Home / Birth / Labor & Delivery Early labor: How to know when it starts—and what to do when it does Wondering what to do in early labor? Spoiler alert: Rest, eat and move, mama! By Diana Spalding, CNM and Caitlin Clement March 25, 2024 Rectangle We spend so much time during pregnancy anticipating labor, but when the big moment finally arrives, it can be tricky to know what to actually do! Should I call my doctor or midwife? Should I take a nap or get on my birth ball? Wait, am I even in labor? Don’t worry, mama. We’ve got you. Early labor is the very first part of labor, when your body is starting the process of giving birth. Early labor can be different for everyone—it may come on suddenly and powerfully, or you may find that it takes a bit to realize that you are in labor. One thing’s for certain though: The baby is on the way and you are really and truly about to become a mama! Everything you need to know about early labor As always, remember that your provider should be your number one resource during labor, so please check with them before trying any of the following methods. You may have specific circumstances that would make them unsafe for you and your baby. How do I know I’m in early labor? Early labor is usually the longest phase of the first stage of labor. It can last roughly from eight to 12 hours for a first-time mom and fewer than one to eight hours for a repeat mom, though it’s important to remember that this can vary widely. During early labor, your cervix will soften, efface (thin) and dilate (open) about six centimeters, accompanied by contractions that start mild and irregular, but progress to stronger and more regular. While it varies for everyone, contractions might start coming every 20 to 30 minutes and last for about 30 seconds. They will gradually become more frequent (about every five minutes), and last about 30 to 45 seconds each. They are generally uncomfortable, but tolerable. Early labor contractions often start low down in your pelvis and feel a lot like menstrual cramps. It can sometimes take a bit for women to have the Oh wait, maybe I am in labor! thought because the cramping can be so minimal. A lot of women think it’s gas at first. You may start to feel them in your lower back and find that they wrap around your belly toward your front. Eventually, you will feel them in your whole belly (your whole uterus). But you’ve got this, mama. What should I do during early labor? When you finally have that ah-ha “I’m in labor!” moment, here are some steps to take during early labor: 1. Call your provider. It may not be time to head to your birthing place yet or to have your midwife come to you, but it’s always good to check in. Your provider will ask you questions about what’s going on and help you determine what the best course of action is (which varies from woman to woman). If you get the green light to stay home longer, and your provider has not recommended any restrictions, you can follow the rest of these steps. This is also a good time to contact your doula if you have one. 2. Have a light meal and stay hydrated. Remember that you are about to run a marathon and you need good sustainable energy. Registered Dietician Nutritionist Crystal Karges suggests multigrain crackers with nut butter, trail mix and dried fruit to help keep you nourished. 3. Go for a walk with your partner or labor support person. Walking during early labor has a lot of benefits: It can encourage your baby to get into a good position to make labor easier, it can bring on more contractions while also helping you tolerate them better and it’s a nice distraction. Don’t be afraid to lean on your partner and sway during the contractions. Your neighbors will love it! (Always keep your phone close by.) 4. Take a warm shower. Anecdotally, baths can slow things down in early labor, but showers are fantastic. They are relaxing and therapeutic, help with pain management and will help lull you into the next step. 5. Take a nap. The marathon is about to start. You may have a lot of energy and excitement during early labor, but see if you can lie down and close your eyes. Even if you can only drift off for a few minutes at a time, catnaps help restore energy. And don’t worry, napping won’t prevent labor from continuing. What is back labor and how can I help it during early labor? Sometimes labor brings a significant amount of back pain, called back labor. This usually happens when the baby is positioned posteriorly, which means that their face is pointing toward your front and the heavy back of their head is against your tailbone. Ouch! Babies can be born in this position (they are called stargazers or sunny-side-up), but it can make for more difficult labor. If you have back labor, one of the best things to do is move—walk, lunge, dance, sway on a birthing ball during labor and hang out in a hands-and-knees position; anything you can do to open up the space in your pelvis so that your baby can rotate. Ask your labor partner to press against your sacrum for some relief. Warm compresses also feel great in these scenarios. When should I go to my birthing place? The