Preterm Labor vs. False Labor -- A Symptom Guide

Cynthia Dermody

delivery room
Flickr photo by Daquella manera
Preterm labor and false labor.

To the mom, it's often just ... labor. It just hurts.

But there's a critical difference. False labor can usually be ignored. Preterm labor is serious. It means the baby is coming before she's ready, and doctors often need to step in. The doctors and midwives need to know the difference, but not all of them do. Many cases of false labor are misdiagnosed, leading to inductions and unnecessary premature births.

The March of Dimes, which is devoted to preventing birth defects and premature births, is jumping in here. They're launching an exciting new research program that aims to help doctors tell the difference between false labor and preterm labor. The Perinatal Advisory Council (PAC/LAC) in California has been charged with developing this new program, first implementing in hospitals in California before going nationwide.

I talked to PAC's executive director Cynthia Fahey about the new testing tools they're developing to help doctors know the difference, and what all pregnant women should recognize about their labor in the meantime ...

Are doctors misdiagnosing false labor and inducing babies much too early?

What's happening is that doctors are jumping to treat what's potentially a very serious situation before fully assessing what's going on. Preterm labor is serious and needs to be treated immediately, but it can be confused with false labor. Sometimes in a desire to treat the patient, a physician might not conduct a standardized assessment -- that is what this program aims to address.

What are the signs of false labor?

False labor can be characterized by sometimes painful contractions that are irregular and unpredictable. As a nurse, I'd often determine false labor by having a woman change her activity or position and then determining whether her contractions changed. For example, if she's sitting, I'll have her walk around. If the intensity of the contractions or the period between contractions decreases, then it's usually false labor.

What are the signs of preterm labor, or are they one in the same?

Preterm labor is labor that occurs before your 37th week of pregnancy. Labor is characterized by contractions that are consistent and predictable and cause changes in the cervix. They gradually become more intense and over time occur closer together. From a medical standpoint, what we're looking for is the shortening of the cervix, which may be preceded by bloody show or a slow leak or rupture of the membranes.

What's the biggest mistake doctors make in trying to tell the difference?

The physician doesn’t make a mistake as much as she might be too quick to treat the patient based on a lack of clear assessment guidelines. This program will help all hospital staff to triage patients more effectively to determine what's going on.

What can pregnant women do now to prevent unnecessary inductions, to try to tell the difference between false labor and preterm labor?

1.       Understand what labor feels like -- it should feel like a belt is wrapped around the midsection of your stomach, and the belt is being tightened from front to back.

2.       Look for a progression of pain -- labor pains get increasingly difficult on a consistent basis as labor progresses.

3.       Monitor the regularity of contractions -- labor contractions are usually a steady distance apart and the time between contractions should steadily decline.

4.       Look for fluids -- take note of any fluids (mainly bloody show or any leakage).

5.       Know whether you're at risk for preterm labor. Talk to your doctor about any other complications such as gestational diabetes, hypertension, etc.

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