A nulliparous client asks about being in "real" labor. The nurse should teach that which signs are most indicative of true labor? Select all that apply.

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11ecbb05_cc05_b7fc_b433_fba521220f50_MD0009_00 A key indicator of true labor is the progressive effacement and dilation of the cervix (Option E). Contractions in true labor are regular, and increase in frequency, duration, and intensity (Option A). The pain may initially start in the lower back and radiate to the abdomen (Option D). (Option B) True labor contractions will not lessen or dissipate with comfort measures (eg, rest, position change, hydration) and may intensify with walking or activity. Braxton Hicks contractions are irregular contractions that occur throughout pregnancy, and they do not result in cervical change. Although usually mild, they can be increasingly painful and regular for short periods during the last weeks before birth. However, in contrast with true labor, Braxton Hicks contractions will typically lessen with comfort measures. (Option C) Mucoid vaginal discharge that is blood-tinged or brownish (eg, bloody show) is a common finding in the days preceding onset of labor; however, it is not a definitive sign that true labor has started. Educational objective: During true labor, contractions increase in frequency, duration, and intensity over time, resulting in progressive dilation and effacement of the cervix. Clients in true labor often experience discomfort in the lower back that radiates to the abdomen with contractions. Contractions associated with true labor do not lessen or dissipate with comfort measures.

A Nulliparous Client Asks About Being in "Real" Labor