And then comes the moment when you think:  my labor has started. You have contractions, maybe your membranes have ruptured, or you have lost your mucus plug. You have had instructions when to call your care provider.

During your pregnancy your cervix is about as long and as hard as your little finger. See picture (A) It is very stiff connective tissue. When your time has come to give birth the cervix softens and shortens, this process is called effacement. (B)

The midwife or obstetrician will be the one to diagnose ‘labor has started’ The clear definition of the diagnosis is:

regular painful contractions, a fully effaced cervix and at least 1 cm dilated.

Observation of the woman and a vaginal exam are nessecary to diagnose labor.  Your cervix must be completely effaced. (C) We do not know how long it takes for a cervix to efface. Effacing is not part of the labor. Some women will not notice effacing , others will feel it from the first to the last millimeter. Because of the painful contractions women in these cases often have the impression that labor has started. This is known as a false start. But if a firm diagnosis “labor has started or not” is avoided, problems are bound to arise later in the process.

A false start does not mean that you are exaggerating. You do experience pain and discomfort that keep you awake and restless.  It is important to prevent exhaustion.  You need to be fit when labor really kicks in. Your caregiver will discuss with you whether it is wise to take a painkiller and/or something to sleep in this case.

The importance of a clear firm diagnosis of ‘ being in labor’  can’t be emphasized enough. Otherwise it will be almost impossible to tell later on if contractions are effective contractions. Without a clear diagnosis you are at risk for a cascade of interventions. Don’t let yourself be fobbed off with vague terms like “You are in the beginning ,” or “this is the latent phase.

You are in labor or not. There is no inbetween. Latent phase doen’t exist!