True labor contractions give some signs that labor has started.  We’ll talk how to time early contractions and what to watch for so you know if you’re having real labor contractions (vs Braxton hicks contractions) — AND what to do if you’re sent home from the hospital in early labor.

True labor contractions have some definite signs of labor approaching. Of course, it’s different for everyone, so let’s read on to see what you should watch for.

But first — why listen to me?

First off, hello! I’m Hilary — many people know me as The Pregnancy Nurse 👩‍⚕️. I have been a nurse since 1997 and I have 20 years of OB nursing experience, I am also the curly head behind this website Pulling Curls and The Online Prenatal Class for Couples. 🩺​ I’ve talked to THOUSANDS of patients trying to decide if they were really in labor or just had false alarms. So, I think I’m an expert on this one.

But, of course you’ll want to call your health care provider if you have any questions as to if you’re in labor. This article is purely informational and not meant as medical advice.

What are True Labor Contractions?

TRUE labor contractions from your uterus cause your cervix to open. Contractions prior to that just soften your cervix and prepare it for labor (many call these braxton-hicks contractions) True labor contractions increase in location (more broad across your belly/back), intensity (more painful), and get closer together.

And yes, if you think labor alone is confusing, wait until you pair it with going into the hospital — which is why I always recommend this.

Labor SOUNDS like it will be really obvious.  However, a lot of you might wonder as you feel aches and pains if “that” is “it”. Towards the end of your pregnancy you will have many contractions and they will likely not be in a regular pattern for a bit.

I’ve said it before and I’ll say it again — TV and movies have NOT done us any favors in our impression of how labor starts and progresses.  Much like everything else, labor in real life is a lot different than how it is on TV.

But, these are some pretty good points for the majority of people.  Want to know more about labor — don’t miss my page – Am I in Labor Quiz.

True Labor Contractions:

** These are not hard and fast rules, pay attention to your body, your doctor and your gut.  As always, never take the advice of something you read or hear, over the advice of your doctor. **

True labor contractions are only great when you’re after 36-37 weeks (almost at the end of your third trimester.  Prior to that, early labor contractions can be problematic (you want to go the full forty) and you will want to call your doctor (even if it’s not office hours). Be sure to ask your health care provider what you should do when you feel contractions!

The Difference Between True and False Labor

	TRUE Labor	FALSE Labor
Contractions	About 2-5 minutes apart and getting closer together in regular intervals	Only occasional, don’t get closer together.
Pain	Gets more intense as time goes on, often severe pain.	Does not get more intense, may taper off.
Location	Extends from back to front	May be felt in just one spot, in back or front.
Other Symptoms	May have some GI involvement.	Usually just feel some pains, nothing else

I actually have a whole podcast on knowing if you’re going into labor

As you can tell — deciding if you’re actually in labor can be more problematic than it sounds at first mention. This is really why you need a trusted friend who can tell you what to expect and plan for as you get closer to do your due date.

Then, what is false labor?

False labor is often known as Braxton hicks contractions, or “practice contractions” — but they essentially contractions that are not opening your cervix and pushing baby into the birth canal. They can still hurt, but for some reason they aren’t strong enough to push baby into the birth canal (could be baby’s position or the readiness of the cervix).

Understanding how labor happens is something I go into in my how to go into labor guide (it’s also included in the bump to bassinet bundle).

Because they’re so similar you can often switch into “true labor” and not really realize it until you’re firmly into active labor and contractions become very frequent and painful.

Early Labor Contractions

Contractions will start out pretty randomly — but with TRUE labor, you’ll want to see them slowly form into some sort of a pattern.

With your first baby, we’d like to see the contractions every 2-3 minutes, on subsequent babies you’d probably want to head to the hospital when they’re about every 5 minutes (only because labor progresses quicker). I once had a patient come in because she’d had two contractions.  I was like, “every two minutes?” She said, “not — just two — but they’re really hard!”

Spoiler alert: She wasn’t in labor.

Pro Tip: Early contractions can SOFTEN your cervix, and make you lose your mucus plug.

Often this early phase of labor is called the latent phase of labor.

You might find this post on the stages of labor on my sister site helpful.

Related Post: Is a headache a sign of labor at 38 weeks?

What does a contraction feel like?

Most women say they feel like menstrual cramps in their lower abdomen. I have a whole post on what a contraction feels like. The pain is felt when the uterus contracts.

True Contraction Timing

Do they have to last exactly a minute — no — but most PRODUCTIVE real contractions last about a minute – meaning 45 to 90 seconds.  Short ones usually aren’t going anywhere big (Chapter three in my prenatal class gives all the info on how to exactly count contractions).

And like I said above, you want them every 2-5 minutes (depending on what # baby it is — you’ll want to ask your doctor about the specifics he/she recommends). That means they’re REGULAR (irregular contractions will be 3 minutes apart, then 8 minutes, then 5 — it won’t follow a pattern).