general rule of thumb for heading into your birthing place is “4-1-1.” Contractions are four minutes apart, they last one minute each, and they have been going on for one hour. Often during early labor, you don’t need to head to your birthplace quite yet. But don’t forget to give your provider a call. They will have a better recommendation of what to do based on your scenario, and may ask you to come in. Once active labor starts, you should head to your birthplace or call your midwife. A few ways to tell you’re going into active labor are that contractions are more frequent, usually coming every three to five minutes and lasting about 60 seconds each. Also, your water might break . As a partner or support person, how can I help during early labor? It can be hard as a partner or support person to see your loved one experiencing sensations and emotions you’ve never witnessed before. Please remember this: You are enough. Your presence alone has a profound impact on her. Research finds that when women have a consistent support person with them in labor, their labors are shorter, require fewer interventions and are more satisfying than they would be otherwise. Just by being there, you are helping her. Here are some things you can do to help her in early labor: Give her comfort. Again, just you being there is helping her! Encourage her to eat and drink (and you should, too!). You’re going to need your energy for what’s to come, too! Help her find ways to cope. Instead of saying, “What do you want to do now?” you could suggest techniques you know she likes. For example, “How about a shower?” Are there warning signs I should look out for in early labor? Usually, everything goes just fine! But it is important to be aware of a few warning signs, and to seek medical attention right away if you have them: Vaginal bleeding (more than about a few drops) Foul-smelling, green or brown amniotic fluid Not feeling the baby move Sharp abdominal pain Seeing or feeling your umbilical cord in your vagina when you water breaks (if this happens, call 9-1-1. Get down on your hands and knees, and then even further down so that your shoulders are touching the ground and your bottom is all the way up.) Anything else that concerns you! Remember: This is your birth and you deserve to feel safe. If you have any worrying symptoms, call your provider or head to your birth place. Even if it’s 2 am. Good luck, and keep us posted! We are so excited for you! Should I be anxious during labor? Feeling anxious during labor is entirely normal and understandable. Childbirth is a significant life event, and it’s natural to feel a range of emotions, including anxiety, excitement, and anticipation. However, excessive stress can interfere with the labor process and increase discomfort. Here are some tips to help manage anxiety during labor: Educate Yourself: Understanding the labor process, what to expect, and your pain management options can help alleviate anxiety. Attend childbirth education classes and discuss any concerns with your healthcare provider. Practice Relaxation Techniques: Techniques such as deep breathing, visualization, meditation, and progressive muscle relaxation can help reduce anxiety and promote relaxation during labor. Practice these techniques before labor so that they become familiar and easier to use when needed. Communicate with Your Support Team: Share your feelings and concerns with your partner, family members, or healthcare providers. Having a supportive and understanding support team can provide comfort and reassurance during labor. Create a Comfortable Environment: Surround yourself with familiar and comforting items, such as music, aromatherapy, or objects. Creating a calming atmosphere can help reduce anxiety. Stay Flexible: Understand that childbirth can be unpredictable, and it’s essential to remain flexible with your birth plan. Trust in your body’s ability to give birth and be open to adjustments during labor. Focus on the Outcome: Remember the joyous moment that awaits you at the end of labor – meeting your baby. Remind yourself of the purpose and meaning behind the discomfort of labor. Consider Pain Relief Options: Discuss pain relief options with your healthcare provider, such as epidurals, nitrous oxide, or other medications, if you feel that anxiety is significantly impacting your ability to cope with labor pain. Scientifically, what happens during early labor? During early labor, the first phase of the first stage of labor, several key physiological changes occur: Cervical Dilation: The cervix, the opening of the uterus, begins to thin and dilate, preparing for childbirth. Contractions: Contractions become more pronounced, lasting between 30 to 60 seconds and occurring every 5 to 20 minutes. These contractions play a crucial role in the progression of labor. Show: A clear or slightly bloody discharge, known as “show,” may occur as the cervix dilates. Duration: This phase can last for an extended period, up to 20 hours, especially for first-time mothers, as the body adjusts to childbirth. Frequently Asked Questions About Early Labor 1. How do I know I’m in early labor? Early labor marks the initial phase of the labor process, during which your body prepares for childbirth. It’s characterized by the softening, thinning, and opening of the cervix, along with contractions that start mildly and irregularly but gradually become stronger and more regular. Contractions typically begin low in the pelvis and feel similar to menstrual cramps, gradually intensifying and spreading across the abdomen. 