prodromal labor

Written By Celina Coppetti

WHAT IS IT?

Prodromal labor, or prolonged early labor, is a normal part of labor that occurs before active labor but does not progress toward delivery. The term “pre-labor” is also used to describe these contractions, and they accomplish changes that allow true labor to occur.

Prodromal comes from a Greek word meaning “precursor”. This is a great explanation for this type of labor since it typically occurs hours, days, or weeks before active labor begins. Prodromal labor consists of contractions that can be fairly regular and can be painful like active labor contractions, more so than Braxton Hicks contractions, and can last for 1 to 3 days, or longer. These contractions are preparatory. It is suggested that they may help encourage the baby into a suitable birthing position, that they prepare the muscles, ligaments, and pelvis for active labor, and they may help prepare for what is soon coming:  active labor.

If you believe you're experiencing prodromal labor, it's helpful to let your OB, Midwife, and Doula know, even if you aren't ready to go into the hospital or birth center. Your care provider can help you assess what's happening.

In general, once your contractions begin happening regularly at less than 5 minutes apart, lasting for longer than one minute each, and continuing like this for longer than an hour, you may be transitioning into active labor and should notify your care team. Most people can labor safely at home for some time in active labor. 

RECOGNIZING

PRODROMAL LABOR

The best way to know which phase of labor you are in is to monitor your contractions and any additional symptoms. It can feel difficult to pinpoint prodromal labor (after 36 weeks) because it’s similar to real labor and Braxton Hicks contractions (20-25 weeks), and can vary in both intensity and frequency. Signs of prodromal labor include:

  • • Backache

    • Lower abdominal or pelvic pressure

    • Tightening, tingling, or intense pain in the front of the abdomen

    • Excessive vaginal discharge

    • Expulsion of the mucus plug

    • Surge of energy

    • Diarrhea

  • • Last up to 1 minute

    • Roughly 5 minutes apart but do not grow closer together

    • Do not grow more intense or frequent over time

  • • True labor tends to be consistent and progress over time, while prodromal labor can persist for hours or even days.

    • While the timeline is different for everyone, the average length of prodromal labor is about 24-72 hours.

WHAT cAUSES PRODROMAL LABOR?

“Prodromal labor is a sign that your body is getting ready for childbirth, and it is a normal part of the process.”

The first thing to know is that if you are experiencing prodromal labor, it is not because of anything you did (or didn't) do, and your baby is not in distress. There’s no official cause or consensus in the medical community, but most sources agree that prodromal labor is the body’s way of preparing for real labor, and some things that may contribute are:

  • 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.

  • Another theory is that prelabor is more likely in those who are anxious about their birth or experiencing excessive stress.

  • It seems that some women are more prone to prodromal labor, leading some sources to believe that it may relate to an uneven pelvis or uterine abnormality.

MANAGING PRODROMAL LABOR

During pre-labor contractions, it is important to make sure you rest. Since there is the potential for active labor to occur not too much later, it is suggested that you conserve your energy for the actual labor and delivery. Here are things you can try to do to keep your mind off of the contractions:

  • • Be patient with yourself

    • The start of labor is so exciting! Prepare yourself, your partner, your family, and even your care provider that your plan is to be patient and that you want your baby to be born at the time your baby and body decide.

    • Do things that calm you:  read a book, write a journal entry, listen to music, meditate, etc.

  • • Keep yourself well-hydrated and eat small, balanced meals. Proper nutrition and hydration can help your body cope with the challenges of prodromal labor.

    • Prepare a light snack or your favorite cup of tea.

  • During prodromal labor, focus on resting. The average labor is 16-24 hours. It’s beneficial to you and baby to conserve your energy and rest as much as possible in the beginning. Rest can help you recharge and endure the discomfort.

  • A warm bath can be relaxing and soothing. If you're feeling anxious, take a bath. Taking a bath can slow down or stop early labor contractions. That said, when you're out of the tub, if your body is ready for labor, the contractions will pick back up.

  • • Experiment with different positions – standing, sitting, walking, or gentle swaying – to find what is most comfortable for you. Since prodromal labor may be partially caused by baby being in a less-than-optimal position, some stretches to help improve baby’s position can help shift out of prodromal labor.

    • Use a warm heating pad on your back or above your pubic bone.

  • Spending time with your doula is the best thing to do during early labor! Your doula wants to guide you to help you feel confident in what you are doing through this stage. We can also help you to identify when it is no longer prodromal labor. There are many variations the process of labor can take and we want to try to help you as much as possible.

Try Not To

  • Overexert yourself

  • Eat a heavy meal

  • Put pressure on yourself

* Getting to the hospital too early means you will either get sent home or medical interventions to induce labor may be performed, essentially out of impatience. Mothers who wait until they are past 4cm dilated to be admitted to the hospital have lower chance of a cesarean birth.

Call your provider if you are experiencing: severe and regular contractions that are increasing in intensity and frequency, sudden gush of amniotic fluid or bleeding, or reduced fetal movement or other concerning symptoms.

Remember that prodromal labor is a sign that your body is getting ready for childbirth, and it is a normal part of the process. Stay positive, take care of yourself, and lean on your support system as you navigate through this unique experience.

Pregnancy is a beautiful journey filled with its unique challenges, and prodromal labor is just one of them. You've got this, and your journey to motherhood is a remarkable one. If you have any questions or concerns, don't hesitate to reach out to your healthcare provider. Enjoy every moment of this special time and look forward to the miracle of childbirth that awaits you.

Research Cited:

Celina Coppetti