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How Do I Know That I Am In Labor?

The question “How do I know that I am in labor?” can be answered as follows: There are usually two mechanisms that indicate signs of early labor, a bloody show and uterine contractions (labor pains).

1. A bloody show is a passing of the mucous plug from the cervical canal followed by “rupture of the membranes“. When a bloody show occurs, labor often starts within 72 hours. However, sometimes nothing further happens and the woman gets nervous that there is no labor and no leaking amniotic fluid. This is normal.

When the water breaks


When the “water breaks” (the amniotic membrane ruptures), it is time to go to the hospital. The rule of thumb is that the baby has to be delivered within 24 hours to prevent a serious infection in the baby or the mother.

If labor does not start on its own, it may have to be induced by an oxytocin drip, which is a hospital procedure.


All this means is that the cervical canal is getting ready for delivery and this happens often in a multigravida (=women with multiple children). In these women or rarely also in a primigravida (=woman getting her first child) there is a sudden leaking amniotic fluid, which has the smell resembling fresh cut uncooked potatoes. There is litmus indicator paper available that turns a pink color into a blue color when amniotic fluid is present.

This needs to be taken seriously: as a rule of thumb the baby should be delivered within 24 hours from passing this initial amniotic fluid. In most women labor pains are coming spontaneously within a few hours and the baby is born within the next 12 to 14 hours. However, if this does not happen there is the danger of an ascending infection as the protective barrier of the amniotic membrane is missing and vaginal bacteria can multiply inside the amniotic cavity and infect the unborn baby.

2. The other mechanism of getting into labor is to get uterine contractions (labor pains). Initially these contractions of the uterine wall may be perceived as stomach pains or abdominal cramps. But by the fact that they are rhythmical, initially perhaps every 15 to 20 minutes, but then shorter and shorter apart (3 to 7 minutes), the pregnant woman will know that she is in labor.

False labor

Occasionally there is false labor. This is recognized by its lack of result after 1 or 2 hours of false labor pains. Internal examination by the health professional will show that there was no cervix opening and the labor pains stop. If the amniotic membrane is still intact and the fetal heart rate is O.K., the best is to let the woman sleep to allow her to regain strength for the time when the real labor pains will start.



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Last modified: November 12, 2014

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.