It can be hard to tell when labor is beginning and that is just as true for new moms as it is for ones who have given birth before. The problem is that most of the early signs of labor tend to be vague which makes them easy to misinterpret. Sometimes it’s hard to tell whether the cramp you are feeling is contractions or the result of some food that you ate the night before. The same is true of deciding whether there is a little bit of urine leaking or your water is breaking.

The fact is that just like parenting, labor is never clear cut. Despite this, the following cues are usually a good indication that you are ready to go to the hospital and give birth.

Signs of Labor

1. Your Baby Drops

One of the first signs of labor is your baby “dropping” a few weeks ahead of time. This is also called “lightening” and when it occurs you will notice a heavy feeling in your pelvis. At the same time, there will be less pressure below your ribcage which should make breathing easier.

2. Braxton Hicks Contraction

If your Braxton Hicks contractions become more frequent or more intense, this may indicate you are in pre-labor. At this point your cervix will get ready for labor and some women will experience a feeling that is crampy and menstrual-like.

In some cases Braxton Hicks contractions will become even more painful or occur more frequently (every 10 to 20 minutes) when true labor gets closer. If it is true labor, the contractions will get stronger and longer as well as closer together; they will also make your cervix dilate progressively. If these things are not occurring, then this is false labor.

3. Water Break

One of the most well-known signs of labor is when your water breaks. This occurs when the amniotic sac around your baby ruptures and causes fluid to leak out of your vagina. No matter the speed or pressure of the flow, you should always call a doctor at this point.

Although most women won’t have their water break until they have already been experiencing regular contractions, the water will sometimes break first. If events occur in this order, it is likely that labor will soon follow. If your water breaks but you still don’t have contractions, doctors may need to induce labor.

4. Cervical Changes

There are several cervical changes that can indicate labor.

• Effacement. This is the ripening of your cervix which means that it thins or softens. Most of the time effacing will occur during your last weeks before you deliver your baby and you won’t even notice it occurring. Because of this, your doctor may check for signs of effacement during vaginal exams and will probably express the results in terms of percentages. When you have 0% effacement, your cervix is very thick and between 3 and 4 centimeters long. In order to have a vaginal delivery, the cervix needs to be 100% effaced which means it is completely thinned out.
• Dilation. Dilation is when your cervix opens and is another early indication of labor. This will be measured in centimeters ranging from zero to ten. Do not be surprised if the dilation happens slowly at first and speeds up drastically once you enter active labor.

5. Increase in Vaginal Discharge

If you experience light spotting between week 37 and week 40 of your pregnancy, this may indicate the beginning of labor. If you have pink or bloody vaginal discharge, this is called the bloody show. It is important to pay attention to your vaginal bleeding during pregnancy, and if it is as heavy as your normal period it may indicate a problem and you need to contact your doctor immediately.

While you are pregnant, there will be a thick mucus plug that blocks your cervical opening and this keeps bacteria out of the uterus. It is possible that this plug will fall out once your cervix begins opening and thinning. Although this is a common sign of labor, it isn’t a sure sign as labor may still take days or even weeks to start.

6. Nesting: Spurt of Energy

Nesting is when you wake up one day and suddenly feel incredibly energetic and want to get everything ready for your baby including preparing meals and putting them in the freezer and organizing the crib and your baby’s clothes. Experts aren’t positive why nesting occurs but think it is a primal instinct from previous generations when preparations were necessary to make childbirth safer.

Nesting can start months before you give birth but in most cases the instinct will strengthen immediately before you deliver the baby. You can follow the urges of nesting but be sure not to use too much energy as labor involves a lot of hard work.

7. Other Signs

When Does It Really Start?

Contractions are the best sign that your labor is actually starting. It is possible (and common) to experience Braxton Hicks contractions in the last few months that you are pregnant. These are occasional and sometimes painful contractions that help your body prepare for labor.

The best way to tell whether you are having Braxton Hicks contractions or actually going into labor is to consider several things.

• First you should see whether the contractions are regular. If it is false labor, they will be irregular but if it is the real thing there should be a regular pattern where they get closer together and stronger.
• The second thing to do is to time the contractions and keep in mind that true ones will last between 30 and 90 seconds.
• The last thing to consider is whether the contractions stop. True contractions will always keep going no matter what you do but false labor contractions may stop depending on your actions.

Watch a video to hear an expert explain the signs of labor:

When to Call Your Midwife

The following list shows some indications that you should contact your midwife or doctor:

• If your water breaks (or you think you are leaking amniotic fluid).
• If your baby moves around less than normal.
• If you have vaginal bleeding (that is not just a small amount).
• You have abdominal pain accompanied by changes in vision, severe headaches or fever.