Signs that labour has begun

Know the signs

There are several signs that labour might be starting, including:

• contractions or tightenings
• a "show", when the plug of mucus from your cervix (entrance to your womb, or uterus) comes away
• backache
• an urge to go to the toilet, which is caused by your baby's head pressing on your bowel
• your waters breaking

When to contact your midwife or maternity unit

Call your midwife or maternity unit for guidance if:

• you think you’re in labour
• you’re having regular contractions coming every 5 minutes or more often

You can also call your midwife or maternity unit if you’re unsure or worried about anything.

Call 111 if you’re unable to contact your midwife or maternity unit.

Latent phase of labour

The start of labour is called the latent phase. This is when your cervix becomes soft and thin, and starts opening for your baby to be born. This can take hours or sometimes days.

You'll probably be advised to stay at home during this time. If you go to the hospital or maternity unit, they may suggest you go back home.

Find out more about the stages of labour and what you can do at home during the latent phase.

Call your midwife if you're unsure or worried about anything.

What do contractions feel like

When you have a contraction, your womb tightens and then relaxes. For some people, contractions may feel like extreme period pains.

You may have had ‘practice contractions’ during your pregnancy, particularly towards the end. These tightenings are called Braxton Hicks contractions, which may feel uncomfortable, but are usually painless. Braxton Hicks contractions generally do not last that long, do not happen very frequently and do not build up.

Your contractions tend to become longer, stronger and more frequent as your labour progresses. During a contraction, your womb muscles tighten and the pain increases. If you put your hand on your abdomen, you'll feel it getting harder. When the muscles relax, the pain fades and you’ll feel the hardness ease.

The contractions are pushing your baby down and opening the entrance to your womb (the cervix), ready for your baby to go through.

Your midwife will probably advise you to stay at home until your contractions become frequent.

Read more information on when to go to hospital

Backache often comes on in labour

You may get backache or a heavy, aching feeling.

A "show" can signal the start of labour

During pregnancy, there's a plug of mucus in your cervix. This mucus comes away just before labour starts, or when in early labour, and it may pass out of your vagina. This sticky, jelly-like pink mucus is called a show.

It may come away in 1 blob or in several pieces. It's pink because it contains a small amount of blood.

If you're losing more blood, it may be a sign something is wrong, so phone your hospital or midwife straight away.

A show indicates that the cervix is starting to open. Labour may quickly follow or may take a few days. Sometimes there is no show.

What happens when my waters break

It's likely your waters will break during labour, but it can also happen before labour starts.

Your baby develops and grows inside a bag of fluid called the amniotic sac. When it's time for your baby to be born, the sac usually breaks and the amniotic fluid drains out through your vagina. This is your waters breaking. Sometimes when you're in labour, a midwife or doctor may offer to break your waters.

If your waters break naturally, you may feel a slow trickle or a sudden gush of water you cannot control. To prepare for this, you could keep a period pad (but not a tampon) handy if you're going out, and put a protective sheet on your bed.

Amniotic fluid is clear and pale. Sometimes it's difficult to tell amniotic fluid from urine. When your waters break, the water may be a little bloodstained to begin with.

Tell your midwife immediately if:

• the waters are smelly or coloured
• you're losing blood

This could mean you and your baby need urgent attention.

If your waters break before labour starts, call your midwife. Use a period pad (not a tampon) so your midwife can check the colour of the waters.

If labour does not start after your waters break

It's usual to go into labour within 24 hours of the waters breaking. You'll be offered an induction if you do not because, without amniotic fluid, there's a small increased risk of infection for your baby.

Until your induction, or if you choose to wait for labour to start naturally, tell your midwife immediately if:

• your baby moves less than usual
• there's any change in the colour or smell of any fluid coming from your vagina

You should take your temperature every 4 hours when you're awake, and tell your midwife if it's raised. A raised temperature is usually above 37.5C, but you may need to call before this – check with your midwife.

There's no evidence that having a bath or shower after your waters have broken increases your risk of infection, but having sex might.

How to cope when labour begins

At the beginning of labour, you can:

• walk or move about, if you feel like it
• drink fluids – you may find sports (isotonic) drinks help keep your energy levels up
• have a snack, if you feel like it
• try any relaxation and breathing exercises you've learned to deal with contractions as they get stronger and more painful – your birth partner can help by doing these with you
• have your birth partner rub your back – this can help relieve pain
• take paracetamol according to the instructions on the packet – paracetamol is safe to take in labour
• have a warm bath

Find out what happens during labour and birth, and what you can do for pain relief in the early stages of labour.

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