How will I know I’m in labour?

This can be harder to work out than you’d think. Let’s start by busting a myth: a woman’s waters breaking (the rupture of the amniotic sac where her baby resides) is rarely a Hollywood-like gush. It usually feels more like a popping sensation followed by wetting yourself, though amniotic fluid smells much cleaner than urine. Waters breaking is the first sign of labour in only around ten percent of pregnant women in the UK. If it’s yours, you should put a pad down in your underwear right away and call your doctor or hospital. Your waters breaking doesn't always mean labour will begin in the next 48 hours, but if it doesn't, you may be induced to avoid a womb infection. Please keep in mind that your waters may not break before or during labour at all, and this is nothing to worry about. Some babies are even born safely inside their amniotic sac, which is known as a mermaid birth.

Here are some other signs that can indicate labour has started:

Contractions: These help push your baby out. They happen when the muscles of your uterus tighten up and then relax. When you’re in active labour, your contractions last about 30 to 70 seconds and come about 5 to 10 minutes apart. You can’t walk or talk during them. They get stronger and closer together over time.
Your bloody show: This is your mucus plug leaving the body through your vagina; it means your cervix is starting to open. The plug was formed in early pregnancy to protect your baby and your uterus from bacteria and infection. It is sticky, jelly-like pink mucus and may come away in one blob or in several pieces. It's pink because it contains a very small amount of blood. It is not always a sign labour has started but still a good reason to check in with your doctor or midwife. If you're losing more blood, it may be a sign something is wrong, so call your hospital or midwife right away.
Strong stomach and/or lower back pain: This often comes on in labour. Contractions can also involve menstrual-like cramps and back pain.
A strong urge to use the bathroom: This is caused by your baby's head pressing on your bowel rather than your bladder.

How can I stay comfortable in early labour (the latent stage)?

If your pregnancy is uncomplicated and you’re past the 37-week mark, you may be advised to stay at home even after you’ve had labour symptoms because you are not yet in active labour and the antenatal ward is sometimes not the most relaxing place to spend this stage. Contact your hospital or medical team to check what’s most appropriate for you. Your only job now is to stay calm and comfortable.

Here are some ways to do it:

Sleep, if you can.
Take a warm bath.
Go out for a walk, or just walk around the house.
Practice your breathing or hypnobirthing techniques for labour.
Have your partner give you a massage.
Sit with a hot water bottle.
Some women find paracetamol or the distraction of TV helps with pain.
Eat healthy snacks like fruit or vegetables with hummus and keep sipping water.

Are there any reasons I should go to the hospital before active labour?

You must go to the birthing centre or hospital if you have a fever, vaginal bleeding, foul-smelling amniotic fluid (after your waters break), or your baby’s movements slow or stop. If you have abdominal scars, any tenderness that hurts or worries you is another reason to get moving. As we mentioned, you need to call them if your waters break, even if nothing smells bad. They may not advise you to come in, but you should be informed. If nothing seems wrong but you feel very strongly that you should not stay at home, there is no harm in going to the birthing centre or hospital. Trust your instincts. They will recommend going home or, if you really don’t want to leave, keep you on the antenatal ward.

How will I know if I’m in active (or established) labour?

You are in active labour when you are 4 cm dilated, which is impossible to tell at home as you can’t check your own vagina accurately without a midwife or doctor. This is when most people go to the birth centre or hospital. Do not try to check your own vagina. Some strong signs you are there include difficulty holding conversations through a contraction, feeling each contraction for about a minute, and contractions happening every 3–5 minutes. Again, your maternal instinct that it’s time to get going is also a good guide. If you’re not sure, simply contact your healthcare provider and they can guide you as to what to do.

Once you are in active labour, a doctor or midwife should be with you until your baby arrives. As we mentioned in the birth plan article/episode, you have a choice as to whether they examine you vaginally to see how far along you are. While it’s not exactly pleasant, it shouldn’t feel any worse than a smear test. Once you’re in active labour, your options for pain relief are broadened. Please see Episodes 9 and 10 of Unii’s Antenatal Journey for more information on medication and natural relief methods.

How will I know I'm in labour and when should I go to the hospital?