Essentially, prodromal labor describes pre-labor or practice contractions that hurt but don’t continue or intensify or result in going into actual labor. However, your doctor is unlikely to use that wording. Prodromal labor is not a stage of labor formally used by most OB/GYNs and the American College of Obstetricians and Gynecologists (ACOG) recommends avoiding the term. “Latent phase” is used when cervical changes are taking place but active labor has not yet begun. “The term ‘prodromal labor’ is not a medical term and was likely used to suggest the time before entering labor when there are uterine contractions resulting in cervical change. This is the time when a patient may be having painful contractions at term (so at 37 weeks or later) but are not progressing into labor and may necessitate pain control,” says Manisha Gandhi, MD, and OB/GYN at Texas Children’s Hospital in Houston and vice chair of the ACOG’s Committee on Clinical Practice Guidelines – Obstetrics. These contractions can be frustrating and worrisome, as it may feel like you’ll never go into real labor. Learn more about prodromal labor and how it differs from Braxton Hicks contractions and active labor.
What Is Prodromal Labor?
Prodromal labor is a term that many doctors and midwives use to describe “practice” contractions (also called “false labor”) that happen before active labor in some pregnancies. These contractions can be strong and frequent but do not cause labor to start or progress, explains Dr. Gandhi. Additionally, there is no way to speed up prodromal labor or get it to progress into active labor. The term is also used to distinguish these practice contractions from Braxton Hicks contractions, which are less painful and not as consistent. Additionally, says Dr. Gandhi, Braxton Hicks contractions do not cause cervical change. Only the contractions of active labor will bring on actual labor but both of these precursors to the main event are thought to help prepare the body for labor and delivery. In fact, the word “prodromal” is derived from the Greek “precursor,” and that’s a good way to describe this type of contraction. Although it has many of the hallmark aspects of labor (painful contractions that come in prolonged intervals), prodromal labor is not strong enough to bring on the cervical changes needed for active labor, says Dr. Gandhi. In fact, prodromal labor can come and go for many weeks or even months before you actually give birth, which is part of why it can be such an irritating experience for many pregnant people who have it. The other aspect of prodromal labor that bothers many people is that it can be downright confusing, especially as prodromal labor shares so many symptoms of real labor.
Causes of Prodromal Labor
The causes and functions of prodromal labor are unknown. However, there are multiple theories, including that these practice contractions are the body’s way of preparing for active labor. Some experts believe there may be a correlation between stress or anxiety and experiencing prodromal labor. Additionally, it may be more common in pregnancies in which the baby is in a breech position—and may be the body’s way to attempt to move the baby into the correct position for labor. Another theory is that prodromal labor may be caused by structural issues in the pelvis or uterus.
How to Tell If It’s Prodromal Labor
Many expectant parents simply want to know how to tell if they are in prodromal “false” labor or “real” labor. In some cases, especially if this is your first instance of prodromal labor, the best way to tell is to call your healthcare provider and discuss your symptoms. Depending on their judgment, your healthcare provider may have you come into the office to perform an exam to see if your cervix has dilated or not, and whether your body is preparing for birth in any other significant way. If all of the below conditions are true, however, you are likely experiencing prodromal labor rather than active labor:
You are in your third trimester, usually toward the end of it. You are experiencing contractions that are intense and possibly painful. Your contractions are regular (usually about 5–10 minutes apart) but not getting closer together. Although your contractions may have some regularity to them, they also stop and start, don’t become more intense, and aren’t strong enough to “take your breath away.” You aren’t experiencing other signs of impending labor, such as ruptured waters, loss of your mucus plug, or bleeding (the “bloody show” of active labor).
For most people who experience prodromal contractions, they occur during the very end of their pregnancies. However, some women experience it beginning at the end of their second trimester or the beginning of their third trimester. It’s most common in first pregnancies and doesn’t necessarily repeat in subsequent pregnancies.
Prodromal Labor vs. Braxton Hicks Contractions
Braxton Hicks contractions are very common as well—almost all pregnant people experience them at some point. But Braxton Hicks contractions generally begin earlier in pregnancy than prodromal labor, and while uncomfortable, they don’t feel as similar (as in truly painful) to real contractions as prodromal labor contractions do.
