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  Using a Doula

False Labor Pains: How To Distinguish From True Labor

Labor is the physiologic process of propelling the fetus out of the uterus and into the world.  Painful and regular uterine contractions have two primary purposes is this process: the first is to dilate the cervix, and the second is to push the fetus through the birth canal.  However, painful contractions alone are not sufficient to make the diagnosis of labor; these contractions must be accompanied by cervical dilation and effacement.  It can therefore be quite difficult for pregnant women to distinguish between contractions that are contributing to actual labor and contractions that are not. 

Contractions that are not contributing to impending labor are called Braxton-Hicks contractions and are generally described as a brief tightening in the lower abdomen or cramping similar to menstrual cramps.  They are often thought to be less painful, less frequent, and of shorter duration than the contractions of true labor; however, as the due date approaches, these contractions do often become more rhythmic, more intense, and more frequent. 

Here are some simple guidelines to help you determine whether or not you’re in labor:

True Labor

False Labor

Contractions come at regular intervals (every 4-6 minutes).

Contractions come at irregular Intervals (ex: 10 min, then 5 min. then 12 min apart with no pattern).

Contractions get progressively closer together.

Contractions do not get progressively closer together.

Contractions get progressively stronger.

Contractions do not get progressively stronger.

Contractions do not slow, stop, or decrease in intensity if you change positions, take a shower, or drink water.

Contractions may slow, stop, or decrease in intensity if you change positions, take a shower, or drink water.

Contractions are typically felt in the lower back as well as the abdominal and uterine areas.

Contractions are typically felt in the lower abdomen only.

Contractions may be accompanied by bloody show, loss of mucous plug, or occasionally rupture of membranes (water breaking).

Bloody show and loss of mucous plug can occur up to 3 days before labor onset, so this could actually occur during false labor.  However, if your water breaks, the baby should be delivered within 24 hours to prevent infection.  Call your doctor regardless of contractions.

If you’re still not sure whether your contractions are those of true labor or simply painful Braxton-Hicks, start timing your contractions.  Write down the time each contraction starts and stops as well as the length of time from the end of one contraction to the beginning of the next (the interval).  It is also a good idea to note the intensity.  If the contractions seem to last for less than 30 seconds and with variable time between them, it is probably false labor. 

If the contractions last for more than 30 seconds and seem to be occurring at regular intervals (especially if that interval is six minutes or less), you could be in true labor.  Try drinking a glass of water, laying down, going for a walk, or taking a shower.  Next, decide whether these actions affected the contractions.  If the intensity or duration of the contractions decreased or the interval between them iincreased, it is probably false labor.  However, if the contractions remained strong, long, and close together, you are probably in true labor!  Call your doctor!

The most accurate way to distinguish false labor from true labor is to determine whether the contractions are causing dilation and effacement of the cervix.  Because most women cannot (and should not) check this themselves, it is very common for women to mistake false labor for true labor.  There is no reason to feel embarrassed or shy about it.  If you’re still not sure, call your doctor!

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