Birth
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Signs of labour: when to call your midwife

Labour often starts slowly. Here are the early signs, what real contractions feel like and when to call your midwife, so you are never guessing alone.

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Signs of labour

In short

01

Early signs

Regular tightenings, a show (a pink or bloody mucus plug), backache or a watery trickle can all be early signs.

02

Real or practice?

Practice contractions (Braxton Hicks) are irregular and ease with rest. Real contractions get longer, stronger and closer together.

03

When to call

Call your midwife or maternity unit if your waters break, if you bleed, if baby moves less, or if contractions are regular and strong.

04

At home first

Many people stay at home in early labour: eat lightly, drink, rest and move. Your midwife will guide you on when to come in.

Early labour often starts slowly

The early (latent) phase can last hours, sometimes days, especially with a first baby. Contractions may come and go and feel like period pain or backache.

This is normal. Most people stay at home for this part, resting, eating lightly and moving.

Signs labour may be starting

A show: the plug of mucus from your cervix comes away, often pink or streaked with blood.

Your waters break, either as a gush or a slow trickle. Backache, an upset stomach, or regular tightenings that get stronger are also common signs.

Practice or real contractions?

Practice contractions (Braxton Hicks) are irregular and ease when you rest or move.

Real contractions come in a pattern and get longer, stronger and closer together. You will find it harder to talk through them.

When to go in

Your maternity unit will tell you when to come in. Many advise calling when contractions come regularly every five minutes or so, last about a minute, and feel strong.

Call sooner if this is not your first baby, if you live far away, or if you just feel you need support.

If your waters break

Call your midwife or maternity unit. Use a pad, not a tampon, so you can check the colour.

Most people go into labour within 24 hours. If not, you will be offered induction, or you can choose to wait with checks.

Based on NHS guidance on signs of labour and NICE intrapartum care guidance. Mia teaches. Your midwife knows you best.

Sources: NHS: Signs that labour has begun · NICE guideline NG235: Intrapartum care · NICE: Prelabour rupture of membranes

Good to know

What if my waters break?

Call your midwife or maternity unit. Note the time and the colour of the fluid.

How far apart are contractions when I should go in?

Your midwife will tell you what suits you. Many units advise calling when they come regularly every 5 minutes or sooner.

Can labour start without contractions?

Yes. It can start with your waters breaking or a show. Call your midwife if your waters break.

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