Is this it? How to tell real labour from practice runs

Is this it? Almost every woman asks that question at least once in the last few weeks of pregnancy, often at three in the morning. Your body has been preparing for birth for months, and the signs of labour can arrive slowly, suddenly or in a confusing mixture. Here is how to tell the difference between practice runs and the real thing, and when to pick up the phone.

Practice contractions

Many women feel Braxton Hicks contractions in the second half of pregnancy. Your bump goes hard and tight for a short time, then relaxes. They are your womb practising.

• They are usually irregular and do not get closer together.
• They often ease when you change position, walk, rest or have a warm bath.
• They are often uncomfortable rather than truly painful.

Signs that labour may be starting

A show

During pregnancy a plug of thick mucus seals the cervix. As the cervix begins to soften and open, this plug may come away. It looks like jelly-like mucus, which may be clear, pink or slightly blood-streaked. A show can happen days before labour or during it, so it does not always mean things will start immediately. If you are losing more than a small amount of blood, call your maternity unit straight away.

Contractions that build

Real labour contractions usually:

• come at regular intervals and get closer together
• last longer over time
• get stronger and more intense
• do not ease when you rest or change position

Many women describe them as waves that start in the back and wrap around to the front, or like strong period pains. Time them: note when each one starts and how long it lasts. A simple app or a pen and paper both work.

Your waters breaking

The bag of fluid around your baby can break before or during labour. It might be a sudden gush or a slow trickle that is hard to tell from urine. If you think your waters have broken:

• put on a pad (not a tampon) so you can see the colour
• note the time
• call your midwife or maternity unit, even if you have no contractions

Call straight away if the fluid is green, brown, smelly or bloodstained, if you are feeling unwell or have a fever, or if your baby is moving less.

Other signs

• a dull, constant backache or one that comes and goes
• a heavy feeling or pressure low in your pelvis
• needing to open your bowels more often, or loose stools
• feeling restless, emotional or unusually focused

Call immediately, whatever the stage

Contact your maternity unit or emergency services straight away if you have:

• bleeding that is more than a small streak of mucus
• your baby moving less or differently
• constant, severe pain that does not come and go
• a severe headache, problems with your vision or sudden swelling
• a fever or feel very unwell
• any signs of labour before 37 weeks
• a strong urge to push

Early labour at home

For many women, especially with a first baby, early labour can last many hours. If your midwife has said it is fine to stay at home for now, you might:

• rest or sleep between contractions if you can
• eat light snacks and sip drinks
• take a warm shower or bath
• walk, sway or lean forward over a ball or the back of a chair
• breathe slowly, making your out-breath longer than your in-breath
• keep timing your contractions

And always remember: if you are worried or unsure, you can call. Midwives expect these calls.

Through the waters

When the waters break, or the waves of labour begin, it can feel as if you are stepping into something much bigger than you. God's promise through Isaiah speaks right into that moment:

“When thou passest through the waters, I will be with thee; and through the rivers, they shall not overflow thee: when thou walkest through the fire, thou shalt not be burned; neither shall the flame kindle upon thee.” (Isaiah 43:2)

The promise is not that there will be no waters to pass through, but that you will not pass through them alone. Whether labour starts with a trickle, a gush or a slow ache, He is with you in it.

A prayer as labour begins

Lord, I think my baby may be on the way. Calm my heart and give me wisdom to know what to do next. Be with me through every wave, guide the people caring for me, and bring my baby safely into the world. Amen.