It can be hard to tell when you are truly in labor. Contractions (belly tightening) are the main sign of labor. They last from 30 to 60 seconds and might feel like period cramps at first.

False labor pains (called "Braxton Hicks" contractions) can happen anytime in pregnancy, but are more common toward the end. 

Here's how to tell if you're in true labor or false labor. If you're not sure, call your health care professional right away.

True Signs of Labor

Contractions that:

• happen 4 times per hour or more, and get closer together (for example, they come every 15 minutes, and then every 10 or 5 minutes, etc.)
• get stronger (more painful) as time goes on and do not get better with rest

Pelvic pressure:

• It feels like the baby is pushing down in your vagina.

A backache:

• Some lower back pain is common during pregnancy, but in labor it will be much stronger.

Your water breaks:

• This can feel like a gush of fluid in your underpants, or a steady trickle.

You do not need to have all symptoms to be in true labor.

False Signs of Labor

Contractions that:

• come less than 4 times an hour
• are not regular
• do not get stronger or more painful
• come and go depending on your position (if lying down, walking, sitting, etc.)

Call Your Health Care Professional If:

• You think that you are in labor.

Go to the ER If:

• You have signs of labor and are less than 37 weeks pregnant.
• You don't feel your baby moving.
• Your contractions are less than 5 minutes apart.
• You are bleeding.
• You have vision changes, a headache, difficulty breathing, or sudden or severe swelling.