When true labor occurs, the cervix becomes softened and dilated and effacement occurs; this process is evident by a bloody show, which is the expulsion of cervical mucus that is pinkish in color. This typically occurs during true labor, however can sometimes occur in false labor if early cervical changes have occurred.
Regular contractions will last for a longer period of time and occur closer together. In addition, strong contractions will occur with increased intensity when walking. Contractions are typically felt in the lower back and radiate to the lower abdomen. Regular, strong contractions occur as a result of increased levels of estrogen and prostaglandins and a decrease in progesterone.
Effacement refers to the thinning and shortening of the cervix. Dilation results in the widening of the cervix. In true labor, effacement and dilation will occur in order to allow for the fetus to pass through the birth canal.
Engagement of the presenting part refers to the head of the fetus passing and engaging with the pelvis inlet. Generally, this occurs before the onset of active labor.
In false labor, contractions occur at irregular intervals and often stop when the pregnant woman changes position or walks. Irregular contractions are felt in the abdomen above the umbilicus or in the back.
In false labor, the cervix may be soft, but there is no apparent dilation or effacement.
When false labor occurs, the fetus does not engage with the pelvic inlet to prepare for active labor.
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