Signs of Labour: What to Expect and When to Call Your Midwife

Labour rarely announces itself as clearly as films suggest. Most people notice a combination of signs building over hours, sometimes days, before established labour begins.

Early signs labour may be starting

• A "show" — the mucus plug that's sealed your cervix during pregnancy comes away, sometimes tinged pink or with a little blood. This can happen days before labour properly starts, or right at the beginning.
• Lower back ache or period-type cramps — often the first thing people notice, easy to mistake for a bad period.
• Tightenings (Braxton Hicks) becoming more frequent or stronger — the line between these and real early contractions can be blurry at first.
• A change in energy — some people get a sudden burst of "nesting" energy or, conversely, feel unusually tired.

Signs of established labour

• Regular, strengthening contractions — this is the clearest sign. Early labour contractions are irregular and manageable; established labour contractions settle into a pattern and get progressively longer, stronger and closer together.
• Waters breaking — a gush or slow trickle of fluid, which should be clear or pale straw-coloured. This can happen before contractions start or well into labour.
• Increasing pain that you can't talk through — a practical marker many midwives use: if you can no longer hold a conversation through a contraction, labour has usually moved into an established phase.

When to call your midwife or maternity unit

Call straight away if:
- Your waters break, whatever colour they are, but urgently if they're green, brown or blood-stained
- Contractions are regular and roughly 5 minutes apart, each lasting about 60 seconds (the general "5-1-1" rule, though your own maternity unit may give slightly different guidance at your booking appointment)
- You're bleeding, have a severe headache, or notice reduced baby movements
- You are simply not sure — maternity units expect calls from people who aren't certain, and would always rather you rang.

Early labour vs established labour — the practical difference

Early labour (sometimes called the "latent phase") can last many hours, even a day or two, especially in a first pregnancy — this is normal, if often frustrating. Most maternity units will suggest staying at home during early labour, moving around, eating light snacks and using a TENS machine or bath for comfort, and coming in once contractions are established rather than at the very first twinge.