How Will I Know that I’m in Labor and What Should I Do Then?

Many parents-to-be, especially those becoming parents for the first time, have questions about what labor looks like and what to do once you are certain you are in labor. Different care providers have different guidelines for what to do once labor has started, so you should definitely talk to your doctor or midwife about any questions you may have. In this blog post, we’ll provide a general overview of the labor signs to watch out for and what to do once the big day is finally here.

Labor Signs

Labor is different for everyone and every labor is different. You might have all of these signs of labor, or you might have just a few. The more signs you have, the more likely you are in labor, but it’s still a good idea to pay attention even if only one or two show up for you.

Mucus plug: Losing your mucus plug—that substance that seals the cervix during pregnancy in order to protect the contents of the uterus—might be a sign that labor is on its way. If you see mucus in the toilet after going to the bathroom or on the toilet paper when you wipe, you may have started to lose your mucus plug. While this loss could signal that labor is on its way, the mucus plug can regrow, so it could still be a while.

Back pain: As discussed in this blog post, back pain is common during pregnancy, but the back pain that means labor is imminent feels like menstrual cramps or might come in a rhythmic pattern.

Water breaking: Whether it’s a gush or a trickle, when the membranes that holds the amniotic fluid in rupture or break, labor is likely to happen soon. Your provider will give you instructions about their preferences when your water breaks: some want to see you immediately and some are okay with you laboring at home. Be sure to call if your water breaks, or if you think your waters have broken.

Diarrhea: Loose stools close to your due date, especially quite a few in a short period of time could be a sign of your body preparing for labor. If you have a fever or the loose stools continue but labor doesn’t start, talk to your provider and be sure to stay hydrated.

Contractions: A contraction is a tightening of the uterus that can spread across to the back. Practice contractions, also known as Braxton-Hicks contractions, are common and some people experience them throughout pregnancy. These contractions are often painless and usually don’t develop into a rhythm. Labor contractions can be more painful, feel like regularly occurring menstrual cramps, and tend to get closer together and more intense. Your care provider likely has a point in your contraction pattern where they want you to come to your birth place—hospital or birth center—so that you arrive in time.

Bloody show: If you see thick mucus that is tinged with blood or brownish from your vagina, especially if it accompanies any of the other symptoms, it is a good sign that your cervix is effacing and dilating, or thinning and opening.

Baby dropping: Often toward the end of pregnancy, the baby’s body drops down into the pelvis, where it can press on the cervix and encourage it to open. After this drop, the baby bump might look smaller. For first time moms particularly, it is a good indicator that labor is on its way soon.

Emotional signs: In addition to physical indicators, there are emotional indicators that might indicate that labor is approaching. Sometimes a strong nesting instinct kicks in and parents to be want to clean the whole house or knit something. You might feel especially overwhelmed or weepy.

Once you are sure you are in labor or if you’re not sure and want reassurance or advice, call your care provider. They will advise you about how to proceed, based on their protocols and standard of care. There are some good ideas in this blog post about when you should plan to head to the birth center or hospital. If your care provider does not want you to come in yet, try to relax at home. Take a bath, watch a favorite TV show, or pack your hospital bag if you haven’t already.

Abby Olena
Dr. Abby Olena has a PhD in Biological Sciences from Vanderbilt University. She lives with her husband and children in North Carolina, where she writes about science and parenting, produces a conversational podcast, and teaches prenatal yoga.

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