I don't know never had contractions with 1st one

Ra

Hey guys I'm 38w 1d and I have been cramping along with back pain since yesterday. I had a doc appt yesterday and was having a few contractions but nothing concerning. Anyway when do you know its like for real need to go hospital stuff? I have to have a c section is why I ask. Today I am cramping and alot of pressure and back pain. But my stomach isn't tightening any like ppl talks.