Major Signs of Labor Contractions

That weird feeling in your belly could be labor -- or it could just be another bout with indigestion or more false labor contractions. So how can you tell if it's the real deal, especially if this is your first pregnancy? The experts say it can be tough to tell. "Labor is difficult to describe," says Siobhan Kubesh, a certified midwife with OBGYN North in Austin. "It's like describing falling in love -- until you're there, you don't really understand the feeling.'" Most experts suggest erring on the safe side and giving your doctor a buzz whenever you're feeling something new. "We don't expect you to know the difference between false labor and the real McCoy," says Bart Putterman, M.D., an ob-gyn at Texas Children's Pavilion for Women in Houston. "If you aren't sure what's going on, call -- even if it means waking someone up."

But if you're nervous about being the girl who cried "Labor!" at every twinge and twang in your abdomen, here are some good general guidelines to consider when you're asking: Is it labor?

• You feel like you're getting your period. "The real [contractions] feel like menstrual cramps -- it's a crampy sensation that gets progressively worse and worse," says Paul du Treil, M.D., director of maternal and child health at Touro Infirmary in New Orleans. "It may not be painful, but your whole stomach will tense and feel hard."
• There's a rhythm to the contractions. They may be irregular at the onset, but if it's real labor, it'll pick up a definite rhythm relatively quickly. "Pretty soon there's a rhythm where they're coming every four to five minutes," Kubesh says. Most health-care pros suggest waiting until they're coming every five minutes for about an hour before you make the call.
• The contractions are getting more intense as time goes on. What started as a slight twinge may soon give you pause whenever the it happens. "You may be able to ignore labor for a while, but as it progresses, you can't do anything else but labor," Kubesh says.
• Your water broke. It's the gold standard for knowing that labor is starting in earnest (and the standard gag for any TV or movie birth story), but it doesn't always happen like that. You can be in labor without your water breaking -- or if your water breaks without contractions. "If it's broken, you'll usually experience a big gush of fluid," Dr. du Triel says. "You definitely need to be evaluated if that happens, even if you don't have contractions."
• You've had some unusual vaginal discharge. Even if your water hasn't broken, you may have had another discharge. "Bloody mucus, or change in discharge associated with contractions, increases the likelihood it's real labor and not a false alarm," Dr. Putterman says.
• You're feeling pelvic pressure along with the contractions. Feel something heavy settling into your hips? That's your baby lining up for his journey through the birth canal. "If you're feeling pelvic pressure with contractions, you should probably call your doctor," Dr. Putterman advises.
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