Articles

Key takeaways

• Your baby dropping, a 'show', and changes in Braxton Hicks can signal labour is near.
• Active labour involves regular, strengthening contractions and your waters breaking.
• Call your midwife for guidance when contractions are regular or if your waters break.
• Stay calm and rest at home during early labour, but call immediately for urgent signs.

Early signs that labour is near

In the weeks before birth, your body starts preparing for labour. This can include your baby's head moving down into your pelvis (known as the head engaging).

When your baby engages, any breathlessness you have had may ease. You might also notice your bump dropping lower. You may feel increased pressure in your pelvis and an urge to wee or poo.

Your baby's head moving down can also cause back pain. This is due to pressure against your spine. First babies often engage earlier, but some babies do not engage until labour starts.

The 'show'

A 'show' is when the mucus plug from your cervix comes away. This plug seals the opening of your womb during pregnancy. It can appear as a single blob of pinkish jelly or in smaller pieces.

It might be reddish-brown and streaked with blood. This is a sign your cervix is beginning to stretch and soften. Labour may follow within hours or days, or sometimes there is no show at all.

If you are losing more blood than a small amount, call your hospital or midwife. If you think your plug has come out before 37 weeks of pregnancy, call your maternity unit or midwife.

Braxton Hicks contractions

From the middle of your pregnancy, you may feel your tummy tighten and then relax. These are practice contractions (Braxton Hicks contractions) that prepare your body for birth.

As your due date gets closer, Braxton Hicks can become stronger. They are usually painless and do not get longer or stronger. They are also irregular and tend to be quite short.

Labour contractions are different. They become more regular, last longer, and get stronger. Early labour contractions may feel like period pains.

The main signs of active labour

The main signs that labour might be starting include regular, strengthening contractions and your waters breaking. Other signs can include backache and an urge to go to the toilet.

Contractions

During a contraction, your womb tightens and then relaxes. For some people, contractions may feel like extreme period pains. If you put your hand on your tummy, you will feel it getting harder.

When the muscles relax, the pain fades. As your labour progresses, contractions get longer, stronger, and more frequent. You should call your midwife or maternity unit if you are having regular contractions coming every 5 minutes or more often.

Your waters breaking

Your baby grows inside a bag of fluid (the amniotic sac). When this sac breaks, the fluid drains out through your vagina. This is your waters breaking.

It can feel like a mild pop, followed by a trickle or a gush of fluid. You cannot control this fluid, unlike when you pass urine. The fluid is usually clear and pale.

Sometimes it can be a little bloodstained at first. 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 fluid.

Tell your midwife immediately if the waters are smelly, or green or brown. This could mean you and your baby need to be checked by a midwife or doctor straight away. It is usual to go into labour within 24 hours of your waters breaking.

What to do when you think labour has started

You can call your midwife or maternity unit straight away if you think you are in labour. They will assess you over the phone and tell you what to do next. Most labours take hours or even days.

You will likely have plenty of time at home before going to the hospital or birth centre. Staying calm and coping with early labour can be easier if you know the signs. If you are unsure, always phone your midwife for advice.

Tips for early labour at home

• Rest – Sleep or rest when you need to and are able to, to save energy for later labour.
• Move around – Have a gentle walk outside or around the house if you feel like it.
• Warm bath or shower – Warm water can help ease the pain of contractions.
• Breathing techniques – Practise deep breaths in through your nose and out through your mouth.
• Snacks – Keep your energy levels up with healthy snacks.

Listen to your body and do what feels right for you. Remember to call your birth partner and check your hospital bag. If you have other children, arrange for their care.

When to call your midwife or maternity unit right away

Call your midwife or maternity unit right away if you have any of the following:

• Heavy vaginal bleeding – This is more than just a small amount of blood in your show.
• Unusual amniotic fluid – if your waters are green, brown, or have a bad smell.
• Reduced baby movements – If your baby is moving less than usual.
• Early labour – If you are less than 37 weeks pregnant and think you might be in labour.
• Long contractions – If any of your contractions last longer than 2 minutes.
• Frequent contractions – If you are having 6 or more contractions every 10 minutes.

If you think your baby is coming now and you have a strong urge to push, call 999 for an ambulance. Do not wait until the next day for urgent signs; call immediately. If you can't get through to your midwife or maternity unit, call 111.