You may not have noticed but throughout your pregnancy your body has undergone many changes to prepare you for labour and birth. Looking out for any sign or symptom that could signal the start of labour is only natural as your due date gets closer. The last few weeks of pregnancy can feel like forever, especially if you’re uncomfortable.
Baby is considered full term at 37 weeks and labour can occur at any moment from then. Waiting for labour to start can be frustrating but it’s impossible to predict exactly when labour will start. There are 3 stages of labour and the duration of labour varies from woman to woman and in each pregnancy.
Below are 5 signs or symptoms to look out for which may signal that your baby is getting ready to make his/her appearance.
1. Lightening or engagement
This describes when the baby’s head ‘drops’ lower into the pelvis so it gets into position for birth. If this is your first baby, this can happen between 1-4 weeks before birth, but in subsequent babies this doesn’t usually happen until just before labour begins.
When your baby ‘drops’ there is more pressure on your bladder so you may feel the urge to go to the toilet more frequently. You may also notice that your belly is sitting lower than usual.
2. Loose bowel movements or diarrhoea
As your body prepares for labour it causes different muscles in your body to relax, including the rectum. You may experience diarrhoea as the rectum relaxes.
3. Water breaks
We see this dramatised in movies where a pregnant woman’s water breaks like a big puddle of liquid as the first sign of labour starting. In reality, there may be a trickle of fluid (like you’ve peed your pants) or there may be a gush of fluid, and more commonly water breaks during labour not at the start. The fluid is clear or slightly pink, and odourless. The fluid comes from the amniotic sac that protects your baby during pregnancy.
4. Bloody show
During pregnancy there is a protective mucous plug covering the closed cervix. As the cervix dilates and opens, this mucous plug may be passed out of the vagina (like vaginal discharge), just before labour begins. This is called a ‘bloody show’ or a ‘show’ and can be clear, pink or brown in colour. Usually there isn’t much discharge: it may be a blob, spotting or a smear.
From about 20 weeks in the second trimester, you may have experienced some irregular, mild contractions (called Braxton Hicks contractions) which are ‘practice’ contractions that prepare your body for labour. These contractions are uncomfortable but not painful.
During true labour contractions your uterus gets tight and then relaxes to push your baby down and open the cervix. They usually start in the lower back then come around to the front, and the abdomen becomes hard. Many women describe contractions as intense period-like cramps that come in ‘waves’ with each contraction reaching a peak of intensity before disappearing as the uterus relaxes and the abdomen softens.
You or your partner should make a note of 2 types of timings:
- Duration each contraction: the length of time from when a contraction starts and ends
- Interval of contractions: the time from the start of one contraction to the start of the next contraction
As you approach active labour, contractions become more regular, get stronger, last longer and get closer together. Active labour is usually when each contraction lasts about 1 minute and occurs 5 minutes apart.
When to go to the hospital?
Your doctor or midwife will give you specific guidelines about labour and when to call the hospital or maternity unit. The following advice was given to me by my obstetrician and midwife for my low-risk pregnancy. They said I should call the maternity unit immediately if:
- you haven’t felt your baby move in the last 1-2 hours, or is moving less than normal
- you think your waters have broken
- there is vaginal bleeding
- contractions are occurring every 5 minutes
They said to always call the hospital in advance to discuss your situation before going there. My hospital’s maternity unit had a midwife staffed on the phone line 24 hours 7 days a week. This was helpful for me for my first pregnancy because I wasn’t sure if labour started and they gave advice about how to cope with contractions at home.
Australian and New Zealand Obstetrics and Gynaecology (2019). Labour and its management [Patient Information Pamphlet]