Labor & Delivery

Signs of Labor: How to Know When It's Starting

Labor rarely starts with a dramatic single moment. Most of the time, it begins gradually with signs that build over hours or days. Here's what to watch for.

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The 5-1-1 rule: head to the hospital when contractions are 5 minutes apart, lasting 1 minute each, for at least 1 hour.

Signs Labor Is Coming in Days

In the days before labor begins:

  • Lightening ("baby dropping"): The baby descends lower into the pelvis. Breathing becomes easier; pressure in the pelvis increases.
  • Bloody show: Pink or brown-tinged mucus discharge as the mucus plug loosens. Labor may be hours to days away.
  • Cervical changes: Your provider may note effacement (thinning) and dilation (opening) at appointments.
  • Nesting instinct: A sudden burst of energy and urge to clean/organize.
  • Loose stools or diarrhea: Hormonal changes before labor can cause GI activity.
  • Back pain or pelvic pressure that is new or increased.

True Labor vs. Braxton Hicks

The key difference is regularity and progression:

  • True labor: Contractions become longer, stronger, and closer together over time. They don't stop with movement or a bath.
  • Braxton Hicks: Irregular, don't strengthen over time, often relieved by changing position or drinking water.
  • True labor: Felt all over (radiating from back to front or starting in lower back)
  • Braxton Hicks: Usually only felt in front/abdomen

When Your Water Breaks

Spontaneous rupture of membranes (SROM) — water breaking — happens at the start of labor for about 10% of people. For most, it happens during active labor. The fluid should be clear or slightly pink. Call your provider immediately if your water breaks. Note the time, color, and smell.

Frequently Asked Questions

What does losing your mucus plug mean?

The mucus plug seals the cervix during pregnancy. Losing it (often called "bloody show") signals the cervix is starting to change. Labor may follow in hours, days, or even a week or more.

Can labor start without contractions?

Yes — for some people, labor begins with the water breaking before contractions start. Or contractions may begin so mild they're not noticed at first.

How far apart should contractions be before going to the hospital?

The 5-1-1 rule: contractions 5 minutes apart, lasting 1 minute, for at least 1 hour. Always call your provider if you're unsure — that's what they're there for.