Signs That Labor Is Starting
Content reviewed against published ACOG, NIH, March of Dimes guidelines
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Your health matters just as much as your baby's. If you are dealing with signs that labor is starting, here is what you need to know.
The short answer
True labor is characterized by regular contractions that increase in frequency, duration, and intensity over time, and do not stop with rest, hydration, or position changes. Other signs that labor may be approaching include loss of the mucus plug (bloody show), water breaking (rupture of membranes), persistent lower back pain, and a feeling of increased pelvic pressure. First-time parents are generally advised to head to the hospital when contractions are about 5 minutes apart, lasting 1 minute each, for at least 1 hour (the 5-1-1 rule).
Key takeaways
- True labor is characterized by regular contractions that increase in frequency, duration, and intensity over time, and do not stop with rest, hydration, or position changes. Other signs that labor may be approaching include loss of the mucus plug (bloody show), water breaking (rupture of membranes), persistent lower back pain, and a feeling of increased pelvic pressure. First-time parents are generally advised to head to the hospital when contractions are about 5 minutes apart, lasting 1 minute each, for at least 1 hour (the 5-1-1 rule).
- Usually normal when: Braxton Hicks contractions that are irregular and stop with rest or hydration
- Call your doctor if: You are having regular contractions before 37 weeks - call your provider immediately as this may be preterm labor
- Varies by age — see the age-by-age breakdown below
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By Age
What to expect by age
36-38 weeks
In the weeks before labor, your body begins preparation through several changes. You may notice Braxton Hicks contractions becoming more frequent (these are irregular and stop with rest or position changes). The baby may "drop" lower into the pelvis (lightening), making breathing easier but increasing pelvic pressure and urinary frequency. You may lose your mucus plug, which looks like thick, sometimes blood-tinged discharge. Nesting urges (sudden bursts of energy and desire to organize) are common. None of these signs mean labor is imminent, but they indicate your body is getting ready.
38-40 weeks
Distinguishing true labor from prodromal (false) labor is one of the most common challenges. True labor contractions follow a pattern: they come at regular intervals, get closer together over time, get longer and stronger, and do not go away with rest or hydration. They are typically felt in the lower back and wrap around to the front. Time your contractions from the start of one to the start of the next. If your water breaks (a gush or steady trickle of clear fluid), contact your provider even if you are not having contractions, as delivery typically needs to occur within 24 hours.
40+ weeks
Many pregnancies go past their due date, and this is normal, especially for first-time parents. Your provider will typically discuss induction between 39 and 41 weeks depending on your circumstances. Signs that labor may start soon include increased vaginal discharge, bloody show, diarrhea, and more intense Braxton Hicks contractions. If you go past 41 weeks, your provider will recommend closer monitoring of baby's wellbeing through non-stress tests and fluid level checks. The decision about induction timing should be a shared discussion with your provider.
What Should You Do?
When to take action
- Braxton Hicks contractions that are irregular and stop with rest or hydration
- Losing the mucus plug days or even weeks before labor begins
- Increased vaginal discharge in the weeks before labor
- Nesting urges and bursts of energy in the final weeks
- You are having regular contractions before 37 weeks (could indicate preterm labor)
- You are unsure whether you are experiencing true labor or Braxton Hicks contractions
- You notice decreased fetal movement in addition to other signs of labor
- You are past your due date and want to discuss your options
- You are having regular contractions before 37 weeks - call your provider immediately as this may be preterm labor
- Your water breaks and the fluid is green, brown, or foul-smelling (possible meconium or infection)
- You are bleeding heavily (more than spotting or bloody show), which could indicate placental abruption
- You notice a sudden decrease or absence of fetal movement - go to your hospital immediately
- Contractions are 5 minutes apart, lasting 1 minute, for 1 hour in a full-term pregnancy (5-1-1 rule)
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Signs That Labor Is Starting.
Things to mention
- You are having regular contractions before 37 weeks (could indicate preterm labor)
- You are unsure whether you are experiencing true labor or Braxton Hicks contractions
- You notice decreased fetal movement in addition to other signs of labor
- You are past your due date and want to discuss your options
Observations to share
- You are having regular contractions before 37 weeks (could indicate preterm labor)
- You are unsure whether you are experiencing true labor or Braxton Hicks contractions
- You notice decreased fetal movement in addition to other signs of labor
Urgent signs to report immediately
- You are having regular contractions before 37 weeks - call your provider immediately as this may be preterm labor
- Your water breaks and the fluid is green, brown, or foul-smelling (possible meconium or infection)
- You are bleeding heavily (more than spotting or bloody show), which could indicate placental abruption
My notes
From ismybabyalright.com — free, evidence-based baby health guides
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Frequently asked questions
Is signs that labor is starting normal?
When should I call the doctor about signs that labor is starting?
When is signs that labor is starting normal?
What causes signs that labor is starting?
What should I mention to my pediatrician about signs that labor is starting?
Is signs that labor is starting normal at 36-38 weeks?
Is signs that labor is starting normal at 38-40 weeks?
Should I go to the ER for signs that labor is starting?
Does signs that labor is starting go away on its own?
References
- [1]American College of Obstetricians and Gynecologists. How to Tell When Labor Begins. ACOG FAQ, 2022. ACOG
- [2]National Library of Medicine. Signs of Labor. MedlinePlus, 2024. NIH
- [3]March of Dimes. Signs and Stages of Labor. March of Dimes, 2023. March of Dimes
All content follows our editorial policy and is reviewed against published clinical guidelines.
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Bottom line
Most cases of signs that labor is starting are normal. Talk to your pediatrician if you are having regular contractions before 37 weeks - call your provider immediately as this may be preterm labor.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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Emerging research has identified molecular mechanisms that act as a biological "timer" for labor onset, helping explain why some pregnancies end prematurely. Scientists have found that changes in progesterone receptor signaling, inflammatory pathways, and cervical remodeling follow a timed molecular program. Understanding this timing mechanism may eventually allow better prediction and prevention of preterm birth. While this research is still evolving, it represents a significant advance in understanding one of the leading causes of infant mortality and morbidity worldwide.
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Postpartum bleeding, called lochia, is the vaginal discharge that occurs after both vaginal and cesarean deliveries as your uterus sheds its lining and heals where the placenta was attached. It typically starts as heavy, bright red bleeding and gradually transitions to lighter pink and then yellowish-white discharge over four to six weeks. While it can be alarming, lochia is a normal and essential part of recovery.
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