Essential reads & resources

Understand different signs of labor and contraction patterns to help you navigate the end of pregnancy safely and confidently.

You may have heard of “false labor”, but anyone who has had a contraction can tell you it’s a very real feeling! Use this overview of the difference between active labor contractions and the “prodromal labor” contractions that some people experience late in pregnancy.

• ‍Labor safety basics
• What is prodromal labor?
• Things you can try 
• Understanding contraction patterns
  

Labor safety basics

If you are reading this right now because you are looking to learn about what to expect in the coming weeks of you or your loved one’s full-term pregnancy, then congratulations! If you are reading this because you are having contractions right now, then congratulations to you as well - please take a moment before reading on to see if any of these concerning symptoms apply to you - if they do, take a few breaths, tune in to your baby, and contact your prenatal health care provider to assess and provide care for you and your baby.

• I am earlier than 37 weeks in my pregnancy and I am having regular contractions or cramping that is rhythmic and continuous.
• I am having any kind of fresh bleeding or unusual discharge that is discolored or foul-smelling.
• I am earlier than 37 weeks in my pregnancy and I think my waters have broken.
• I have a fever or severe or sudden symptoms that don’t stop, such as sustained pain or vomiting that doesn’t stop.
• I’m experiencing severe dizziness, changes to my vision, a severe headache, or sudden swelling.
• I have any signs of infection, injury, or a sudden or severe change that I feel instinctively might be a problem.
  

What is prodromal labor?

A labor contraction is a muscular mechanism of the uterus that squeezes the organ’s muscle fibers in multiple directions in order to:

• Shorten and soften the cervix, the thick, closed opening of the uterus that connects the womb (uterus) to the birth canal (vagina)
• Gradually open or dilate the cervix to 10cm, or about 4 inches in diameter
• Assist the baby in rotating and descending down and out of the pelvis
  

The American College of Obstetricians and Gynecologists defines labor as uterine contractions that cause these specific cervical changes, and labor is described two phases - the latent (or “early”) phase, beginning with the start of labor contractions, and the active phase, after contractions have dilated the cervix to about 6 centimeters and the rate of dilation typically accelerates. Prodromal labor is a term used in medicine to describe full-term uterine contractions that do not cause an obvious or measurable change in the cervix - you can think of it as a precursor or first sign of the latent, earlier phase of labor.

However, just because contractions are not resulting in a measurable change in the cervix, does not mean that they are not productive or useful! In fact, ACOG doesn't even recommend focusing on the term “prodromal” or “false labor” because it can be confusing to clients experiencing real contractions! These contractions are still a part of the process, and may help position the baby more optimally within the pelvis, strengthen and stretch the muscles and ligaments that will be working hard as labor progresses, and make subtle changes to the cervix that are simply difficult to measure manually.

Unlike Braxton-Hicks contractions, which tend to be mild, infrequent or brief, and felt all over, prodromal labor usually features contractions that are: 

• Strong enough to cause more intense sensation than before 
• Come in a more recognizable pattern of frequency, as close as 5-10 minutes apart; this pattern may become apparent and then fizzle out
• Lasting about a minute each, from when it starts to when it fades
• Felt low in the pelvis, somewhat like strong menstrual cramps
  

Even if contractions aren’t very strong, prodromal labor can be physically and mentally tiring because it may start and stop over a few days or slow down before building momentum into active labor. 

Things you can try

Whether you are experiencing prodromal labor that stops and starts or find that your contractions are gradually building into a more regular early labor pattern, the recommendations for taking care of yourself and your baby are pretty similar. 

Prioritizing rest, nourishment, and relaxing bonding activities are always good ideas for your long-term energy and supporting the hormones of birth, but you can also use some of these activities to informally “test” your labor pattern - if any of these cause your contractions to stop or slow down, you probably have some more time before active labor picks up.

