Recognizing Labor Contractions: Signs, Patterns, and When to Go

True labor contractions have distinct characteristics:

• Regularity: Predictable intervals (e.g., every 5 min), progressively closer.
• Duration: 30–70 seconds, lengthening over time.
• Intensity: Increasing strength; cannot talk through them.
• Location: Starts in back, radiates to lower abdomen; or whole uterus hardens.
• Persistence: Continue regardless of position change, walking, rest.
• Cervical change: Dilation/effacement on exam.

Associated signs: Bloody show (mucus plug), membrane rupture (gush/trickle), nausea, loose stools, backache, urge to void.

Braxton Hicks (false labor): Irregular, often painless, stop with hydration/position change, no cervical change.

When to Contact Provider / Go to Hospital

• Contractions 5 min apart, lasting 60 sec, for 1 hour (5-1-1 rule).
• Water breaks (note color, odor, time).
• Vaginal bleeding > spotting.
• Decreased fetal movement.
• Severe constant pain (not contracting).