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False labor vs real labor? This is how you can tell the difference!

birth contractions false labor prelabor true labor

As your due date draws nearer, it can be quite tricky to determine whether you're really experiencing the start of labor or just going through the warm-up phase. So in this post I will address the question that crosses probably your mind too: how will you be able to tell when you are truly in labor and what are the sings of pre-labor contractions, and what is also sometimes called as false-labor!

Prelabor is the term for the early, irregular contractions, and this is sometimes also called false labor. I personally do not like this second expression, as there is nothing false about this, there is nothing false with those contractions. There is nothing wrong in what your body is doing! Your body actually just doing what it has to do: it is preparing, warming up for the real job, for the birth of your baby! And those very early contractions, before the onset of labor, play a crucial role in the birth process, as they prepare the cervix for the dilation when the right time comes, allowing your uterus to release your little bundle of joy.

When you are approaching your due date, during the checkup with your care provider, the focus is mostly on the opening of the cervix. "Is it already open? How many centimeters have you dilated?" or "How many fingers wide is the dilation?" However, there are many other important changes that occur in your body before the opening of the cervix… and those changes are all really essential for bringing your baby into the world and that is where prelabor plays a very important role too! So let us now see a bit the cervix before we dive into the differences between pre-labor and true labor!

When your body is not preparing for labor, either because you are not pregnant or because labor is still far away, the cervix is a few centimeters long, cone-shaped muscular structure that is a continuation of the uterus. Its hard, almost as hard as a bone (as your forehead for example) and normally points towards your backside. But as you prepare for labor, the cervix needs to turn towards your front to be aligned with the birth canal. So the cervix needs to change its position and it also need to get softer before dilation begins..

During this process from something as hard as your forehad, the cervix first becomes like your nose, and eventually as soft as your lips! But achieving this forward movement and softening takes time – and per-labor contractions! But not only do these changes happen to the cervix, but its shape also undergoes a complete transformation! The 2-3 cm high cone gradually flattens to become paper-thin and, at the end of this process it retracts and basically disappears into the uterus!! It's an amazing transformation that occurs within just a few days - or sometimes just within a few hours!

Regarding pre-labor contractions, the key point to note is that they generally do not cause the cervix to open yet, so they do not dilate the cervix, but rather facilitate those cervical changes which we have just mentionned. So they are softening the cervix, moving it forward and effacing it…And what sets them apart from "real" labor contractions, which are already dilating the cervix? So how can you know if you are in the pre-labor stage or already really in labor? The big difference between the two is that pre labor contractions do not progress over time! They may come irregularly, sometimes five minutes in between, sometimes two, sometimes ten...Or even if they are regular, their rhythm, their intensity, and their duration do not really evolves for hours (or even for days). But please do not worry at all if you do not have at all pre-labor and if you do not experiance this foreplay stage but your body starts immediately with real labor contractions. That is also perfectly normal!

So let’s now see the real labor contractions. When we talk about true labor, about contractions which are already opening the cervix, then contractions do progress and they do evolve! They become more frequent, they become longer, and they become stronger over time! If at least two out of these three conditions are true, then you are definitely in real labor, and your cervix is very likely already dilating! In most cases all these three conditions apply (so contractions are becoming closer together, longer and stronger), but again, if already for example just their frequnecy and strength increases but their length remains the same, that is already a definite sing of labor! The same applies if contractions are still not getting closer, but you feel them becoming stronger and longer - that is also a clear indication of labor.

It is also quite common for those irregular or non-progressive early contractions to eventually transition into true labor after a while, but sometimes this pre-labor stage last a day or even days! On the flip side, it is also entirely normal for these pre-labor contractions to stop after a while and then resume the following day or even a couple of days later. So this period can be so diverse and can last for quite a long time, it can be nerve-wracking for both you and your partner! That is why it is essential to prepare for this and to face it calmly. And the best strategy I suggest is to ignore these irregular contractions, try not to focus on them, try not to time them…but just go with the flow and try to continue your normal activity according to the time of the day as much as you can! Important remark: if you have had a membrane sweeping, you may expect also a quite long prelabor phase before the onset of regular contractions.

One vital point is that after 37 weeks, if you do not have any issues, any pregnancy related risks, you don't need to worry, you do not need to rush to the hospital or call your provider because of these prelabor contractions! Not even if you notice a few drops of bleeding, some pinkish discharge, or mucus. These are entirely normal signs of prelabor, because as your cervix changes, tiny blood vessels may burst in your cervix and that is why the mucus may become streaked with fresh blood. So this is also a very definite sing that the big moment, the onset of labor is now really getting closer!

But the pre-labor period can be nerve-wracking and and can test your patience if it is long! Try to accept this phenomenon calmly and patiently, trust your body that your body knows what it's doing and what its task is. So think on the pre-labor period as an important preparation for your body, for the birth of your little baby!

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