What Is Prodromal Labour?

Overview of prodromal labour

Prodromal labour can be defined as false labour contractions that occur in pregnancy usually in the 3rd trimester or in the weeks near the due date. These contractions will be felt in the front of the abdomen (belly) as intense pain or tightening in the abdomen. They usually last around 60 seconds and can occur consistently, 5 to 10 minutes apart. Prodromal labour contractions are often mistaken for real labour as they feel very similar.¹

• Prodromal labour does not advance to active labour, the cervix does not actually dilate or thin in prodromal labour.¹ Research has shown that prodromal labour is the body's way of preparing for actual labour because the contractions will strengthen uterine ligaments and muscles.² Prodromal labour starts and stops before active labour begins.³ Prodromal labour is normal and not a cause for concern in pregnancy.⁴ It can however be worrying and painful so it is important for pregnant people to understand the concept. 

Definition

Prodromal labour can be broken down as follows: 

• Prodromal means precursor; it comes from the Greek word¹ 
• Labour is the process of a baby leaving the uterus, also referred to as childbirth. Labour involves the continuous and progressive contraction of the uterus that helps the cervix dilate and thin out  

Prodromal labour is also referred to as false labour and can be described as being in between Braxton Hicks contractions and active labour.³ Braxton hicks contractions are also false labour contractions however, they can happen in the second trimester and are typically less painful and  less consistent than prodromal labour.¹ Note that sometimes prodromal labour and Braxton Hicks are referred to as the same thing, however they are 2 different forms of false labour. 

Read on for more details about prodromal labour and how to manage the discomfort it can cause. 

Characteristics of prodromal labour

Duration

• Prodromal labour can last for 1-3 days or longer in some pregnancies⁴
• Prodromal labour will fully stop before active labour begins³
• ^.Prodromal labour does not make active labour quicker⁴
• Prodromal labour contractions last for around 1-4 minutes
• Consistent prodromal labour contractions occur between 5-10 minutes apart⁴
•  This pattern of contractions lasts for less than one hour in prodromal labour⁴

Signs and symptoms

Contractions

As described, prodromal labour is felt as false labour contractions. These contractions are felt in the belly and can feel tight and painful. This pain will usually last one minute at a time, with consistent contractions occurring no less than 5-10 minutes apart.¹

Other signs and symptoms

Prodromal labour can be associated with some general symptoms as well as contractions:⁵

• Loose stool 
• Increase in nesting instinct: nesting during pregnancy refers to the bursting desire and energy to prepare your home for the baby. It is associated with an urge to clean and organise
• Loss of mucus plug: a mucus plug is a collection of mucus that forms early in pregnancy in the cervical canal preventing infectious agents from entering the uterus and harming your baby. This plug is lost at the very end stage of pregnancy. Loss of mucus plug results in a clear, off-white and mildly bloody vaginal discharge 

Onset and incident 

• Prodromal labour can happen in the third trimester of pregnancy, usually in the weeks near the due date¹
• Prodromal labour is normal in pregnancy but doesn't happen in all pregnancies 

Differentiating from true labour contractions

It is helpful to be able to spot the difference between active labour and prodromal contractions. The table below is a guide for this:^1,6 

Note that a cervical examination is the only way prodromal labour can actually be confirmed.¹

Differentiating from Braxton hicks 

As described before Braxton hicks contractions are also false labour contractions. They are similar to prodromal contractions but can be differentiated by the following characteristics:¹  

Causes of Prodromal Labor

Healthcare professionals do not fully understand what causes Prodromal Labour.  Some potential causes are:¹  

• Anxiety / Stress
• Having 3 or more previous pregnancies
• Foetal movement into position for delivery
• Baby being breech (bottom / feet first)
• Pelvis irregularity
• Uterine anomaly  

Ways to manage discomfort

Prodromal labour can be very uncomfortable. There are a number of ways to help distract yourself from the contractions:⁴  

• Take a warm shower
• Breathing exercises 
• Being active like short walks 
• Resting  
• Changing positions
• Stay hydrated and feed 

When to seek medical attention?

Monitoring your contractions is very important as it can help guide you when you need medical attention. You should seek medical attention if you start to suspect you are entering active labour. If you are experiencing the below symptoms, it could be a sign that you are entering active labour: 

• Regular contractions are less than 5 minutes apart
• Contractions lasting longer than a minute each 
• Consistent contractions lasting longer than one hour
• Your water breaks

Note if you are struggling to know what contractions you are experiencing, contact your healthcare provider for further advice or to arrange a cervical examination.  

Summary 

Prodromal labour is also known as false labour and can occur in the third trimester of pregnancy. It is the experience of contractions that are very similar to active labour contractions. However whilst prodromal labour can make pregnant people feel or think as though they are about to give birth it does not lead to active labour. Your cervix does not dilate during prodromal labour. The contractions felt in prodromal labour tend to be weaker than those felt in active labour. There are also key differences in the patterns; unlike in active labour, prodromal labour contractions do not get closer together, will not last for longer than a minute or occur less than 5 minutes apart. Tracking your contractions and symptoms is key to understanding if you are entering active labour or just experiencing prodromal labour. Healthcare providers will be able to assist people with this when needed.

FAQs 

Does prodromal labour mean active labour is coming?

No, prodromal labour is not a sign that you are about to enter labour or that your cervix is dilating. It does however tend to occur in the weeks near to your due date.¹

How to know if you are experiencing prodromal labour?

Prodromal labour is associated with 1 minute long contractions that feel tense and quite painful at the front of your belly. These contractions will occur fairly regularly but for no longer than an hour. Prodromal labour contractions occur between 5-10 minutes apart, and do not get any closer together.¹ See the tables in this article for clear guides on how to differentiate prodromal labour with active labour and Braxton Hicks. 

Can you sleep through prodromal labour ?

Yes, rest is good to manage discomfort and conserve energy.⁵