Many women, especially women with their first baby, are surprised if they are having contractions and we tell them, "We have to see if you are in labor."
"But I'm having contractions!" is often the reply.
There is a great obstetrical difference between having contractions and being in labor. While all women who are in labor are having contractions to some degree, not all women who are having contractions are in labor. The definition of labor is not just having contractions, but having contractions which cause a readily measurable change in the cervix.
For example, I admitted a young woman recently who was having contractions about every five to eight minutes. They were mild as far as the work the uterine muscle was doing, but were very painful to her. I examined her and her cervix was 2 and 1/2 centimeters dilated. She had been 2 centimeters dilated on her last exam. Although she was having contractions, I couldn't definitely say she was in labor. The "change" of 1/2 centimeter could actually be the result of two different examiners. In fact, if you had five different people examine you one right after another (which would be down-right cruel) all the results may be different, but they should all be in the same ball park. I have told family members that trying to determine the dilation of the cervix simply by feeling it with the fingers would be like putting your finger in your mouth and telling someone how long your tongue was!
If this particular woman had been 3 1/2 centimeters dilated, I could have said that was a definite change and it would have been easier to say she was in labor.
In cases where there is little or no cervical change, we often observe the woman for a few hours to give the contractions more time to dilate the cervix. The woman can walk if she would like. While walking will not put someone into labor, if you are in labor, it helps to make the contractions more efficient.
The hallmark feature of true labor is that the contractions become "progressive". This means that over time the contractions come closer, they last longer and they become more intense. This is one of the main reasons to time contractions. That doesn't mean you have to time every contraction. Time several and then put the watch aside. Come back a while later and time some more. You should begin to see a pattern after doing this a few times.
Especially in the case of the first baby, there is rarely a hurry. A first baby can take a long time and the first phase of the first stage, called early labor (up to 4 centimeters) can last up to 24 hours and still be considered normal. Most women with their first baby are less than 4 centimeters dilated when admitted to the hospital. Of course, you should always notify your health care provider regarding your contractions according to the instructions they have given you.
