Pregnancy and getting ready for birth

Early Signs of Labour: Contractions, Show and Waters

Near your due date, a trip to the loo can turn into an investigation. Was that a show? Is this backache different? Has the baby sent a calendar invitation that everyone else received?

You do not need to spot every sign, and you do not need to prove you are in labour before asking for help. The useful things to notice are your contractions, any fluid or bleeding, your baby’s usual movements and how you feel. Here is what those changes can mean and what to do next.

When should you call your maternity unit?

Call your midwife or maternity unit if you think you are in labour, or your contractions are coming regularly every five minutes or more often. You can also call because you are worried, unsure or need help coping. Follow any individual instructions your maternity team has given you, including plans for an earlier call or admission.

If you are under 37 weeks, regular tightenings, period-like pains, unusual backache or a trickle or gush of fluid need an urgent call. Do not wait for them to settle into a five-minute pattern.

Your baby should keep moving up to and during labour. Call immediately if movements become less frequent, stop or change from your baby’s usual pattern. A home Doppler does not tell you that the baby is well, and a fixed kick-count target is not a substitute for noticing what is usual for them.

Five early signs of labour and what they feel like

1. Contractions or tightenings

A contraction is your womb tightening and then relaxing. It can feel like a strong period pain: the discomfort builds, your bump hardens, then the pain eases as the muscles relax. Putting a hand on your bump may help you notice that change.

Early contractions can be irregular, with pauses that leave you wondering whether the whole thing has been cancelled. As labour progresses, they tend to become longer, stronger and more frequent. The pattern matters, but it cannot tell you exactly how far your cervix has opened.

Tell your maternity team about pain that is continuous or different from the contractions, or if you feel unwell. Do not use a contraction app to talk yourself out of calling.

2. A pink, jelly-like show

During pregnancy, mucus forms a plug in the cervix. As the cervix begins to open, that mucus may come away as one sticky blob or several pieces. A show is often pink because it contains a small amount of blood.

Labour can follow quickly, or it may take a few days. Some women never notice a show. It is a clue rather than a countdown, so there is no need to keep checking for another piece. Our mucus plug guide goes into what it can look like.

More than a small amount of blood in the mucus needs an immediate call. If you are unsure whether you are seeing a show or bleeding, phone your maternity unit rather than trying to match it to an internet photograph.

3. Backache or a heavy aching feeling

Backache can come on in labour, sometimes as a heavy ache across your lower back. Note whether it comes and goes with tightenings or is continuous, and tell the midwife. Backache alone cannot give you a reliable time for the birth.

If it is unusual for you, particularly before 37 weeks, call for advice. You do not have to wait for waters or a show as well.

4. An urge to go to the toilet

Your baby’s head pressing on your bowel can make you feel that you need a poo. Mention new pressure along with your other symptoms when you call.

That toilet feeling is different from a strong urge to push when you think the baby is coming now. The latter needs 999 and an ambulance, rather than one more lap around the bathroom.

5. Your waters breaking

This can be a sudden gush or a slow trickle that you cannot control. It is not always the dramatic splash from a television birth scene. Amniotic fluid is usually clear and pale, and it can be difficult to distinguish from urine.

Your waters often break during labour, but they can go before contractions begin. Either way, call your maternity unit urgently. Put on a period pad, not a tampon, so the fluid’s colour can be checked.

Is it early labour or Braxton Hicks?

Braxton Hicks are practice tightenings. They may feel uncomfortable but are usually painless, tend to be short and do not build up. Early labour can also be irregular, so there is no perfect at-home test.

This comparison is a way to describe what is happening to your midwife, not a reason to delay a call. You can need help even if the contractions are irregular or you can still talk through them.

How to time contractions without overcomplicating it

There are two different measurements:

• Duration: how long one contraction lasts, from the tightening starting until it ends.
• Frequency: how far apart contractions are, measured from the start of one to the start of the next.

For example, a contraction starts at 12:00 and ends at 12:00:50. The next starts at 12:05. The first lasted 50 seconds, and they were five minutes apart. The rest between them was four minutes and ten seconds; that is a different measurement.

A phone timer, an app or a note on paper can do the job. Write down a few start times and lengths, plus whether the contractions are getting stronger. Give your midwife the actual pattern instead of an app’s prediction.

There is no need to wait for a perfect “5-1-1” pattern before phoning. Call if you think you are in labour, follow your own team’s instructions and use the urgent signs above whenever they apply.

What to do if your waters break before contractions

1. Call your maternity unit urgently. Tell them when the fluid started, its colour and smell, your pregnancy weeks, your baby’s movements and any other symptoms.
2. Use a period pad. Avoid a tampon. Keep the pad so the team can assess the fluid if they ask.
3. Mention coloured or smelly fluid, bleeding or feeling unwell immediately. Do not wait to see whether contractions catch up.
4. Get your individual plan. Your team will tell you about assessment, waiting and induction. If you have been told you have group B strep, mention it straight away because it can change the plan.

