What Is Prodromal Labor? How Do I Know If I’m Having It?
Much to my amazement, significant evidence-based research on the topic of prodromal labor, historically and unfortunately termed “false labor,” is lacking. There is nothing false about the preparatory work of the maternal body and baby. As midwife Anne Frye states, “false labor” lends “credence to the myth that one is either in labor or not, and denies the gradual rhythmic process that is truly how the female body deals with all sexual and reproductive energies.”(1)
If prodromal labor is not false labor, then what is it?
Prodromal labor describes a uterine contractile pattern that does not result in a significant or progressive change in the position and descent of the baby, or a significant change in the dilation and/or effacement of the cervix. The uterine contractile pattern is most often irregular and varies in intensity. The kicker is that prodromal labor contractions may feel crampy, achy, and sharp and can come and go over the course of days or weeks.
What can cause prodromal labor?
The jury is still out. However, theories in the medical communities, both allopathic and integrative/alternative, suggest that the following factors could contribute to prodromal labor patterns:
- Fetal positioning: Babies that are in the breech, posterior(2), occiput transverse, and asynclitic position, or with a face presentation, may contribute to a prodromal labor pattern. In these various positions, the presenting part of the baby is most often not well aligned to the maternal pelvis and not well applied to the cervix. Both of these components are essential for labor to progress in a rhythmic and coordinated process.
- Physical contributing factors in the maternal body: Restrictions, injuries, imbalances, and anatomical anomalies/abnormalities within the uterus or supporting tissues.(4)
- Psychological influences: Here at BIRTHFIT, we are proponents of the Polyvagal Theory. You can read all about it in an earlier blog post by Lindsay Mumma here. In a nutshell, when there is perceived threat or fear, our body has an involuntary, protective response that downregulates our whole body system to varying states of immobilization depending on the level of perceived threat.(5) How does this sound protective and how does it relate to birth and prodromal labor? Two examples: 1. A deer is laboring and she senses a predator. Her labor will cease until she finds safety and then labor can resume. 2. Similarly, if a pregnant person perceives fear, anxiety, compromised safety, etc., as labor becomes imminent or in progress, the person’s nervous system can initiate a primitive response that downregulates the physiological forces of labor, “quiescing” it or overriding it completely.
- History of previous pregnancies: Multiple pregnancies can change the structure and hormonal receptor sensitivity of the uterus and cervix, potentially making the uterus more prone to earlier onset of Braxton-Hicks contractions and prodromal labor contractions.
How do you distinguish prodromal contractions from Braxton-Hicks and labor contractions?
Braxton-Hicks contractions begin in early pregnancy and become more noticeable as the pregnancy advances. They are most often described as a tightening of the uterus/abdomen, are generally painless, palpable (the pregnant abdomen feels tight and firm), associated with maternal or fetal movement, and can be caused by maternal dehydration. Labor contractions begin similarly to prodromal labor contractions in that they can feel crampy, achy, and sharp. These more “mild” sensations progressively increase in intensity. Additionally, labor contractions have a regular pattern of frequency and duration that increases over the course of labor. During early labor, one may experience contractions every 10 minutes that last for about 30 seconds. Many people in early labor are able to talk through and/or between contractions. During active labor, one may experience contractions every 2-3 minutes that last for about 60 seconds. Contractions during active labor require the birthing person’s full attention both during the contraction and the resting space between.
Wondering what you can do to optimize your baby’s position and body for easier labor?
- Tune into the positioning of your baby starting at the beginning of the third trimester. Belly mapping is a great tool that empowers the birthing person to explore the position of their baby.(6) Providers that are trained and skilled in performing Leopold’s Maneuvers(7) can non-invasively assess fetal position. Ultrasound is a useful tool for accurately assessing/confirming fetal positioning,(8) particularly in the cases of breech, posterior,(9) and transverse positions.
- Engaging in regular physical activity(10) and stretching offers far-ranging benefits to the birthing person and their baby.(11) BIRTHFIT offers amazing movement programs for before the bump, pregnancy, and postpartum.
- Supplementing your self-care routines with Chiropractic care,(12) Mayan Abdominal Massage, Physical Therapy, Pelvic Floor Therapy, and Acupuncture, to name a few, can be therapeutic and balancing for the maternal body and baby.
Certified Professional Midwife
- Frye, Anne. Holistic Midwifery, a Comprehensive Textbook for Midwives in Homebirth Practice. Labrys Press, 2013.
- Cohen, Susanna R, and Celeste R Thomas. “Rebozo Technique for Fetal Malposition in Labor.” Journal of midwifery & women’s health vol. 60,4 (2015): 445-51.
- Tully, Gail. “3 Principles of Spinning Babies – Prepare for Easier Birth.” Spinning Babies, spinningbabies.com/start/in-pregnancy/the-3-principles-in-pregnancy/.
- Ohm, Jeanne. “Optimal Positioning: Balancing the Pelvis for a Safer, Easier Birth.” Optimal Positioning: Balancing the Pelvis for a Safer, Easier Birth | Pregnancy & Birth, 14 Sept. 2017,
- Mumma, Lindsay. “Science of Breath Part 1: Intro to Polyvagal Theory.” BirthFit, 30 Apr. 2018, birthfit.com/blog/2018/04/30/science-of-breath-part-1-intro-to-polyvagal-theory/.
- Tully, Gail. “Belly Mapping.” Spinning Babies, 30 Dec. 2016, spinningbabies.com/belly-mapping-2/.
- Mcfarlin, B, et al. “Concurrent Validity of Leopold’s Maneuvers in Determining Fetal Presentation and Position.” Journal of Nurse-Midwifery, vol. 30, no. 5, 1985, pp. 280–284.
Gizzo, Salvatore et al. “Intrapartum ultrasound assessment of fetal spine position.” BioMed research international vol. 2014 (2014): 783598.
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