5 Signs You're Having Labor Contractions

Could it be labor? Know the signs of true labor contractions so you can tell!

Could that weird cramp in your belly be the start of labor—or is it just another bout of indigestion? Maybe it's the real deal, or maybe it's just Braxton Hicks. Can you even have contractions before your water breaks? When you get to those final weeks of pregnancy, inching closer to your calculated due date, every little ache and cramp might make you think labor is finally here.

So, how can you tell if this is real labor, especially if this is your first pregnancy? Experts say it can be tough to tell. "Labor is difficult to describe," says Siobhan Kubesh, CNM, MSN, APRN, a midwife in Austin, Texas. "It's like describing falling in love—until you're there, you don't really understand the feeling."

Most experts suggest erring on the safe side and calling the doctor whenever you feel something new during pregnancy. "We don't expect you to know the difference between false labor and the real McCoy," says Bart Putterman, MD, an OB-GYN in Houston, Texas. "If you aren't sure what's going on, call—even if it means waking someone up."

But if you're nervous about being the pregnant person who cried "Labor!" at every twinge and twang in your abdomen, here are some good guidelines to consider when you're asking, is it labor?

It Feels Like Period Cramps

Early labor pains often feel like you're getting your period. "The real [contractions] feel like menstrual cramps—it's a crampy sensation that gets progressively worse and worse," says Paul du Treil, MD, director of maternal and child health at Touro Infirmary in New Orleans. "It may not be painful, but your whole stomach will tense and feel hard."

If you think you're experiencing labor contractions, watch out for the following signs:

• Dull aches in the lower back and pelvic areas
• Aches that feel like strong menstrual cramps
• The contraction pain comes in regular waves
• Contractions last for 30 to 60 seconds
• Contractions are spaced apart by five to 10 minutes in regular intervals

The Contractions Are Regular

During true labor, there is a rhythm to the contractions—they may be irregular at the onset, but if it's real labor, they'll pick up a definite rhythm relatively quickly. "Pretty soon there's a rhythm where they're coming every four to five minutes," says Kubesh. Most health care pros suggest waiting until they're coming every five minutes for about an hour before you make the call.

Real contractions will also get more intense as time goes on. What started as a slight twinge may soon give you pause whenever it happens. "You may be able to ignore labor for a while, but as it progresses, you can't do anything else but labor," says Kubesh.

Quick Tip

Not sure if your contractions are coming at regular intervals? Time them! Use a clock or stopwatch (most smartphones come with a standard stopwatch feature) to record when a contraction starts and ends.

Your Water Has Broken

While your water breaking is a solid sign that you're in labor, it doesn't always happen the way it does in the movies. In fact, you can be in labor and have contractions without your water breaking. You can also have your water break without experiencing noticeable contractions. Either way, if you believe your water has broken you will need to be evaluated, even if you don't have contractions, says Dr. du Triel.

If your water breaks before week 37, call your doctor immediately. Preterm premature rupture of membranes (PPROM) is a serious and potentially life-threatening emergency. According to the PPROM Foundation, PPROM is responsible for 30% to 40% of all preterm births in the U.S. and affects 150,000 pregnant people every year.

You Notice Bloody Vaginal Discharge

If you've had some unusual vaginal discharge along with contractions, you might be in labor (or at least close to it). "Bloody mucus, or change in discharge associated with contractions, increases the likelihood it is real labor and not a false alarm," Dr. Putterman says.

Some people experience what's known as "bloody show" or vaginal discharge that is tinged with blood as the blood vessels in the cervix break during labor. Along with bloody show, sometime before or during labor, you'll also lose your mucus plug, which is the protective glob of mucus that acts like a cork in the cervix to protect the fetus during pregnancy.

You Feel Pelvic Pressure

If you're feeling pelvic pressure along with contractions, that is a good sign that you're in real labor. Feel something heavy settling into your pelvis? That's your baby lining up for their journey through the birth canal. "If you're feeling pelvic pressure with contractions, you should probably call your doctor," advises Dr. Putterman.

When To Call the Doctor

You can have labor contractions without your water breaking or seeing bloody show, but if your contractions are not growing more intense and coming in regular waves, something else could be happening, such as false labor, Braxton Hicks contractions, or early labor. Any time you feel cramping that's worrisome or you wonder whether you could be in labor, it's always wise to err on the side of caution and call your doctor.