Labour: What to expect and when to call as birth approaches
Prepared by: First Births Pain Management Patient Education Task Group – August 1997
Revised: March 1999/August 2003

As you reach the 36th week of your pregnancy, the long-awaited arrival of your baby is very near……knowing the signs of beginning labour and the signs of well established labour will help you decide when to call your doctor/midwife and when to go to the hospital.

Please note: If you have had any health problems during your pregnancy, please speak with your doctor/midwife as this information may not apply to your health.

What to expect in late pregnancy
During the days and early hours before your baby’s birth you may experience some physical changes. These changes are normal and signs that your body is getting ready for your baby’s birth.

What should I notice?

  • Increased pre-labour contractions
  • Increased back discomfort
  • Increased pelvic pressure-the baby’s head moves down or drops into position
  • The need to urinate (pee) more often
  • Restless sleep
  • Loose bowel movements
  • Mucousy, blood-stained discharge from your vagina – sometimes called “show”

How do I know I’m in true labour?
Every woman experiences labour in her own personal way. Because labour begins in different ways, for some women the signs are clear while for others it is not so easy to tell.

Can you answer “YES” to the following questions?

  1. Are you having contractions or tightenings that are gradually getting longer, stronger and closer together?

Discomfort or pain caused by tightening of your uterus (also called womb) is called a contraction. However, not all contractions of the uterus mean that labour has begun. Pre-labour contractions are different from established labour because these contractions are not usually regular and will stop. On the other hand, throughout established labour your contractions will become more frequent, more regular, and more painful. You may also have back pain.

2. Has the water sac around your baby broken?
The sac (also called the membranes) surrounding your baby contains fluid called amniotic fluid. This sac can break and the fluid will leak from your vagina. You may feel just a trickle, or it may occur in a sudden gush. The colour of the fluid should be clear.

My labour is starting, what now?

Stay at home until labour is active

  • The comfort of your home is the best place for you and your family to be in your early labour
  • If possible, surround yourself with people who can support you and keep you calm and relaxed

Time your contractions

  • If you think your contractions are becoming regular, time them for a while to see if a pattern has begun.
  • Count the minutes that go by from the beginning of one contraction to the beginning of the next. Also time how long the contractions last.
  • Your doctor/midwife will be able to tell you if your labour is progressing and if it is time to go to the hospital.

Stay comfortable

  • Eat light, easily digested meals. Smaller, more frequent snacks are easier to handle.
  • Drink plenty of fluids. Drink at least one glass of water, juice or milk every hour.
  • Continue light activity as long as you are comfortable. Walking often helps to keep you more comfortable and it also helps your labour. Balance activity with rest. Take a nap if possible, otherwise rest and stay calm.

Stay relaxed. Try:

  • Relaxation breathing
  • A warm shower or bath
  • Massage
  • Music
  • Soothing warm packs/cold packs

Try different positions at different times:

  • Sitting
  • Kneeling
  • Lying on your side
  • Standing
  • Walking
  • Squatting

When to call your doctor of midwife
If you feel you are in labour or your water sac has broken, call your doctor/midwife to discuss your situation. Together you will decide when you should call him or her next, and if or when you should go to the hospital

What can I do to promote the best possibility for a safe, natural birth?
By learning the signs of labour and staying at home until your labour is active, you will promote a safe, natural birth. Discuss the signs of labour with your doctor/midwife and other care givers.

Any of the following situations are signs to call the doctor immediately:

  • You feel constant abdominal pain that does not go away
  • Your water sac is broken and you develop a fever (feel hot or shivery)
  • The fluid from your water sac is coloured yellow, green and red
  • You have bright red bleeding from your vagina
  • Your baby’s movements have slowed down (less than six movements in a two hour period) or stopped

If you have difficulty reaching your doctor, call your hospital or BC Women’s at 604-875-3070. Please have someone call who can speak English. If this is not possible, come to the hospital immediately.

See our other articles on Labour here.