Signs of Labour: What to Watch For

As your due date approaches, you may find yourself wondering how you'll know when labour truly begins. Understanding the signs of labour can help you feel more prepared and confident about when to take action, whether that's calling your midwife, heading to hospital, or simply continuing to wait patiently at home. Every woman's experience of labour is unique, but there are common signs that indicate your body is preparing for or beginning the process of giving birth.

Early Signs of Labour

In the days and weeks leading up to labour, your body begins preparing for birth. These early signs don't necessarily mean labour will start immediately, but they indicate that your body is getting ready:

Lightening or Engagement

Also known as "dropping," this occurs when your baby's head moves down into your pelvis, typically 2-4 weeks before labour in first pregnancies, though it may happen closer to labour in subsequent pregnancies:

• You may notice your bump looks lower or different in shape
• Breathing becomes easier as pressure is taken off your diaphragm
• You may feel increased pressure in your pelvis and bladder
• Walking may become more uncomfortable
• You might need to urinate more frequently

Braxton Hicks Contractions

These practice contractions become more frequent and noticeable as your due date approaches:

• Irregular tightening of your uterus that comes and goes
• Generally painless, though they may become uncomfortable
• Often triggered by activity, dehydration, or a full bladder
• Typically ease with rest, change of position, or hydration
• Don't follow a regular pattern or increase in intensity

Nesting Instinct

Many women experience a sudden burst of energy and an overwhelming urge to prepare their home:

• Intense desire to clean, organise, or complete baby preparations
• Feeling energised despite being in late pregnancy
• Compulsion to ensure everything is "ready" for baby's arrival
• May occur days or weeks before labour begins

Changes in Cervix

Your cervix begins to soften, thin (efface), and possibly dilate in preparation for labour:

• These changes may be detected during routine antenatal appointments
• You won't necessarily feel these changes happening
• Some women may be several centimetres dilated weeks before labour begins
• Others may not dilate until labour is well established

Definitive Signs of Labour

These signs indicate that labour has likely begun and you should start timing events and preparing to contact your midwife or birthing team:

Regular, Progressive Contractions

True labour contractions have distinct characteristics that differentiate them from Braxton Hicks:

• Regularity: Contractions follow a consistent pattern, coming at regular intervals
• Progressive intensity: They gradually become stronger, longer, and more painful
• Duration: Each contraction typically lasts 30-70 seconds
• Frequency: They occur every 3-5 minutes in established labour
• Persistence: They continue regardless of rest, position changes, or hydration
• Location: Pain often starts in your back and moves forward to your abdomen

Waters Breaking (Rupture of Membranes)

Your waters may break before or during labour, and the experience can vary significantly:

• Dramatic gush: A sudden release of a large amount of clear or slightly yellow fluid
• Slow leak: A steady trickle of fluid that you might initially mistake for urine
• Multiple gushes: Fluid released in several smaller amounts over time
• During labour: Waters may not break until well into the labour process

Key points about waters breaking:

• Only about 10-15% of women experience waters breaking before contractions begin
• The fluid should be clear or slightly yellow with a sweet smell
• If fluid is green, brown, or has a strong odour, contact your midwife immediately
• Once waters break, there's an increased risk of infection, so labour usually needs to begin within 24 hours

Bloody Show or Mucus Plug

The loss of your mucus plug is another sign that labour may be beginning:

• A thick, jelly-like discharge that may be clear, pink, or slightly bloody
• May come away gradually over several days or all at once
• Indicates that your cervix is beginning to open
• Labour may begin within hours or up to a week after losing the plug
• Not all women notice losing their mucus plug

Understanding the Stages of Labour

Labour is divided into three distinct stages, each with its own characteristics and duration:

First Stage: Early and Active Labour

The first stage is the longest part of labour and is divided into two phases:

Early Labour (Latent Phase)

• Cervix dilates from 0-4 centimetres
• Contractions are mild to moderate and may be irregular
• Can last 6-12 hours for first-time mothers, shorter for subsequent births
• You can usually manage at home during this phase
• Good time to rest, eat light meals, and stay hydrated

Active Labour

• Cervix dilates from 4-10 centimetres
• Contractions become stronger, longer, and more frequent
• Usually lasts 4-8 hours for first-time mothers
• This is typically when you'll want to be at your chosen birthing location
• Pain relief options become more important during this phase

Second Stage: Pushing and Birth

This stage begins when your cervix is fully dilated (10cm) and ends with your baby's birth:

• You'll feel an overwhelming urge to push
• Contractions may space out slightly, giving you rest between pushes
• Can last 30 minutes to 3 hours for first-time mothers
• Usually shorter (under an hour) for subsequent births
• Your midwife will guide you on when and how to push effectively

Third Stage: Delivery of Placenta

After your baby is born, your uterus continues to contract to deliver the placenta:

• Usually completed within 30 minutes of birth
• You may have managed or physiological third stage
• Mild contractions help separate and expel the placenta
• Your midwife will examine the placenta to ensure it's complete

