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Signs of Labour: When to Reach Hospital?

Signs of Labour

How will I know that my labour has begun? Will I reach the hospital in time? How do I know it's not false labor? Will I be able to walk when my water breaks? Will I be able to take the labor pains? How long does the labor last? 

Hello everyone, once again, I bring greetings to you from Lafiyata. So everyone has heard stories about labour. Labour is a sign that your baby is about to come.

What is Labour?

How do you define labor? Labour is a series of continuous, progressive, contractions of uterus which help the cervix dilate. What's cervix? Cervix is the mouth of the uterus. Now this allows the baby to move through your birth canal into the outside world.

How do you know when your labor is starting?

What are some signs which can help you identify labour? And what is the right time to reach the hospital? while labour feels different for every woman, here are three definite signs of labor.

  1. Passage of show
  2. Labor contractions and 
  3. Rupture of water bag 

Now either one of them or two of them or all three could begin together. 

The show 

So let's talk about the first sign of labor. The bloody show. This refers to the mucus plug coming out. 

Mucus plug keeps your cervix closed, when it is time for your baby to come out, the mucus plug dislodges. This mucus comes out of your vagina and may contain some blood. 

It's a slimy jelly like pink colored blob coming out of your vagina. This type of mucus is known as show, there is a very slight bleeding with it. 

Actually the bleeding should not be heavy, if its heavy bleeding instead could mean that probably the placenta has separated inside which is a catastrophe. 

Labour Contractions

Now let us first understand what are the uterine contractions. Your uterus is a muscular organ made up of a thick muscle. Now the baby is contained in the cavity of the uterus. 

When the uterine muscle contracts, it builds up the pressure inside the uterus which pushes the baby down. Also the contractions of the uterine muscle help to pull up or shorten the cervix and dilate it. Now since the uterine muscle is contracting, it has to relax too. 

Signs of Labour

So the contractions always come and go in a coordinate manner. They are never continuous and since these contractions are painful and there is a lot of labour involved in it, these are known as labour pains. How simple! So the labour pains now we can say are the rhythmic tightening and relaxing of your uterine muscles. 

What causes the labor contractions? 

No one knows for sure what triggers the real labor contraction. Is it the baby telling the mom, I am ready to come out? Or the mom saying it's now time to come out? Researchers now believe that when a baby is ready for life outside the mother's uterus, his or her body releases a tiny amount of chemical which signals the mother's hormone to begin labour. 

But then why do some babies come prematurely? Why do some pregnancies go post-dated? We do not yet have these answers, only some speculations. 

How do contractions feel like?

Now this is a very common question which all my patients ask me. Early labor contractions can feel like mild menstrual cramps the way you have pain during your periods. It could be mild intestinal discomfort, lower abdominal pressure or just the lower back ache and as the labor progresses the contractions become more intense and severe.

Where do you feel the labor contractions?

You may feel the pain in just the lower abdomen or in the lower back or the pain may even radiate down the legs particularly the upper thighs. 

When to report to the hospital? 

Regular contractions that occur at an interval of 5 to 10 minutes and last for at least 30 seconds may mean that labor has started and it's now time to reach the hospital. 

What are Braxton Hicks contractions? 

Towards the end of your pregnancy you might feel mild contractions on and off. It's a very common pregnancy symptom but it should not be confused with real contractions. These are painless contractions and actually your uterus is just practicing for the day. 

How to differentiate between true labour and false labour 

So let's now understand how do I differentiate between a true labour pain and a false labour pain. The true labour pains will get frequent intense and regular with time while the false labor pains will be shorter and they usually settle after one to two hours on their own. 

True labor pains do not get relieved by change of position while the false labor pains could get relieved by the change of position. 

True labor pains may be associated with brownish or pinkish discharge from the vagina while false labor pains usually there is no associated discharge. 

True labor pains may be associated with upset stomach, cramps or diarrhea while false labor pains usually do not have any associated symptoms. 

True labor pain may be associated with rupture of your water bag while false labor pains are usually dry contractions. 

Rupture of water bag

So now let's understand about the third major sign of labor which is the rupture of amniotic sac. Commonly people say my water broke. So when it's time for your baby to be born the amniotic sac in which the baby floats usually breaks and the amniotic fluid drains out through your vagina. 

Now this is your water's breaking. It can be small leak or it could be enough to wet your clothes or your bed linen completely. It can happen either during the labor or sometime even before it while sometimes the water may not break till the end and the baby may come out in a sac. 

This is very beautiful to watch, it is called born in call wherein we can see the baby born in a balloon like sac. 

How does labour water feel? 

Water breaking may feel like a slow trickle or a sudden gush of water which you cannot control. It may be less or it may be more but it will always be continuous. 

Sometimes it's difficult to differentiate the amniotic fluid from the urine. Many people, many women actually say sir I can't really make out whether it is the urine or the amniotic fluid. 

So in that case you should empty your bladder. If the clothes are still getting wet then it's in all probability your amniotic fluid leaking. In case of any confusion please report to the hospital immediately. 

Nowadays we have tests available to make sure that it is the amniotic fluid not the vaginal discharge or the urine. Remember amniotic fluid is clear and absolutely colorless. However when your waters break initially the water may be slightly blood tinged. 

If the amniotic fluid is green in color it's a sign that the baby has poked inside and this could be a sign of fetal distress. 

Pre-laboir symptoms

1. Baby drops: For the first time mom the baby could drop into the pelvis weeks before the labor begins usually at 37 weeks but for the subsequent labor the baby could actually descend into the pelvis only during the active labor. 

2. Frequent urination: As the baby's head descends it now presses on the mother's bladder and there could be a frequent urge to pee as a result of reduction in bladder capacity by fetal head compression. Don't worry this is not UTI.

3. Cervix begins to dilate, cramps and increased back pain: As the baby descends into the pelvis it causes pressure on your back leading to a bad backache. 

4. Loose feeling joints: The hormone called relaxin relaxes the joints in your pelvis. This is the nature's way of making your baby's birth easy but it also causes clumsiness in your movements and also make you to become a waddling kid. 

5. Diarrhea: Just as the muscles in your uterus are relaxing in preparation for your birth so are the other muscles in your body including those in the rectum too and that can lead to what is known as pre-labour diarrhea. 

6. Weight gain stops: Now this signals the end of pregnancy. So do not panic. Just be watchful. Trust the mother nature. Trust your doctor and get ready to welcome the baby. 

Wishing you a very safe delivery and a very joyous motherhood. So today if you found this post useful, you found this information useful do not forget to share and subscribe to Lafiyata and I will see you soon.


1. Bonapace J, Gagné GP, Chaillet N, Gagnon R, Hébert E, Buckley S. No. 355-Physiologic Basis of Pain in Labour and Delivery: An Evidence-Based Approach to its Management. J Obstet Gynaecol Can. 2018 Feb;40(2):227-245. doi: 10.1016/j.jogc.2017.08.003. PMID: 29447711.

2. Hundley V, Downe S, Buckley SJ. The initiation of labour at term gestation: Physiology and practice implications. Best Pract Res Clin Obstet Gynaecol. 2020 Aug;67:4-18. doi: 10.1016/j.bpobgyn.2020.02.006. Epub 2020 Feb 22. PMID: 32220530.

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