The only way to know if one is in true labor is to document a change in the cervix. There are clues which would indicate true labor: persistent, regular contractions for more than two hours; contractions which last for 45 to 90 seconds; pain with contractions; bloody show; leakage of amniotic fluid. None of these, however, will absolutely tell if someone is truly in labor. Only a vaginal examination which shows dilation, softening, or thinning (effacement) of the cervix will reveal true labor. Unfortunately, this sometimes means false alarms and "wasted" trips to the hospital.

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