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At times, it can be difficult to distinguish the difference between prelabor and the early signs of "true" labor. While there are many prelabor signs, the only sure signs of actual labor are consistent uterine contractions that become increasingly longer, stronger, and closer together. Certain signs of early labor -- such as vaginal bleeding that is more than spotting -- require quick action.

Are These Signs of Labor or Prelabor Signs?

It is often difficult to tell when true labor begins. However, there are some early signs that signal labor is approaching. These are called prelabor signs. The signs and symptoms of prelabor can precede real labor by a month or more, but sometimes they only show up a few hours before labor begins. Key signs of prelabor include thinning and dilation of the cervix. Yet there are a number of other prelabor signs you might also notice, such as:


(Click Prelabor Signs to learn more detail about each of these signs of prelabor.)


True Labor Signs

It's often impossible to say exactly when "true" labor begins. In some women, the early contractions of true labor may feel like the Braxton Hicks contractions that have been going on for a few weeks. The only sure signs of labor are consistent contractions of the uterus that become increasingly longer, stronger, and closer together. The contractions may be as far apart as every 10 minutes or so in the beginning, but they won't stop or ease up no matter what you do. In time, the contractions become more painful and closer together. In some cases, though, the onset of strong, regular contractions comes with little or no warning -- it's different for every woman and with every pregnancy.
You should call your doctor if you experience any of these true signs of labor:
  • The contractions intensify with activity (rather than easing up) and aren't relieved with a change in position.
  • Pain begins in the lower back and spreads to the lower abdomen or vice versa.
  • Contractions become increasingly more frequent and painful. Sometimes, the contractions also become more regular, but not always.
  • "Show" (cervical mucus) is present and is pinkish or blood-streaked.
  • Membranes rupture (the "water breaks").
Written by/reviewed by:
Last reviewed by: Arthur Schoenstadt, MD
Last updated/reviewed:
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