The Most Common Signs Of Labor

Labor rarely follows a perfect script. Some signs show up slowly and others appear all at once. You might also wonder if what you’re feeling is the real thing or a false start — and that’s completely normal. Franciscan Health OBGYNs across Indiana and Illinois understand these concerns and support families through each step.

At the start of pregnancy, prenatal appointments can help you feel supported, informed and reassured as your body begins to change.

“It’s often not clear to a patient if she is in labor based on symptoms alone. Contractions are quite common in the third trimester, and they can be quite painful and regular even when the patient is not in labor,” said Reece Clark, MD, an OBGYN at Franciscan Health Family Birth Center Mooresville.

Dr. Clark shares tips for women to better know how to evaluate their labor symptoms and determine when to call their doctor and present to care.

Key Takeaways: Labor Signs

• Labor often starts with back pressure, pelvic pressure or cramps. Your water breaking, regular contractions and bloody are other key labor signs.
• Contractions grow stronger and closer together once labor becomes active.
• The 5-1-1 rule is a helpful way to gauge active labor: contractions every 5 minutes, lasting 1 minute, for at least 1 hour. (Always confirm with your OBGYN.)
• Franciscan Health supports labor and delivery care across Indiana and Illinois.

How Do I Know I Am In Labor?

Labor is defined as regular contractions with cervical change. In addition to contractions, some patients who are in labor may experience water breaking (rupture of membranes) and/or vaginal bleeding.

Sustained painful contractions 5 minutes or less apart, leakage or a gush of fluid, and any amount of vaginal bleeding are all reasons to call your doctor (or midwife) or present to care, where labor can be diagnosed definitively. 

A contraction often feels like a wave that builds and peaks. Early contractions often feel mild or similar to menstrual cramps. They start far apart and eventually move closer together. This might feel like you have a tightening that stops you mid-sentence, or a deep pulling sensation low in your belly. Some women describe the early phase as “period cramps with purpose.”

“True labor is a positive feedback loop,” said Dr. Clark. “Contractions should only increase in frequency and intensity in true labor. If contractions diminish or come and go, usually the patient is not in labor.”  

Other signs of labor include: 

• A sudden burst of energy or a sense that something shifts
• Dull back pressure that does not go away
• Loose stools
• Pelvic pressure that feels low and steady

If something feels different or you’re not sure, a quick call to your OBGYN team can give you answers. And if you want more guidance on what to expect throughout childbirth, explore our pregnancy and delivery services at Franciscan Health.

What Happens Right Before Labor Starts?

Your body often sends early signals hours or days before labor begins. These changes help your cervix soften and prepare for birth.

Common early signs of labor include:

• Lightening: This is when your baby settles deeper into your pelvis. You may feel more space in your chest and notice easier breaths, but you may also feel new pressure low in your belly or pelvis. Some people describe it as the baby “dropping.”
• Bloody show :A small amount of blood or mucus passes as the cervix opens
• Back pressure: The American College of Obstetricians and Gynecologists (ACOG) said that back pressure often appears as the body prepares for labor and may show up before contractions form a steady pattern.

You may also notice mood shifts, trouble sleeping or a sense that your body feels “different.” These changes don’t confirm labor, but they often happen close to the start.

How Do Braxton Hicks Contractions Differ From Real Labor?

Braxton Hicks contractions are common in late pregnancy and often feel like a tight squeeze across your belly. They usually fade once you rest, drink water or change position.

Real contractions follow a clear pattern and grow stronger over time.

A quick guide:

“Braxton-Hicks contractions can be uncomfortable or even truly painful, but they do not change the cervix,” said Dr Clark. “Given time, Braxton-Hicks contractions will eventually diminish and usually disappear completely. However, there are instances when it is almost if not completely impossible to tell whether or not a patient is laboring just based on her symptoms.”

If you’re unsure which type you’re feeling, call your OBGYN. You never need to guess alone.

When Should I Go To The Hospital?

ACOG explains that if you think you are in labor, or are not sure, it’s important to call your OBGYN office. You should head to the hospital if contractions follow a steady pattern or your water breaks.

The 5-1-1 rule can help you decide. Head to the hospital if your contractions:

• Come every 5 minutes
• Last 1 minute each
• Continue for 1 hour

Still, every labor is different, so call your OBGYN for personalized guidance. Go to the hospital if you have any of these labor warning signs:

• Your water has broken and contractions have not started
• You are bleeding heavily from the vagina
• You have constant, severe pain with no relief between contractions
• You notice your baby is moving less often

“Never wait if something feels wrong,” Dr. Clark said. “I always want you to reach out. A quick call can protect both mom and baby.”

What If My Water Breaks First?

A patient’s water can break at any time. Sometimes it happens shortly before the onset of labor, sometimes it happens after the onset of labor, and sometimes it happens without the onset of labor for quite a long time. If fluid leaks or gushes, note the color and smell. If you think your water may have broken, an immediate evaluation is required, and you should call your doctor and come to the hospital. 

Does Labor Always Follow A Predictable Timeline?

No. The first stage of labor can last hours, especially for first-time moms. Early labor often starts mildly and builds gradually before shifting into active labor. Active labor often includes stronger contractions and shorter breaks.

You may notice that early labor feels slow and steady, almost like your body is “warming up.” As labor becomes active, the sensations grow more intense, focused and rhythmic — a clear shift that tells you things are changing.

“Labor can present in many different ways,” said Dr. Clark. “Fortunately, the patient does not have to diagnose her own labor. The key is to contact your doctor and/or go to the hospital whenever you have any of the concerning symptoms we have discussed. That’s why your care team is ready 24/7!”

Support From Your Partner Or Birth Support Person During Labor

Your partner or support person plays a key role in helping you feel calm and confident during labor. Encourage them to:

• Time contractions for you when they become distracting
• Help you breathe through intense moments
• Offer water, snacks or a warm compress
• Stay calm and reassuring — your emotions often mirror theirs

Along with your partner or support person, you may wish to obtain the services of a doula to help you through the labor and delivery process. The support of doulas during the labor process has been shown to be very helpful to patients, even to the extent of reducing the rate of C-section. If you do elect to work with a doula, please take great care to ensure that your doula is supportive of evidence-based healthcare.

How Franciscan Health Supports You

Franciscan Health offers coordinated labor and delivery care across Indiana and Illinois. Our OBGYNs, midwives and nurses guide each family with compassion and skill.

Our teams provide:

• Education and preparation
• Fetal monitoring
• Pain control options
• Personalized labor support
• Respect for birth plans and preferences

If you have questions about labor signs or want help preparing for birth, Franciscan Health OBGYNs are here to guide you. Our mission centers on safe, loving and extraordinary care for every family.