Tips for Surviving Prodromal Labor

During every one of my pregnancies I’ve learned many new words and terms that I didn’t even know existed before we started having children… Words like placenta previa, nuchal cord, VBAC and HBAC (and lots of others).

After having five babies myself and serving as a doula for many others, I’d started to feel that I finally had a pretty good understanding of all of the terms associated with pregnancy and birth. To my surprise, I got to learn and experience yet another new term this time around… prodromal labor.

What is Prodromal Labor?

Prodromal labor is a type of labor that happens prior to the onset of full active labor. It is often considered a type of “false-labor,” but this is a misnomer, because doctors and midwives will explain that the contractions are real but they start and stop. So basically, it is real labor in terms of pain, contractions, and regularity but it comes and goes.

Prodromal labor often starts and stops at the same time each day or at regular intervals, and many moms (even experienced moms) often end up calling their birth team or going to the hospital thinking it is real labor. Prodromal labor can last days, weeks or even a month or more, often starting and stopping at the same time each day (or night).

Prodromal vs. Braxton Hicks

There is often a misconception that prodromal labor is the same as having Braxton Hicks contractions, but there is a definite difference. Most women experience Braxton Hicks contractions, or “practice contractions” at some point during pregnancy. These contractions can be very tight and uncomfortable, but rarely last long periods of time or pick up in intensity.

Additionally, it is often possible to alleviate Braxton Hicks contractions by hydrating, eating or relaxing. These techniques typically do not stop prodromal labor. Prodromal labor can also slowly dilate or efface the cervix, while BH contractions typically do not.

Another difference is that Braxton Hicks contractions are often not regular or intense, while prodromal labor can follow a very regular contraction pattern and vary in intensity.

What Causes Prodromal Labor?

There seem to be several potential causes of prodromal labor, but no official cause or consensus in the medical community. Most sources agree that prodromal labor is the body’s way of preparing for real labor, and some things that may contribute are:

• The baby’s position in the womb– Many sources think that prodromal labor may be the body’s way of trying to move the baby into the correct position for labor. Basically, the uterus tries to move the baby with contractions for several hours and eventually stops if it doesn’t work, only to start again after resting.  This theory may make sense as moms with a baby in breech position are more likely to experience these early contractions (this was true in my case).
• Pelvic or uterine abnormality–  It seems that some women are more prone to prodromal labor than others, leading some sources to think that it may relate to an uneven pelvis or uterine abnormality.
• Emotions or anxiety– Another theory is that prodromal labor is more likely in women who are anxious or concerned about their birth or who are experiencing a lot of stress.
• More than three pregnancies– There are definitely exceptions, but prodromal labor seems to be more common in moms who have had at least three children, so perhaps there is an element of the way the uterus changes or relaxes after several pregnancies.

My Experience

After having experienced prodromal labor myself over the last month of pregnancy, I can now vouch for the fact that the contractions are very much real and feel like “real” labor. Each woman will experience prodromal labor differently, but most of the time, I’d compare the contractions to those I felt in early labor in previous pregnancies (4-5 cm range).

The physical toll of these early contractions is exhausting, but I found that the real struggle was emotional, mainly due to a lack of sleep. My prodromal labor started about a month before my little one finally arrived and I experienced it almost every night from 1-5 AM. Definitely not the best for sleep!

Though I’d been through labor many times before, I actually called the midwives on one of my first nights of prodromal labor because the contractions were so strong and regular (and proceeded to feel like a first-time mom who didn’t know what labor actually felt like yet!).

This pattern continued for the next several weeks, making me wonder almost every night if labor was starting and pushing me to the edge of my sanity many nights. Here are some of the ways I tried to stay sane.

Tips for Surviving Prodromal Labor

After a month of this very uncomfortable “labor”, I wouldn’t wish it on my worst enemy, but I did learn a few coping mechanisms that really seemed to help. If you’re also going through the trial of prodromal labor, hopefully these will be helpful to you too:

Remember, You Aren’t Crazy

This was the hardest part for me. I knew that the contractions felt like real labor contractions, yet they started and stopped and never seemed to turn into active labor. They definitely hurt, were regular, and I could time them.

After weeks of this, I was on the verge of tears every night, doubting my ability to tell if I was in real labor or not and telling my husband “I can’t keep doing this every night… I’m so exhausted!”

It really helped to talk to several other friends who had experienced prodromal labor before and to research more about it. Though this was my first experience with it, this is a very common occurrence that many women experience and it seems to make most of us feel crazy at some point.

Remember that you aren’t crazy, the contractions are real and they really do hurt and that it will (eventually) lead to a baby in arms!

Practice for Labor

The silver lining of prodromal labor, if there is one, is that the contractions are very much real in intensity and timing. Not seeing the silver lining in that? You’ll have plenty of time to practice relaxation and coping mechanisms for when labor finally picks up.

I know, this isn’t much of a comfort in the middle of the night when you’d rather be sleeping, but I figured that if I was going to have the contractions anyway, I might as well use them to practice relaxing.

Breathe, relax, move around, or find whatever relaxation methods work best for you.

Try Some Exercises to Improve Position

Since prodromal labor may be partially caused by baby being in a less-than-optimal position, some exercises and stretches to help improve baby’s position can help calm these early contractions or speed them up.

Check out this list of exercises for early labor from Spinning Babies.

Take Naps and Rest When You Can

This is the toughest part, especially if prodromal labor happens at night, as the physical exhaustion was the hardest part for me. After several weeks, I eventually was so tired that I was able to sleep somewhat during the contractions but didn’t feel rested until after she was born.

Try natural methods to help promote sleep, or talk to your doctor or midwife to see if there is something they can recommend to help you rest.

Take naps during the day if you are able, and rest when you aren’t having contractions.

Check Your Dilation

One of the most frustrating parts is not knowing when labor changes from prodromal to active and many women have more than one false alarm during these extended early contractions. One thing that was helpful to me was learning how to check my own dilation so I would know when labor had started in earnest.

It can be a little tricky to learn to check dilation on yourself, but there are also some alternative methods to help gauge dilation.

Stay Hydrated and Nourished

Women who experience prodromal labor often have shorter active labors, so it is important to eat enough and stay hydrated to be ready for labor when it starts. Exhaustion is often the toughest part of labor, especially after laboring prodromally for so long, and keeping the body hydrated and nourished can help.

The Benefit of Prodromal Labor

Though this “false labor” can seem pointless and exhausting, many women who experience it report having shorter active labors, and this was certainly my experience. My typical labors have been 20+ hours with my shortest being about 15. This labor was 3.5 from “I think this is labor” to “hi Baby!”

Prodromal labor certainly isn’t a guarantee of a short labor but it does seem to help for many women. If you are struggling with prodromal labor, try to focus on the fact that even if you aren’t in active labor yet, the contractions are preparing your body and may make things easier when real labor starts.

Did you experience prodromal labor? What helped you? When did active labor finally start?

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