Childbirth is a very personal experience, but preparation helps you understand what your body is doing and when to ask for help. Good preparation does not mean controlling every detail; it means recognising labour signs, warning signs and the choices you may have during birth.
Signs that labour may be approaching include losing the mucus plug, period-like cramps, lower back pressure, a change in vaginal discharge or more frequent Braxton Hicks contractions. Labour most often begins with regular uterine contractions or with the waters breaking.
If you are getting ready to go to hospital or a birth centre, see the practical hospital bag checklist. For the first days after birth, read the guide to getting started with breastfeeding. You may also want to read the late-pregnancy guides for 38 weeks, 39 weeks and 40 weeks pregnant.
Labour pain is purposeful pain: the uterus is working, the cervix is opening and the baby is moving down through the birth canal. The intensity, location and tolerability of pain vary widely. Pain may be felt in the lower abdomen, lower back, pelvis, vagina or perineal area.
Breathing, movement, changing position, warm water, massage, continuous support and medical pain relief can all help. Options differ by country and facility: in the US this may include epidural analgesia and IV medication, while in the UK gas and air, pethidine/diamorphine and epidural analgesia may be discussed. Ask your OB-GYN, midwife, labour ward or birth centre what is available where you plan to give birth.
Always follow the instructions from your maternity unit, midwife, OB-GYN or doctor, especially if your pregnancy is higher risk or you have a personal birth plan because of previous births or medical history.
Contact your maternity unit immediately, go to triage or call emergency services if you notice any of the following:
Labour is commonly described in three stages:
The first stage begins with regular contractions and ends when the cervix is fully dilated. Early contractions may be milder and further apart. As labour progresses, contractions usually become stronger, longer and closer together.
A midwife, nurse, doctor or OB-GYN assesses progress by looking at cervical dilation, your waters, the baby's position and the baby's heartbeat. Fetal monitoring may be intermittent or continuous, depending on your pregnancy, your preferences and local clinical guidance.
The second stage begins when the cervix is fully dilated, usually around 10 cm. The baby's head moves down through the birth canal and you may feel strong pressure or an urge to push.
Your care team will guide pushing, positions and breathing, and will monitor the baby's wellbeing. The second stage ends with the birth of the baby.
After the baby is born, the placenta separates from the wall of the uterus and is delivered. This usually happens within a short time after birth. Your care team will also check bleeding and how well the uterus is contracting.
If you and the baby are well, the newborn is often placed skin-to-skin on your chest and early feeding can begin. The baby is then weighed, measured and given the first newborn checks and routine care used in your hospital or birth centre.
Mucus plug is thick mucus that helps seal the cervix during pregnancy and may come away near the end of pregnancy.
Waters means amniotic fluid, the fluid around the baby in the uterus. Call your maternity unit if your waters break or you think they are leaking.
Fetal monitoring means checking the baby's heartbeat during labour. This may be done with a handheld Doppler, intermittent monitoring or continuous electronic monitoring.
Third stage is the stage of labour when the placenta is delivered after the baby is born.
Call when contractions are regular and painful, your waters break, you have bleeding, your baby is moving less than usual or you feel worried. Your own maternity team may give different timing based on your pregnancy and local policy.
Not always. The mucus plug can come away days or even weeks before regular contractions begin. Call for advice if it is followed by bleeding, waters breaking, regular contractions or reduced baby movements.
Note the time, colour and smell of the fluid, then contact your maternity unit or clinician for instructions. Seek urgent advice if the fluid is green, brown, bloody, foul-smelling or your baby's movements are reduced.
Warning signs include heavy bleeding, blood clots, reduced or absent baby movements, green or brown waters, fever, severe headache, vision changes, severe swelling, chest pain, shortness of breath or labour signs well before your due date.
