A contraction is the rhythmic tightening and relaxing of the uterine muscle, which works to thin and open the cervix and move the baby down the birth canal. When these begin to occur about 20 minutes apart, it often signals the beginning of the labor process. This early phase is typically characterized by mild, widely spaced contractions that may feel similar to menstrual cramps or a low backache. Recognizing this initial timing is important for managing the process at home and preparing for the hours of labor ahead.
Identifying True Labor Versus Practice Contractions
Determining if a contraction is the start of true labor or merely a practice contraction, known as a Braxton Hicks contraction, is the first step in managing this phase. True labor contractions follow a pattern of progression, consistently growing stronger, lasting longer, and occurring closer together over time. Braxton Hicks contractions, in contrast, are irregular and unpredictable, often remaining weak or even decreasing in intensity.
A defining difference is how the contractions respond to activity or a change in position. Practice contractions may stop entirely if you walk around, move, or simply rest, while true labor contractions will continue regardless of what you do. The location of the sensation can also offer a clue, as Braxton Hicks contractions are usually felt only in the front of the abdomen. True labor contractions often begin in the lower back and wrap around to the front, feeling more like a comprehensive tightening.
True labor contractions also cause physical changes to the cervix, such as effacement and dilation, which practice contractions do not. Since cervical changes cannot be felt, the pattern of increasing frequency and intensity is the most reliable indicator for a person to track at home.
What to Expect During the Early Labor Phase
The early or latent phase of labor begins when the cervix starts to dilate and typically lasts until it reaches about six centimeters of dilation. This stage is often the longest part of the birthing process and can last many hours, especially for first-time parents. Contractions during this time are usually mild and may be spaced anywhere from 5 to 20 minutes apart, lasting about 30 to 45 seconds each.
The goal during this lengthy phase is to conserve energy and remain calm, as you are likely still hours away from delivery. Staying home in a comfortable and familiar environment is generally recommended, provided there are no complications. Simple activities like walking, taking a warm shower or bath, or changing positions frequently can help manage discomfort and encourage the process to continue.
Distraction is an effective coping mechanism for the mild intensity of early labor, so consider watching a movie or playing a game to pass the time. Maintaining adequate hydration and eating light, easily digestible snacks is important for sustaining energy reserves. Other signs may appear during this phase, such as the loss of the mucus plug, which is a thick, blood-tinged vaginal discharge sometimes called the “bloody show”.
Knowing When to Contact Your Healthcare Provider
The transition from managing labor at home to seeking medical care is often guided by a change in the contraction pattern. The widely used guideline for when to call a healthcare provider is the 5-1-1 rule. This rule suggests contacting the care team when contractions are consistently occurring five minutes apart, lasting for one minute each, and have maintained this pattern for at least one hour.
This progression indicates that early labor is ending and the more intense active labor phase is beginning. However, there are specific, urgent circumstances that require an immediate call, regardless of the contraction timing. The 5-1-1 rule is a general benchmark, but it is important to discuss individual circumstances and preferences with your healthcare provider well before labor begins.
Immediate Concerns
A sudden gush or continuous trickle of fluid, which may indicate that the amniotic sac has ruptured, warrants a call, especially if the fluid is green or brown. Other symptoms that require immediate contact include a significant decrease in fetal movement, heavy vaginal bleeding, or any concerning pain that is constant rather than intermittent.