Labour marks the exciting and sometimes nerve-wracking beginning of childbirth. It’s the moment when your body starts preparing to deliver your baby. But many women, especially first-time moms struggle to differentiate between real labour, false labour, and normal late pregnancy symptoms.
This guide explores the key signs that labour is starting, what to expect, how to tell the difference between false and true labour, and when to go to the hospital.
What Is Labour?
Labour is the process by which the uterus contracts to help the cervix open (dilate) and thin out (efface), making way for the baby to pass through the birth canal.
Labour is generally broken into three stages:
| Stage | Description |
|---|---|
| First Stage | Cervix dilates from 0 to 10 cm; includes early, active, and transition phases |
| Second Stage | Pushing and delivery of the baby |
| Third Stage | Delivery of the placenta |
Early Signs of Labour Approaching
Even before active labour begins, your body starts giving you signs that the big day is near.
1. Lightening (Baby “Drops”)
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The baby moves lower into the pelvis.
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You may feel increased pressure in your pelvis but easier breathing.
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Common in first pregnancies a few weeks before labour; later in repeat pregnancies.
2. Increased Vaginal Discharge
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Thicker or more mucus-like as the cervix prepares.
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Sometimes includes the mucus plug (a thick, jelly-like substance).
3. Loss of the Mucus Plug (Bloody Show)
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Pinkish, brown, or blood-tinged discharge.
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Can happen days or hours before labour begins.
4. Nesting Urge
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Sudden burst of energy or desire to clean and prepare.
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A psychological and hormonal sign of approaching labour.
True Signs That Labour Has Started
| Sign | Description |
|---|---|
| Regular Contractions | Painful, come at consistent intervals, get stronger, longer, and closer together |
| Lower Back Pain | Persistent and rhythmic, often accompanies contractions |
| Cervical Changes | Dilation (opening) and effacement (thinning), confirmed during a pelvic exam |
| Water Breaking | Rupture of the amniotic sac; may be a gush or a trickle of fluid |
| Pelvic Pressure | Increasing pressure or heaviness in the pelvis |
Tip: True labour contractions do not go away with rest, hydration, or movement.
False Labour vs. True Labour
| Characteristic | False Labour (Braxton Hicks) | True Labour |
|---|---|---|
| Contraction pattern | Irregular, inconsistent | Regular and getting closer |
| Duration and strength | Stay the same or ease off | Increase in strength and duration |
| Pain location | Mostly front of abdomen | Starts in back, radiates to front |
| Change with movement | Stop with walking/rest/hydration | Continue regardless of position |
| Cervix changes | No dilation or thinning | Cervix dilates and effaces |
Water Breaking: What to Know
Also called rupture of membranes (ROM), this can happen as:
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A gush of fluid
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A slow leak
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Clear or slightly yellow, odorless fluid
If you think your water has broken:
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Note the color, odor, and amount
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Call your doctor or midwife immediately
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Avoid inserting anything into your vagina
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Wear a pad (not tampon) and prepare to go to the hospital
When to Go to the Hospital or Call the Midwife
Follow the “5-1-1 Rule” for contractions:
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Every 5 minutes
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Lasting 1 minute
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For at least 1 hour
Also go if:
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Your water breaks
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You have heavy bleeding (not just bloody show)
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You have fever or chills
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You feel reduced baby movement
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You’re less than 37 weeks pregnant with symptoms of labour (preterm)
Signs That Need Emergency Attention
| Emergency Sign | What It Could Indicate |
|---|---|
| Heavy vaginal bleeding | Placental abruption or previa |
| High fever and uterine tenderness | Infection (chorioamnionitis) |
| Severe upper abdominal pain | Preeclampsia or other complications |
| Blurred vision, swelling, headache | Preeclampsia warning signs |
| Green or foul-smelling discharge | Meconium or infection in amniotic fluid |
How to Track Contractions
Use a contraction timer app or a simple notebook.
Record:
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Start time of each contraction
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Duration (how long each contraction lasts)
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Interval (how far apart they are)
Pattern of stronger, longer, and closer-together contractions typically signals true labour.
What Not to Confuse with Labour
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Braxton Hicks contractions: These can be uncomfortable but are not true labour.
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Pelvic pressure: Often increases in the third trimester even before labour starts.
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Cramping or gas pains: Common and not necessarily a sign of labour unless rhythmic.
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Diarrhea: Can occur before labour as hormones relax the bowels, but not always a labour sign.
Preparing for Labour Emotionally and Practically
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Pack your hospital bag ahead of time
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Have a birth plan, but be flexible
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Inform your birth partner of signs to look out for
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Stay calm, labour can take hours, even days for first-time moms
Final Checklist: Are You in Labour?
| Question | Yes/No |
|---|---|
| Are contractions regular and increasing? | |
| Do contractions continue no matter what you do? | |
| Has your water broken? | |
| Are you bleeding heavily or feeling unwell? | |
| Is your baby moving less than usual? |
If you’re answering yes to the first few, you may be in labour. If in doubt, call your healthcare provider.
Conclusion
Knowing the signs of labour can reduce fear, anxiety, and unnecessary hospital trips. While every woman’s experience is different, recognizing the difference between false labour and the real thing is crucial.
Trust your instincts, listen to your body, and reach out to your doctor or midwife whenever you’re uncertain. Labour is a journey, and you don’t have to go through it alone.