This is it! The moment you’ve been waiting for. Only…IS this it?

Wait – is that a REAL contraction or a Braxton Hicks?

Is that my water leaking or a little baby-weight incontinence?

Does my lower back hurt because I’m in labor, or is it just because we’ve had a busy week?

There Is No Unified Start to Labor

Labor begins different ways for different women. One thing we can tell you for sure – LABOR DOESN’T START THE WAY THEY SHOW IT IN THE MOVIES.

You know the scenes – – one minute a woman is enjoying a tea with her friend, or walking through the park and then WHAM! She’s struck by a contraction so intense that it rocks her world, causes her to bend over in agony and shout, “I’m going into labor!” In most cases, there is a more gradual progression.

Pregnancy Monthly Guide - What's Happening When Baby Arrives

Image courtesy of Arztsamui at

Typical Signs You Are Going Into Labor

The most typical signs that your body is gearing up for bona-fide labor include things like:

  1. Your water breaking. There’s no mistaking this one. It will feel like you wet your pants in a big way – and can happen anytime of the day or night. While it can still take up to 24-hours or more before your baby is actually born, the rupturing of the amniotic sac usually starts the onset of more intense, and regular contractions. If your water breaks and you haven’t gone into active labor within 24 hours, you should contact your healthcare provider.
  2. Contractions that are more intense. Some women have small “labor” contractions for days or even weeks leading up the day their baby is born. But, these contractions are fairly mellow and don’t progressively intensify, and they don’t come closer together until more active labor is ready to start.
  3. Your water leaks. Sometimes, the water doesn’t break but a small leak occurs instead. Things can feel a little more moist or wet around your panty line – so gradual that you wonder if it’s your imagination. The leaking may get worse, stop again, or your water my break – but contractions will usually increase within the next 24 to 48 hours.
  4. There is bloody show. There is a thing called a “mucous plug” that helps to seal the cervix while you’re pregnant. This can come out in a single lump or – more commonly – it starts coming out in a slightly bloody, mucous string over the course of one to a few days.
  5. Your lower back aches. You may feel a more continuous ache in your lower back, but if it is labor, the back pain will usually come and go the same way contractions do. There is a sort of rhythm to it.
  6. Your contractions intensify. If your contractions stop when you lay down or put your feet up, they’re probably Braxton Hicks – or “practice contractions.” If laying or sitting down doesn’t stop them, or slow them down, you are probably in “Real Labor.” The contractions will progress from, “Hey this isn’t so bad…can you pass me another piece of chicken….” To “Don’t look at me, talk to me, or touch me – I’m having a contraction…” Your contractions will also come more frequently.

Stages of Labor and the 4-1-1 & 5-1-1 Rule

Early Labor. It’s best to experience early labor where you are most comfortable. Here’s the thing: for medical and legal reasons, most hospitals don’t want you to leave once you come in, even if you’re only in early labor. However, labor can last for hours more – and you may be more comfortable at home until you’ve progressed. For this reason (especially first-timers) we highly recommend you accurately time the length of your contractions, as well as how fast together they are coming so you don’t check yourself in to the hospital soon. Nobody wants to be strapped to a monitor and in bed for longer than they have to be, but you also want to be conscientious about the health of yourself and the baby.

During the early stages of labor, we recommend taking a nap if you can to “rest up,” drink plenty of fluids, eat light snacks, take a relaxing bath or shower. You may even want to do a few last chores or take a walk to get things going. For most women, early labor lasts anywhere from six to 12 hours – although it can be much shorter or longer than that.

Active Labor. Once your contractions are coming more regularly, it’s time to track the contractions so you know when it’s time to head out the door. You’ll need a watch with a second hand or a stop watch. OR, in this day and age, use some version of a Contraction Timer app. It’s probably best if your partner, a friend or family member does this for you.

Active labor gets a little more intense…and ends with you giving birth to your beautiful baby. In the beginning, you will probably stop talking and simply breathe or groan a little when a contraction comes but they may still be fairly erratic. Some will be relatively easy while others can really take you by surprise by their intense physical sensations.

Before you know it, your contractions will cause you to go into your own world as you simply “ride the wave.” By this point, you should definitely be timing the contractions paying attention to the 5-1-1 and 4-1-1 rule.

  • 5-1-1: Your contractions come five minutes apart, they last for at least one minute and this continues – without fail – for at least one hour.
  • 4-1-1: Your contractions come four minutes apart, they last for at last one minute, and this continues – without fail – for at least one hour.

At Overlake, we like our patients to give us a call and check in at the 5-1-1 mark and we will either have you come in, or will tell you to wait until the 4-1-1 mark, depending on your birth history and pregnancy. Most first-time mothers labor longer, and labors can get progressively quicker with each pregnancy.

Typically, women spend at least eight hours in active labor and some spend significantly longer or shorter – it’s always a very personal thing.

Your doctor or midwife will prioritize your comfort, health and safety – as well as the baby’s and will try to honor your birth plan to the best of their ability. In most cases, the baby will artfully make its way down the birth canal. With a fair amount of pushing and hard work on your part, your labor will end with a healthy, newborn daughter or son being placed in your arms.