If you have never given birth before, you may think you will just know when the time comes. In reality, it is not always easy to know when you are going into labor. The steps leading up to labor can drag on for days.

Keep in mind that your due date is just a general idea of when your labor may start. Normal term labor can start any time between 3 weeks before and 2 weeks after this date.

False labor; Braxton Hicks contractions; Prodromal labor; Latent labor; Pregnancy - labor

Most pregnant women feel mild contractions before true labor begins. These are called Braxton Hicks contractions, which:

• May occur at any time after the first trimester of pregnancy
• Are typically short
• Are not painful
• Do not come at regular intervals
• Are not accompanied by bleeding, leaking fluid, or decreased fetal movement
• Do not result in cervical changes that suggest the onset of true labor

This stage is called "prodromal" or "latent" labor.

Lightening. This happens when your baby's head "drops" down into your pelvis.

• Your belly will look lower. It will be easier for you to breathe because the baby is not putting pressure on your lungs.
• You may need to urinate more often because the baby is pressing on your bladder.
• For first-time mothers, lightening often happens a few weeks before birth. For women who have had babies before, it may not happen until labor has begun.

Bloody show. If you have bloody or brownish discharge from your vagina, it may mean your cervix has begun to dilate. The mucous plug that sealed your cervix during your pregnancy may be visible. This is a good sign. But active labor may still be days away.

Your baby moves less. If you feel less movement, contact your health care provider, as sometimes decreased movement can mean that the baby is in trouble.

Your water breaks. When the amniotic sac (bag of fluid around the baby) breaks, you will feel fluid leak from your vagina. It may come out in a trickle or a gush.

• For most women, contractions come within 24 hours after the bag of water breaks.
• Even if contractions do not begin, let your provider know as soon as you think your water has broken.

Diarrhea. Some women have the urge to go to the bathroom often to empty their bowels. If this happens and your stools are looser than normal, you may be going into labor.

Nesting. There is no science behind the theory, but plenty of women feel the sudden urge to "nest" right before labor starts. If you feel the need to vacuum the entire house at 3 a.m., or finish your work in the baby's nursery, you may be getting ready for labor.

In true labor, your contractions will:

• Come regularly and get closer together (about 5 to 10 minutes apart)
• Last from 30 to 70 seconds, and will get longer
• Not stop, no matter what you do
• Radiate (reach) into your lower back and upper belly
• Get stronger or become more intense as time goes on
• Make you unable to talk to other people or laugh at a joke

Contact your provider right away if you have:

• Leaking amniotic fluid
• Decreased fetal movement
• Any vaginal bleeding other than light spotting
• Regular, painful contractions every 5 to 10 minutes for 60 minutes
• Contractions lasting 60 to 90 seconds

Also make contact for any other reason if you are unsure what to do.

Kilatrick S, Garrison E, Fairbrother E. Normal labor and delivery. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 11.

Thorp JM, Grantz KL. Clinical aspects of normal and abnormal labor. In: Lockwood CJ, Copel JA, Dugoff L, et al, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 9th ed. Philadelphia, PA: Elsevier; 2023:chap 40.