False vs True Labor: How to Tell the Difference

Braxton Hicks vs True Labor

One question I get from almost every mom-to-be, whether she’s a first-timer or a mother with several children is, “How do I know if I’m real labor?”

Are My Contractions the Real Thing?

While taking care of thousands of pregnant women I’ve learned that each pregnancy is different and “normal labor” is a relative term. Contractions that are “normal” come down to what’s normal for the individual. Because contractions are unlike anything else, they are difficult to describe to someone who’s never experienced them before. If it’s your first pregnancy know that what’s normal for you as far as contractions can be extremely difficult to determine.

What is Braxton Hicks?

Before experiencing true contractions, many women have what’s known as Braxton Hicks contractions, also referred to as practice contractions or false labor. They are described by the American Congress of Obstetricians and Gynecologists as “irregular and they do not come closer together.” Therefore, the key to recognizing actual labor is understanding the pattern of the contractions.

These false labor contractions can begin in the second or third trimester and have been said to be the uterus practicing or toning up for real labor. They can range from a completely painless tightening to a jolt that can take your breath away. They can sometimes increase in frequency as the big day approaches.

False vs. True Labor

The timing of the contractions is a big component for recognizing the differences between true and false labor. Other differences you might notice include the contractions changing when you change positions, like stopping with movement or rest. The strength of contractions is also different, and the pain is felt in different places.

Here’s how tell the difference:

It’s false labor if…

  • Contractions don’t come regularly and they don’t get closer together
  • They stop with walking or resting or with changes in position
  • They are usually weak and don’t get stronger, or start strong and get weaker
  • Usually the pain is only felt in the front

It’s true labor if…

  • Contractions come and get closer together over time, lasting about 30-70 seconds each
  • They continue regardless of movement or resting
  • They progressively get stronger
  • Usually they start in the back and move to the front

Other ways to recognize labor:

  • The 5-1-1 Rule: The contractions come every 5 minutes, lasting 1 minute each, for at least 1 hour
  • Fluids and other signs:
    • You might notice amniotic fluid from the sac that holds the baby. This doesn’t always mean you’re in labor, but could mean it’s coming
    • A bloody show or a “mucus plug” could mean a cervical change, which means labor is close
    • Nausea and/or vomiting might happen due to the contractions becoming very intense and the change in hormones in the bod
    • Sometimes vaginal tears can indicate the discomfort is more intense and things are progressing
  • One definite sign: The only way to know for sure if you’re in true labor is to be evaluated by a professional, as true labor is when contractions cause cervical change

When to Call Your Provider

  • If you’re leaking fluid or think you might be
  • If you notice decreased fetal movement
  • If you’re bleeding
  • If you have painful contractions of six or more in an hour — before 37 weeks of pregnancy