Signs of Labour, Stages of Labour and When to Go to Hospital

As your due date approaches, it’s natural to wonder when labour will begin and how you’ll know it’s time to go to the hospital. Every labour is different. Some begin gradually, while others start more suddenly.

Understanding the signs of labour and knowing when to contact your maternity hospital can help you feel more prepared and confident.

What Is Labour?

Labour is the natural process that prepares your body to give birth. During labour, your cervix gradually softens, shortens and opens (dilates), allowing your baby to move through the birth canal.

Labour usually begins between 37 and 42 weeks of pregnancy.

Early Signs That Labour May Be Starting

In the days or hours before labour begins, you may notice changes such as:

Period-like cramps

You may experience cramping low in your abdomen or lower back that comes and goes.

Backache

Some women develop a constant or intermittent lower backache.

A Show
You may notice a small amount of sticky, blood-stained mucus. This is called a show and happens when the mucus plug sealing your cervix comes away.

A show can happen hours, days or sometimes weeks before labour begins.

Your Waters Breaking

Your waters (amniotic sac) may break before or during labour.

This may happen as:

* A sudden gush of fluid
* A slow, continuous trickle of clear fluid

If you think your waters have broken, contact your maternity hospital or maternity assessment unit for advice. Even if you are not yet having contractions, your maternity team will advise you on what to do next.

Contractions

True labour contractions become:

* Regular
* Stronger over time
* Longer in duration
* Closer together

Unlike Braxton Hicks contractions, true labour contractions do not usually stop if you change position or rest.

The Three Stages of Labour

First Stage of Labour

The first stage begins when regular contractions cause your cervix to open and ends when it is fully dilated (10 cm).

This stage has two phases:

Early Labour

During early labour:

* Contractions may be irregular.
* They gradually become stronger and more frequent.
* Your cervix begins to soften and open.

Many women are more comfortable staying at home during early labour if everything is progressing normally.

You may find it helpful to:

* Stay hydrated.
* Eat light meals if you feel hungry.
* Rest between contractions.
* Walk or change positions.
* Use breathing and relaxation techniques.
* Take a warm bath or shower if advised by your maternity team.

Active Labour

During active labour:

* Contractions become stronger, longer and closer together.
* Your cervix continues to dilate.
* Your baby gradually moves lower into the pelvis.

Your midwife will monitor both you and your baby’s wellbeing throughout labour.

Second Stage of Labour

The second stage begins when your cervix is fully dilated.

During this stage:

* You will feel the urge to push.
* Your baby moves through the birth canal.
* Your baby is born.

Your midwife or doctor will guide you through pushing and support you during your baby’s birth.

Sometimes an assisted birth using a vacuum (ventouse) or forceps, or a caesarean section, may be recommended if it is the safest option for you or your baby.

Third Stage of Labour

The third stage begins after your baby is born and ends when the placenta has been delivered.

Your healthcare team will discuss options for managing this stage, including the use of medication to help reduce the risk of heavy bleeding after birth.

After the placenta is delivered, you will be examined to check whether you have any tears that require stitches.

When Should I Contact My Maternity Hospital?

Contact your maternity hospital or maternity assessment unit if:

* You think you are in labour.
* Your waters have broken.
* Your contractions are becoming regular and stronger.
* You have vaginal bleeding that is more than a show.
* You are worried about your baby’s movements.
* You have severe abdominal pain.
* You develop a severe headache, blurred vision or sudden swelling of your face, hands or feet.
* You have a fever or feel unwell.
* You have any concerns about yourself or your baby.

Your midwife will advise whether you should remain at home for a while longer or come to the hospital.

When Should I Go to Hospital?

Your maternity hospital will give you advice that is specific to your pregnancy and birth plan.

In general, you will usually be advised to come to hospital if:

* Your contractions are regular, becoming stronger and closer together.
* Your waters have broken.
* You have vaginal bleeding.
* You are concerned about reduced or changed movements of your baby.
* You have been advised to attend because of a medical condition or pregnancy complication.
* You feel unable to cope at home or are worried about your symptoms.

If this is not your first baby, labour may progress more quickly. Contact your maternity hospital early if you think labour has started.

What Should I Bring to Hospital?

Before your due date, it’s a good idea to have your hospital bag packed.

Your bag should include:

For You

* Comfortable clothing
* Nightwear
* Dressing gown and slippers
* Toiletries
* Maternity bras
* Maternity pads
* Phone and charger
* Snacks and drinks if advised

For Your Baby

* Baby grows
* Vests
* Hat
* Nappies
* Blanket
* Going-home outfit
* Correctly fitted infant car seat for the journey home

Remember

Every labour is unique.

Some women have long labours, while others progress quickly. Your maternity team is there to support you throughout the process and answer any questions you may have.

If you are ever unsure whether labour has started or you are worried about yourself or your baby, contact your maternity hospital for advice.

Key Points

* Labour usually starts between 37 and 42 weeks of pregnancy.
* Signs of labour include regular contractions, a show and your waters breaking.
* Labour has three stages: the cervix opening, the birth of your baby and the delivery of the placenta.
* Contact your maternity hospital if your waters break, you think you are in labour or you have any concerns.
* Attend hospital when advised by your maternity team or sooner if you have vaginal bleeding, reduced baby’s movements or other urgent symptoms.
* Every labour is different, and your healthcare team will support you every step of the way.