Prodromal Labour: Contractions That Stop and Start

What prodromal labour means

Prodromal labour is an informal name for contractions that feel like the start of labour, settle, and come back, sometimes over several days, before labour is established. It is not a clinical term in the main guidance: NICE's intrapartum care guideline, the NHS labour pages and ACOG's 2024 guideline on managing the first and second stages of labour do not use it.

What those bodies describe instead is the latent phase. NICE defines it as "a period of time, not necessarily continuous", with contractions and "some cervical change, including cervical position, consistency, effacement and dilatation up to 4 cm." The NHS says it "can take many hours, or even days" before you are in established labour, and that "there's no set pattern to how many contractions you get or how long they last." Stop-start is built into the definition. Our page on the latent phase of labour covers it in detail.

ACOG's patient information uses an older phrase, "false labor", for Braxton Hicks contractions. The label can mislead: the contractions are real, and ACOG itself says these "practice" contractions "can be very painful and can make you think you are in labor when you are not."

Prodromal labour vs Braxton Hicks vs early labour

The line between the three is drawn by your cervix, which you cannot see. This is how the NHS, NICE and ACOG describe each.

ACOG offers a home test: time your contractions and see whether they continue when you rest and drink water. "If rest and hydration make the contractions go away, they are not true labor contractions." The reverse does not hold: contractions that carry on are not proof of established labour. Our page on Braxton Hicks vs real contractions covers the first comparison in more detail, and timing contractions shows how to record them.

Is it doing anything?

By NICE's definition, the latent phase is real work even when the centimetre figure barely moves. The cervical change it describes includes position, consistency and effacement as well as dilatation: the cervix moving forward, softening and thinning. Our explainer on cervix dilation and effacement sets out what each of those means.

Some websites say stop-start contractions help move the baby into a better position. NICE, the NHS and ACOG do not make that claim, and nobody can tell you how much a given night of contractions has achieved without examining you.

How long can prodromal labour last?

There is no fixed normal length, which is partly why it is so draining. ACOG says "the normal latent phase of labor varies widely among individuals, regardless of parity." The NHS calls the latent phase "usually the longest stage of labour". NICE gives average durations only for established labour.

ACOG's guideline gives the closest thing to a number. Friedman's 1950s data put the longest normal latent phase (the 95th percentile) at 20 hours for a first labour and 14 hours for later ones. Using contemporary data, ACOG says "a prolonged latent phase may be defined as longer than 16 hours." It also says that most people with a prolonged latent phase "ultimately will enter the active phase with expectant management", that with few exceptions the rest either stop contracting or reach the active phase with help such as breaking the waters or an oxytocin drip, and that a caesarean for a prolonged latent phase when you and your baby are well "should be avoided".

What helps while it goes on

The advice for the latent phase applies. NICE says breathing exercises, a shower or bath, and massage may reduce pain in this phase. The NHS suggests:

• At night: "try to stay comfortable and relaxed. Sleep if you can."
• In the day: "stay upright and gently active", which helps your baby move down into your pelvis.
• Eat and drink: "you'll need energy for when labour is established". Isotonic sports drinks may help keep energy up.
• Use your birth partner: breathing and relaxation together, and a back rub.

If you are 33, 34 or 35 weeks pregnant

Do not treat regular tightenings before 37 weeks as prodromal labour to wait out. The NHS defines premature labour as labour before the 37th week and says about 8 in 100 babies are born prematurely. It asks you to call your midwife or maternity unit if you are less than 37 weeks pregnant and have regular contractions or tightenings, period-type pains, a gush or trickle of fluid from your vagina, or backache that is not usual for you. They may offer a vaginal examination, blood and urine tests, and monitoring of contractions and your baby's heartbeat.

When to call

Call your midwife or maternity unit for guidance if you think you are in labour, or you are having regular contractions every 5 minutes or more often. You can also call if you are unsure or worried about anything. The NHS says that if you go in before labour is established, you may be advised to go home again for a while; our page on being sent home in early labour explains why.

Call urgently if your waters break, you have vaginal bleeding, your baby is moving less than usual, you are less than 37 weeks pregnant and think you might be in labour, any contraction lasts longer than 2 minutes, or you are having 6 or more contractions every 10 minutes. The NHS: "Do not wait until the next day – call immediately, even if it's the middle of the night." Call 999 if you think your baby is coming now and you have a strong urge to push.

In the US, ACOG says to call your obstetric care provider if you think you are in labour or are not sure, and to go to the hospital if your water has broken and you are not having contractions, you are bleeding heavily, you have constant, severe pain with no relief between contractions, or the baby is moving less often.

Frequently asked questions

How long does prodromal labour last?

There is no fixed length. The NHS says the latent phase can take many hours, or even days. ACOG's guideline defines a prolonged latent phase as longer than 16 hours and says most people in one go on to active labour by waiting. If it goes on for days and you are exhausted, call your maternity unit.

Can prodromal labour turn into real labour?

Usually, yes. In UK terms it is the beginning of labour: the latent phase, which NICE says is not necessarily continuous. ACOG says most people with a long latent phase reach active labour without intervention, and with few exceptions the rest either stop contracting or reach active labour with help such as breaking the waters.

Are prodromal labour contractions painful?

They can be. The NHS says latent-phase contractions range "from being slightly uncomfortable to more painful", and ACOG says even Braxton Hicks practice contractions can be very painful. What tells you more is whether they are getting longer, stronger and more frequent, which the NHS says happens as labour progresses.

Should I go to hospital with prodromal labour?

Phone first rather than going straight in. NICE asks maternity units to assess early labour by telephone and decide whether you need to be seen, either at home or in your planned place of birth. For any of the urgent signs above, call straight away.