How do you know you're in labor?

Each labor experience is different in its details, so expect some variance from the "norm" in your own labor.

Typically, labor begins with regular, strong contractions that are about 3 to 5 minutes apart and last about 45 to 60 seconds each. But some labors begin with contractions that are 20 minutes apart and last 30 seconds, and other labors begin with the water breaking.

The following charts describe signs of labor.

Possible signs Significance

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.

Early signs Significance

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.

Positive signs Significance

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.