By Margaret HanahoeYou’re likely to recognise the signs of labour when the time comes, but if you’re in any doubt, don’t hesitate to contact your midwife. The main signs of labour starting are strong, regular contractions and a “show”. A show is when the plug of mucus from your cervix comes away. Other signs that labour is beginning include your waters breaking (rupture of the membranes), backache and an urge to go to the toilet, which is caused by your baby’s head pressing on your bowel. What are contractions like? When you have a contraction, your womb (uterus) tightens and then relaxes, like a stronger version of period pains. You may have had contractions throughout your pregnancy, particularly towards the end. During pregnancy, these painless tightening’s are called Braxton Hicks contractions. When you are having regular, painful contractions that feel stronger and last more than 30 seconds, labour may have started. As labour gets going, your contractions tend to become longer, stronger and more frequent. During a contraction, the muscles in your womb contract and the pain increases. If you put your hand on your abdomen, you will feel it getting harder. When the muscles relax, the pain fades and your hand will feel the hardness ease. The contractions are pushing your baby down and opening your cervix (entrance to the womb), ready for your baby to go through. Your midwife will probably advise you to stay at home until your contractions become frequent. When your contractions last 30-60 seconds and occur every five minutes, call your midwife for guidance. If you’re planning to have your baby in a maternity ward, phone the hospital. When to go to hospitalBackache often comes on in labourYou may get backache or the aching, heavy feeling that some women experience with their monthly period. A “show” signals the start of labourWhile you are pregnant, a plug of mucus is present in your cervix. Just before labour starts, or in early labour, the plug comes away and you may pass this out of your vagina. This small amount of sticky, jelly-like pink mucus is called a show. It may come away in one blob, or in several pieces. It is pink in colour because it’s bloodstained, and it’s normal to lose a small amount of blood mixed with mucus. If you’re losing more blood, it may be a sign that something is wrong, so telephone your hospital or midwife straight away. A show indicates the cervix is starting to open and labour may follow quickly, or it may take a few days. Some women do not have a show. What happens when your waters break? Most women’s waters break during labour, but it can also happen before labour starts. Your unborn baby develops and grows inside a bag of fluid called the amniotic sac. When it’s time for your baby to be born, the sac breaks and the amniotic fluid drains out through your vagina. This is your waters breaking. You may feel a slow trickle, or a sudden gush of water that you cannot control. To prepare for this, you could keep a sanitary towel (but not a tampon) handy if you are going out and put a protective sheet on your bed. Amniotic fluid is clear and a pale straw colour. Sometimes it’s difficult to tell amniotic fluid from urine. When your waters break, the water may be a little blood-stained to begin with. Tell your midwife immediately if the waters are smelly or coloured, or if you are losing blood, as this could mean you and your baby require urgent attention. If your waters break before labour starts, phone your midwife or the hospital for advice. Without amniotic fluid your baby is no longer protected and there is a risk of infection. How to cope when labour beginsAt the beginning of labour:- You can be walking/moving about if you feel like it. - You can drink fluids and may find isotonic drinks (sports drinks) help keep your energy levels up. - You can have a snack, although many women don’t feel very hungry and some feel sick.- As the contractions get stronger and more painful, you can try relaxation and breathing exercises – your birth partner can help by doing these with you.- Your birth partner can rub your back as it can help relieve pain. Midwife and antenatal teacher Margaret Hanahoe founded the National Maternity Hospital’s DOMINO and Home Birth schemes. She is the co-author of two ebooks “From Bump to Birth” and “After Birth” available to download on Amazon. More information from: bumptobirthtobaby.com