The term "false labor" has been popular throughout the years. However, the more appropriate name is “Prodromal Labor” (aka practice labor). We see prodromal labor occur in about 30% of pregnancies/labors. Prodromal labor does not discriminate! It happens to first time moms, moms on their eighth baby, moms of one baby, moms with multiples, moms who didn’t have it with one baby but are now having it with the next, and happens with moms from 37 weeks to 42 weeks! One thing that all these pregnant women have in common: they HATE prodromal labor.

Prodromal labor is defined as contractions and signs of labor that do not progress into true labor. Sometimes a labor does start with prodromal labor. However, during the time period we say a mother is in “prodromal labor” it is usually not progressing with contractions getting closer together, stronger, and lasting longer.

Time periods in labor are labeled when certain signs are present. The primary stages of labor are often described as these:

Early first stage labor: Mom is having contractions, they are getting closer, they are starting to get stronger, but moms are still pretty functional especially in between contractions.

Active first stage labor: Very challenging work, contractions get very close together and/or become very strong. This is the time where you see a shift occur. Moms become more serious and are not communicative even between contractions.

Transition: this is the time between first and second stage labor and is most often described as the most challenging part of labor.

Second stage labor: the pushing stage of labor

Third stage labor: from birth of baby to birth of placenta

Early labor and prodromal labor can almost be identical so it can be confusing and challenging to know which one you are experiencing. The unfortunate reality is that we do not know for certain if you are in early labor or the beginning of prodromal labor until you get to the next stage of labor. Both prodromal labor and early labor have contractions and sometimes other signs of labor. Many moms will just feel “off”. Sometimes feel achey or nauseous. Contractions can be anywhere form 5-30 minutes apart and they can sometimes be strong. Many moms struggle with this aspect of prodromal labor. Sometimes contractions are so uncomfortable that mothers do not feel as if they can be as functional. The other aspect that is challenging is that sometimes mothers experience some form of prodromal labor for days or even weeks. There are, however, some things that that can be done to ease the unpleasantness.

• PREPARE for the fact that prodromal labor can happen. Many moms find that when contractions start it is SO exciting. They have been waiting 9+ months for labor to start! Not only do the parents want that baby to be born but they are usually getting many reminders from well meaning friends and family that it is time for the baby to be born. Then pressure from a medical care provider can add a bit more longing for every contraction to be a sign that it is finally happening! Prepare yourself, your partner, your family, and even your care provider that your plan (as long as everyone is healthy) is to be patient and that you want your baby to be born at the time your baby and body decide.

• IGNORE labor at first. As you start to feel you might be in labor, try your absolute best to ignore it. Do everything you can to go about your life as much as possible. If you aren’t at a point where you can go to work, drive, etc, you can still do some other things. Try to find things that will promote rest/relaxation. Some moms try taking a bath, getting a pedicure, maybe a going on favorite dinner date (could be your last one for a while), eating chocolate, or even visiting with a friend.

• SLEEP. During prodromal labor (which could be early labor) focus first and foremost on resting, and better yet, sleeping! The average labor is 16-18 hours. However, we have found that it is so beneficial for a couple to plan for labor to be 24 hours. If that is the case, once contractions start, you will think, “I might not have this baby until tomorrow. I need to sleep now, I am going to need to conserve my energy!” We can’t stress enough how helpful it is to rest and sleep as much as possible in the beginning.

• BUT HOW TO SLEEP?! For some couples, this is really tough. The adrenaline is running and it is difficult to shut everything off to sleep. Additionally, contractions can be disruptive. Some moms find some relief in taking a bath or shower. To help even more, soaking in a bath with magnesium flakes has been shown to relax muscles and can help the uterus to relax. It can sometimes give moms a bit of a break and offer her the chance for more sleep. There are some mothers who need a bit more. There is an option through your medical care provider called “therapeutic rest”. Some doctors or midwives will prescribe OTC pain medication for moms to try get a bit or relief to sleep. Some care providers will offer a prescription or narcotic if it is determined that the mom is truly experiencing prodromal labor.

• GET THINGS GOING. There are times during a suspected prodromal labor that sleep has already happened or it is just not going to happen. So the other option is to try to “bump” the labor progress into the next stage of progression. Some of the things you can try are walking, squats, or any other activity being up and moving around. We often recommend mother use the positions in the Miles Circuit at least once a day starting around 38 weeks. If prodromal labor is happening due to the baby’s position, this circuit can help baby shift in to a better position. Some moms are comfortable using supplements or herbs and some care providers will supply that or advise what and how to use. We recommend Lizzie’s Herb Shop in Kernersville for recommendations from their Certified Herbalist. Some moms try using a breast pump for nipple stimulation. That can increase the flow of oxytocin which is the hormone that helps contractions to happen. Some mothers can stay in close touch with their care provider and can discuss some other options such as membrane stripping or trying castor oil. (That is another blog post entirely!)

• USE RESOURCES. We have seen many moms be “successful” in ending prodromal labor and seeing progressive labor start after an induction massage! This is something that you usually need to schedule in advance. We suggest that mothers get a few massages during pregnancy especially towards the end. Ideally it is great to schedule on at 36 weeks, 39 weeks, 40 weeks and 41 weeks with the hope that the last one can be cancelled! We recommend Ruth at Touch of Serenity in Greensboro. She has impressive outcomes for getting labor to start for moms that are at or past their due date. We also have seen it helpful to see a Webster Certified chiropractor during pregnancy and around the due date to help get a mom’s pelvis in alignment and help baby get into the best position for labor. We have great chiropractor recommendations in our area, so just ask us! Very similar to the massage, it is most beneficial to be seeing the provider a bit in advance instead of after two days of prodromal labor and meeting them for the first time. Also, it is a proactive way to prevent prodromal labor entirely.

• LET IT GO. Sometimes it seems that prodromal labor just needs to happen. No matter what we try or do, it is just the route a baby takes to come in to this world. Many times we do not know what it is that needs to happen so we try all the things! It can be encouraging to know that many mothers make a good amount of progress during the prodromal labor time. Some moms will slowly dilate and efface or baby will slowly get lower even without the type of contractions that progress like in active labor. Regardless, at some point there will be a shift and labor will start. It is impossible to be pregnant forever!

• CALL YOUR DOULA! This is the best thing to do during prodromal or early labor! Your doula(s) want to walk though this with you to help you feel confident in what you are doing through prodromal labor. We can also help you to identify when it is no longer prodromal labor. There are many variations the process of labor can take and we want to try to help you as much as possible with whatever your personal labor scenario is.

Prodromal labor is one reason that couples go to the hospital or birth location too soon in the process. Many care providers and birth locations are encouraging mothers to stay at home longer and there is evidence based research to support that approach! Mothers who wait until they are past 4cm to be admitted to the hospital have lower chance of a cesarean birth. More conservative and natural birth friendly care providers and birth locations (such as a birth centers) encourage mothers to come to their birth location when they are even further in to their labor and well past the early/prodromal stage.

Prodromal labor is a challenging situation. However, with the right physical and emotional support from the partner, doulas, and care providers, it can be mananged well. Ultimately, if mom and baby are healthy, it is best to wait out this type of labor. However, you always need to communicate with your brith team and draw on the support that you have to do what works best for you. As always, your doulas are available for any support or suggestions and you can get in touch with us at any time!!