Labor: Real or false?

Definition
Labor is a series of contractions in a pregnant woman's uterus that leads to the birth of a baby. It typically happens between weeks 37 and 42 of the pregnancy. During labor, the cervix -- the tip of the uterus that extends into the vagina -- effaces (thins) and dilates (opens) to allow the baby to move down the birth canal. False labor occurs when the uterus contracts sporadically and there are no changes in the cervix.

Causes/associated factors
During false labor, your body is experiencing Braxton Hicks contractions. These contractions prepare your uterus for real labor. Quite simply, it's your body's way of rehearsing for the real thing. Braxton Hicks contractions may begin as early as the 12th week of pregnancy, but aren't usually strong enough to be noticed until after the 20th week. These contractions last between 30 seconds and two minutes. As you approach your due date, the false labor contractions may be stronger and come more often. It can be difficult to tell Braxton Hicks contractions from real labor.

Signs/symptoms
Signs of false labor include:
contractions that become weaker or may stop when you move around or change position
irregular contractions that keep the same intensity or decrease in strength, usually lasting 20 to 30 seconds
contractions through which you can sleep and talk comfortably
long intervals between contractions
pain mainly in the lower abdomen
Signs of real labor may include:

contractions that sometimes become stronger with activity, usually lasting about one minute
no reprieve from the contractions with a change in position
regular contractions that become stronger
short intervals between contractions (generally every two to eight minutes)
contraction pain that will cause you to stop what you're doing and breathe through the pain
pain that wakes you from sleep
sometimes, pain that begins in the lower back and spreads to the abdomen
possibly, a large bloody, mucus-like discharge
possibly, a gush or trickling of fluid

Diagnosis
You may be able to feel and time your own contractions. Here's how:
Palpating your contractions: Place one hand on each side of your abdomen. With your hands lying flat and your fingers spread apart, feel the contractions with your fingertips. When your uterus is contracting, your abdomen will feel hard or tight. It will soften as the contraction ends.

Timing your contractions: The interval between contractions measures the time from the beginning of one contraction to the beginning of the next one. The duration of the contraction measures the time from when it's first felt until it stops.

It may be difficult to tell false labor contractions from true labor contractions. You may even need a medical exam to be sure. If you think you may be going into labor, call your doctor.

Your doctor may want to evaluate your contractions with an electronic monitoring device and examine your cervix for effacement and dilation. If the diagnosis is uncertain, you'll be carefully observed. The medical staff will closely monitor your vital signs, as well as your baby's.

If you're not in true labor, you'll most likely be able to resume your usual activity.


Complications
It's important to pay attention to the possible symptoms of labor. Assuming your contractions are false labor may delay necessary care in some instances.

Prevention
Learn the signs of real labor and false labor early in your pregnancy. Discuss with your doctor which symptoms you should report. Be sure you know how to reach your doctor during and after office hours. Being prepared will help you make decisions that can ensure a smooth delivery.