Signs of Labour: How to Know When to Go to the Hospital

As your due date approaches, one of the biggest questions on your mind is probably: how will I know when I’m really in labour? The truth is, it can be tricky to tell — even for second-time parents. Here’s what to watch for and when to call your midwife or head to the hospital.

The Difference Between Real Labour and False Labour

Braxton Hicks contractions — sometimes called “practice contractions” — can start as early as week 20 and become more frequent in the third trimester. These are your uterus warming up, and they’re completely normal. But they can be confusing because they feel similar to real contractions.

Braxton Hicks contractions:

• Are irregular and don’t follow a pattern
• Usually stop when you change position or walk around
• Are uncomfortable but generally not painful
• Don’t get stronger or closer together over time

Real labour contractions:

• Follow a regular pattern and get closer together
• Get longer, stronger, and more intense over time
• Don’t stop when you move or change position
• Are felt in the abdomen, lower back, and sometimes thighs

The 5-1-1 Rule

Most midwives and hospitals advise going in when contractions are 5 minutes apart, lasting 1 minute each, for at least 1 hour. This is known as the 5-1-1 rule and is a good general guide for first-time parents. If it’s your second or subsequent baby, you may be advised to go in earlier as labour can progress more quickly.

Other Signs That Labour Is Starting

Your waters breaking

When the amniotic sac ruptures, you may feel a sudden gush or a steady trickle of fluid. Call your midwife or maternity unit straight away — most hospitals advise coming in within 24 hours if contractions haven’t started, due to the risk of infection.

A “bloody show”

A pink or blood-tinged mucus discharge (the mucus plug) means your cervix is beginning to dilate. This can happen days before labour starts, or right as it begins. On its own it’s not a reason to rush to hospital, but it’s a good sign that things are moving.

Lower back pain

Persistent, dull lower back pain that radiates to the front can signal the start of labour, especially if it comes in waves alongside contractions.

Nesting urge

Many parents experience a sudden burst of energy and an urge to clean and organise in the days before labour. Enjoy it — but don’t exhaust yourself!

When to Go Straight to Hospital

What to Bring to Hospital

Have your hospital bag packed by week 36. Key items: your birth plan, maternity notes, nightgown or comfortable clothes for labour, snacks, phone charger, toiletries, baby’s first outfit, nappies, and a car seat for the journey home.

Labour Stages: A Quick Overview

1. Early labour (latent phase): Cervix dilates to 4cm. Can last many hours or even days. Rest, stay hydrated, use a TENS machine if you have one.
2. Active labour: Cervix dilates from 4cm to 10cm. Contractions are intense and regular. This is when most people head to hospital.
3. Transition: The most intense phase — cervix goes from 8–10cm. Often brief but powerful.
4. Pushing and delivery: Once fully dilated, you push your baby out.
5. Third stage: Delivery of the placenta.

Remember: there’s no right or wrong way to experience labour. Every birth is different, every parent is different. Whatever happens on the day, what matters most is a safe outcome for you and your baby.