Signs of early labor -- before the 37th week of pregnancy -- might be more subtle than dramatic, doctors say.

"It's not necessarily even painful," said Dr. James Marquardt, an obstetrician/gynecologist in Midlothian, Va.

Here are some tips on early labor:

Be aware of contractions. They can feel as if if your abdomen is tightening like a fist every 10 minutes or less, rather than something sharp or painful.

Pay attention to back pain. A dull ache in the lower back can be a sign of trouble, whether the discomfort is constant or comes and goes. You also might feel more pressure or fullness in your pelvic area, as if your baby is pushing down.

Be aware of cramping. Regular abdominal cramps that feel like a menstrual period or gas pains -- with or without diarrhea, nausea or vomiting -- aren't a normal discomfort of pregnancy.

Don't wait for your water to break. Even with full-term births, only about one in four women will experience the stereotypical gush of water before labor begins. But increased vaginal discharge -- watery, mucus-like or bloody -- can indicate preterm labor.

Stay in tune with your baby. A decrease in typical fetal movement might need attention.

Err on the side of caution. Call your doctor with concerns. If symptoms worsen or return -- or if there's any doubt in your mind -- head to a hospital.

Report any problems. Tell your doctor about abnormal symptoms even if they go away. Also share any history of preterm birth, which is a risk factor for early labor in subsequent pregnancies.

DAILY PRESS (NEWPORT NEWS, VA.)

Exercise is hard, but it's worth itFitness expert Chuck Runyon -- author of "Working Out Sucks!" and co-founder of Anytime Fitness -- offers common-sense advice on how to place one foot in front of the other on the hard, tough road to feeling and looking better.

Start moving slowly. "If you're a sedentary person, if that's one-tenth of a mile, great."

Broadcast your goals. Make sure friends and relatives know what you're trying to accomplish, and enlist their help and support.

Write down your goals. "Accountability is the magic ingredient."

Find your motivation. "It's not about what the scale says."

Build in incentives. For example, perhaps you set aside one day to eat a favorite dessert.

Take a rest day. Everyone needs a break.

CHICAGO TRIBUNE