Start of labour Heather Welford How to tell labour has started, and what to expect if your baby has gone to term.

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Is this it? How to tell it's labour

Have a plan Passing the time

Home birth What's a contraction?

Labour begins when the uterus starts contracting regularly. These contractions then become stronger and more frequent.

Contractions allow your uterus to push the baby downwards and to pull the cervix upwards, allowing the exit to get bigger and bigger in preparation for your baby's head.

Most labours start quite slowly and gently

Most labours start quite slowly and gently, and you may have several hours of wondering whether or not it has actually begun.

Some women experience quite powerful Braxton Hicks 'practice' contractions. It's not uncommon to think labour's started and some women even end up at hospital - only to be sent home because nothing's happening.

Don't be embarrassed if this happens to you - maternity staff have seen it all before.

If you've had a normal pregnancy so far, when the real thing does start there's no need to make a mad dash for the hospital. You'll probably cope better with the contractions if you're free to walk around and choose your own distractions.

If you're in doubt, though, call the labour ward and speak to a midwife. She'll discuss what's happening and advise you whether you should wait before going in.

• Time your contractions. It's almost certainly labour if your contractions last more than 40 seconds and you're having three every ten minutes, and probably labour if you notice your contractions getting closer together and more intense, even if they're not at the 'three in ten' stage yet.
• You've had a 'show'. This is a loss of pink mucus from the plug that keeps the cervix closed. Labour can start any time after this, although it could be as long as a few days. Some women don't notice the show, so just because you haven't seen yours it doesn't mean you aren't in labour.
• Your waters have broken. This means the membranes holding the amniotic sac, which contains your baby and the amniotic fluid, have started to leak. It can happen suddenly, but is more likely to be a gradual trickle. Again, you may not notice. It's more likely to happen when you're already in established labour. There's a risk of infection if your waters break too soon before labour and the waters could bring the cord down as well, compressing your baby's oxygen supply (this is rare). Call the hospital if you're concerned.

Don't be afraid to leave your home in case you go into labour. Just ensure you have a plan in case anything does happen.

• Make sure you've got contact details for your partner/birthing partner.
• Carry a spare pair of knickers and a couple of sanitary towels. If your waters break, you'll want to change your underwear for your own comfort and the sanitary towels will help to absorb the fluid
• Keep a bag of essentials for your hospital stay with you or in your car.

Once labour has started, you may be told to wait a while before going into hospital. Have a warm, relaxing bath or find something enjoyable and undemanding to do - listen to music, watch TV or read a book. If you're in bed and your contractions aren't too strong, try to sleep.

If you're in great pain, if you notice any loss of blood, if you feel sick or have a bad headache, or if you think there's anything happening that shouldn't be, call the labour ward.

If you're giving birth at home rather than in a hospital, you'll probably have already discussed the sequence of events with your midwife. Give her a call when you're fairly sure you're in labour and discuss your symptoms with her. This will allow her to plan when to come to you.

The womb is made up of a network of muscle fibres. At the height of a contraction, the muscle fibres are at their shortest and the pain is most intense. It can feel like strong period pains or a belt tightening across your abdomen. You can feel pain in your back or front.

The fibres then relax and the contraction fades, but the muscle fibres remain slightly shorter than they were before. The baby is pushed down a little further and the cervix stays open a little wider.

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