Am I in Labor? Know the Signs

Learn how to recognize the signs of labor, understand the difference between true and false labor, and know when to contact your delivering provider or go to the hospital.

As your due date approaches, you may notice contractions or tightening in your abdomen. But how can you tell whether labor is actually beginning?

True Labor Contractions

• Become more regular, stronger, and closer together over time.
• Usually continue even when you rest, drink water, or change positions.
• May begin in your lower back and move toward the front of your abdomen.
• Cause changes in your cervix, including dilation and effacement.

False Labor (Braxton Hicks Contractions)

• Are often irregular and do not develop a consistent pattern.
• Usually do not become progressively stronger or closer together.
• May decrease or stop when you rest, hydrate, or change positions.
• Do not cause progressive cervical changes.

Helpful Tip: Try timing your contractions from the beginning of one contraction to the beginning of the next. Notice how long each contraction lasts and whether they are becoming stronger and more frequent.

Important: You cannot always determine whether you are in true labor based on contractions alone. If you are unsure, contact your delivering provider or labor and delivery unit for guidance. Do not wait for a regular contraction pattern if you have vaginal bleeding, leaking fluid, decreased fetal movement, or symptoms of labor before 37 weeks.

Every pregnancy is different, and your delivering provider may give you specific instructions about when to come to the hospital.

Regular, Strong Contractions

For many first-time parents, the 5-1-1 guideline can help identify when labor may be progressing:

• Contractions occur approximately 5 minutes apart.
• Each contraction lasts about 1 minute.
• This pattern continues for approximately 1 hour.

This is a general guideline, not a rule. If you have delivered a baby before, live far from the hospital, have a high-risk pregnancy, or have received different instructions, you may need to call or go in sooner.

Call Your Delivering Provider or Labor and Delivery Unit Promptly If:

• You think your water has broken, even if you are not having contractions.
• Your baby is moving less than usual.
• You experience vaginal bleeding beyond light spotting.
• You have contractions or other possible labor symptoms before 37 weeks.
• You are unsure whether you are in labor or need evaluation.

Seek Immediate Medical Attention If:

• You have heavy vaginal bleeding.
• You experience severe, constant abdominal pain.
• You have a seizure, fainting, or difficulty breathing.
• You have a severe headache, vision changes, or other concerning symptoms that could indicate a pregnancy complication.

For a life-threatening emergency, call 911.

Remember: You do not need to wait until contractions follow the 5-1-1 pattern if you have any warning signs. When in doubt, contact your delivering provider or labor and delivery unit.

Your baby is surrounded by amniotic fluid inside the amniotic sac. When the membranes rupture (commonly called your “water breaking”), fluid may come out as a sudden gush or a slow, continuous trickle.

How Can I Tell If My Water Has Broken?

• You may notice a sudden gush of fluid or persistent leaking from your vagina.
• Amniotic fluid is usually clear or pale yellow, although its appearance can vary.
• Unlike urine, leaking amniotic fluid may continue even after you empty your bladder.
• You may not experience contractions immediately.

What Should I Do?

• Contact your delivering provider or labor and delivery unit promptly, even if you are not having contractions.
• Note the time the leaking began and the fluid's color and odor.
• Wear a clean sanitary pad to help observe the fluid.
• Avoid inserting anything into your vagina, including tampons, and avoid sexual intercourse until you have been evaluated.

Important Warning Signs

Tell your labor and delivery team immediately if the fluid is green or brown, has a foul odor, or is accompanied by fever, vaginal bleeding, or decreased fetal movement.

If you think your water has broken before 37 weeks, seek prompt evaluation because this may indicate preterm premature rupture of membranes (PPROM).

Remember: It is not always possible to distinguish amniotic fluid from urine or normal vaginal discharge at home. Your healthcare team can perform an evaluation to determine whether your membranes have ruptured.

Learn More: How to Tell When Labor Begins — ACOG