As you approach your estimated due date, you will, naturally, be looking for signs that you are going to go into labour soon. Here I list some of the most common signs that labour may be about to begin.
Labour may come as a surprise
I often liken labour to puberty – you know that you will go through it, but you do not know exactly when it will begin, how long it will take, or how you will feel during it. When it comes to pre-labour signs, some women experience every sign under the sun whilst others may get a couple of indications that labour will start soon. Some women will simply have a gut feeling that they are about to go into labour. For others the onset of labour will come as a complete surprise.
The signs listed in this post are things that you can look for, but don’t be alarmed if you experience none of these. Every body is different and every labour is different.
Signs that labour may start soon
The head engages
As labour approaches, the presenting part of you baby, usually their head, moves lower into the pelvis. When more than three fifths of the head is lying deep in the pelvis, it is described as being ‘engaged’. You may feel that your bump has ‘dropped’ as baby moves down. When your midwife palpates your tummy, they will be able to tell you whether baby is engaged.
There’s something in your knickers
As the cervix moves forward, softens and thins (a process called ripening), you may notice an increase in vaginal mucous. There is a thick plug of mucous that seals the entrance to the cervix, preventing infection entering the uterus. In the days before labour begins this may come away and you may notice some jelly-like mucous in your underwear or on toilet paper when you go to the loo. It may come out in one go or in smaller bits and you may not notice it at all if you lose it while on the toilet.
Some women may also find streaks of blood within or in addition to the mucous plug. This is called the “bloody show”. It is caused by small blood vessels in the cervix rupturing as it moved forward and starts to thin.
The loss of the mucous plug and the bloody show may occur individually, together or not at all.
Your body may purge itself
Some women’s body will clear itself out before labour begins so that all of its energy resources can be focussed on the uterus, not on digesting lunch! Unfortunately this means some women will vomit or have a bout of diarrhoea in the days leading up to labour beginning. If you’re sure that you have not suffered from food poisoning or a sickness bug, these unpleasant symptoms could be a sign that your labour will start soon, so rest up and keep hydrated.
You may feel twinges
Some women experience the earliest contractions as twinges of discomfort. You may experience Braxton Hicks contractions during your pregnancy. These are not a sign that labour is imminent, but are instead thought to play a role in toning the uterine muscle for labour and in promoting blood flow to the placenta. Labour contractions, that you may first feel as twinges or as light period pains that come and go, will become regular and increase in intensity over time.
Your waters may break
One of the biggest misconceptions that many women have about labour is that the first sign of it will be their waters breaking. This is where the amniotic sac which surrounds and protects your baby during pregnancy breaks and the fluid that is in it comes out. The waters may come out in a trickle or a gush, depending on where the amniotic sac has broken. For some women this will be one of the first concrete signs of labour, but for many others it will not. It’s hard to find concrete statistics on the percentage of women whose waters break before labour begins, but most NHS trusts put the figure at between 6% and 19%.
If your waters do break before you go into labour, you will be advised to contact triage. Most hospitals have a policy requiring the mother to go into labour within 24 hours of her waters breaking. This is due to the slight increase in infection for both mother and baby once the amniotic sac is broken. If you do not go into labour after this time, you will usually be offered antibiotics and/or induction.
A 2014 Cochrane review of evidence on the administration of antibiotics to women whose waters have broken found that there was not strong evidence of benefit from antibiotics. It advised that antibiotics should not be routinely used for pregnant women with ruptured membranes prior to labour at term, unless a woman shows signs of infection.
A 2017 Cochrane review regarding induction versus waiting for labour to begin naturally found a slight increase in infection rates for baby (from 0.5% to 1%) and for mothers (1% increase).
If your waters do break before labour begins, or during labour, they should be clear. Any colouration could indicate that your baby has passed meconium (their first poo). There is a small risk of the baby inhaling meconium into their lungs during birth (2-5% of babies with meconium in the waters). 95-98% of babies who have meconium in the waters do not experience any adverse effects. It is worth noting that 15-20% of women’s waters have meconium in them.
Find out more
Dr Rachel Reed has excellent informative blogposts on the topics of:
Waters breaking before labour begins
Meconium stained waters and the risks that this carries
Signs of labour is one of the topics that I dive into in my comprehensive antenatal hypnobirthing course. You can find out more about my courses here.