Patient Education

How to Tell When Labor Begins

The few weeks before the birth of your baby are an anxious and impatient time for you and others. Birth oftentimes occurs within two weeks before or after your expected due date. Many women are worried they will not know when labor begins and how to tell if it is real. This page will go over the basics of how to plan for your baby’s birth, how to tell that labor is beginning, and how to tell the difference between false labor and true labor.


It is always important to have a plan of action for your baby’s birth so that labor can go more smoothly. Ask your doctor beforehand important questions such as, when should I call you, how can I reach you after hours and are there any special steps I should follow when I am in labor, etc.

Before it is time to go to the hospital to give birth, there are many things to consider that you may not have time to think about when you are in labor. Make sure you consider these things beforehand:

  • Distance- how far do I live from the hospital?
  • Transportation- who can take me to the hospital, no matter what time?
  • Time of day- will there be traffic on the roads, especially during early and late rush hours?
  • Home arrangements- do I have a babysitter who can take care of my other children?
  • Work arrangements- do I have my workload covered and a way to let my coworkers know that I have had my baby?

Oftentimes, couples find it helpful to rehearse going to the hospital, which can help you get a feel for how long it might take in a real life situation. If it is dangerous or takes too long, you can re-plan your route.


Doctors do not yet know the exact cause of labor, but they do know that hormones are important in the process. The cervix dilates during labor. The uterus begins to contract at regular intervals, causing the abdomen to become hard when contracted, and soft when not. Here are signs that you are approaching labor:

  • A feeling that the baby has dropped lower, otherwise known as “lightening”. This can happen from a few weeks to a few hours before labor begins.
  • An increase in vaginal mucus, which happens when the mucus above the cervix drops down as the cervix dilates.
  • Discharge of watery fluid from vagina in a gush or a trickle, which is the rupture of membranes.
  • A regular pattern of cramps that may feel like a bad backache or menstrual cramps, which are called contractions. These mark the onset of labor.


Sometimes, women may have several periods of irregular contractions of the uterus before true labor begins. These “false” contractions are called Braxton Hicks contractions, and are normal, but can cause pain, especially towards the end of the day. Usually, false labor contractions are less strong and regular than true labor. Sometimes, the only way to tell the difference is to have a doctor examine the vagina.

Oftentimes, timing the contractions is a good way to tell the difference. Note the time between the contractions, keeping a record for an hour. If you think you are in true labor, call your doctor’s office or go to the hospital. Other signs that you should go to the hospital include:

  • Your membranes have broken (your water breaks) but you are not having contractions.
  • You are bleeding other than bloody mucus from the vagina.
  • You have constant severe pain with no relief between contractions.
  • You notice the baby is moving less often.


The beginning of labor marks the beginning of a new, very special time in your life. Although the time surrounding labor can be uncertain and confusing, it is helpful to know the facts about labor and the signs that your baby is about to come.