True and False Labor: How to Tell the Difference

False labor, also called Braxton Hicks or practice contractions, is the uterus tightening without the progressive cervical changes of established labor. The tightening can be uncomfortable, but its pattern often changes when you walk, rest, hydrate, or change position. It may be felt mainly across the front of the abdomen.

True labor tends to develop a pattern. Contractions continue despite rest or a position change, become more intense, last longer, and occur with less time between them. Pressure in the pelvis, aching in the lower back, a thick mucus discharge, or fluid leaking from the vagina can occur as labor progresses. Only an examination can confirm cervical change, so sensation alone cannot always distinguish the two.

Note when each contraction begins and ends, how far apart they are, and whether the pattern changes. Rest in a comfortable position, drink fluids if you have not been told to restrict them, and use the comfort measures in your maternity plan. Keep your phone charged and arrange transport if your midwife or obstetric team asks you to come in. Contact the maternity unit if you cannot tell whether labor has begun; they can use your pregnancy details and symptoms to guide you.

Call your maternity team promptly if your waters may have broken, you have vaginal bleeding, your baby is moving less than usual, or contractions are becoming regular and painful. Seek urgent medical help for heavy bleeding, severe constant abdominal pain, fainting, trouble breathing, or a strong urge to push. If these symptoms happen before your maternity team considers the pregnancy full term, urgent assessment is especially important because preterm labour needs prompt attention.

Follow the specific instructions given for your pregnancy, since the timing for calling can differ after a previous birth, with a multiple pregnancy, or when complications are present.

Ask: Which symptoms should make me call immediately? How should I time contractions? Where should I go if my waters break? What should I do if my baby’s movements change? Are there pregnancy-specific reasons for me to be assessed sooner?