Signs of labor: how to tell labor is starting

Labor is starting when contractions settle into a regular pattern and get longer, stronger and closer together. Your water breaking is the other clear sign, and for most women contractions follow within 24 hours (MedlinePlus).

Earlier changes, such as the baby dropping lower, losing your mucus plug, backache and loose stools, can signal that labor is getting close. The lead-up can stretch over days, and none of these signs tells you the exact hour.

When does labor usually start?

A pregnancy lasts about 40 weeks on average, but there’s no way to know exactly when you’ll go into labor. ACOG (the American College of Obstetricians and Gynecologists) says most women give birth between 38 and 41 weeks. MedlinePlus, the health site of the U.S. National Library of Medicine, puts it another way. Normal labor at term can start any time from 3 weeks before to 2 weeks after your due date.

What sets labor off isn’t fully understood. ACOG says changes in hormones may play a role. Cleveland Clinic describes prostaglandins, which help open the cervix and cause contractions. It also names oxytocin, which your body releases when the baby presses against the cervix.

Early signs that labor is getting close

You might notice some of these changes, all of them or none before labor begins. Their timing varies a lot from person to person.

The baby drops (lightening)

Lightening is when the baby’s head settles lower into your pelvis. Your belly may look lower, and breathing gets easier because there’s less pressure on your lungs. You may also need to pee more often because the baby presses on your bladder.

ACOG says lightening can happen anywhere from a few weeks to a few hours before labor. According to MedlinePlus, it often happens a few weeks before birth in a first pregnancy. If you’ve had a baby before, it may not happen until labor has begun.

Losing your mucus plug or a bloody show

During pregnancy, a thick plug of mucus seals your cervix. When the cervix begins to open, which can be several days before labor or right at its start, the plug is pushed out. You may notice more discharge that is clear, pink or slightly bloody, and some people pass the whole plug at once (ACOG).

MedlinePlus notes that bloody or brownish discharge can mean your cervix has started to dilate, but active labor may still be days away. Our mucus plug guide explains what’s normal and when to call.

Practice contractions

Braxton Hicks contractions can come and go for many weeks before labor, and you might notice them more at the end of the day. They’re usually less regular and weaker than labor contractions. Sources describe them differently: ACOG notes they can be very painful, while the NHS says they’re usually painless, don’t last long and don’t build up. If resting and drinking water make them go away, they weren’t labor contractions. Our guide to Braxton Hicks contractions goes into more detail. If contractions keep stopping and starting over days, see prodromal labor.

Backache and loose stools

You may get backache or a heavy, aching feeling as labor approaches. Some people also need to empty their bowels often, and looser stools than normal may mean labor is starting. The NHS explains the urge to go to the toilet by the baby’s head pressing on your bowel.

A burst of energy (nesting)

Many people feel a sudden urge to clean, organize or finish the nursery right before labor. Cleveland Clinic lists nesting among the pre-labor signs that might hint labor will start soon. MedlinePlus is more cautious and says there’s no science behind the theory, even though plenty of women feel the urge.

Signs that labor has started

Two changes tell you more than any early sign: contractions that fall into a pattern, and your water breaking.

Contractions that follow a pattern

Labor contractions come at regular intervals and get closer together over time. They keep going whether you rest or move around, and they get steadily stronger. The pain usually starts in your back and moves to the front. ACOG compares the pain to menstrual cramps, and what contractions feel like describes it in more detail.

How long they last and how far apart they are depends on how far labor has progressed. Cleveland Clinic says early labor contractions last 20 to 30 seconds and come every 30 to 60 minutes. They feel more like an ache or pressure. MedlinePlus describes true labor contractions as 30 to 70 seconds long and about 5 to 10 minutes apart. They get longer over time and become so strong that you can’t talk or laugh at a joke during them. How long contractions last has the typical values for each stage.

ACOG sums up the differences like this:

	Practice contractions	Labor contractions
Pattern	No pattern, don’t get closer together	Regular, closer together over time
Rest or movement	May stop when you walk, rest or change position	Keep going
Strength	Weak, don’t get much stronger	Get steadily stronger
Where you feel them	Usually only in the front	Usually start in the back and move to the front

ACOG adds that sometimes only a vaginal exam can show whether your cervix is changing. Timing your contractions for an hour or so helps you see whether a pattern is forming. You can write them down on a contraction chart or use a timer.

Your water breaks

When the fluid-filled sac around the baby breaks, you may feel a trickle or a gush. Call your provider and follow their instructions, even if you have no contractions yet. According to MedlinePlus, contractions start within 24 hours for most women. NICE, England’s guideline body, gives a figure of 60% within 24 hours when the water breaks before labor at term. Our guide to your water breaking covers what to check and what happens next.

How long does early labor last?

Early labor, also called the latent phase, is when your cervix softens, thins and starts to open. It’s the first phase of the stages of labor. The NHS says it can take hours or sometimes days. Cleveland Clinic says early labor typically lasts 6 to 12 hours. Providers consider it prolonged after more than 20 hours in a first birth. If you’ve given birth before, the cutoff is 14 hours.

It doesn’t always run smoothly from start to finish. NICE describes the latent phase as a period that is not necessarily continuous. Contractions can space out for a while before they pick up again. If all is well, you’ll probably be advised to stay at home during this phase. Moving around, drinking fluids, having a snack, using breathing exercises and taking a warm bath can help you cope.

Signs labor is 24 to 48 hours away: what’s known

Many lists online promise signs that labor is 24 to 48 hours away. The medical sources behind this article don’t list any, and ACOG says plainly that there’s no way to know exactly when you’ll go into labor.

The closest thing to a short-term signal is your water breaking, because most women go into labor within a day afterward (MedlinePlus, NICE). The other signs have wide time ranges. The baby can drop weeks or only hours before labor, and after a bloody show, active labor may still be days away. Nesting has no scientific backing as a sign, and none of these sources gives a time frame for loose stools or backache.

When to call your provider or go to the hospital

Ask your provider well before your due date which rule they want you to follow, because advice differs:

• The NHS says to call your midwife or maternity unit if you think you’re in labor. It also says to call for regular contractions every 5 minutes or more often.
• Cleveland Clinic says to call the labor floor or your provider after an hour of contractions every five minutes.
• MedlinePlus says to contact your provider for regular, painful contractions every 5 to 10 minutes for 60 minutes. The same goes for contractions lasting 60 to 90 seconds.

Whatever rule you use, call when your water breaks, whether or not you have contractions. Cleveland Clinic also says to get help right away for:

• chest pain
• dizziness or fainting
• severe nausea and vomiting
• shortness of breath
• swelling in your legs, arms or face

Your provider may give you a rule such as 5-1-1, which our 5-1-1 rule guide explains. The Contraction Timer app lets you set that rule, or your own, and alerts you when your contractions reach it. How the app calculates shows how it checks the rule.

ACOG suggests packing your bag before labor begins and leaving it somewhere handy. Our hospital bag checklist covers what to pack.