You will soon be bringing your baby into the world. Labour generally begins spontaneously between 38 and 41 weeks after the start of your last menstrual period. However, delivery anywhere between 37 and 42 weeks is considered full-term. Your expected delivery date is not a deadline. Even if you have not given birth at more than 40 weeks, there is still a good chance labour will begin on its own. In some cases it may be preferable to give birth between 41 and 42 weeks than to wait until 42 weeks have passed. If you have completed 41 weeks and there is no sign that labour has started, you can discuss your options with your doctor or midwife. They may have you undergo some tests (monitoring, ultrasound) to determine whether you can continue to wait for labour to begin on its own or whether it is preferable to induce labour (see Possible interventions during labour,).
No one can predict when and how your labour will begin. Most women will recognize labour because of certain tell-tale signs. It’s normal at that point to feel excited or scared.
Passing the mucus plug
The mucus plug, which blocks the cervix during pregnancy, is made of thick secretions sometimes tinged with blood. You may lose your mucus plug without even realizing it several days before you give birth or during labour. It’s also possible to lose it in stages.
If you do notice it, don’t be too quick to jump to conclusions. This doesn’t necessarily mean labour has started. You will need to wait for other signs.
For most women, labour begins with uterine contractions (see How to tell the difference between contractions and other abdominal pain). You may have already felt your abdomen become hard during pregnancy. These are contractions that, while sometimes uncomfortable, aren’t really painful (Braxton Hicks contractions).
Contractions experienced during delivery are different from Braxton Hicks contractions. Your abdomen gets tight and hard and the contractions become more and more uncomfortable. Generally women feel pain in the lower abdomen, but for others the pain is located in the lower back and spreads to the front. Some women find the pain of contractions similar to menstrual cramps, only stronger. Every woman will experience contractions in her own way. The feelings may even be very different for the same woman from one pregnancy to the next.
Natural rupture of the amniotic membranes
For some women (about one in ten), the rupture of the amniotic membrane, or amniotic sac, signals the beginning of labour. The amniotic membrane is made up of two layers, hence they are often referred to as “membranes.” These membranes surround your baby and contain the amniotic fluid around him. When they rupture, the amniotic fluid leaks out. It is often referred to as having your “water break” because the liquid that leaks out is clear like water, although sometimes tinged with a bit of blood. You may only leak a few drops or it may leak enough to wet your bed or your clothes. There may be so much liquid that it drips onto the floor.
At the end of pregnancy it can be difficult to distinguish between normal vaginal discharge and amniotic fluid (see Possible types of discharge). Generally with amniotic fluid, there will be enough to soak a sanitary pad.
What should I do?
When your water breaks, you should head for the hospital or birthing centre, even if you have no contractions.
The staff will make sure your baby is doing well and will check whether your membranes did actually rupture, or if it is merely vaginal discharge, which tends to be heavier at the end of pregnancy.
Labour will likely start in the hours after your water breaks. If the contractions still haven’t begun or if you are a carrier of streptococcus (also called group B or BGS), labour may need to be induced.