How can you tell when labor is starting?

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Labor can begin naturally in two ways: with contractions or your water breaking
.

9 out of 10 labors begin with contractions
. During pregnancy, your uterus is shaped like a balloon and consists, among other things, of muscle tissue. During a contraction, the muscles of your uterus contract. This reduces the space inside your uterus and pushes the baby toward your cervix. This causes the cervix—which normally has the shape of a long, stiff tube—to first soften and then shorten. Once the uterus has fully dilated and the cervix can no longer be felt, the cervix opens. When your cervix opens, accessibility. If you've given birth before, it's possible that the dilation of your cervix and the onset of the first stage of labor occurred at the same time.

Your cervix is located about a finger’s length inside your vagina. You can’t see whether your cervix is shortening or dilating; your midwife can tell you this by feeling it. We call this examination an internal exam or vaginal exam.

You can tell when you're having a contraction because uterus during a contraction, it tightens and becomes completely hard. You can pre-weave
These are contractions where the tightening of your uterus feels uncomfortable but causes little or no pain. For example, you can still talk through the contraction and only need to focus on it for a brief moment. Pre-labor contractions can be part of your body’s preparation for childbirth; for example, they can help soften or shorten your cervix, and sometimes these contractions can even cause a small amount of cervical dilation. However, Braxton Hicks contractions can subside completely and may not return until a few hours, a few days, or even a few weeks later, when they turn into the actual labor contractions. Some women experience frequent and intense Braxton Hicks contractions, while others don’t experience them at all. Both are normal. If your contractions are still relatively short, the breaks between them are still a bit longer, and the pain is still manageable, we recommend finding a distraction. So don’t start timing your contractions from the very first one; instead, try to take your mind off things. Watch a TV show, fold the laundry, bake a cake, or just try to rest a bit more. You’ll know on your own when labor is really getting underway: the contractions will come closer together and become stronger. Sometimes, however, this doesn’t happen, and the contractions subside again.

During early contractions, as well as during labor, you can use the mucus plug discharge. This is thick mucus that is clear in color or has some red and brown streaks of blood running through it. Losing your mucus plug is normal. Your body can regenerate the mucus plug, so you may feel as though you’re losing it multiple times. Losing the mucus plug does not indicate whether or when labor will begin.

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The contractions that indicate labor has truly begun and will continue are those that are strong and last longer. Almost all women find these contractions painful: during a contraction, you won’t want to talk or do anything else; instead, you’ll need to focus on the contraction and your breathing. A contraction takes the form of a wave or a mountain: when the contraction starts, the pain is at a low point, but it builds up to the peak of the wave or mountain and then subsides again. An effective contraction often lasts at least 60 seconds and is so intense that you have to focus on the contraction and your breathing throughout the entire contraction. Most women feel the contraction in their abdomen or lower back; some women also feel the pain of the contraction in their thighs. After the contraction, you have a break, and the pain is completely gone or only very minimal. In the next video, I’ll tell you more about how contractions build up and the difference between a first birth and subsequent births. But first, I’m going to tell you a bit about when your water breaks.

One in 10 births begins with the rupture of the membrane
. You can tell this is happening because you’re losing fluid that’s as thin as tap water. Amniotic fluid can clear or pink It has a certain color, and you can see little white flakes floating in it. The amniotic fluid can also be green or brown; in that case, it has changed color because the baby has passed stool in the amniotic fluid. We call this amniotic fluid containing meconium. A baby may pass stool in the amniotic fluid simply because the intestines are functioning normally, or because the baby is or has been stressed. If the amniotic fluid is green or brown, or if you have any doubts, please let us know right away. This is a reason to keep a closer eye on the baby.

When your water breaks, some women suddenly lose a lot of fluid: your underwear and pants are soaked, and you continue to lose fluid even after the initial gush. In that case, it’s clear: your water has broken! It’s also possible that you’ll lose a little bit of fluid at a time. For example, you might notice that you lose fluid every time you change position and that your underwear is completely soaked each time. Toward the end of your pregnancy, you might also experience involuntary urine leakage or have a lot of vaginal discharge that can be as thin as water. In that case, it can be difficult to tell for sure whether your water has broken. Sometimes it helps to smell the fluid you’re losing: amniotic fluid is odorless or has a slightly sweet smell, which is different from the smell of urine. Call us if you’re unsure whether your water has broken; we can then work with you—using questions or additional tests—to determine whether or not your water has broken. I explain in more detail when and at what times you should call if your water has broken in the videos with the calling instructions.