation increases more rapidly.

LISA:  When should a pregnant woman in her last days of pregnancy go to the hospital? If she’s not, if she doesn’t feel the baby kicking for example, is that a tell tale sign to hurry up?

KEITH:  Absolutely, there are really three major things. One is if you have bleeding, bleeding is more then what we call the bloody show, which is usually very minimal like a period. If you have heavy bleeding go to the hospital immediately. If you don’t feel the baby moving, then you should go to the hospital immediately. Or if you feel like the baby wasn’t moving like it was, I haven’t felt the baby move as much today, and then go. The third is if you are having contractions, usually the pain goes away between the contractions. If it doesn’t, if you are having pain between the contractions, you should go to the hospital.

LISA:  How do feel about induction?

KEITH:  It’s a common fallacy that induced labor is a harder labor then regular labor or actual labor. That’s not true at all. The only thing we do with the medications that we use to induce labor is to induce a normal labor pattern. The strength of the contractions are the same, the frequency is the same. Its using a synthetic form of the hormone that we, that you make.

LISA:  Right.

KEITH:  To just achieve the same thing.

LISA:  Pertossin.

KEITH:  Exactly.

LISA:  And it would grow the way a natural process would grow?

KEITH:  Absolutely, you start with mild contractions, they are spaced apart, you make them more frequently, you make them more strong, and-

LISA:  You scream at your husband.

KEITH:  Exactly.

LISA:  It’s just like anything else.

KEITH:  And you get your epidural and it’s just like a normal labor.

LISA:  Okay, lets talk about epidurals. I love an epidural; in fact I had one thins morning before I get here. Now why would a doctor advise against an epidural?

KEITH:  There are only a few situations for that, that would be advised against. In other words if the woman had a coagulation disorder, or a severely low platelet count, then there is a risk of putting the epidural in. But those are the only times that I would recommend not having an epidural. The overwhelming majority of the time women can have them, and we encourage them. I agree with you, I think that pain during pregnancy is not a necessary thing. It should be a happy process.

LISA:  Right. Right, exactly. Well thank you so much Dr. Eddleman we’ll see you again soon.

KEITH:  Okay, thank you.

LISA:  For howdini.com I’m Lisa Birnbach.
meet theexpert
  • Dr. Keith Eddleman

    Dr. Keith Eddleman Director of Obstetrics, Mount Sinai Hospital, New York Dr. Keith Eddleman is Director of Obstetrics at Mt. Sinai Hospital in New York City. He practices Clinical Genetics, Maternal & Fetal Medicine, and Obstetrics and Gynecology. Dr. Eddleman is the author of two books on pregnancy. more about this expert »

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