What are the first signs of labour?

How will I know I’m in labour? – Probably the most common question from mums in our antenatal course!

Their partners have a slightly different question – “how do i know when to take her to hospital?” – which is understandable as they just want to hand you over to the support and expertise of Midwives so that they don’t carry all the responsibility themselves!

Women often mistakenly think that their waters breaking will be one of the first signs of labour, but in fact this only happens around 10% of the time! Therefore they are often focussed on the question “Will I know when my waters break?  Will it be a trickle or a gush?” Well actually it could be either a trickle OR a gush, dependant upon your baby’s position in the pelvis, where the water sac “breaks” and if there is a cushion of water in front of the baby’s head.

If your waters release before you have contractions you should contact your midwife and let her know.  Most waters “go” much later in labour which is fabulous as the sac of amniotic fluid helps to cushion the baby from strengthening contractions.  The vast majority of our doula clients we support in birth release their waters at the end of first stage (dilation from 0 – 10 cms) or during second stage (when the baby is coming through the birth canal).

So if it isn’t waters, what are the first signs of labour?

Many of our mums report a nesting instinct where they want to tidy everything up, finish off odd jobs or just get everything “in place”.   Alternatively some of our mums have a last minute rush of hormones that may make them feel a little extra emotional – if this is you then just succumb, have a good weep and then go to bed for a rest, you might need all of your energy very soon for birth!

Lots of women find they have diarrhoea just before labour, this is your body’s way of emptying the bowel to allow the baby as much room as possible to navigate through the pelvis so whilst it may feel terrible at the time it is actually a great positive for your birth.

A fairly certain sign of approaching labour is when the mucous plug comes out.  This is a jelly like substance that “seals up” your cervix in pregnancy to stop infections from reaching your baby.  A show can have many different appearances, from jelly like discharge through to a snot like ball ( welcome to the glamour of birth! ).  The show is a fabulous sign that your cervix is softening and opening in preparation for birth and most commonly women will go into labour in the next couple of days.

In fact the only TRUE sign of labour is contractions – and they need to be REGULAR.  In our course we encourage our mums and partners not to focus too much on how much time is there between each contraction as these are different for every woman, and indeed every birth.  Instead we encourage them to consider the length and strength of each surge.   Ask your midwife at which point she suggests you call the hospital as each pregnancy will be different based on if you are  considered “low or high risk” 

So to answer the guys original question – “When do I take her to hospital?” the answer is probably much later than you think – certainly not at the first “twinge”!  Be prepared to remain at home with your partner, offering reassurances and reminding her of all those coping strategies you have learnt in your antenatal class.

The majority of women will be asked to call their unit initially when they have contractions every 5 minutes that last 30 – 60 seconds and will then be advised to come in when their surges pick up to 3 in every 10 minutes.  Of course you will need to take into consideration your travel distance, time of day and how you are coping.