VBAC (Vaginal birth after C section)
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Chandrima Biswas
Consultant Obstetrician and Lead Clinician for Labour Ward at The Whittington Health ICO NHS Trust. Obstetric lead for the North Central London Maternity Network.
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Birth and labour

How will I know I'm in labour?

The answer to this question is less obvious than it sounds. There are basic guidelines to help you know when you are going into labour, and when to call your midwife or go to the hospital.
In Short
If your 'contractions' aren't getting closer together as time passes, this is the latent phase - which can go on for hours of days.

The second part of the first stage is called "active labour". The contractions will be much stronger, and more regular, and impossible to ignore. The cervix might be dilating quickly and you will feel the urge to push.

Call your midwife or the hospital when you reach active labour. Then it's time to go in.

Am I in Labour?

It’s a common question and not as obvious as it sounds. Midwives frequently receive calls from women who are uncertain if they’re in latent labour or active labour, and who need advice. Hospitals frequently have women turning up expectantly only to find out they’re not yet in active labour and need to go home again. To save you all the trouble of not knowing, here are some guidelines. Remember every woman’s labour is different but overall there is a basic pattern followed:

  • Engagement
  • 1st stage – 1st part – Latent labour
  • 1st stage – 2nd part – Active labour and transition
  • 2nd stage – Begins with full dilation and ends with the birth
  • 3rd stage – The delivery of the placenta and membranes
Braxton Hicks contractions

Braxton Hicks contractions are usually irregular and don’t get closer together as time passes. Changing your activity or resting can make them go away.

These classically come from 32 weeks onwards and don’t cause dilation of the cervix.

In comparison, labour contractions can be irregular in the beginning but then start to gradually get longer, stronger and closer together. Changing your activity or resting doesn’t make them go away.


Towards the end of your pregnancy, your baby’s head will drop down into the lowest part of your pelvis. This is known as ‘engagement’ and is the preparation for labour and birth. Engagement can happen several weeks before labour (more common in first-time mums) In women who have had a baby before, engagement may not happen until just before birth.

1st stage – 1st part – Latent labour

The latent stage may include all, or just some, of the following:

  • Persistent lower back or abdominal pain along with cramps and a pre-menstrual feeling.
  • Mild contractions that start lengthening over time, so you know they’re real. These prepare your cervix before it starts to dilate, ready for established labour.
  • Your waters may break before labour starts. Your membranes may break with a gush or trickle of amniotic fluid. To prepare for this, you could keep a sanitary towel (not a tampon) handy if you are going out, and put a plastic sheet on your bed.
  • The Show, the plug of mucus in the cervix, which has helped to seal the uterus during pregnancy, comes away and out of your vagina. This small amount of sticky pink, brown or blood-tinged mucus and cells usually come away before or in early labour as the cervix prepares so open and shorten. There should only be a little blood mixed in with the mucus. If you are losing more blood, red and like a period, it may be a sign that something is wrong, so phone your midwife or hospital straight away.
When to call the midwife and what to say?
  • Once you are certain that your contractions are definitely stronger. Longer and more regular, or you feel you need pain relief. The midwife will want to know how close together your contractions are, so it’s good if you’ve timed this before calling. They can usually tell by asking you some questions and by the tone of your voice whether you need to go to hospital yet.
  • Call if your waters break.
  • If your baby is moving much less than usual contact your midwife urgently and count the number of movements you can feel when lying down quietly over a 10 minute period. It’s always better to have this checked out rather than stay at home worrying.
  • Vaginal bleeding, unless it’s the tiny little bit associated with the show.
  • You have a fever, changes in vision, severe headaches, along with abdominal pain (or if you monitor your blood pressure at home and it goes up).
1st stage – 2nd part – Active labour & transition

At this stage, symptoms will intensify.

During a contraction, your abdomen will feel hard as the muscles of your womb tense up and work to gradually open your cervix making it wider and thinner. Your contractions are not under your mental control and are able to push your baby out. As your labour progresses, the contractions will become more intense and, as your muscles relax after each one, the pain will fade.

Active labour will induce the following changes to your body:

  • Long and frequent contractions, you probably won’t be able to speak during one.
  • Usually 45 – 60 seconds in length – and most women contract at least every 5 minutes.
  • Shakiness, chills and/ or sweats caused by a sudden surge in hormones.
  • Nausea or being sick, as the body clears its digestive system (again you might have low blood pressure so ask about this if you are vomiting with each contraction).
  • More blood-tinged show.
  • Tightness in the throat and chest area.

Strong pressure in the lower back and rectum feeling like you need a poo.

When you’ve reached active labour – call the hospital or midwife.
Packing your hospital bag

Do this in advance – so when you really are in labour, and if you’re heading off to the hospital, you can just pick it up (along with your notes) and go! Mum, Melissa, gives some advice on what to pack in the following video.

See also our article on ‘Stages of labour’.

Share the knowledge
This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Essential Parent has used all reasonable care in compiling the information from leading experts and institutions but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details click here.