Signs of Labor: How to Know It Is Time
Last reviewed:
Content reviewed against published ACOG, WHO guidelines
As your due date approaches, knowing the difference between true labor and false alarms can help you feel prepared. Here is what to look for, based on ACOG guidelines.
Key takeaways
- True labor contractions are regular, get stronger over time, and do not stop with rest
- The 5-1-1 rule: contractions 5 minutes apart, lasting 1 minute, for 1 hour — time to call your provider
- Water breaking may be a gush or a slow trickle — note the time and call your provider
- Bloody show (mucus plug) can precede labor by hours or days
- Braxton Hicks contractions are irregular and stop with movement or rest
- Go to the hospital immediately for heavy bleeding, decreased fetal movement, or water breaking before 37 weeks
Early signs that labor is approaching
These signs may appear days or weeks before active labor begins:
- Lightening (baby drops): Baby moves lower into the pelvis, relieving pressure on the diaphragm but increasing pelvic pressure
- Increased Braxton Hicks: More frequent irregular contractions as your body prepares
- Mucus plug/bloody show: Thick, pink-tinged mucus discharge as the cervix begins to dilate
- Nesting urge: A sudden burst of energy and desire to organize and clean
- Loose stools: Hormonal changes can cause diarrhea in the days before labor
- Back pain: Persistent low back pain that may come and go
True labor vs. Braxton Hicks contractions
Understanding the difference is key to knowing when it is time:
| True Labor | Braxton Hicks | |
|---|---|---|
| Pattern | Regular, predictable intervals | Irregular, unpredictable |
| Progression | Gets stronger and closer together | Does not get stronger over time |
| Location | Starts in back, radiates to front | Usually felt only in front |
| Activity | Continues regardless of activity | Stops with rest or position change |
| Intensity | Progressively more intense | Mild, stays the same |
When your water breaks
- Amniotic fluid is usually clear, odorless, or slightly sweet-smelling
- It may be a sudden gush or a slow, continuous trickle
- Note the time, color, and odor of the fluid
- Call your provider immediately — most recommend delivery within 12-24 hours
- Do not put anything in the vagina after your water breaks (no baths, no intercourse)
- Green or brown-tinged fluid may indicate meconium — seek immediate evaluation
The 5-1-1 rule: when to go to the hospital
A common guideline for first-time parents:
- 5: Contractions are 5 minutes apart (measured start to start)
- 1: Each contraction lasts at least 1 minute
- 1: This pattern has continued for at least 1 hour
Your provider may give you different guidelines based on your specific situation, distance from the hospital, or pregnancy history.
When to call your provider immediately
- Heavy vaginal bleeding (more than spotting)
- Water breaks before 37 weeks (preterm)
- Green or brown-tinged amniotic fluid
- Decreased fetal movement
- Severe headache with vision changes
- Constant, severe abdominal pain (not coming and going)
- Fever above 100.4 degrees F (38 degrees C)
Frequently asked questions
How do I know if contractions are real labor?
What does it feel like when your water breaks?
Can labor start without contractions?
What is a bloody show?
Should I go to the hospital with Braxton Hicks?
Bottom line
Every labor is different. Trust your instincts — if something does not feel right, call your provider. It is always better to be checked and reassured than to wait too long.
You know your body. If you are unsure whether you are in labor, your provider would rather hear from you than have you wait. That is what they are there for.
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members