Am I In Labor? Determining The True Signs
Photo Credit: Erin Heuser Photography
Even as a professional birth doula, I found myself thinking to myself, "Am I in labor?"
Despite helping numerous women through their births, when it came to my own body, I still experienced uncertainty. During my last labor, I needed my own doula to help me figure out what was happening. Determining whether you're in labor can be confusing for anyone—even those of us who do this for a living!
If you're reading this wondering if your body is preparing for birth, you are not alone. Let's explore the signs of true labor, false labor, and how to tell the difference - with insights from my own experience.
When Even the Doula Needs a Doula: My Story
I remember texting my doula during my last pregnancy. I was having regular contractions, but they weren't particularly painful. "I think something might be happening," I wrote, "but I'm not sure if this is it."
As someone who had given birth before and who regularly supports women in labor, I felt somewhat embarrassed by my uncertainty. But my doula reminded me of something important: every pregnancy is different, and our bodies can surprise us. She asked thoughtful questions about the pattern and sensation of my contractions and suggested I try certain movements to see if they intensified or subsided.
With her guidance, I eventually recognized that yes, I was indeed in early labor. Without her support, I might have waited too long to prepare, thinking it was just another round of practice contractions.
Why It's Difficult to Tell If You're in Labor
There's a good reason why "Am I in labor?" is such a common question. Labor rarely follows the dramatic pattern we see in movies, where a woman's water breaks suddenly and contractions immediately become intense. In reality, labor often begins subtly and builds gradually, making it difficult to identify that crucial transition point.
Additionally, your body practices for labor for weeks before the real event. This can include:
Braxton Hicks contractions (practice contractions)
Prodromal labor (sometimes called "false labor")
Early labor signs that start and stop
All of these can mimic true labor in certain ways, creating confusion even for experienced mothers.
Comprehensive Signs of Labor
Labor presents itself through various signs that can be categorized as possible signs, preliminary signs, and positive signs. Let me break these down for you:
Possible Signs of Labor
These are early indicators that labor may be approaching, though they don't necessarily mean labor is imminent:
Backache: A vague, low, and nagging pain that may come and go.
Lower abdominal cramps: Similar to menstrual cramps and may extend to the thighs.
Soft bowel movements: You might experience multiple bowel movements in a short period, sometimes with digestive upset.
Nesting urge: A sudden burst of energy and desire to prepare for your baby's arrival.
Preliminary Signs of Labor
These signs suggest your body is preparing more actively for labor:
Non-progressing contractions: These contractions stay consistent in length, strength, and frequency. They may last for a short time or hours before either stopping or progressing to active labor.
Bloody show: A blood-tinged mucus discharge as your cervix begins to change.
Leaking amniotic fluid: Caused by a small rupture in the membranes, resulting in a slow leak rather than a gush.
Positive Signs of Labor
These are the most reliable indicators that labor is truly underway:
Progressing contractions: These grow longer, stronger, and closer together over time. They're often described as "painful" or "very strong" and can be felt in the abdomen, back, or both.
Gush of amniotic fluid: Caused by a large rupture in the membranes.
Dilation of the cervix: The cervix begins to open in response to contractions.
Understanding False Labor (Prodromal Labor)
Prodromal labor isn't actually "false"—your body is doing real work to prepare for birth. However, it differs from active labor in several important ways:
Contractions may be regular but don't progressively intensify
Pain is often concentrated in the lower abdomen rather than starting in the back
Contractions often stop or slow with rest or position changes
There are no cervical changes or they're minimal
It can start and stop over days or even weeks
During my second pregnancy, I experienced prodromal labor for nearly two weeks before active labor began. The contractions would become regular in the evening, convincing me "this is it," only to disappear by morning. This pattern can be physically exhausting and emotionally draining.
Braxton Hicks vs. Real Contractions
Braxton Hicks contractions are your uterus "practicing" for the big event. They're named after the doctor who first described them and are considered normal throughout pregnancy, especially in the third trimester.
Braxton Hicks characteristics:
Often painless (though can be uncomfortable)
Irregular and don't form a pattern
Typically felt in the front of the abdomen
Usually stop with movement, hydration, or position changes
Don't increase in intensity
Real contractions:
Progressively become more painful
Follow a regular pattern that intensifies
Often start in the back and wrap around
Continue regardless of your activity
Gradually increase in intensity, frequency, and duration
Trusting Your Intuition While Seeking Support
One of the most powerful lessons I've learned both as a doula and as a mother is the importance of balancing intuition with support. God designed your body with the innate wisdom to birth your baby, but He also created us to journey alongside one another.
Scripture reminds us in Ecclesiastes 4:9-10: "Two are better than one, because they have a good return for their labor: If either of them falls down, one can help the other up."
This is why, even as someone knowledgeable about birth, I needed my doula's perspective and support during my own labor. Sometimes we need another person to help us see what's happening in our own bodies.
When to Contact Your Provider
While every pregnancy is different, here are general guidelines for when to reach out to your healthcare provider or head to your birthplace:
Contractions that are regular and painful, coming every 5 minutes (or following your provider's specific guidance)
Your water breaks, even if contractions haven't started
A pretty large amount of bright red bleeding (soaking a pad)
Decreased fetal movement
Any concerning symptoms like severe headache, vision changes, or abdominal pain
Remember that if you're unsure, it's always better to call. Your healthcare team would rather hear from you unnecessarily than miss something important.
A Prayer for the Waiting Mother
If you're in that uncertain space—wondering if labor is beginning, experiencing prodromal labor, or simply awaiting your baby's arrival—I would love to give you this prayer:
Lord, You knit this child together in my womb, and You know the perfect timing for this birth. Give me patience during this waiting period, wisdom to recognize when labor truly begins, and peace that passes understanding. Help me to trust the body You've designed and the birth story You’ve written for my baby. Amen.
Final Thoughts: It's Okay to Be Unsure
The journey to meeting your baby isn't always straightforward, and discerning true labor can be challenging for anyone—even birth professionals like myself! Give yourself grace in this process, and remember that seeking guidance is a sign of strength, not weakness.
Whether this is your first baby or your fifth, each birth journey is unique. Trust your instincts, but don't hesitate to reach out to your support team when you're uncertain.
If you already have a doula, she is your best resource during this time—reach out to her with your questions and concerns. She knows your specific situation and can provide personalized guidance.
If you're one of my clients, you know how to reach me when these questions arise. And if you're reading this and don't have birth support yet, I offer private coaching calls specifically for situations like these, where we can discuss your symptoms and help determine what's happening in your body.