At 37 weeks or later, labour often begins within 24 hours of the waters breaking. NICE recommends discussing waiting for up to around 24 hours or induction as soon as possible; if labour has not started after about 24 hours, induction is offered. Your circumstances can mean earlier action. This is a discussion to have after calling, not permission to sit at home for a day without contacting anyone.

If your team advises waiting, ask what they want you to monitor and when to call again. NHS advice includes checking your temperature every four hours while awake and reporting a rise; your midwife should tell you the threshold for you. Report reduced movements or a change in the fluid’s colour or smell immediately.

A bath or shower after waters have broken has not been shown to increase infection risk, but sex may do so. Follow your maternity team’s advice, and remove a TENS unit and its pads before getting into water.

Why can early labour stop and start?

The first stage begins with the latent phase, when the cervix softens, thins and starts opening. Contractions can stop and start during this phase, and it may take hours or sometimes days. A quiet spell does not mean you imagined the earlier pain.

Established labour involves regular contractions and progressive opening of the cervix. A timer cannot measure that opening. Your maternity team considers the whole picture, including how you and your baby are doing and whether you need examination or support.

You may be advised to stay at home during early labour, or return home after an assessment. Ask what the plan is, what would mean calling again and what pain relief is available. If you are distressed or struggling, say so; you do not have to keep coping simply because the first advice was to stay home.

It can help to have your maternity number, bag and transport arrangements sorted before you need them. Our before-baby checklist covers useful preparation without turning the last weeks into a shopping challenge.

What helps at home in early labour?

If your team is happy for you to be at home, aim for comfort and rest. This is not an endurance test with a prize for the most laps of the living room.

• Rest when you can. If contractions settle, use the break. At night, try to sleep or rest rather than timing every small twinge.
• Move if it feels good. Walking gently, rocking or changing position may help. You can stop when you want to; movement is not an obligation.
• Eat something manageable. A snack or light meal may suit you if you feel like it and your team has not advised otherwise.
• Drink when you are thirsty. Keep a drink nearby without forcing extra litres. NICE advises that drinking more than normal brings no benefit and can be harmful.
• Try a warm bath or shower, slow breathing or a back rub. Tell your birth partner if touch helps, or if you would rather be left alone.
• Ask about pain relief. The NHS advises paracetamol in early labour according to the packet. Check with your midwife or pharmacist if it is unsuitable for you, you are unsure of the dose or you take other medicines containing paracetamol.

A maternity TENS machine may help some women with early labour back pain, though it is not proven effective in active labour. Learn how to use it beforehand and follow your midwife’s advice and its instructions. Our labour TENS buying and hiring guide explains the practical options.

If you are tempted to speed things up, our guide to natural ways to induce labour separates comfort measures from claims that a particular food or activity will start birth.

What your birth partner can do

Take over the practical jobs: keep the maternity number handy, write down contraction times if asked, sort the bag and transport, and offer drinks or food. Ask before rubbing a back or suggesting another breathing exercise. The right support may be conversation, quiet or just being there.

For the maternity call, have these details ready. If something feels urgent, phone first and collect the information while you speak.

You can keep pain-relief preferences and important details in your birth plan. Leave room to change your mind. If uncertainty is making the waiting particularly hard, our pregnancy anxiety guide has more support.

Quick questions about early labour

Are there definite signs labour will start in the next 24 or 48 hours?

A show, backache or irregular tightenings cannot promise a particular birth day. Waters breaking needs an urgent call and a care plan, rather than a home countdown. Watch what is happening now and keep your team informed.

Can I be in labour without a show or my waters breaking?

Yes. Sometimes there is no noticeable show, and waters often break during labour. You do not need all five signs before calling.

Do I need to go straight to hospital with the first contraction?

Phone your maternity unit for guidance. They may advise staying at home during the latent phase, but your care plan, symptoms and how you are coping matter. Urgent signs need an immediate call, regardless of the contraction pattern.

Can I sleep if the contractions stop?

If your team is happy with the situation and has advised staying home, resting during a lull can help. That does not apply to waiting out broken waters, bleeding, reduced movements or other urgent signs without contacting them.

Sources

1. NHS: signs that labour has begun and when to call
2. NHS: stages of labour and birth
3. Cambridge University Hospitals: labour and the latent phase
4. NICE: intrapartum care, waters breaking and early-labour assessment
5. NHS: your baby’s movements
6. NHS: premature labour and birth
7. NHS: pain relief in labour
8. NHS: paracetamol for adults