What to do when labour starts

Most labours take hours or even days. You are likely to have plenty of time at home before you head to the hospital or birth centre to give birth. 

Knowing the signs of labour, and how it progresses, can help you to stay calm and cope with early labour (latent phase) in the comfort of your home.  

If you're not sure whether your labour has started, phone your midwife or maternity unit for advice.

What are the first things I should do when labour starts?

• Call your birth partner, or partners, to let them know you are in labour.
• Write down how much time there is between your contractions and how long each one lasts. Use the timer function on your phone, or a contraction timer app.
• If you're having a home birth, tell your midwife you think labour has started.
• If you have other children, and have arranged childcare during labour, ask them to be ready to watch your children.
• Double check you have all you need for labour and birth in your hospital bag. Remember to pack your pregnancy notes. Pack a hospital bag even if you are planning a home birth, just in case.
• If you plan to travel to a maternity unit, get some money ready to pay for the parking meter or taxi.
• Try to relax. Use any techniques you’ve learned, such as breathing exercises.

“My contractions started at home, after my waters had broken. I rang the maternity unit who asked a lot of questions to assess my condition. I was advised to stay at home to begin with before eventually going to the hospital during the early hours of the following day.”

Nicola

When should I ring the hospital or midwife?

Call your midwife or maternity unit straight away if you think you are in labour. They can assess how far along you are over the phone and let you know about the next steps.

Your midwife will:

• Ask about your symptoms, for example, any tightenings, bleeding or if your waters have broken.
• Ask you about your birth plans, hopes and concerns.
• Ask about your baby's movements, and whether they have changed.
• Explain what you can expect in the early stage of labour, including things you can try to help with the pain.
• Offer you support and pain relief, if needed.
• Tell you who to contact next and when.
• Give advice and support to your birth partner if you have one.

If your midwife thinks you are in the early or latent phase of labour, they will likely suggest that you stay at home until you are in what’s called established labour, or the active phase of labour. 

Find out more about the latent phase of labour, including what you can do to stay as comfy as possible.

During this time, you should call your midwife or maternity unit straight away if:

• Your waters break. Take note of the colour of your waters. Tell your midwife if they are yellow, green, pink or red.
• You are bleeding.
• Your baby is moving less than usual. (You should be able to feel your baby move right up to the time you go into labour, and during labour.) 

You reach active or established labour, when your cervix has dilated to more than 4cm. At this point you will start having stronger, longer and more regular contractions. 

Call your midwife, birth centre or hospital labour ward when your contractions are:

• regular
• strong
• lasting at least 60 seconds
• coming every 5 minutes.

Even if your contractions are not regular, if you think you may be in active labour or are at all worried, call your midwife. They can advise whether you need to go to the hospital or birth centre and will reassure you. 

Although you may be anxious to get straight to the place you’ve chosen to give birth, staying at home during early labour can increase your chances of having a straightforward birth. You are more likely to have a smoother labour and fewer interventions if you stay at home until you are in established labour.

Who will be with me during labour?

During your labour and birth, in a birth centre or a hospital, you will be supported by a midwife. Depending on how long your labour lasts, you may have more than one midwife, as one shift ends and the next one begins. 

You may have a second midwife, or a maternity support worker, who is also present during labour or at the birth. Or, you may have a pro birth partner called a doula, to support you through labour and birth. And of course, if you have chosen to have a birth partner, they will be with you all the time. Once you know who you would like to have with you, put it in your birth plan.

If all is going well with your labour, your midwife may leave you and your birth partner for a while during early labour. But they should show you how to call for help if you need it. 

If you are having your baby at home, your midwife will be with you all the time, unless you ask to be left alone with your birth partner for a while. 

Once you are in established or active labour, your midwife or midwives will give you one-to-one care to help you give birth to your baby. They’ll also look after you and your baby after the birth. They’ll do this by:

• Monitoring you and your baby.
• Encouraging you to have skin-to-skin contact with your baby.
• Helping you give birth to the placenta.
• Showing you how to get started with your infant feeding choice – your midwife will be able to support you with breastfeeding or formula feeding.