Signs of labour

You’ve been pregnant for 37 weeks now. You’re probably thinking that the bump on your belly can’t possibly get any bigger and feeling just a little bit concerned about when you’ll go into labour… And how you’ll know when it’s starting… And whether or not you’ll get to hospital on time…

You’ve probably read a “news” horror story or two about a woman giving birth in a shopping mall or on the train because they didn’t realise they were in labour soon enough to get to hospital. Don’t worry – these are rare occurrences! But how will you know when to head for hospital?

You’re in labour if your water breaks

The rupturing of the amniotic sac, a fluid-containing sac that protects the unborn baby while it’s developing, is one good indicator of labour. It’s commonly referred to as the “water breaking”.

However, the vast majority of women (90%) begin labour before their amniotic sac ruptures – sometimes many hours before. These women must identify the beginning of labour based on their experience of cervical contractions, which cause (often very intense) pain, referred to as labour pain.

Labour pain tells you that you’re in labour

You’ve almost certainly been informed by friends or others that labour is one of the most painful things you’ll ever experience. (Your friends should also have told you that the intense pain is only temporary and all worth it when you’re handed your bundle of joy!) So you know labour will be painful, but what sort of pain?

What do the pains feel like?

The labour pains that precede childbirth can be described as a painful tightening inside the vagina. It occurs because the cervix (opening to the womb) is contracting, preparing itself to expand exponentially to allow the baby to pass through.

Contractions of the cervix occur in some women from around the 16th week of pregnancy. These early contractions (known as Braxton-Hicks contractions) seem to occur because the cervix is practising in preparation for the birth. They do not cause pain; nor do they increase in intensity or frequency as the pregnancy progresses.

On the other hand, contractions of the cervix that signal the beginning of labour cause pain in the vagina, and often also the abdomen and lower back. They occur rhythmically and are experienced with increasing intensity as labour progresses.

How long do the contractions last?

Each contraction typically lasts 30–40 seconds. The intervals between contractions vary depending on the stage of labour. The closer a woman is to giving birth, the shorter the period of time between her contractions.

The doctor can check if it’s really labour

The shapes of the reproductive organs changes during labour – the vagina becomes shorter and the cervix dilates (enlarges) to prepare for the passage of the baby.

If the Braxton-Hicks contractions occur with increasing frequency in late pregnancy, it’s easy to confuse them with labour pains. This is known as false labour. A doctor will be able to identify false labour by examining the vagina and cervix, which will not change shape with Braxton-Hicks contractions.

Should I leave for hospital straight away?

So now that you know how to identify whether or not you’ve started labour, you’re probably worrying about when to leave for hospital. It’s different for every woman.

In many cases, women choose to stay at home for several hours after their labour pains begin. This allows them to relax in a familiar environment for a bit longer. Others prefer to leave for hospital sooner, so that they are closer to medical support. It’s really your decision, so do whatever makes you feel most comfortable.

It’s time to go if…

When your contractions occur 5 minutes apart, it’s time to go to hospital!

If your water breaks, it’s also time to go, even if you haven’t had any labour pains. The amniotic sac protects the foetus from infection while it is intact. Once it ruptures, the unborn baby is at increased risk of infection, so you need to get to a sterile environment straight away.

You should also leave for the hospital if you experience vaginal bleeding or watery/bloody discharge from the vagina; don’t feel the baby moving inside you anymore; or experience high blood pressure or persistent stomach pains at any stage of the pregnancy. If there is anything else about your pregnancy that makes you concerned, you should go to the hospital for advice.

More information

For more information, see How Will I Know When I am in Labour?