Expectant parents often wonder if labor has truly begun when contractions start and then fade away. The process of labor involves the uterus contracting to thin and open the cervix, but it does not always follow a linear path. Understanding the different stages and types of uterine contractions can clarify why this intermittent pattern occurs. The body often engages in significant preparation before the sustained effort of birth begins.
Defining the Stages of Labor
The first stage of labor, from the onset of regular contractions to full cervical dilation, is divided into two phases. The initial phase is Latent Labor, characterized by the cervix dilating from zero to approximately six centimeters. Contractions during this early period are often irregular, sometimes feeling like strong menstrual cramps, and can be relatively far apart. This phase is typically the longest and least predictable, sometimes lasting for hours or even days.
Active Labor begins when the cervix reaches about six centimeters of dilation. Contractions become markedly different, growing longer, stronger, and much closer together in a regular pattern. During Active Labor, the cervix dilates at a more rapid rate, typically one to two centimeters per hour. Progression from six to ten centimeters signals the final stretch before the second stage of labor, which is the birth of the baby.
The Phenomenon of Prodromal Labor
The medical term for contractions that start, become somewhat regular, but then stop completely is Prodromal Labor. While often mistakenly labeled “false labor,” these contractions are real uterine activity preparing the body for the main event. Prodromal contractions can be painful and timeable, sometimes occurring as close as five to ten minutes apart and lasting for a minute each. This timing often confuses individuals trying to determine if they should head to a birthing center.
The defining characteristic of Prodromal Labor is its lack of sustained progression toward delivery. These contractions fail to cause significant or continuous changes to the cervix, such as steady dilation and effacement. The pattern may persist for hours, days, or even weeks before resolving or progressing into true Active Labor. This intermittent pattern is thought to help position the baby and ripen the cervix, making eventual Active Labor more efficient.
How to Differentiate True Labor from False Labor
To distinguish between preparatory contractions and those that signal true progression, focus on the qualitative differences. True Labor contractions are characterized by increasing intensity, frequency, and duration over time. They will persist regardless of whether you change your activity or position, such as walking or resting. The sensation often begins in the lower back and radiates toward the front of the abdomen.
In contrast, False Labor, often referred to as Braxton Hicks contractions, is usually inconsistent and does not follow a predictable pattern. These contractions are generally felt in the front of the abdomen and tend to be milder and less painful than true contractions. A key indicator of False Labor is if the contractions dissipate or stop entirely when you walk around, rest, or drink a large glass of water. Prodromal Labor falls between these two, being more painful and regular than Braxton Hicks but still lacking the progressive cervical change of True Labor.
Actionable Advice for Intermittent Contractions
When contractions are irregular and start and stop, the best approach is to conserve energy and manage discomfort at home. Comfort measures can include taking a warm shower or bath, staying well-hydrated, and using light distraction like reading or watching a movie. Resting is beneficial, as Active Labor requires significant energy reserves.
It is important to contact a healthcare provider if the contractions meet a consistent pattern, such as the widely used “5-1-1” rule: contractions coming every five minutes, lasting one minute each, for at least one hour. Some providers recommend the “4-1-1” rule as a slightly more conservative guideline, especially for first-time parents. Additionally, contact your care team immediately if you experience a sudden gush or steady trickle of fluid (suggesting rupture of membranes), bright red vaginal bleeding, or a noticeable decrease in fetal movement.