Is It Time? Recognising the True Signs of Labour and When to Go to Hospital

As your due date draws near, every twinge, ache, or new sensation can bring a flurry of questions: “Is this it?” “Am I in labour?” This anticipation, mixed perhaps with a little anxiety, is perfectly normal for expectant parents. Knowing the common Signs of Labour can help you feel more prepared, confident, and understand when it’s truly time to make your way to the hospital.

My name is Dr. Vrushali Pillai, and as a Senior Consultant in Obstetrics & Gynaecology at Borneo Hospital, Thane – part of the Borneo Hospitals group serving families across Thane, Nashik, Chhatrapati Sambhaji Nagar, and Raipur – I’ve guided countless mothers through this exciting transition. Our aim at Borneo Hospital is to ensure you feel supported and well-informed every step of the way.

This article will help you understand the typical signs that labour might be approaching or has begun, differentiate between early or ‘false’ labour and the real thing, and know when it’s the right moment to contact your doctor and head to Borneo Hospital. Remember, every woman’s labour experience is unique, but this guide provides valuable general information.

Pre-Labour Signs: Your Body Getting Ready

In the days or even weeks leading up to active labour, your body often gives subtle (and sometimes not-so-subtle!) signals that it’s preparing for childbirth. Not everyone experiences all these signs, and their appearance doesn’t mean labour will start immediately, but they indicate things are moving in the right direction.

• Lightening (‘Baby Dropping’): You might feel your baby settle lower into your pelvis. This can bring some relief, making it easier to breathe as there’s less pressure on your diaphragm. However, it might also mean increased pressure on your bladder, leading to more frequent trips to the loo!
• The ‘Nesting’ Instinct: Some women experience a sudden burst of energy and an almost irresistible urge to clean, organise, and prepare their home for the baby’s arrival.
• Increased Braxton Hicks Contractions: These are often called ‘practice’ contractions. You might have been feeling them for a while, but they can become more frequent or noticeable. Unlike true labour contractions, Braxton Hicks are usually irregular, don’t get progressively stronger or closer together, are often felt more in the front of the abdomen, and may ease or stop if you change position, walk, or rest.
• Cervical Changes (Mucus Plug / ‘Show’): During pregnancy, a thick plug of mucus seals your cervix. As your cervix begins to soften, thin out (efface), and open (dilate) in preparation for labour, this plug may be dislodged. You might notice a thick, jelly-like vaginal discharge, which could be clear, pinkish, or slightly blood-streaked. This is called the ‘show’ or losing your mucus plug. While it’s a sign your body is preparing, labour could still be hours, days, or even a week or so away.
• Loose Bowel Movements/Diarrhoea: Some women experience looser stools or mild diarrhoea as hormone levels shift and the body prepares for labour.
• Persistent Dull Backache or Cramping: A general achiness in your lower back or period-like cramping that comes and goes can also be an early indicator.

Recognising the True Signs of Labour: When It’s Really Happening

These are the more definitive signs that labour has truly begun or is progressing:

1. Regular, Progressively Stronger, Longer, and Closer Contractions:

This is the hallmark of true labour.

• What They Feel Like: Contractions often start as mild, irregular tightenings, perhaps feeling like period pains or a dull ache in your lower back. As labour progresses, these sensations become more distinct, with your uterus muscle tightening noticeably and then relaxing.
• The Pattern is Key: Unlike Braxton Hicks, true labour contractions establish a regular pattern and become:
  • Stronger: They increase in intensity and you can’t easily talk through them.
  • Longer: Each contraction lasts for a longer duration (typically from 30 seconds up to 60-70 seconds or more as labour advances).
  • Closer Together: The time from the start of one contraction to the start of the next gets progressively shorter.
• Timing Contractions: Note the time when a contraction begins and when it ends (this is the ‘duration’). Then, note the time from the start of one contraction to the start of the next (this is the ‘frequency’).
• The ‘5-1-1’ or ‘4-1-1’ Guideline (General Advice for First-Time Mums): A common guideline for first-time mothers is to contact your doctor or hospital when your contractions are coming regularly every 4 to 5 minutes, each lasting for about 1 minute, and this pattern has been consistent for at least 1 hour. However, your doctor at Borneo Hospital will give you personalised advice on when to call, especially if this isn’t your first baby or if you have a high-risk pregnancy.

2. Rupture of Membranes (‘Water Breaking’):

• What It Is: The amniotic sac (bag of waters) surrounding your baby breaks, and amniotic fluid is released.
• What It Feels Like: This can vary. It might be a dramatic gush of fluid, or it could be a slow, continuous trickle that you can’t control (unlike urine).
• What to Note & Do: If you think your water has broken, put on a sanitary pad (not a tampon) and note the following:
  • Time it happened.
  • Amount of fluid (gush or trickle).
  • Colour of the fluid (it should be clear or pale straw-coloured; if it’s greenish, brownish, or has a bad odour, this needs to be reported immediately).
  • Odour (amniotic fluid is usually odourless or has a slightly sweet smell). Contact your doctor or Borneo Hospital straight away if your water breaks, even if you are not having contractions. There’s an increased risk of infection for you and your baby once the membranes have ruptured, so we need to assess the situation.

