How to Manage Prodromal Labor

During the course of your pregnancy, you probably learned all about the signs of labor – namely, regular contractions that get longer, stronger, and closer together. It is common to be advised that when the contractions are 5:1:1 (5 minutes apart, lasting 1 minute, for 1 hour), it is time to call your provider and think about coming into the hospital or birth center, or for your homebirth midwife to get ready to head your way.

But what if your contractions start out at five minutes apart and a minute long? Many people are confused or even alarmed when this happens to them: they are getting ready to settle down for the evening, and they notice that they have been having some stronger contractions that are coming at regular intervals. They time them, and discover that they are already five minutes apart! Things must be moving along quickly. But when they call their provider to put them on the alert, they will most likely be advised to rest, wait it out, sleep, and call if things change.

And, after waiting through hours of contractions that continue at five minutes apart, the pattern fizzles out as if nothing ever happened. Frustrating! And the worst part is – this can happen more than once, over several days and nights, before labor starts – and it could even do this for a day or two, and then disappear until labor starts a couple of weeks later. This is prodromal labor.

So how on earth do we know what’s what if these crazy contraction patterns happen? The main thing to remember is that the hallmark of “real” labor is that the contraction pattern progressively changes – longer, stronger, and closer together as you go. If your contractions are staying the same, it should raise the question. This is exactly why we will, more often than not, advise that you ignore your contractions for as long as possible in early labor, and go about your normal activities. In other words:

  • If you would normally be sleeping, sleep.
  • If you would normally be working, work.
  • If you would normally be exercising, go ahead and exercise.
  • If you would normally be lounging with your feet up in front of Netflix, do that.

In most cases, prodromal labor contractions will gradually or suddenly cease as you go about your regular life, and if you haven’t expended too much energy focusing on it, it won’t be a big deal, and we can go back to waiting for early labor to begin (hopefully soon!)

What can be a problem, though, is if these contractions keep you awake for one or more nights before labor really begins. We’ve talked before about how important it is to sleep during early labor, to conserve energy for the hard work to come – but that can be a challenge with prodromal labor, as the contractions can feel strong.

To help with sleep during prodromal labor, we might suggest that a person start with a warm bath, and perhaps some Natural Calm magnesium to try calming things down. Sometimes, we may suggest a half glass of wine, or even some diphenhydramine (Unisom or Benadryl) in severe cases. What we do know is that sleep is king in almost all instances – if our pregnant clients are awake for nights on end, it doesn’t do anyone any good when the real thing starts.

All of this sounds (and is) super frustrating, but we want to leave you with a little bit of reassurance: though you may have heard prodromal labor referred to as “false labor”, it is not true that these contractions are pointless. They are likely doing something to help you along, such as softening and thinning the cervix, or shifting baby into a better position. So it’s not all for nothing!