It can be hard to distinguish between prodromal labor and real labor contractions—here are some tips for coping with prodromal labor and knowing when it's time to head to the hospital.

By Chaunie Brusie

You're a first-time expectant mom and you're settling into bed after a long, exhausting day of well, being pregnant, when suddenly, you feel it: that tightening in your lower belly, that upside down swell that seems to grab you from the bottom and grow up, an internal squeeze that can only be one thing—a contraction.

But when the contractions hit, next comes the question: Am I in labor?

Near the end of pregnancy, some moms, especially first-time moms, might experience what is called prodromal labor, or pre-labor. If you have prodromal labor, you might think you're going into labor and head into the hospital, only to be sent back home when you find out it's not "real" labor just yet. Prodromal labor can be an incredibly frustrating experience, but if you encounter it, here's what you should know.

What is Prodromal Labor?

Prodromal labor is essentially pre-labor. G. Thomas Ruiz, M.D., an OB/GYN at MemorialCare Orange Coast Medical Center in Fountain Valley, CA, said that one of the best ways to explain it is uterine activity that is somewhere between Braxton Hicks contractions and active labor.

During prodromal labor, the uterus contracts, sometimes even in a pattern for several hours, but the contractions don't actually cause any change in the cervix. To be considered labor, a woman's cervix must actually change by opening or thinning out, but during prodromal labor, nothing happens at the cervical level. It's straight-up uterine action only.

Many women who have prodromal labor mistake it for real labor because it can feel different from Braxton Hicks contractions. Braxton Hicks contractions typically don't hurt and they are more sporadic and irregular, but prodromal labor contractions can be uncomfortable, have more of a pattern, and last for a few hours, so it can be hard to distinguish them from true labor contractions. 

Prodromal labor occurs in women who are at term in their pregnancies, at 37 weeks pregnant or more, and tends to be completely random. You might experience prodromal labor with one pregnancy, but not the next, or vice a versa. It tends to kick in after a long day, when a woman has been very active or on her feet a lot.

And not all women experience prodromal labor. In fact, Dr. Ruiz noted that the majority of women will not encounter it. It is, however, more likely to happen in first-time mothers because their uterus has not gone through labor yet.

Prodromal Labor vs. Real Labor

According to Dr. Ruiz, prodromal labor is not as intense or painful as what real labor can be. For mom blogger Leah Outten who experienced prodromal labor with four out of six of her pregnancies, prodromal labor contractions were indeed different.

Outten found that her active, real labor contractions tended to get closer together and grow in intensity, while the prodromal contractions pretty much stayed the same, even if they happened over a long period of time.

Wondering how on earth you'll know if it's go-time when you start contracting? Here are a few signs to look for:

  • Your water broke. If it's real labor, your body might be giving you clues in other ways. For example, if your water is leaking or you're having bloody show, it's probably the real deal.
  • Drinking water does not end your labor symptoms. Dr. Ruiz explains that if your contractions are actually prodromal labor, guzzling a lot of water or taking a warm shower will stop them completely. That's because water can relax smooth muscles in the body, such as—you guessed it—the muscles of the uterus. If your contractions are the real deal, however, no amount of chugging water or bathing is going to stop them.
  • Your contractions are 5/10 minutes apart. Dr. Ruiz advises women pregnant with their first baby to wait to go to the hospital until they experience a pattern of contractions that are painful enough to take your breath away, last 45 seconds to one minute, and occur every five minutes for two hours. "You're looking for a very regular pattern of painful contractions. You should really feel uncomfortable," he explains.

Prodromal labor can be a frustrating experience for moms-to-be who go through it, but if you do encounter it, just keep in mind that it's a natural process your body is going through to get ready for the main event. Your body is doing what it needs to do to prepare and just like with motherhood, we all do things a little differently, even when it comes to labor and contractions.

Trust your body and when in doubt, head to the hospital to get checked if you think you might be in labor.

Benefits of Prodromal Labor

Dr. Ruiz explains that prodromal labor is still sometimes called "false labor" among many pregnant mamas-to-be. But these days, we know now that prodromal labor isn't necessarily "false labor." Instead, it's more like a warm-up to the main attraction.

If you do experience prodromal labor, despite the fact that it can be extremely frustrating to feel like you're waiting for the real deal to start, there may be some hope in sight, because all of that "pre-work" could mean less work and time when labor actually begins.

For example, both Sheena Mac Isaac, 34, from Ontario, and Kat Fantin, 25, from Michigan, experienced prodromal labor during all of their pregnancies. While these pre-labor contractions were difficult to deal with, they found that they progressed to delivery very quickly once labor actually began.

"All my deliveries were really quick once it was actually go-time," Isaac said. "So maybe it's a payoff more practice means efficient game time?"

Fantin's experience was similar: After being sent home from the hospital twice with prodromal labor, she said she felt like she was "losing her mind." But once her water broke, her son was born in only three hours. "I'm not sure if that was because my uterus had plenty of practice contracting the last couple of weeks," she said.


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