3. Persistent Lower Back Pain or Intense Abdominal Cramping:

For some women, especially if the baby is in a posterior (back-to-back) position, the primary sensation of labour is intense, persistent pain or cramping in the lower back, which may not ease completely between contractions. If this is strong and regular, it could be labour.

Differentiating False Labour from True Labour: A Clear Comparison

It can sometimes be tricky to tell the difference, especially for first-time mums! Here’s a quick comparison:

If you’re ever unsure, it’s always best to call your doctor or the hospital for advice.

A Brief Overview of the Stages of Labour (For Context)

Understanding the typical progression can be helpful:

• First Stage (Longest – Cervical Dilation): This stage is about your cervix thinning and opening.
  • Early Labour (Latent Phase): Your cervix gradually dilates from closed to about 3-4 cm. Contractions are usually mild, shorter (e.g., 30-45 seconds), and further apart (e.g., 10-20 minutes). Many women manage this phase comfortably at home.
  • Active Labour: The cervix dilates more rapidly, typically from 4 cm to 7-8 cm. Contractions become much stronger, longer (e.g., 45-60 seconds), and closer together (e.g., 3-5 minutes). This is usually when you should be at or heading to Borneo Hospital. Concentration and coping strategies are key.
  • Transition: The cervix completes dilation from 8 cm to 10 cm (fully dilated). This is the shortest but often the most intense part of the first stage.
• Second Stage (Pushing & Birth): From when your cervix is fully dilated until your baby is born. This is the ‘pushing’ stage.
• Third Stage (Placenta Delivery): After your baby is born, the placenta (afterbirth) is delivered. This usually happens within 5-30 minutes.

When to Call Your Doctor or Go to Borneo Hospital (Critical Guidance!)

This is the key question! It is always best to call your obstetrician (like myself, Dr. Pillai) or the labour ward at your chosen Borneo Hospital branch (Thane, Nashik, Chh. Sambhaji Nagar, Raipur) for guidance before you rush in, unless it’s an obvious emergency or you’ve been given specific different instructions. We can advise you based on your symptoms, your pregnancy history, and how far along you are.

However, go to the hospital (or call for emergency help) IMMEDIATELY if you experience any of these:

• Your water breaks (a gush or a continuous trickle), regardless of whether you are having contractions. Note the time, amount, colour, and odour of the fluid.
• You experience bright red vaginal bleeding that is like a period or heavier (not just the pinkish/brownish ‘show’).
• You are having regular, strong, painful contractions that meet the criteria discussed with your doctor (e.g., for first-time mums, often when they are 4-5 minutes apart, lasting 1 minute each, for at least 1 hour – the “5-1-1” or “4-1-1” rule).
• You notice a significant decrease or change in your baby’s usual pattern of movements.
• You have severe, persistent abdominal pain that doesn’t feel like typical on-and-off labour contractions.
• You develop symptoms of pre-eclampsia, such as a severe headache that doesn’t go away with simple pain relief, vision changes (blurring, flashing lights, spots), or severe pain just below your ribs.
• You have a high fever or feel generally very unwell.
• You have any other urgent concerns, or your intuition tells you something is seriously wrong. Always trust your instincts.

For Second or Subsequent Babies: Labour can often progress much more quickly. Your doctor will likely advise you to contact them or come to the hospital earlier in the contraction pattern.

For High-Risk Pregnancies: You will have received personalised instructions from your obstetrician about specific Signs of Labour or other symptoms that require you to come in immediately. Please follow that advice strictly.

What to Do During Early Labour at Home (If Comfortable & Cleared)

If your contractions are mild and irregular, and your waters haven’t broken, your doctor might advise you to stay comfortable at home for a while. During this time:

• Stay Calm & Conserve Energy: Try to relax. Rest or engage in light activities if you feel up to it.
• Time Contractions: Keep a note of how often they are coming, how long they last, and their intensity.
• Hydrate & Eat Lightly: Sip water, clear fluids, or light juices. Eat small, easily digestible snacks (like toast, fruit, yoghurt) if you feel hungry.
• Use Comfort Measures: Take a warm (not hot) bath or shower (if your waters haven’t broken), ask your partner for a gentle back massage, change positions frequently, walk around, listen to calming music, or practice breathing techniques learned in antenatal classes.
• Prepare: Ensure your hospital bag is packed and easily accessible. Inform your birth partner or support person.

Borneo Hospital: Ready for Your Arrival

When it is time, rest assured that all our Borneo Hospital branches are fully equipped and our dedicated teams are prepared 24/7 to welcome you and your baby. We offer experienced obstetricians like myself, skilled nursing and midwifery staff, comfortable and safe labour rooms, a range of pain relief options should you choose them, and immediate access to expert neonatal support (including our advanced NICU) if your baby needs any extra care.

Recognising the true Signs of Labour can help ease anxiety and ensure you arrive at the hospital at the most appropriate time for a safe, supported, and positive birth experience. Remember the key indicators: regular, progressively stronger contractions, and/or your water breaking. Distinguishing these from pre-labour signs or false labour comes with awareness.

Every labour is unique, but understanding these general guidelines empowers you. Trust your body, listen to its signals, and always maintain open communication with your doctor or the dedicated maternity team at Borneo Hospital. We are here to guide you through this incredible milestone. We look forward to supporting you as you welcome your little one!