Braxton Hicks Contractions
The characteristics of Braxton Hicks contractions are as follows:
Usually, they begin around the fourth month of pregnancy. They feel like a tightening in your abdomen or uterus, rather than the intense squeezing or cramping feeling of prodromal or active labor. They are sometimes described as painful, but they’re usually more of a strong sensation or discomfort rather than truly painful. They do not usually have a regular pattern or become closer together. Generally, they do not get more intense over time. Often, they come about when you are feeling fatigued, dehydrated, or over-extended. Usually changing positions, lying on your side, drinking water, and resting will decrease your Braxton Hicks contractions.
Prodromal Labor vs. Active Labor
Prodromal labor is similar to real labor because:
Prodromal labor contractions may be painful or intense.Prodromal labor contractions may be as close as 5 minutes apart.Prodromal labor contractions may continue on and off regularly for an hour or longer.
Kind of confusing, right? However, there are some important distinctions between prodromal labor and active labor:
Active labor contractions become longer, more intense, and get closer together over time. Active labor contractions are usually accompanied by other signs of labor (such as leaking fluids, backache, diarrhea, or bleeding). Drinking water or showering usually will ease or stop prodromal labor but will have no significant effect on active labor contractions. Active labor contractions are prolonged and increase in power and result in progressive cervical change. Eventually, you will find yourself unable to converse or concentrate on much else when you are experiencing active labor contractions.
How to Cope
Just because prodromal labor is not “real” labor doesn’t mean it isn’t disruptive and uncomfortable. Some women say their prodromal labor contractions are as intense as their early active labor contractions end up being. And when it’s been many days or even weeks in a row of prodromal labor symptoms, you can end up feeling exhausted and in need of a break. Here are some strategies that might ease some of your symptoms:
Stay hydrated and well-fed (smaller, more frequent meals may be best at the end of pregnancy).Rest, rest, rest. Put your feet up! Get pampered. You deserve it.If you are up for it, take a walk outside for a change of scenery and to calm your nerves.Take a shower and direct the shower head on your abdomen to soothe it.Watch a movie or listen to music to relax and distract yourself.If you are losing sleep, ask your healthcare provider about safe methods to help you sleep.
When to Contact Your Doctor
It’s normal to feel unsure about when to contact your doctor or midwife with your questions but that’s what they are there for. Feel free to call them with even the smallest issues. For any non-urgent questions, keep a running list to bring to your next appointment. But for anything that feels uncertain or stressful or might be something important, err on the side of caution. In addition, if your contractions are accompanied by any of the following other symptoms of labor, it’s definitely time to call:
You’ve lost your mucus plug, which looks like a thick, long glob of mucus and may be blood-tinged. You have experienced spotting or light bleeding (any excessive bleeding should be reported to your healthcare provider ASAP). Your water has broken. You are experiencing diarrhea or nausea. Your contractions have become intense enough that it’s difficult to have a normal conversation or pay attention to anything else. Your contractions have become more painful, closer together, and longer-lasting over time. You have experienced “lightening,” where your baby drops low into your pelvis, usually felt as downward pressure and an increased need to urinate. You may also notice that you can now breathe more easily and deeply because your lungs have more room. Lightening is experienced more often by first-time moms.
Once you call your healthcare provider to report any or several of these symptoms, they will help you decide what your next move is, whether to “wait it out,” come in for an exam, or get to your hospital or chosen birth location immediately.
A Word From Verywell
Although prodromal labor, which many OB/GYNs refer to as practice contractions or the latent phase of labor, is not the same as active labor, it can be extremely uncomfortable and impact your day-to-day life. Although most cases of prodromal labor only last a few days, some people experience weeks of it. Aim to rest as much as possible during this time—you’ll need your energy for active labor. Rest assured that if you are not experiencing any of the other tell-tale signs of labor (your healthcare provider can usually tell by just hearing your voice on the phone) and your contractions have not increased in intensity, you’re probably not in labor. Also, don’t worry if you don’t experience prodromal labor—not everyone does. The silver lining to all this is that many pregnant people report that prodromal labor got them well acquainted with what to expect from early active labor contractions. So, you’ll be even better prepared when the big day finally arrives.