When to Contact Your Midwife

Knowing when to call your midwife or maternity unit is crucial for ensuring you receive appropriate care at the right time:

Contact Immediately If:

• Waters break: Especially if the fluid is not clear or if you're less than 37 weeks pregnant
• Heavy bleeding: More than a heavy period or bright red blood
• Severe, constant abdominal pain: That doesn't ease between contractions
• Reduced baby movements: If you notice a significant decrease in your baby's normal movement pattern
• Visual disturbances: Seeing spots, flashing lights, or severe headaches
• Signs of infection: Fever, chills, or foul-smelling discharge

Contact When:

• Regular contractions: Coming every 3-5 minutes and lasting 45-60 seconds for at least an hour
• First baby: When contractions are strong and regular, even if they're not yet very close together
• Subsequent babies: When contractions become regular, as labour may progress more quickly
• You're concerned: Trust your instincts - if something doesn't feel right, it's always better to check

Information to Have Ready

When you call your midwife or maternity unit, be prepared to provide:

• Your name, date of birth, and NHS number
• Your estimated due date
• Details about contractions (frequency, duration, intensity)
• Whether your waters have broken and the colour of the fluid
• Any bleeding or discharge
• Your baby's movements
• Any other symptoms or concerns

Common Misconceptions About Labour Signs

There are several myths about labour that can cause unnecessary anxiety or confusion:

Myth: "Labour always starts with waters breaking"

Reality: Only about 10-15% of women experience their waters breaking before contractions begin. For most women, contractions start first, and waters break during labour or may even need to be broken artificially.

Myth: "If your waters break, you must rush to hospital immediately"

Reality: Whilst you should contact your midwife when your waters break, if the fluid is clear and you're full-term, you don't necessarily need to rush to hospital. Your midwife will advise you based on your specific circumstances.

Myth: "Labour pain is unbearable from the start"

Reality: Labour typically starts gradually, with mild contractions that build in intensity over time. Early labour is often manageable, and there are many pain relief options available as labour progresses.

Myth: "First babies always come late"

Reality: Whilst first labours tend to be longer, first babies can arrive early, on time, or late. Only about 5% of babies arrive on their exact due date.

Myth: "You'll definitely know when you're in labour"

Reality: Many women, especially first-time mothers, are unsure whether they're in early labour or experiencing strong Braxton Hicks contractions. This uncertainty is completely normal.

Preparing for Labour

Being prepared can help you feel more confident when labour signs begin:

Create a Birth Plan

• Discuss your preferences for pain relief, positions, and interventions
• Consider who you want as your birth partner
• Think about your preferred environment and atmosphere
• Remember that birth plans are flexible - labour may not go exactly as planned

Pack Your Hospital Bag

Have your bag ready by 36 weeks, including essentials for labour, after birth, and your baby:

• Comfortable clothes and nightwear for labour and after birth
• Toiletries and personal items
• Baby clothes in newborn and 0-3 month sizes
• Nappies, blankets, and car seat for the journey home
• Snacks and drinks for after birth
• Important documents and contact numbers

Know Your Route

• Plan the quickest route to your chosen birthing location
• Consider alternative routes in case of traffic
• Know where to park or arrange transport
• Have contact numbers readily available

Discuss Plans with Your Birth Partner

• Ensure they understand the signs of labour
• Share your birth preferences and discuss their role
• Make sure they know when and how to contact your midwife
• Discuss comfort measures they can help with during labour

Dealing with False Alarms

It's common to have several false alarms before real labour begins, especially with your first baby:

Don't Feel Embarrassed

• Many women contact their midwife multiple times before labour truly begins
• Healthcare providers expect this and would rather assess you than miss the real thing
• Each "practice run" helps you become more familiar with your body's signs
• Being sent home is not a failure - it's all part of the normal process

What to Do During False Alarms

• Try to rest and conserve energy for when real labour begins
• Stay hydrated and eat light, nutritious meals
• Use relaxation techniques to manage any discomfort
• Time contractions to see if they follow a pattern
• Take a warm bath or shower, which may ease Braxton Hicks contractions

Special Circumstances

Some situations require particular attention when it comes to recognising labour signs:

Previous Quick Labours

If you've had a previous labour lasting less than 3 hours, you should:

• Contact your midwife as soon as regular contractions begin
• Consider staying closer to your birthing location as your due date approaches
• Have a clear plan for quick transport to hospital
• Discuss the possibility of a home birth if appropriate

High-Risk Pregnancies

If you have pregnancy complications, you may need to contact your healthcare provider earlier:

• Follow specific guidance given by your consultant or midwife
• Be aware of any additional warning signs specific to your condition
• Don't hesitate to contact your team if you're unsure about any symptoms
• Ensure you're familiar with the direct contact numbers for your specialist team

Planned Caesarean Section

Even with a planned caesarean, labour may begin before your scheduled date:

• Contact your maternity unit immediately if you think labour has started
• Your caesarean may need to be brought forward
• Don't eat or drink once labour signs begin
• Go directly to hospital rather than calling first