Signs of labour

Signs of labour

In your third trimester, you may find yourself counting down the final weeks of your pregnancy. It can be a tense time as you eagerly look for any signs of labour.

One of our biggest priorities is supporting you through these final stages of your pregnancy. From early symptoms to the three stages of labour, we’ll be by your side through the whole process.

To help you prepare for the big event, you should consider attending one of our Antenatal Classes. These offer practical information from our maternity experts about the signs of labour and the birthing process.

We’ve also put together this guide, which outlines what to look out for, what to expect and when you should head to the hospital.

If you are unsure at any time, please do not hesitate to call us on:

(07) 5430 3320

Early symptoms of labour

Labour is divided into three stages. Before you get to the first of these three stages, you may experience some early symptoms of labour. You may experience some pain and discomfort. It is good to stay at home in a familiar environment at this point.

You may also have:

A blood-stained mucous vaginal discharge known as a “show”
Lower back pain
Period-like cramps
Diarrhoea
Nausea and/or vomiting

You may also begin to experience contractions. However, many women experience false labour contractions, also known as Braxton Hicks contractions. It’s important to know the difference.

Braxton Hicks contractions

Braxton-Hicks contractions can occur as early as week 20 in your pregnancy. They can feel like mild period cramps or a tightening across your abdomen that comes and goes. They are actually contractions in your uterus, preparing your body for birth. Normally these contractions will settle with a little rest.

If this is your first baby, it can be easy to mistake these pains as the real deal, so what exactly should you look out for? Here are some key differences between Braxton Hicks contractions and labour contractions:

Braxton Hicks

Irregular and short (usually lasting for 30 seconds)
Don’t get closer together
Usually not painful, just uncomfortable
Will usually stop if you change position or walk around

Labour

May start irregular, but will become regular and last longer as they continue
Will get closer together
Become more intense as time goes on
Walking will make them more intense

Stages of labour

The three stages of labour are:

Dilation of the cervix
Birth of your baby
Delivery of the placenta

First stage of labour

During the first stage of labour, your cervix will begin to thin out and dilate to about 10cm. Your labour will be closely monitored to ensure everything progresses normally, and you and your baby remain healthy.

This stage is divided into three phases:

Early phase: Longest and least painful as your cervix dilates to 3cm, with mild contractions that can start irregularly and become more regular as time passes.
Active phase: Strong, painful contractions about two minutes apart as your cervix dilates to 7-8cm.
Transitional phase: Contractions will be intense, painful and feel as if they are constant. You may also feel as though you need to use the bathroom as your baby moves down the birth canal and puts pressure on your bowel.

Second stage of labour

Once your cervix is fully dilated, it’s time for your baby to be born. You will be experiencing regular, intense contractions and you may feel the urge to push. Your doctor and midwife will provide guidance during this stage as they help ensure a safe, smooth delivery of your baby.

Once your baby crowns, your doctor or midwife will guide your baby’s shoulders to come out, which is followed by the body.

The length of the second stage of your labour differs with each pregnancy. If this is your first baby, it can take a little longer (between an hour and two hours). Though you will be closely monitored to ensure your labour is progressing as it should. If not, any issues that could be causing a delay will be investigated and handled.

Third stage of labour

This stage is the delivery of the placenta. Once your baby is born, your uterus begins to contract to loosen your placenta. You may not feel these contractions.

This stage can be handled in two different ways:

Active management: With your consent, your doctor will give you an injection of the hormone oxytocin into your arm or thigh. Once the umbilical cord is cut, the obstetrician or midwife will gently pull the cord while applying counter pressure to the uterus to speed up the delivery of the placenta. This process is called controlled cord traction (CCT) and it helps to reduce the risk of blood loss and other complications. This is considered best practice. Speak to your obstetrician if you do not wish to have active management. The oxytocin injection will not interfere with delayed cord clamping.
Expectant management: This is when you decide to let the placenta deliver naturally. The umbilical cord will remain attached to the baby until it stops pulsating.

The length of this stage varies and depends on your management preference and your risks.

When to ring the hospital

If this is your first baby, knowing when to go to the hospital can be a nervous time. You may be thinking it’s too early, but secretly wondering if you’ve waited too long. Don’t worry; this is normal for all first-time parents.

You should call the hospital on 07 5430 3320 if:

Your waters break: This is your membranes rupturing. You may feel a sudden gush or a trickle of fluid – put a pad on and call the hospital. The midwife will ask you what colour the fluid is and how much. It is normal for the colour to be pink or clear.
You have regular contractions: The time between contractions is consistent (eg two minutes), and the contractions last a similar amount of time (eg one minute).
You notice blood loss: If you notice any vaginal blood loss, put on a pad and phone the hospital.
You want reassurance: Call the hospital and speak to a midwife.

Also call the hospital on 07 5430 3320 if you experience any of the following concerns:

Change in the pattern of your baby’s movements: Your obstetrician will discuss the relevance of foetal movements with you and any changes to look out for. If you have any concerns or there are changes in the pattern of your baby’s movements, you can ring the hospital or your obstetrician at any time.
Signs of high blood pressure: blurred vision, upper abdominal pain, headaches, significant and sudden swelling of your face and hands.
Early labour: If you notice any labour signs before you are 38 weeks pregnant.

If you’re just experiencing the early symptoms of labour, you should try to relax and get comfortable at home. Call your birthing partner to let them know that you’re in the early stages of labour.

As your contractions start to get more regular, and they are around seven to 10 minutes apart, you should start timing them. Note how many minutes pass between the start of one and the start of the next.

Once your contractions are around five minutes apart, or if you no longer feel comfortable and safe at home, or if you need some help with pain management -- it’s time to go to the hospital. It’s a good idea to phone ahead to let us know you’re on your way.

If at any time during this period, you aren’t sure what you should do, you can call our midwives. They will ask you a few questions to assess your situation and provide helpful advice on what you should do.

For more information on early labour please visit the Pregnancy, Birth & Baby website (Australian Government, Department of Health).