Before labor begins

What happens to your body

Increase in Braxton Hicks

contractions

Cervix softens, thins,

dilation may begin

Burst of energy (nesting

instinct)

Sleep more lightly

Stage 1
Early phase

Helpful hints for you

Do light activities

Pre-register at
hospital

Pack bags for

hospital

Rest, take naps

What happens to your body

Cervix softens, thins, dilates

1 to 4 cm

Contractions may be 30 to
60 seconds long and 5 to 20
minutes apart; become longer,
stronger, more frequent as time
goes on

Bloody show

Possible water break or leak

Possible frequent bowel

movements

Possible low back ache

Helpful hints for you

If it's night, try to

sleep

If it's day, do light

activities or walk

Time contractions

Drink clear liquids

(water, tea)

Empty bladder
every hour

Relax with
contractions

Begin breathing
techniques as needed

Call doctor as
directed

Go to hospital if
directed by doctor

Stage 1
Active phase
What happens to your body

Cervix continues thinning,

dilates 4 to 8 cm

Contractions may be 40 to
80 seconds long and 2 to 4
minutes apart; become more
intense, closer together, longer
peak

Possible water break or leak

Helpful hints for you

Go to hospital as
directed by doctor

Use relaxation and

breathing techniques

Use focal point

Change positions
as needed

Relax

Comfort measures
for lips/mouth: lip
balm, ice chips,
Popsicle, mouth
wash, brush teeth

Stage 1
Transition phase
What happens to your body

Cervix dilates to 8 to 10 cm

Helpful hints for you

Take it one

Contractions may be 60 to
90 seconds long and 2 to 3
minutes apart; become very
strong, may have more than
one peak

Rectal pressure, urge to

push

Nausea, vomiting

Hiccups

Cramps in legs and thighs

Increase in bloody show

Uncontrolled shaking

Cold feet

Drowsiness between
contractions

This phase can be very

intense but short
Stage 2
What happens to your body

Cervix is completely dilated

Contractions may be 60
seconds or longer and 2 to 5
minutes apart

Baby descends through the

birth canal

Strong urge to push,

pressure in vagina and rectum

Burning sensation as head

crowns

Birth of baby

contraction at a time
Continue to use
relaxation and
breathing techniques;
change techniques as
needed
Pant to avoid
pushing

Helpful hints for you

Relax perineum,
pelvic muscles

Rest between
contractions

Follow body's cues;

bear down only with
contractions

Listen to doctor's
instructions

Pant when
necessary

Keep eyes open

Stage 3
What happens to your body

Mild contractions

Separation and delivery of

placenta

Repair of episiotomy/tears

Helpful hints for you

If asked, push to
help expel the
placenta

Use breathing
techniques as
necessary

Hold and enjoy

your baby

Stage 4
What

happens to your body

Recovery begins
Shaking
Possible afterpains
Hunger
Perineal discomfort
Possible difficulty urinating

Helpful hints for you

Rest

Get acquainted
with baby

Begin breastfeeding

Eat and drink

Massage uterus
Urinate

Signs of Labor
Some women experience very distinct signs of labor, while others do not. No one knows what causes labor
to start or when it will start, but several hormonal and physical changes may indicate the beginning of
labor:

Lightening

Passing of the mucus plug

Contractions

Water breaking

Effacement and dilation of the cervix

Lightening During Labor

The process of your baby settling or lowering into your pelvis just before labor is called lightening.
Lightening can occur a few weeks or a few hours before labor. Because the uterus rests on the bladder
more after lightening, you may feel the need to urinate more frequently.
Passing of the Mucus Plug
The mucus plug accumulates at the cervix during pregnancy. When the cervix begins to open wider, the
mucus is discharged into the vagina and may be clear, pink, or slightly bloody. Labor may begin soon after
the mucus plug is discharged or one to two weeks later.

Labor Contractions
During contractions, the abdomen becomes hard. Between contractions, the uterus relaxes and the
abdomen becomes soft. The way a contraction feels is different for each woman, and may feel different
from one pregnancy to the next. But labor contractions usually cause discomfort or a dull ache in your
back and lower abdomen, along with pressure in the pelvis. Contractions move in a wave-like motion from
the top of the uterus to the bottom. Some women describe contractions as strong menstrual cramps.
Unlike false labor contractions or Braxton Hicks contractions, true labor contractions do not stop when you
change your position or relax. Although the contractions may be uncomfortable, you will be able to relax in
between contractions.
What's the Difference Between True Labor and False Labor?
Before "true" labor begins, you may have "false" labor pains, also known as Braxton Hicks contractions.
These irregular uterine contractions are perfectly normal and may start to occur in your second trimester,
although more commonly in your third trimester of pregnancy. They are your body's way of getting ready
for the "real thing."

What Do Braxton Hicks Contractions Feel Like?

Braxton Hicks contractions can be described as a tightening in the abdomen that comes and goes. These
contractions do not get closer together, do not increase with walking, do not increase in duration, and do
not feel stronger over time as they do when you are in true labor.
How Do I Know When I Am in True Labor?
To figure out if the contractions you are feeling are the real thing, ask yourself the following questions.
Contraction
Characteristics

False Labor

True Labor

How often do the

contractions occur?

Contractions are often irregular and do Contractions come at regular intervals

not get closer together.
and last about 30-70 seconds. As time
progresses, they get closer together.

Do they change with

movement?

Contractions may stop when you walk Contractions continue despite

or rest, or may even stop if you change movement or changing positions.
positions.

How strong are they?

Contractions are usually weak and do Contractions steadily increase in

not get much stronger. Or they may be strength.
strong at first and then get weaker.

Where do you feel the Contractions are usually only felt in the Contractions usually start in the lower
pain?
front of the abdomen or pelvic region. back and move to the front of the
abdomen.