Labor & Delivery Unit
953-4601/4602/4603

Am I in Labor?

This is one of the trickiest things for first time mothers because you have never experienced it and you have to rely on descriptions by others to figure out what is going on.

Adding to this confusion, your body will often have practice contractions called Braxton Hicks contractions to prepare the uterus for labor.

Pre-term Labor Guidelines

20 to before 37 Weeks

The first concern is pre-term labor because it can occur between 20-36 weeks. Your baby needs to continue to grow inside you for the full term of your pregnancy. Labor earlier than three weeks before your due date can lead to a premature (preemie) baby with many possible health problems since he is not ready to live outside the womb.

The signs of labor include the following. You may not have all the signs.

• Low , dull backache
• 4 or more uterine contractions per hour. Uterine contractions maybe perceived by you as:

Menstrual cramps
Sensation of the “baby rolling up in a ball”
Abdomen tightening like a fist
Abdominal cramping (with or without diarrhea)
Increased uterine activity compared to previous patterns

• Increased pelvic pressure (maybe with thigh cramps)
• Sensation that something feels different such as agitation, flu-like feelings , sensation that the baby has dropped
• Spotting or bleeding or a change in your normal vaginal discharge

If you experience any of the above symptoms you should

• Stop what you are doing and empty your bladder
• Drink 3-4 glasses of water
• Lie down on your left side for one hour and place your hands on your abdomen and feel for tightening and hardening of your uterus
• Count how many contractions you have in an hour
• If you have more than four contractions in an hour call either your clinic or Labor & Delivery Nurse's Station 953-4601/4602 immediately

If you have any of the above signs and the things you do work, tell your health care provider during regular appointments.

If you are experiencing the signs of labor after 36 weeks or the “Things to do” above don't work, you may be in true labor. The chart below shows the difference between true labor and false labor.

True vs. False Labor
True Labor	False Labor
Contractions are usually • regular • get closer together • duration increases over time • become more painful • pain spreads, usually felt in the back and coming around to the front • intensify if you walk & they do not go away	Contractions are usually • irregular • don't get closer • duration stays the same • pain usually does not increase • pain often felt in and stays in the lower abdomen • stop if you walk or stop when you stop walking
Bloody show	No bloody show
Drinking fluids has no affect	Drinking fluids slows down contractions
Water breaking

Timing Contractions

Time for one hour

To determine how far apart the contractions are (frequency), you start the time at the beginning of a contraction and end the time at the beginning of the next contraction. This will be in minutes and measured to the closest minute or half minute.

To determine how long the contraction lasts (duration), you start the time at the beginning of the contraction and end the time at the end of the contraction. This will be in seconds up to about 90 seconds and usually measured in 15 second intervals.

You should discuss with your doctor when to go to the hospital. Generally it will be when your contractions are about 3-5 minutes apart and last for about 60 seconds or more for a first pregnancy. Second and subsequent babies tend to come quicker. Be sure to allow for traffic at the tunnels. The Virginia Department of Transportation provides updated traffic information on AM 610. If you are unsure or have question call Labor & Delivery at 953-4601/4602.