Blog

How to Identify Labor Signs: Insights from Dr. Sadia Mobeen

In a recent episode of the Healthful Woman podcast, “How do I know if I’m in labor?”, host Dr. Nathan Fox talks with Dr. Sadia Mobeen, an obstetrician and gynecologist at MFM Associates. During the podcast, they discuss how medical professionals evaluate patients to see when they are in labor, the questions they may ask you, and more.

How Do You Know If You’re in Labor?

Dr. Mobeen receives at least one phone call every shift with the same question, “Am I in labor?” Dr. Fox and Dr. Mobeen hope to help patients understand how doctors evaluate labor. As Dr. Fox explains, “The point is to help people understand the framework that we use when evaluating someone to determine if you’re in labor.” Every patient’s situation is unique, and it is important to receive a personalized evaluation with your doctor or midwife.

How Dr. Mobeen Defines Labor

For most patients, labor involves having regular, painful contractions that cause cervical change. These contractions typically grow stronger, last longer, and become more consistent over time. However, the only way to confirm labor is through a series of cervical exams to detect any change. Some people have contractions without cervical change, which is not labor, while others experience cervical dilation without strong contractions, which is also not labor. Labor requires both happening together.

How Labor Can Begin

Contractions First

The more common onset of labor involves gradual, regular, painful contractions. Patients often describe these as strong cramps that last about 60 to 90 seconds. If it is your first baby, Dr. Mobeen recommends calling when contractions are about five minutes apart for an hour straight.

Water Breaking First

For about 10% of patients, labor begins when the amniotic sac ruptures before contractions begin. This is called pre-labor rupture of membranes or PROM. If your water breaks, you should be evaluated promptly. Dr. Mobeen shares, “Most of the time, they will have a large gush of fluid where they’re either, like, soaked in their clothes or wake up with the couch or, like, the bed being soaked. That’s the obvious way to know. Now, other times, patients can have a small gush of fluid where they’re not sure if their water broke.” Even if contractions have not started, labor often follows within 12 to 24 hours. If you aren’t sure if your water broke, placing a pad and walking around for an hour may help, as continued leakage usually means your water is broken.

Braxton Hicks vs Contractions

Braxton Hicks contractions are common during the third trimester. These contractions are often mild, irregular, and do not cause cervical change. In contrast, true labor contractions are intense, consistent, and progressively worsen. Dr. Mobeen explains, “Typically, how you can differentiate between a labor contraction and Braxton Hicks is a labor contraction kind of, like, knocks the wind out of you, stops you in your tracks, usually lasts anywhere from 60 to 90 seconds. You’re not able to, like, talk or walk through it or sleep through it.”

Evaluating Water Broken Before Labor

If a patient suspects their water has broken, they’re typically asked to come into the office or hospital. The evaluation usually begins with a speculum exam to check for fluid, sometimes followed by a cough test if no fluid is detected. Additional methods may include a pH strip that changes color in the presence of amniotic fluid, a sonogram to assess fluid levels, or microscopic examination of a sample. These tests help determine whether the water has broken.

Questions We Ask

When patients call about contractions, these are common questions we may ask:

• Are you having painful contractions at regular intervals?
• Do your contractions feel strong and regular?
• Can you walk or talk through the contractions?
• How long do the contractions last, and how far apart are they?
• How long have the regular contractions been occurring?
• Is the baby moving normally?
• How many weeks pregnant are you, and have you reached your due date?
• Has there been any vaginal bleeding?
• Did your water break?
• What time did your water break?
• How much fluid do you notice? Any odor or color?
• Is this your first baby?
• How far are you from the hospital?
• What is your medical and pregnancy history?

These questions can help determine if you are in false labor or active labor and how urgent it is that you get to the hospital.

Gray Areas When Labor Starts

Labor is not always easy to define. Cervical change can be slow at first, and it may take several hours to confirm if labor has truly begun. Additionally, not everyone in early labor needs to be admitted to the hospital. Some patients prefer to labor at home, especially if they’re not in significant pain and the baby is doing well. Others may opt to come in early for support, comfort, or pain management.

Learn More

To learn more about symptoms of labor, listen to the full episode of the Healthful Woman podcast. For pregnancy care, contact MFM Associates in New York by completing the online contact form.

Carnegie Imaging for Women blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!