How to Know the Difference Between True and False Labor
The last few weeks of pregnancy can feel like a waiting game. Your body is getting ready for birth, and it may start sending signals that can be hard to read. Are these the real thing? Or is it a false alarm?
The good news is that most pregnant people experience what is called "false labor" before real labor begins. It is completely normal. Here is what to look for.
When does labor usually start?
The average pregnancy is 40 weeks long. Most people give birth somewhere between 38 and 41 weeks. There is no way to know exactly when labor will start, but your body will give you clues.
Signs that labor may be getting close
In the days or weeks before labor begins, you may notice some of these changes. Not everyone experiences all of them, and that is okay.
Lightening
This is the feeling that your baby has dropped lower into your pelvis. Because the baby is no longer pressing on your diaphragm, you may feel like you can breathe more easily, like you feel "lighter." Lightening can happen anywhere from a few weeks to just a few hours before labor begins.
Loss of the mucus plug
A thick mucus plug forms at the cervix during pregnancy to help protect your baby. As your cervix begins to open in the days before labor (or at the very start of labor), this plug is pushed out. You may notice an increase in discharge that is clear, pink, or slightly bloody. Some people expel the entire plug at once. This is normal and a sign that your body is getting ready.
Water breaking
When the amniotic sac breaks, you may feel fluid trickling or gushing from your vagina. This is called "rupture of membranes" or your water breaking. Call your NHC provider right away if your water breaks and follow their instructions, even if you are not having contractions yet.
Contractions
As your uterus contracts, you may feel pain in your back or pelvis that can feel similar to menstrual cramps. True labor contractions follow a regular pattern and get closer together and stronger over time.
You might or might not notice some of these changes before labor begins. Every pregnancy is different. Trust your instincts and call your care team if you are unsure.
Related: Understanding OB Care
What are Braxton Hicks contractions?
Braxton Hicks contractions are sometimes called "false labor" or "practice contractions." They can start weeks before real labor begins, and they can feel surprisingly strong. You may notice them more at the end of the day.
The key difference between Braxton Hicks and real labor contractions is their pattern. Braxton Hicks contractions do not follow a regular pattern, do not get closer together over time, and often stop when you rest, change positions, or drink water.
True labor vs. false labor
True labor
- Contractions come at regular intervals and have a pattern
- They get closer together over time
- Each contraction lasts about 60 to 90 seconds
- They continue even when you rest or move around
- They steadily get stronger
False labor (Braxton Hicks)
- Contractions do not have a regular pattern
- They do not get closer together
- They may stop when you walk, rest, or change position
- They are weak and do not get much stronger
- They may start strong and then weaken
A helpful trick: time your contractions and drink a glass of water. If they disappear with rest and hydration, they are likely Braxton Hicks. If they keep coming (and keep getting stronger and closer together), it may be the real thing. When in doubt, always call your provider.
Related: Exercise During Pregnancy
When to call your provider or go to the hospital
Not sure if what you are feeling is real labor? Call your provider if you think you might be in labor or if you are not sure. It is always okay to call.
Go to the hospital right away if you have any of these signs:
- Your water has broken and you are not having contractions
- You are bleeding heavily from the vagina
- You have constant, severe pain with no relief between contractions
- You notice your baby is moving less often than usual
When in doubt, go in. It is always better to be checked and sent home than to wait too long. Your care team would rather hear from you.
Remember, sometimes the only way to truly tell the difference between true and false labor is a vaginal exam to check whether your cervix is changing. Your provider can do this and let you know where things stand.
Have questions about labor signs or what to expect as your due date gets closer? Talk to your NHC care team. We are here for you every step of the way. Call us at (503) 941-3033 or find your clinic.
The information in this article is for educational purposes only and is not a substitute for medical advice, diagnosis, or treatment. Please talk with your care team about questions or concerns related to your health.
Anna Mikulic, Family Physician
This blog was reviewed by Anna Mikulic, MD, a Family Physician at NHC’s Tanasbourne Medical Clinic. Dr. Mikulic earned her Doctor of Medicine from Oregon Health & Science University in Portland and completed her residency at OHSU Cascades East Family Medicine. Before joining NHC, she served two years in the Peace Corps teaching health in local primary and secondary schools. At NHC, she provides care for patients of all ages and backgrounds, including chronic and acute disease management, health maintenance, postpartum care, and newborn care.