Labor Signs: When to Go to the Hospital

How do you know if you are in labor? Key signs to know

You're in the last few weeks of pregnancy and every little pain or contraction makes you wonder: am I in labor yet? It is a very frequent doubt, especially in first-time mothers. Recognizing the true signs of the onset of labor can give you security, help you decide when to go to the hospital or contact your midwife, and avoid unnecessary false alarms.

In this article, we explain in a clear and evidence-based way what are the most reliable signs that indicate that labor has begun or is about to begin.

Regular and painful contractions: the most obvious sign

True contractions are the clearest sign that labor has begun. Unlike Braxton Hicks contractions (which are irregular and usually painless), labor contractions:

• They are regular and rhythmic, every 5-10 minutes at the beginning and then more frequent.
• They do not disappear with the change of posture or rest.
• They increase in intensity and duration progressively.
• They feel like pressure going from the lower abdomen or back forward.

According to the American College of Obstetricians and Gynecologists (ACOG), these contractions are usually held for at least an hour before being considered true labor contractions.

Loss of mucus plug: a sign of preparedness

During pregnancy, the cervix is sealed by a thick substance called a mucus plug, which protects the baby from infection. As labor approaches, this plug is expelled. Find out all about the mucus plug.

• It usually has a gelatinous texture and may have threads of blood.
• It is expelled all at once or several times.
• It's a sign that your cervix is starting to dilate, but it doesn't mean that labor is immediate. It can be missed from hours to several days.

Loss of the mucus plug can be one of the first signs of the onset of labor.

Water breaks: does it always happen?

The famous "water break" occurs when the amniotic sac ruptures. Amniotic fluid may come out in a large stream or in a steady drip. It is often colorless and odorless

• If the water ruptures before labor begins, it is known as premature rupture of membranes.
• According to the World Health Organization, if labor does not start spontaneously within 24 hours, intervention may be necessary to reduce the risk of infection.

If your water breaks, even without contractions, it is recommended to contact your midwife or go to the hospital.

Cervical Changes: Dilation and Effacement

The cervix is erased (thinned) anddilated (opened) to allow the baby to pass through. This is not always noticeable to the mother, but it can be accompanied by:

• Discomfort similar to menstruation.
• Pelvic pressure or feeling like the baby has "gone down."
• More rhythmic and intense contractions.

Dilation can only be confirmed by a vaginal examination performed by a professional.

"Labor is a physiological process unique to each woman. Not all of them show the same signs at the beginning, so it is essential to listen to your body and have professional accompaniment."

In addition to the main signs, some women experience other changes before or at the onset of labor:

• Gastrointestinal discomfort, such as diarrhea or nausea.
• Increased energy or "nest instinct," with sudden urges to clean or prepare the house.
• Continuous low back pain, different from typical pregnancy.
• Changes in vaginal discharge, which may become heavier or mucous in appearance.

When to go to the hospital or call the midwife?

A common guideline is the 5-1-1 rule: contractions every 5 minutes, lasting 1 minute, for at least 1 hour. But you should also go earlier if:

• You've had your water breaking, especially if the liquid is greenish or smelly.
• You have heavy red bleeding.
• You notice a decrease in the baby's movements.
• You have a fever, malaise, or suspected infection.

Whenever you have doubts, it is better to consult.