• If it’s nighttime, sleep, if it’s daytime, take a nap! Sufficient sleep is incredibly helpful for the labor process, and if sleeping slows down labor, it’s a good sign that your body needs the rest before active labor will start.
• Feast! Again, nourishing yourself with plenty of nutrients and calories will give you and your baby the stamina and endurance for the journey ahead, and if eating slows down labor, you know you’ve probably got some time for more rest (and another meal!)
• Light movement like a walk around the block or some slow stretching is safe and okay, just don’t wear yourself out with high-intensity exercise. If walking slows things down, that’s okay, and if it picks things up, it may be because the movement aided the progress of your labor.
• Use your labor coping skills! Breathing techniques, guided meditations or relaxation exercises, shifting positions when you aren’t sleeping, and comforting touch or massage from a partner can all help you to move through the sensations and get into the zone to either rest or continue with labor if it picks up.
• Visit an experienced bodywork professional who knows how to support full-term pregnant clients in acupuncture, chiropractic care or massage therapy. Sometimes some tension relief, gentle central nervous system stimulation, or postural adjustment can make all the difference for you and baby’s comfort and process.
• Drink red raspberry leaf tea, an herbal tea safe to use in pregnancy that supports effective contractions by toning the uterus.
• Get support if you need it! Overwhelming feelz? Cry it out with your doula or partner. Talk to a friend or loved one who understands how you navigate new experiences, or vent to your pregnancy support group of you are feeling impatient! 
• Call your provider if your symptoms change or you have a concern: it’s what they are here for and they want to know what’s going on with you so they can help you get the best care as needed. Even if their advice is to simply wait it out, it’s helpful to be on the same page and they may have additional recommendations based on your health history.
• Find your center using whatever mindful practices or stress-management skills work best for you. The emotions and anticipation of labor combined with the unknowns of birth in general can be both exciting and difficult. Honor your feelings, and do what you can to balance your body and nerves - a relaxed physiological state is far more conducive to the process of labor than tension, cortisol and worry.
  

Understanding contraction patterns

Overall, the frequency and duration of contractions in a typical labor will pick up momentum over the course of a labor, but it isn’t helpful to think of it as a linear process because a person’s health history, environment, care and support will all influence the ebb and flow of their energy output and recovery time. While prodromal contractions may be as far as 10 minutes (sometimes more) apart in the beginning, that frequency will move closer to five, then four minutes and even closer. Want to know how to measure contractions? Check out our overview of contraction timing and how to use the 5-1-1 rule for assessing your labor pattern at home here.

It is helpful to think of labor as a relatively gradual process that is supported not just by the moving parts of the laboring person, but also that person’s sense of well-being, safety, support and calm. The neurotransmitters and hormones that influence labor itself are also related to our social experience as human beings, so consider that “vibes” matter just as much and sometimes even more than measurements. Common misunderstandings about labor patterns, such as the idea that every person’s cervix should dilate one centimeter per hour, are based on very old, outdated, poorly done or misconstrued science. There is truly a wide range of variation in what is healthy and normal for different birthing people, which is why personalized care and flexible plannings are so important to both health outcomes and satisfaction.‍

Support from loved ones and your care team can help you to cultivate your sense of safety, empowerment and strength, however your unique labor experience unfolds. Want more ways to boost that support and give yourself more tools for labor and beyond? Check out our resources page, or consider joining your own private Seven Starling group, with expert-facilitated education and pregnant peer connection from conception through your baby’s first year!

Selected Sources

• ‍reVITALize: Obstetrics Data Definitions. ACOG. Accessed April 2021. 
• Ebrahimzadeh, S., Golmakani, N., Kabirian, M. and Shakeri, M.T. (2012), Study of correlation between maternal fatigue and uterine contraction pattern in the active phase of labour. Journal of Clinical Nursing, 21: 1563-1569. https://doi.org/10.1111/j.1365-2702.2012.04084.x‍
• HANTOUSHZADEH, S., ALHUSSEINI, N. and LEBASCHI, A.H. (2007), The effects of acupuncture during labour on nulliparous women: A randomised controlled trial. Australian and New Zealand Journal of Obstetrics and Gynaecology, 47: 26-30. https://doi.org/10.1111/j.1479-828X.2006.00674.x