Preparing for labor: How do you know you're in labor?

Vague, nagging backache causing restlessness and a need to keep changing positions

This is different from backache commonly experienced during pregnancy.

Several soft bowel movements, sometimes accompanied by a flu-like, "sick" feeling

This is probably associated with an increase in prostaglandins, hormone-like substances in the bloodstream that soften and thin the cervix.

Intermittent or continuous cramps, similar to menstrual cramps; discomfort may extend to the thighs

This may be associated with prostaglandin action and early contractions.

Unusual burst of energy resulting in great activity; the "nesting" urge

This ensures that the mother will have strength and energy to handle labor, so don't start painting the dining room or organizing the kitchen cupboards.

Blood-tinged pink or red mucous discharge, called "bloody show," released from the vagina, which will continue to be passed on and off during labor

This is associated with the thinning of the cervix; may occur days before other signs, or may not begin until after contractions have started; may be confused with a normal brownish discharge that sometimes occurs after a pelvic exam.

A trickle (or gush) of fluid from the vagina that can't be controlled like a flow of urine; the amniotic sac is leaking or has ruptured

After your water breaks, labor may still not begin for some time; only 10 to 12 percent of labors begin this way; call your health care provider or the hospital right away.

Continuing, nonprogressing contractions that do not become longer, stronger, and closer together over time

This is productive; it's the softening and thinning of the cervix, which allows the cervix to begin to dilate.

Progressing contractions that become longer, stronger, and closer together over time; felt in the abdomen, back, or both; distraction from these contractions is difficult

This is a sign that your uterus is dilating and thinning your cervix.

Spontaneous breaking of the amniotic sac with a pop or a gush of fluid, followed within hours by progressing contractions

This is often associated with a rapid labor; rupture of membranes usually doesn't happen until late labor; call your health care provider or the hospital right away.