Every pregnant woman at some point in her pregnancy will be given to wonder if she is in labor. Most women have a few false starts. Braxton-Hicks contractions can be confusing and can become frequent and regular, at least for a short time. Women frequently have physiologic discharge or will urinate and wonder if their water is broken. So how can you tell real labor from false labor?

The answer is time. Real labor is progressive in every way, but you won’t be able to see this until some time has passed. If you’re having some regular contractions, the best thing to do is to see what happens over the next two or three hours. If you are really in labor, your contractions will become more frequent (maybe going from every 6 to 7 minutes apart to every 3 to 4 minutes apart), they will last longer (going from, say, 30 seconds in length to 45 or 50 seconds in length), they will become more painful, they will become more regular and predictable, and they will persist. False labor, on the other hand, may seemingly start strong but over two or three hours will lose steam and wane.

If it’s your first baby, you have plenty of time. Labor will likely last many hours and you will have plenty of time to arrive at the hospital. If it’s your fourth baby, then you already know what to expect; if you are reading this anyway, your labor probably won’t last that long and you should head to the hospital a little sooner.

In some cases, your doctor may ask you to come to the hospital a bit earlier; for example, if you’re positive for group B strep, then you will need four hours of IV antibiotic therapy in addition to however long it takes to get to the hospital, get admitted, and get an IV started, before the baby born.

If your water breaks, you should probably head on the hospital. This may be a sign that your labor is already very advanced, since women’s water tends to break at an average of about 8 cm. If your water is broken and you’re not already in labor, then you should still go to the hospital because your labor likely needs to be augmented or induced.

If you have had a previous cesarean delivery, then you should come to the hospital much sooner because you do not want to risk laboring at home. A trial of labor after cesarean is a good idea for most women, but because of the risk of uterine rupture, that trial of labor should happen at the hospital as much as possible.

How can you tell if your water is truly broken? You can’t always tell; but in general, once your water breaks, it keeps coming. Ruptured membranes is not just a small gush or a little bit of spotting; if you think your water has broken, clean up and see if the leakage persists. If it does or you are unsure, you probably need to be examined.