Wanting to time them, but not wanting to use your phone (I never did) something like this will work.

Pro tip:  You’ll want to make SURE that baby is still moving, even if you’re contracting — check out my post on kick counts for more info on that!

How will I know when I’m having true contractions?

True labor radiates.  It will usually involve your entire torso.  Like someone has wrapped a scarf of pain around your midsection.  Usually starting in the back and radiating towards the front (or it can go the opposite).  If it’s JUST in the back or on a certain area of your belly, it may well not be quite the real deal.

Of course, I discussed a lot of this on my Signs of Labor post — it won’t be JUST contractions.  There are lots of labor symptoms. Usually, there’s some other physical changes going on also, like diarrhea, some bloody show (normally a small amount of dark brown blood), changes in vaginal discharge, loss of your mucus plug, extreme fatigue possibly even leaking amniotic fluid — so, click over there to learn more about the different signs of labor.

True contractions don’t usually come alone — they come with other symptoms. If you want to know JUST about the signs of labor — check out my mini class: Labor Made Easy

If you ARE having True Contractions, be sure to pack your hospital bag.

The big question in most people’s minds is

How do you know they are true labor contractions?

The answer is cervical change.  And usually about a centimeter/hour.   Cervical changes means that you’re heading into (or are in) active labor. It’s the real thing.

If you were to come to the hospital and be only 1-3 cm we’d probably have you walk for an hour and then re-check you.  If you haven’t moved a centimeter, it likely means you’re not in true labor and your time would be better spent at home (learn more about vaginal exams in labor). The contractions you’re feeling could be “practice contractions” that will head into labor, or possibly stop.

Now, many women feel dejected after that.

Why being sent home from the hospital isn’t a bad thing

Let me be the FIRST to tell you that this isn’t a bad thing:

1. You’ve made sure baby is safe and sound inside (babies sometimes move less as you go into labor, so that can be disconcerting).
2. You might have NO idea what a contraction is and isn’t and when you’re on the monitor it can help show you that.
3. You know you’re safe to labor at home for a bit.
4. By pushing things, and being stuck in the hospital longer, you are increasing your chance of a c-section (be sure to check out my post on natural labor that gives tips and tricks for that!)

Just because it was a “false alarm” doesn’t mean it wasn’t alarming to you — and that’s why the hospital is there, to help educate you and make sure everyone is safe.

Enjoy some natural labor at home! And I do go into what to do when you’re in early labor (to keep things going) in my guide on how to go into labor.

I have to say that deciding if you’re in true labor can be harder than you imagine. I mean, sometimes you can’t even tell if your water broke or you peed.

What to do before you’re in real labor?

So, please don’t feel bad if we send you home from Labor and Delivery.  Here are a few things to do at home to wait for real labor to get to your uterus (and sometimes that takes a while).

1. Take a shower.  Let that water run on your back and it will really help it feel better.  Some nurses recommend a bath — but a) You don’t want the water too hot in a bath, you’ll cook your baby.  b) It’s tough to get in and out of the bath 9 months pregnant (depending on your type of tub) — so I always recommend a shower — but a bath can be nice too!
2. Get some housework done.  Do it now, honestly.  Distract yourself and be productive.  Win-win.
3. MOVE — making the choice to change position every 30 minutes or so can really help baby find their way out!
4. Use a warm pack where it hurts and try to get some rest.  Use a microwaveable heating pad just warmed up (not hot) for your back or hips to help you try to relax.
5. Eat.  I wouldn’t gorge myself on the giant burrito from your local Mexican restaurant, but I’d eat something.  Something you love.  Once you get to the hospital, often, your doctor won’t let you eat.
6. Sit on your yoga ball — this is my personal favorite (pick a larger one — like this).  I think that rotating your hips on a yoga ball can really help that baby descend.  Kind of like drilling it down to find the right position.
7. Move around.  Take a walk, dance, whatever speaks to you.  But moving around will help distract you as well as finding new positions for that baby to drop into the ol’ pelvis.
8. TV, Movies, Facebook, apps.  Seriously, laze around.  Binge watch.  Tell your family I told you to. 🙂

Of course, things besides labor can be a reason to head into the hospital — and I go through all of that in my free beginning prenatal class:

FAQ’s about Labor Contractions

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Anyway, as I’ve said before — false labor pains often progress into true labor.  And the BEST thing you can do is stay REALLY well hydrated and wait for the labor fairy to call you number.  🙂

It really seems like you want more information about pregnancy & labor which is awesome (and SO NORMAL). I really do recommend taking this class. It’s guaranteed to get you feeling more prepared. And, if you don’t believe me — read the reviews!

BUT, if you’re not quite ready for that class, check out my free beginning class:

This post was originally written in 2016, but has been updated.