Signs of labour: how to tell it's starting, and when to call

Is this it? How to tell real contractions from practice ones, what your waters breaking actually looks like, and exactly when to pick up the phone.

The signs labour has started

Contractions or tightenings. Your bump goes hard, it hurts, then it eases off as the muscle relaxes. In labour, contractions get longer, stronger and closer together.
A show. The plug of mucus that seals your cervix comes away. It may be pink or streaked with a little blood. Labour might follow quickly, or not for a few days.
Backache. A deep, nagging ache in your lower back, sometimes coming and going with contractions.
Needing the loo. An urge to poo, caused by your baby's head pressing on your bowel.
Your waters breaking. This can be a slow trickle or a sudden gush.

Real contractions vs Braxton Hicks

Braxton Hicks are practice tightenings. They're usually painless, short, irregular and don't build up. They often ease if you move around or change position.

Labour contractions become longer, stronger and more frequent over time, and they don't go away when you rest or move. Timing them, from the start of one to the start of the next, is the best way to tell.

If you're wondering whether to call, call. Maternity units would always rather hear from you.

When your waters break

The fluid is usually clear or pale and can be hard to tell apart from wee at first. Put on a pad (not a tampon) and call your maternity unit. Tell them straight away if the fluid is coloured, smelly or you're losing blood, as you may need to go in sooner.

Labour usually starts within 24 hours of your waters breaking. If it doesn't, you'll be offered an induction, because there's a small increased risk of infection for your baby once the waters have gone. Until then, your midwife may ask you to check your temperature every few hours.

When to call your midwife or maternity unit

Call if you think you're in labour, if your contractions are coming every 5 minutes or more often, or if you're unsure or worried about anything. If you can't get through, call NHS 111.

Call straight away, even in the middle of the night, if:

your waters break
you have any bleeding
your baby is moving less than usual
you're under 37 weeks and think you might be in labour
a contraction lasts longer than 2 minutes
you're having 6 or more contractions in 10 minutes

Call 999 if you think your baby is coming now and you have a strong urge to push.

Early labour at home

Early labour can last hours, sometimes days, especially with a first baby. You'll often be encouraged to stay at home until contractions are strong and regular. Things that help:

keep moving, sway, bounce on a birth ball or walk around
have a warm bath or shower
eat light snacks and keep sipping water
rest between contractions if it's night time
try a TENS machine, breathing techniques or massage from your birth partner
time your contractions with an app, and have your hospital bag by the door

What are the first signs of labour?

Common early signs include contractions, a show (mucus that may be pink), backache, an urge to poo and your waters breaking.

When should I go to hospital in labour?

Call your maternity unit first. Call if you think you're in labour or your contractions are coming every 5 minutes or more often, and straight away if your waters break, you're bleeding or your baby is moving less.

How do I know if my waters have broken?

You may feel a trickle or a gush of clear or pale fluid that you can't control. Wear a pad and call your maternity unit, and tell them straight away if it's coloured or smelly.

How can I tell Braxton Hicks from real contractions?

Braxton Hicks are usually painless, irregular and don't build up. Real contractions get longer, stronger and closer together and don't ease with rest.

Keep reading

This article is general information, not medical advice. Always follow the advice of your own midwife and maternity unit. See the NHS guide to the signs of labour.

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