Labour can start very quickly or it can seem to take ages. Sometimes it can start without you realising it. The start of the first stage is often slow and it may take a while to establish that you are actually in labour. Once you are well dilated, your contractions are longer and stronger and your labour progresses more quickly. Call your midwife or maternity unit for advice at any time.
The first stage
Health professionals normally describe labour as being in three stages. The first stage is usually the longest and can last anything from one hour to twenty hours, or even longer.
Obvious signs of labour
The ‘show’: this is the release of the mucus plug, which seals the opening of the cervix. In some women it comes out of the vagina as a single blob of pinkish jelly; in others it is a series of smaller pieces, and in others it can be reddish brown and blood tinged.
It is a sign that the cervix is beginning to stretch and soften a little, in preparation for labour. It may not mean you are actually in labour. It can be several days between the show and the start of labour proper, or just an hour or so, or anything in between.
The breaking of the waters: the amniotic sac is the bag of fluid surrounding the baby inside the uterus. When the membranes break, or rupture, the fluid escapes. It can happen as a sudden gush of liquid down your legs. More usually, though, it will start to trickle.
There may be a risk of infection to the baby if the membranes rupture and labour doesn’t start within a day or so. If the baby’s head is not yet engaged, or if your baby is breech, a rush of waters may bring the cord with it. The cord could then become compressed which would be risky for your baby’s oxygen supply. Telephone your midwife or the hospital if your waters break.
Contractions: these are the only sure signs of labour if they gradually come closer together and last longer than 40 seconds. You should feel them getting stronger, longer and more rhythmical, too.
Sometimes women start to have contractions and then they fade away. These can be deceptive, and make you think you are in labour. You go to hospital, only to find everything stops.
If this happens to you, you may be examined, and may be disappointed that you are not very far on in your labour; maybe your cervix doesn’t show that the contractions have had any effect at all. In this situation, you may be asked if you’d prefer to go home. This is sensible, unless you live a long way from the hospital. Don’t feel embarrassed, or worry. This sort of false alarm happens all the time. See our section called Braxton Hicks for more information.