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Differences between prelabour contractions and first stage labour

Differences between prelabour contractions and first stage labour


About prelabour contractions

How to time contractions

Coping with prelabour contractions

Each stage of the labour is characterised by different types of contractions. During the 1st stage of labour each contraction makes the uterine muscles slightly shorten, and in doing this they pull up the cervix into the lower segment of the uterus. The shortening of uterine muscles decreases the size of the uterine space, so the baby is pushed down and out the vagina (or birth canal).

Waves of contractions start at the top of the uterus (called the fundus) and radiate down the uterus to the cervix. Simultaneously, the lower segment of the uterus is pulled up, to open the cervix.

Uterine contraction action Image 3-13 shows the action of the uterus contracting.

There is a wide range of variations in labour patterns, because every woman is uniquely different. Early and active 1st stage contractions are usually defined as pains that come every 2, 3, 4 or 5 minutes (timed from the beginning of one contraction to the beginning of the next contraction). They usually last more than 40 seconds and up to 70 seconds each time. Prelabour contractions are usually further apart, shorter in length (or very long eg. 2 minutes) and can often be erratic.

About prelabour contractions

Below are some examples of how prelabour contractions may emerge before the first stage of labour truly begins. These patterns can occur the day you start labour, 2 to 3 days leading up to the day you start seriously labouring, or on and off for 2 to 3 weeks before labour begins......

....as we said.....it is just the beginning.

Prelabour contractions may:

  • Start with regular contractions that are 10, 15 or 30 minutes apart, lasting for approximately 20 to 40 seconds. A regular pattern can start to emerge as the contractions become stronger, longer and closer together over time, until the early first stage of labour becomes recognisable. OR
  • Be strong contractions lasting 20 to 30 seconds coming around 5 or more minutes apart. This may happen early every morning or late at night, lasting for a couple of hours and then stopping, perhaps on and off for a couple of days or even a few weeks before your actual 'labour day'. OR
  • Come in various patterns at the end of the day when feeling tired or trying to get some sleep. The contractions can be strong and some women will use a bath or hot water bottle to relieve them. Most women eventually fall asleep after a while, waking up still pregnant! OR
  • Be a dull ache in the lower belly, upper thighs and / or lower back. Some women experience strong, period cramping lasting 2 to 3 minutes or more over many days, on and off for 2 to 3 weeks. OR
  • Come as a series of painful contractions that are irregular (say 3, 5, 7, 10, 15, 30 minutes apart at various times) and lasting for 20 to 40 seconds around the clock for two or more days, with no regular rhythm developing making it difficult to rest or sleep. OR
  • Be painful, but not enough to stop you doing normal tasks. OR
  • Not be particularly noticeable. You may have slept through most of them during the night, or you may confuse them with the discomforts of late pregnancy. OR
  • Not start at all! We will look at this later in Induction of labour.

How to time contractions

You will need a watch, or clock, with a second hand and a labouring woman!

  • Time the contractions from the beginning of one to the beginning of the next one, this tells you how far apart the contractions are.
  • How long a contraction lasts is from the beginning of the contraction until the end of that contraction.
  • There is no need to time all the contractions during prelabour. This will become tiresome and place pressure on the woman to get into labour. You may wish to time a few contractions every few hours or time some in the early phase of 1st stage to see if a rhythm is developing.
  • Some partners write each contraction down. This is OK if you are bored, but not necessary. When the woman is in strong labour, pen and paper will quickly be disregarded!
  • Intermittent timing is preferred over continual timing, otherwise the main focus will be on the clock (and for the woman to labour faster). Continual timing can also distract the partner or support person instead of 'being there' completely of the woman.
  • Time some when they are 7 to10 minutes apart, then stop timing them (these are prelabour contractions and can remain like this for some time). Time the contractions again when they appear closer together, say 5 to 7 minutes apart. You may wish to time a few just before contacting your caregiver (this is one of the questions they normally ask you).
  • Contact your caregiver when the woman feels she needs to talk with someone, or wants to leave home for the hospital or birth centre. If she is giving birth at home it will be when she requests her caregiver to be with her.
  • Your caregiver will usually ask you how often the contractions are coming, and how long they are lasting. The caregiver may stay on the phone while the woman has 1 or 2 contractions to listen to the sounds she is making and the depth of her breathing. This can give the caregiver some feedback about the intensity of the contractions and the possible stage of labour.
  • Most caregivers use a benchmark for when the contractions are coming every 3 to 5 minutes, lasting for around a minute each time, to indicate that the woman is in established labour (or the strong, active phase of the 1st stage). Be aware that this benchmark may not reflect the progress of every woman's labour.

Coping with prelabour contractions

Many women find their prelabour contractions difficult to cope with. This is particularly the case if the contractions are somewhat painful and seemingly relentless. Some women are too uncomfortable to have a good sleep and become disheartened because they are not really in established labour yet.

If you do go into the hospital during prelabour (because you feel like it is the start of your established labour), your caregiver will probably send you home again until the pattern changes (or suggest inducing the labour). If your caregiver allows you to stay for an hour or two to settle in, sometimes the pattern of contractions changes and intensifies on its own. This happens for some women because they are now in the place they intend to give birth and being there helps them to relax enough for the labour to progress. If you are planning a homebirth, this may also be apparent once your midwife arrives at your home.

Many women feel like they are between a 'rock and a hard place' during prelabour. If your prelabour is prolonged, the inevitable tiredness that ensues (often for the partner as well) can contribute to a tendency to request drugs for pain relief or accept an induction to 'get things going' in a sense. Some women feel OK about their prelabour but their caregiver strongly suggests they accept some intervention to 'get the show on the road'. If both you and your caregiver feel this is the right decision for you, then use the options you feel comfortable with.

For others who wish to continue (and avoid unnecessary intervention), you may feel some comfort in knowing that prelabour primes your cervix very well, so that once you start established labour the progress is often comparatively rapid. From this perspective prelabour can feel like a 'positive pain' experience that gets much of the work done before the strong labour begins in earnest. For example, it is not unusual for a woman take 2 to 3 days to get to 3cm dilation in prelabour, and then only 2 to 6 hours for the baby to be born (once the established labour starts). This is why keeping well nourished and hydrated during prelabour is an important support strategy, so your body can maintain good energy levels to help you continue and cope with your labour.

Prelabour is exactly that, preparation for labour. The body and the baby beginning, getting ready for the woman to say YES to the labour, whatever that labour may bring.

Updated November 2007

Information sources

Stables D. and Rankin J. Physiology in Childbearing with Anatomy and Related Biosciences. 2004, Bailliere Tindall, Edinburgh.


Last revised: Saturday, 24 November 2012

This article contains general information only and is not intended to replace advice from a qualified health professional.

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