Early Labor: What to Expect

By Dr. Kenosha Gleaton, OBGYN

Labor and delivery consist of multiple stages and phases, all of which can occur within a few hours to a few days. There are a lot of misconceptions about labor, so it’s important to know what to expect, when to visit your provider, and what you can do to increase your comfort. 

Stages of Labor

Labor and delivery can be a long (or on occasion, very quick) process, marked by three different stages. The first stage of labor is exactly that: labor. This stage is usually the longest and can last anywhere from 12 to 19 hours. [1-2] This stage is marked by regular contractions and the dilation and thinning of the cervix. There are two phases of labor: early labor and active labor. [2] 

The second stage of labor, pushing and birth, begins when the cervix is 10 centimeters dilated. [1] This stage is usually the most difficult and can last anywhere from 30 minutes to several hours. [2] During the second stage, you can expect to have slower contractions, during which you will begin to push (assuming you’re having a vaginal birth). Eventually, your baby will crown, and your provider will guide the baby through the birth canal. [2] Once the baby has been born, the umbilical cord can be cut. 

The third stage of labor is the delivery of the placenta, which typically doesn’t last more than 30 minutes. [1-2] Contractions will begin again (I know, it seems unfair) within 30 minutes after birth to help expel the placenta. Fortunately, these contractions shouldn’t be as painful or strong as they were when you were delivering your baby. [2] 

Note that the stages of labor and delivery will be a bit different for those undergoing a cesarean section (C-section). Labor can also progress very differently from person to person, especially for those who have given birth before. [1-2] If you have questions about your delivery, be sure to speak with your healthcare provider. 

What Is Early Labor?

Early labor is the first of two phases that make up the first stage of labor. Early labor is the very first stage of labor and delivery that you will experience. [2-3] Mild, irregular contractions will begin and gradually become stronger, more regular, and more frequent. [3] During early labor, the cervix will begin to dilate and efface, meaning it will get wider, shorter, and thin. This will allow your baby to move into the birth canal. 

How Long Does Early Labor Last?

Everyone’s labor experience is different, but early labor typically lasts between six to 12 hours. [1-3] Those who are giving birth for the first time may be in early labor for longer than those who have given birth before. For most people with an uncomplicated pregnancy, early labor can be spent at home without the need for a healthcare provider. 

Symptoms of Early Labor

When someone is in early labor, they will likely first experience irregular and mild contractions. [3] These contractions will gradually become more regular, more frequent, and stronger. As the cervix prepares for birth, you may notice an increase in vaginal discharge that is clear, pink, or slightly bloody. [4] This is a result of the mucus plug being pushed into the vagina.

Other symptoms that may occur before or during labor include lightening and water breaking. [4] Lightening refers to the sensation of the baby dropping lower in the pelvis. Because the baby is no longer pressing on the diaphragm, some will report feeling “lighter.” If you believe your water has broken, which can feel like a gush or trickle of fluid from your vagina, you should call your healthcare provider. [2-4] 

What Does Early Labor Feel Like?

Early labor contractions most often start as mild, irregular contractions and will progress to be more regular and frequent. Contractions will eventually be five to 15 minutes apart and will last for a minute each. [2-3] Unless your provider instructs you to do otherwise, you should plan to go to the hospital or birthing center once your contractions are five minutes apart for one hour or longer. [2-3] 

Contractions can sometimes cause pain in the back or pelvis and are sometimes described as similar to menstrual cramps. [4] Labor contractions happen in a regular pattern and get closer together over time. Keep in mind that many people will experience Braxton Hicks, or false labor contractions in the weeks or days leading up to labor. Learn how to tell the difference between Braxton Hicks and true labor contractions →  

Finding Comfort During Early Labor

Early labor isn’t exactly comfortable, but it often isn’t very painful either. That being said, no one wants to be uncomfortable for hours and hours while waiting for labor to progress. Trying to stay relaxed may help reduce any discomfort. A few things to consider trying include [3]:

• Go on a walk
• Take a warm shower or bath
• Listen to relaxing music
• Create a comfortable environment with dim lighting, warmth, and peaceful surroundings
• Try breathing and relaxation techniques
• Rock or sway in place during contractions
• Changing positions
• Have your support person use massage maneuvers

Learn about your pain relief options during labor → 

Does Baby Move Between Contractions in Early Labor?

When someone is going into or nearing labor, their baby will begin to drop lower in the uterus with their head settling deep in the pelvis, known as the engaged position, also referred to as dropping or lightening. [1] During a contraction, the muscles in the uterus will tighten and relax, which helps your baby progress into the birth canal. [1-2] 

It’s common for your baby to kick and squirm when reacting to labor contractions. [5] In fact, a study found that of all uterine contractions, nearly 90% were associated with fetal movement. [5] This study found that fetal movement was more common during uterine contractions rather than between, but it is normal to feel some movement in general while you’re in labor. If you don’t feel any fetal movement or notice a decrease in fetal movement, you should contact your healthcare provider. [2-3] 

Warning Signs During Labor

Unless your provider has told you otherwise, you are likely safe to go through the early labor phase in the comfort of your own home. Once your contractions are five minutes apart for at least an hour, you should consider reaching out to your provider. [2-3] 

If you notice any of the following, it’s recommended that you call or visit your provider immediately [1-2]:

• Your water breaks
• Heavy vaginal bleeding
• Chest pain
• Dizziness or fainting
• Decreased or lack of fetal movement
• Swelling in the face, arms, or legs
• Shortness of breath
• Severe nausea or vomiting

You should also reach out to a healthcare provider immediately if you believe you are in preterm labor, which occurs before week 37 of pregnancy. 

Pregnancy, Labor, and Postpartum Support

While we tend to think of labor and delivery as moments to “get through”, there can be a lot of beauty in the journey. Remember that it’s normal to feel a mix of emotions and that there is only so much within your control. No matter where you are in your pregnancy journey, you can find helpful information and products from Natalist that can support your nutrition and comfort. Prepare for postpartum life with breastfeeding essentials, or shop self-care products to support your labor and delivery, like hydration and energy packets, cooling cream, and more. 

References:

1. Hutchison J, Mahdy H, Hutchison J. Stages of Labor. [Updated 2023 Jan 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544290/
2. Stages of Labor. Cleveland Clinic. April 2022. https://my.clevelandclinic.org/health/symptoms/22640-stages-of-labor
3. Stages of labor and birth: Baby, it's time! Mayo Clinic. January 2022. https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/stages-of-labor/art-20046545
4. How to Tell When Labor Begins. FAQ 004. ACOG. November 2023. https://www.acog.org/womens-health/faqs/how-to-tell-when-labor-begins
5. Reddy UM, Paine LL, Gegor CL, Johnson MJ, Johnson TR. Fetal movement during labor. Am J Obstet Gynecol. 1991;165(4 Pt 1):1073-1076. doi:10.1016/0002-9378(91)90473-5

Dr. Kenosha Gleaton is board-certified in gynecology and obstetrics and is the Medical Advisor of Natalist. She received her MD from MUSC and completed her residency at Carolinas Medical Center in Charlotte, NC.

Dr. Gleaton is passionate about women, health equity, and mentoring. She is the CEO of The EpiCentre, an OBGYN spa-like practice, and is a Clinical faculty member of Charleston Southern University. She is also a member of the American College of Obstetrics & Gynecology, the American Association of Gynecologic Laparoscopists, and the American Association of Professional Women.