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The early signs of labor can be hard for some women to recognize, although this may seem hard to believe. This, in part, can be due to the fact that they vary so greatly from woman to woman, and from pregnancy to pregnancy.

The following factors are commonly cited as potential symptoms of labor:

• Contractions
• Cervix Dilation
• Lightening
• Losing the Mucus Plug
• Bloody Show
• Cervix Effacement
• Fetal Movement

Contractions

Contractions are perhaps the most obvious element associated with labor. However, they may not be a reliable indicator of whether true labor has begun, especially in a first pregnancy. Women commonly experience Braxton-Hicks or false labor contractions in the weeks preceeding labor. As there are subtle differences between the two, it is critical to understand how to recognize a labor contraction from Braxton-Hicks to determine whether labor is immiment.

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Cervix Dilation

Cervix dilatation is the opening of the cervix from 0 to 10cm, the point at which it is fully open in preparation for giving birth. But cervix dilation alone may not be the most reliable indicator of the onset of active labor.

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Lightening

A lesser-known of the symptoms of impending birth, lightening during pregnancy occurs when the baby drops further down into the pelvis in preparation for birth. In first pregnancies, this can occur 2-4 weeks before labor begins. In subsequent births, it may not occur until after labor has officially begun.

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Losing the Mucus Plug

Much misinformation surrounds the loss of mucus plug as an early labor sign. The mucus plug serves an important protective function during pregnancy, acting as a barrier between the cervical opening to prevent infection or transmission of bacteria into the uterus. As losing the mucus plug can occur all at once or over time, it cannot always be used as a reliable sign of labor.

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Bloody Show

The the bloody show, while not often cited, may be the most accurate way to determine whether active labor has begun. Its presence signals that significant cervical changes may have taken place, indicating that labor may well be very close behind it.

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Cervix Effacement

Cervix effacement, while less commonly mentioned in favor of cervix dilation, is actually a much more important factor in a first pregnancy. In first time mothers, the cervix must efface before it can dilate effectively, meaning the degree of cervical effacement seen prior to the onset of labor can be a predictor of a shorter labor as well as one of the more accurate signs of labor.

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Fetal Movement

Feeling the baby move, while often the highlight of pregnancy, can also factor in as one of the early signs of labor. In the final weeks of pregnancy, subtle changes in fetal movement can provide insight into how soon the baby might arrive.

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In summary, a woman can experience all of these signs and, in fact, labor can still be days, or weeks, away. In contrast, a woman may experience no overt labor symptoms and be minutes from delivering that precious baby.  If symptoms of labor are intermittment or contractions fluctuate throughout the day without forming a regular pattern, then prodromal labor could be in full force.

References

Lauzon L, Hodnett E. Antenatal education for self-diagnosis of the onset of active labour at term. Cochrane Database of Systematic Reviews 1998, Issue 4. Art. No.: CD000935. DOI: 10.1002/14651858.CD000935.

Lauzon L, Hodnett E. Labour assessment programs to delay admission to labour wards. Cochrane Database of Systematic Reviews 2001, Issue 3. Art. No.: CD000936. DOI: 10.1002/14651858.CD000936.

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Page Last Modified by Catherine Beier, MS, CBE