2. What should I do during early labor? During early labor, it’s crucial to stay in touch with your healthcare provider for guidance tailored to your specific circumstances. However, some general steps you can take include: Contacting your provider: Inform them of your symptoms and follow their recommendations. Maintaining nutrition and hydration: Consume light, energy-sustaining meals and stay hydrated to prepare for the labor ahead. Engaging in physical activity: Going for a walk with your partner or engaging in gentle movement can help ease discomfort and encourage progress. Taking a warm shower: Showers can provide relaxation and pain relief, aiding in your comfort during early labor. Resting: Rest whenever possible to conserve energy for the upcoming stages of labor. 3. What is back labor, and how can I manage it during early labor? Back labor refers to significant back pain experienced during labor, often resulting from the baby’s posterior position. To alleviate back labor during early labor, consider: Movement: Engage in activities such as walking, lunging, or swaying on a birthing ball to encourage optimal positioning of the baby. Comfort measures: Apply warm compresses or ask your support person to provide counterpressure on your sacrum for relief. 4. When should I go to my birthing place? The “4-1-1” guideline suggests heading to your birthing place when contractions are four minutes apart, lasting one minute each, and have persisted for one hour. However, always consult with your healthcare provider for personalized advice based on your labor progression. 5. How can a partner or support person help during early labor? Support from a partner or loved one can significantly impact the birthing experience. Some ways to assist during early labor include: Providing comfort: Offer physical and emotional support to ease discomfort and anxiety. Encouraging nourishment: Remind the laboring individual to eat and drink for sustained energy. Suggesting coping techniques: Propose relaxation methods or activities that may help manage pain and stress. 6. What warning signs should I be aware of in early labor? While complications are rare, it’s essential to recognize warning signs and seek medical attention if you experience: Vaginal bleeding beyond a few drops Foul-smelling, discolored amniotic fluid Absence of fetal movement Sharp abdominal pain Prolapsed umbilical cord Always prioritize your safety and well-being by promptly contacting your healthcare provider or seeking emergency assistance. Remember, each birthing experience is unique, and it’s essential to communicate openly with your healthcare provider and support team throughout the labor process. Office on Women’s Health. (2017). Labor and birth. Retrieved February 21, 2017, from https://www.womenshealth.gov/pregnancy/childbirth-and-beyond/labor-and-birth López-Zeno, L. A., & Harrington, L. (2004). Normal labor and delivery. In J. J. Sciarra (Ed.), Gynecology & obstetrics (Volume 2, Chapter 68). Hagerstown, MD: Lippincott Williams & Wilkins. Retrieved July 22, 2013, from http://www.glowm.com/resources/glowm/cd/pages/v2/v2c068.html American College of Obstetricians and Gynecologists. (2011). FAQ: How to tell when labor begins. Retrieved February 13, 2017, from http://www.acog.org/Patients/FAQs/How-to-Tell-When-Labor-Begins American College of Nurse-Midwives. (2012). Second stage of labor: Pushing your baby out. Retrieved February 13, 2017, from http://www.midwife.org/ACNM/files/ccLibraryFiles/Filename/000000001793/Second%20%20Stage%20of%20Labor%20-%20Pushing%20Your%20Baby%20Out.pdf (PDF 125 KB) Joy, S., Lyon, D., & Scott, P. L. (2015). Abnormal labor. Retrieved February 17, 2017, from https://emedicine.medscape.com/article/273053-overview#showall World Health Organization. (2007). Managing complications in pregnancy and childbirth: A guide for midwives and doctors. Retrieved February 21, 2017, from https://apps.who.int/iris/bitstream/handle/10665/43972/9241545879_eng.pdf (PDF 5.5 MB) Maughan, K. L., Heim, S. W., & Galazka, S. S. (2006). Preventing postpartum hemorrhage: Managing the third stage of labor. American Family Physician, 73, 1025–1028. Retrieved April 25, 2017, from http://www.aafp.org/afp/2006/0315/p1025.pdf (PDF 172 KB) A portion of this article has been excerpted from The Motherly Guide to Becoming Mama. The latest News They asked me to ‘prepay’ for my baby: The rising cost of maternity care no one prepares you for Birth We should stop discarding placentas after birth, scientists say Birth Stories When my youngest daughter was in the NICU, I felt like I was failing both of my kids Birth Stories American mom gives birth in Japan and the amenities are jaw-dropping