How do you know if you’re having true labor contractions? Your due date is approaching and you’re excited to meet your baby – you’re ready! You may have started experiencing some pre-labor symptoms such as diarrhea, pressure, bloody show, hot flashes, weight loss, moodiness, and Braxton-Hicks contractions. If your Braxton-Hicks contractions are on the stronger side you may convince yourself that you’re actually in early labor only to be disappointed when the contractions dissipate or your midwife tells you it’s not real labor contractions yet. What a bummer!

False labor contractions symptoms can be pretty convincing while true labor contractions signs are sometimes elusive. What are the differences between the two? Here are 4 characteristics of true labor contractions to help you determine when it’s time to call your provider.

1. Back Pain During Contractions
False labor often involves contractions that cause tightening mostly in the front part of the uterus. True labor contractions involve the entire uterus and cause pressure and tightening in the back.

 2. Persistent Contractions
True labor contractions are continuous and do not lighten up with changes in activity; whereas, false labor contractions often subside with rest and hydration.

3. Labor Contractions Increase In Frequency, Duration, & Strength
True labor contractions will follow a pattern and get stronger, longer, and closer together. False labor contractions may occur at more random intervals and vary in strength and duration.

4. Labor Contractions Cause Cervical Change
This is the only definitive sign that labor is real. True labor contractions will cause the cervix to dilate (open) and efface (thin out). False labor leads to no changes in the cervix. Therefore, even if you experience the first three signs described above, you are not in true labor until the cervix has changed.

What to do when you are experiencing true labor contractions

If this is your first pregnancy and you experience the first three signs of labor, wait until your labor contractions are coming at least every 5 minutes apart, lasting at minimum one minute, and the pattern repeats for 1 – 2 hours before you call your provider to check in. If you have delivered a baby before and this is your second or third baby, you should call when labor contractions are about 8 minutes apart. Your provider will let you know when to come in for a cervical check to see if your cervix is dilating or effacing. If it is not quite time to be admitted to your birth site and you live far away or are faced with rush hour traffic, try walking in a nearby park or at a mall to see if your contractions become more frequent and more intense. Follow your provider’s instructions regarding when to call back. If you notice that you’re leaking amniotic fluid, bleeding, or have other concerns call your provider right away no matter what your contraction pattern is like.

To learn more about what to expect for labor and birth, consider taking a childbirth preparation class. You can find one near you at a Baby+Company birth center. You and your partner or support person will practice position changes and learn comfort techniques that will help you manage labor at home until it’s time to come to your birth site. Staying in the familiar surroundings of your home until you are in more active labor will help you remain calm and allow you to more easily cope with your contractions.