Active labor is characterized by the onset of regular, strong uterine contractions that lead to progressive changes in the cervix, specifically effacement (thinning) and dilation (opening). Recognizing the signs of active labor helps individuals understand their body’s progression and know when to seek medical attention.
Understanding Contractions
Distinguishing between true labor contractions and Braxton Hicks, or “practice,” contractions is important. True labor contractions follow a predictable pattern, becoming more regular and increasing in both frequency and duration over time. These contractions also intensify, feeling stronger and often starting in the back before radiating to the front of the abdomen. Unlike Braxton Hicks contractions, true labor contractions do not ease or disappear with changes in activity, position, or hydration.
Braxton Hicks contractions are irregular and unpredictable, varying in strength and rarely increasing in intensity. They are often felt as a general tightening sensation in the front of the abdomen and are usually painless or resemble mild menstrual cramps. These practice contractions may subside with rest, hydration, or by changing positions. Accurately timing contractions involves noting the duration of each contraction from start to end, and the frequency by measuring the time from the beginning of one contraction to the beginning of the next.
A common guideline for active labor is the “5-1-1 rule,” which suggests that contractions are approximately 5 minutes apart, each lasting for 1 minute, and this pattern has been consistent for at least 1 hour. Healthcare providers may offer slightly different instructions. The increasing strength and consistent rhythm of true labor contractions signify the uterus is effectively working to dilate the cervix.
Other Key Physical Signs
Beyond contractions, other physical signs can indicate active labor. One such sign is the “water breaking,” or the rupture of the amniotic sac. This can manifest as either a sudden gush of fluid or a slow, continuous trickle from the vagina. Amniotic fluid is typically clear or pale yellow and generally has no odor, helping to differentiate it from urine. Water breaking does not always occur before active labor is well-established, and labor typically begins within 24 hours after the rupture.
Another indicator is the “bloody show,” the expulsion of the mucus plug, often mixed with a small amount of blood. This discharge typically appears pinkish, brownish, or streaked with blood. The mucus plug is a thick, jelly-like substance that seals the cervix during pregnancy, acting as a protective barrier. Its release signifies that the cervix is beginning to soften, thin, and open. The bloody show is distinct from heavy, bright red bleeding, which warrants immediate medical attention.
Some individuals may also experience other subtle changes as labor approaches, such as a sudden burst of energy, sometimes referred to as the “nesting instinct”. Nausea or diarrhea can also occur as the body prepares for labor. These accompanying signs, alongside the more pronounced changes in contractions and fluid release, contribute to the overall picture of impending labor.
When to Contact Your Provider
Knowing when to contact a healthcare provider or head to the hospital is important. While general guidelines exist, it is always recommended to follow the specific instructions provided by your healthcare team.
For many, the 5-1-1 rule for contractions (5 minutes apart, lasting 1 minute, for at least 1 hour) serves as a signal to call their provider. First-time parents may be advised to call when contractions are more frequent, such as every 3-4 minutes.
Contact your provider if your water breaks, even if contractions haven’t started. Note the fluid’s color and smell, especially if it appears green or brown, as this could indicate meconium and requires immediate assessment. Other situations that warrant an immediate call include heavy vaginal bleeding that is more than typical bloody show, a significant decrease in fetal movement, or experiencing a severe headache, vision changes, or sudden swelling, which could be signs of complications like preeclampsia. A fever is also a reason to call. Having a pre-discussed labor plan with your provider can also help guide decisions during this time.