Signs of labor often begin gradually and may include rhythmic contractions, cervical dilation, and thinning of the cervix. Many women also experience the loss of the mucus plug and the rupture of the amniotic sac, commonly referred to as their water breaking.
Labor can begin as early as 20 weeks in cases of preterm birth, but typically starts from 37 weeks for full-term pregnancies. The duration of labor can range from 11 to 24 hours and is often shorter with each subsequent delivery.
Most signs of labor appear progressively, starting with mild cramps similar to menstrual pain that gradually become more intense and regular.
What are the signs of labor?
The main signs that labor may be starting include:
1. Rhythmic contractions
Contractions can occur throughout pregnancy, especially in the third trimester, as the body prepares for labor.
Also recommended: Cramps During Pregnancy (1st, 2nd and 3rd Tri): Causes & Relief tuasaude.com/en/pregnancy-crampsHowever, in the hours leading up to birth, these contractions become more frequent, stronger, and more regular. They usually begin with longer intervals between them, which shorten over time. Many providers recommend going to the hospital when contractions last between 45 and 60 seconds and occur every 3 to 5 minutes.
2. Loss of mucus plug
The mucus plug is a thick, jelly-like secretion that forms in the cervix during pregnancy to help prevent infections. As labor begins and the cervix starts to dilate, the plug is expelled.
Many women notice the mucus plug when wiping after using the bathroom. It may appear clear, pink, brown, or slightly blood-tinged.
3. Water breaking
Water breaking refers to the rupture of the amniotic sac, which causes a sudden or gradual release of fluid from the vagina. This fluid is typically lighter in color and slightly cloudy, sometimes with whitish streaks.
Unlike urination, this release of fluid cannot be controlled. Once the water breaks, labor may begin soon or may already be underway.
4. Easier breathing
Many women notice that breathing feels easier in the days or weeks before labor begins. This happens when the baby drops lower into the pelvis, relieving pressure on the diaphragm. This shift, known as lightening, is a common early sign of labor.
5. Dilation of the cervix
Cervical dilation is the process of the cervix opening to allow the baby to pass through the birth canal. This change can only be confirmed by a doctor or nurse during a pelvic exam at the hospital or clinic.
To give birth vaginally, the cervix typically needs to dilate to about 10 centimeters.
6. Change in cervical thickness
As labor approaches, the cervix also becomes thinner in a process called effacement. Effacement helps the cervix stretch and open more easily. Like dilation, this change is usually confirmed during a clinical exam.
7. Lower back pain and pelvic pressure
Many women experience persistent lower back pain or a feeling of heaviness in the pelvis in the hours or days leading up to labor. These sensations often occur as the baby moves lower and creates more pressure in the lower abdomen and spine.
8. Increased urination
Frequent urination may increase before labor begins, especially after lightening. The baby's lower position in the pelvis places extra pressure on the bladder, which can lead to more frequent trips to the bathroom.
9. Change in vaginal discharge
Some women notice an increase in clear or milky-white vaginal discharge in the days before labor begins. This discharge is different from the mucus plug and is usually not bloody or thick. It’s one of several subtle signs the body is preparing for delivery.
10. Emotional changes
Sudden emotional shifts—such as increased restlessness, anxiety, irritability, or sensitivity—are also common signs of labor approaching. Some women feel a surge of energy known as the nesting instinct, which may include a strong urge to clean, organize, or prepare for the baby’s arrival.
11. Bloody show
The bloody show is a pink, brown, or red vaginal discharge that can occur minutes to days before labor starts. It results from the rupture of small blood vessels in the cervix during dilation and often appears with or shortly after the loss of the mucus plug.
While it is a sign that the body is preparing for labor, the bloody show does not always mean that active labor will begin immediately.
12. Lightening
Lightening is when the baby “drops” into the pelvis before labor. This can occur several weeks before labor in first-time pregnancies, or just hours before labor begins in others. It can ease breathing but may increase pelvic pressure, back pain, or the need to urinate more frequently.
Is diarrhea a sign of labor?
Diarrhea is not typically a sign that labor is beginning. However, if you experience diarrhea along with other symptoms like fever, vomiting, or blood in the stool, it's important to speak with a healthcare provider.
What do early signs of labor feel like?
Early signs of labor can feel different from one person to another. They may begin with mild menstrual-like cramps, backache, pelvic pressure, or a tightening sensation in the lower abdomen. These signs often come and go and may be mistaken for Braxton Hicks contractions.
Other early symptoms can include increased vaginal discharge, more frequent urination, and sudden emotional changes like anxiety or bursts of energy. As labor progresses, these signs usually intensify and become more consistent, leading to stronger and more rhythmic contractions.
How to tell Braxton Hicks from real labor
It can be hard to tell the difference between Braxton Hicks contractions (false labor) and true labor contractions, especially in late pregnancy.
Braxton Hicks contractions are irregular, usually mild, and tend to stop with movement or rest. They often occur in the front of the abdomen and don’t lead to cervical dilation. In contrast, true labor contractions follow a regular pattern, become more intense over time, and typically begin in the lower back before moving toward the front.
Table: Comparison of Braxton Hicks vs. True Labor Contractions
Signs labor is still days away
Some signs may suggest labor is approaching but still several days away. These include lightening, increased urination, backache, pelvic discomfort, and a rise in clear or white vaginal discharge.
A common behavioral sign is the nesting instinct—a sudden burst of energy that may lead to cleaning, preparing the baby's space, or organizing items for the hospital. These symptoms are normal as the body prepares for birth.
What causes labor to start?
Labor begins through a complex mix of hormonal, fetal, and physical changes. One of the key triggers is an increase in placental corticotropin-releasing hormone (CRH), which helps regulate birth timing. As the fetus matures, the lungs release surfactants and cortisol, signaling readiness for delivery.
Inflammatory compounds such as prostaglandins and cytokines also play a role in softening the cervix and stimulating contractions. These processes can vary between pregnancies, which is why labor can begin differently for each person.
When to go to the hospital
You should go to the hospital when contractions become strong, last between 45 and 60 seconds, and occur every 3 to 5 minutes. The pain will usually intensify and become harder to manage at home.
If your water breaks—even if contractions haven’t started—you should seek medical attention. For first-time pregnancies, healthcare providers may recommend going to the hospital earlier than for those who have given birth before.