Signs of Labour & When to Go to Hospital

How will you know it’s really starting? These are the signs of labour, the difference between real and practice contractions, and when to leave for hospital.

Reviewed against ACOG & WHO guidance Updated 25 September 2026

Signs that labour is near

  • Lightening: the baby drops lower into the pelvis – breathing gets easier, but you need to urinate more.
  • Show: the mucus plug that sealed the cervix comes away, often streaked with a little blood. Labour may follow within hours or days.
  • Waters breaking: a gush or a steady trickle of clear fluid from the vagina.
  • Regular contractions that get longer, stronger and closer together.
  • Low back ache that comes and goes, loose stools, or a strong nesting urge.

True vs false labour

Braxton Hicks (false)True labour
PatternIrregularRegular, getting closer
StrengthStays the same or fadesGets steadily stronger
Effect of rest or walkingOften stopsContinues
Where you feel itFront of abdomenStarts in back, wraps to front

When to go to hospital

A common guide for a first baby is the 5-1-1 rule: contractions every 5 minutes, lasting about 1 minute each, for 1 hour. If you’ve given birth before, or live far from the hospital, leave earlier. Always follow the instructions your own doctor gives you.

Go immediately if…

  • Your waters break, especially if the fluid is green, brown or smelly
  • You have vaginal bleeding
  • Your baby is moving less than usual
  • You have severe, constant abdominal pain
  • You have a severe headache, blurred vision or fits
  • You have contractions before 37 weeks

Call 108 for an ambulance or 102 for free pregnancy transport where available.

Hospital bag checklist

  • MCP card, ID proof, insurance papers, all scan and test reports
  • Loose nightwear that opens at the front for breastfeeding, dupatta or shawl
  • Maternity pads, disposable underwear, nursing bra
  • Baby clothes, cap, socks, mittens, soft cotton cloths and a swaddle
  • Phone charger, water bottle, light snacks, toiletries

Frequently asked questions

How long does labour last?

For a first baby, active labour often lasts around 8–12 hours, but it can be shorter or much longer. Later labours are usually quicker.

What does it feel like when your waters break?

It can be a sudden gush or a slow trickle that you can’t control. If you’re not sure, put on a pad and call your doctor.

Medical disclaimer: The results and information on this page are estimates for general education only. They are not a diagnosis and do not replace advice from your gynaecologist, obstetrician or midwife. If you have pain, bleeding, reduced baby movements or feel unwell, contact your doctor or call 108 immediately. Read the full disclaimer.

Written by the Pregnancy Calculator editorial team. Based on published obstetric guidance (ACOG, WHO, MoHFW India, FOGSI). Last updated . How we create content.

Sources & further reading

  1. World Health Organization. WHO recommendations on antenatal care for a positive pregnancy experience (2016). who.int
  2. Ministry of Health & Family Welfare, Government of India. Maternal health guidelines, PMSMA and Anemia Mukt Bharat. nhm.gov.in
  3. NHS (UK). Pregnancy tests; Ovulation; Your pregnancy and baby guide. nhs.uk

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