Many women often experience “false labor” before “true labor” actually begins.

False contractions may begin as early as three or four weeks before the termination pregnancy. Contractions, show, the cervix, and fetal movement all are vital in distinguishing between true and false labor (see Table 2-1).

FACTOR	TRUE LABOR	FALSE LABOR
Contractions	Produce progressive dilation and effacement of the cervix.  Occur regularly and increase in frequency, duration, and intensity.	Do not produce progressive dilatation and effacement.  Are irregular and do not increase in frequency, duration, and intensity.
Show	Is present.	Not present.  May have brownish discharge that may be from vaginal exam if within the last 48 hours.
Cervix	Becomes effaced and dilates progressively.	Usually uneffaced and closed.
Fetal Movement	No significant change, even though fetus continues to move.	May intensify for a short period or it may remain the same.

Table 2-1.  True verses false labor.

a. Contractions.

(1) True labor. The contractions of true labor produce progressive dilatation and enfacement of the cervix. These contractions occur regularly and increase in frequency, duration, and intensity. The discomfort of true labor contractions usually starts in the back and radiates around to the abdomen and is not relieved by walking.

(2) False labor. False labor contractions are referred to as Braxton Hicks contractions. They do not produce progressive cervical effacement and dilatation. They are irregular and do not increase in frequency, duration, and intensity. Discomfort is located chiefly in the lower abdomen and groin area. Walking often offers relief.

b. Show.

This is another sign of impending labor. After the discharge of the mucous plug that has filled the cervical canal during pregnancy, the pressure of the descending presenting part of the fetus causes the minute capillaries in the cervix to rupture. This blood is mixed with mucus and therefore has a pink tinge.

(1) True labor. Show is usually present in true labor. There will be pinkish mucus or a bloody discharge. This mucus or discharge may also be from the mucous plug from the cervix.

(2) False labor. Show is not present in false labor. However, the mother may have an old, brownish discharge especially if she had a vaginal exam within the last 48 hours.

c. Cervix.

(1) True labor. In true labor, the cervix becomes effaced and dilates progressively. This change can be identified within an hour or two.

(2) False labor. In false labor, the cervix is usually un-effaced and closed. There is no change identified if the cervix is rechecked in an hour or two.

d. Fetal Movement.

(1) True labor. There is no significant change in fetal movement even though the fetal continues to move.

(2) False labor. Fetal movement may intensify for a short period or it may remain the same.