Signs of Labor: When to Go to the Hospital

Full-term baby at week 39 — recognising the signs labour has begun

"Is this it?" is the most common question of late pregnancy — and the most uncertain. Real labour can start subtly over hours or arrive with one unmistakable contraction. This guide explains every sign, the difference between true and false labour, the 5-1-1 rule for when to leave for the hospital, and the warning signs that mean to call right away regardless of contractions.

Pre-Labor Signs (Days to Weeks Before)

In the final two to four weeks before labour, your body starts preparing. Many of these signs come and go:

Early Signs of Labor (Hours to Days Before)

Mucus Plug ("Show")

Throughout pregnancy, a thick mucus plug seals the cervix. As the cervix softens, you may pass it as one blob or in stages. It can be clear, pink, or streaked with brown or red blood. Losing your mucus plug means labour is approaching, but it can still be days or even a week or two away.

Bloody Show

A small amount of pink or red-tinged mucus often appears as the cervix opens. This usually means labour is closer — within 24 to 48 hours for many women. Heavy bleeding is not normal — call your provider.

Mild Cramps and Backache

A persistent low backache, period-like cramps or a heavy ache low in the pelvis can be the very start of labour contractions. They often come and go before settling into a regular rhythm.

GI Changes

Nausea, loose stools, vomiting and a feeling of "off-ness" are common in early labour as your body releases prostaglandins.

Real Labor vs. Braxton-Hicks

The single most useful comparison in late pregnancy:

Braxton-Hicks (false) Real labor
Frequency Irregular, unpredictable Regular, getting closer together
Duration Variable, often less than 30 sec 30 to 70 sec, getting longer
Intensity Stays the same or weakens Steadily intensifies
Location Front of belly only Lower back wrapping to front
Effect of activity Eases with rest, walking, hydration or warm bath Continues regardless of what you do
Cervix changes No Yes — opens and thins

Water Breaking — What to Do

Membranes can rupture as a sudden gush or a slow trickle. Amniotic fluid is usually clear or pale straw-coloured, odourless and continues to leak. Once your waters break:

Call immediately if the fluid is green, brown or yellow (meconium-stained), if it has a foul smell, if you see blood, or if you cannot feel the baby moving normally afterwards.

The 5-1-1 Rule

For a first-time mother with an uncomplicated pregnancy, the standard guideline is:

5-1-1: Contractions are 5 minutes apart, each lasting 1 minute, for at least 1 hour. Time from the start of one contraction to the start of the next.

For second and subsequent babies, many providers advise 7-1-1 (7 minutes apart) or going in as soon as contractions are strong and regular — second labours can be much faster. If you live more than 30 minutes from the hospital, go earlier.

When to Go to the Hospital

🏥 Head in if any of these are true

When to Call Immediately (Regardless of Contractions)

Phone your maternity unit straight away if you experience: heavy vaginal bleeding (more than spotting), green or brown amniotic fluid, decreased fetal movement (see our kick-counts guide →), severe persistent headache or vision changes (possible preeclampsia), severe one-sided abdominal pain, fever above 38°C, or any symptom that just feels deeply wrong.

The 3 Stages of Labor

Stage 1: Dilation (Longest)

From the first true contraction to full cervical dilation (10 cm). Three sub-phases:

Stage 2: Pushing and Birth

From full dilation to your baby being born. Average 30 minutes to 2 hours for first baby; faster for subsequent. Pushing with contractions, often in waves of 60 to 90 seconds.

Stage 3: Delivery of the Placenta

5 to 30 minutes after the baby is born. Mild contractions help the placenta detach and deliver. You may not even notice it.

Make sure your bag is ready: Hospital Bag Checklist → · Third Trimester Guide →

Frequently Asked Questions

How do I know if my water broke?

Water breaking can be a sudden gush or a slow trickle that you cannot stop. Amniotic fluid is usually clear or pale straw-coloured and odourless. Once your waters break, contact your maternity unit — most providers want you assessed within 24 hours.

What does the mucus plug look like?

The mucus plug is a thick, jelly-like discharge that may be clear, pink or streaked with brown or red blood. Losing it (a 'show') can happen days or even weeks before labour begins, so it is a sign — not a starting gun.

How long does early labor last?

Early labour averages 6 to 12 hours for a first baby and is usually shorter for subsequent babies. Contractions are mild to moderate and 5 to 20 minutes apart. The cervix opens to about 6 cm during this phase.

Can I sleep through early labor?

Yes — and you should try to. Early labour can take many hours. Resting, eating lightly, hydrating and saving your energy for active labour is the right strategy. Use breathing or a warm bath to manage discomfort.

What is the 5-1-1 rule?

5-1-1 means contractions are 5 minutes apart, lasting 1 minute each, for at least 1 hour. For a first-time mother having an uncomplicated pregnancy, this is typically when to head to the hospital. Your provider may give you slightly different guidance — follow theirs.

When should I go to the hospital with my second baby?

Second and subsequent labours are usually faster. Most providers recommend the 7-1-1 rule (7 minutes apart, 1 minute long, for 1 hour) or going in as soon as contractions are strong and regular. If you live far from the hospital, go earlier rather than later.

What if my contractions stop?

Prodromal labour — early contractions that start and stop over hours or days — is common. If contractions ease with rest, hydration or a warm bath, you are likely not in active labour yet. True active labour contractions intensify and get closer together regardless of what you do.

Can I eat during early labor?

Light, easy-to-digest snacks (toast, fruit, soup, yogurt) are usually fine in early labour. Most providers restrict food once you are in active labour or have an epidural. Sip water and electrolyte drinks throughout.

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