Just as every woman is unique, so is her pregnancy and onset of labour. Signs that delivery is approaching can vary from one individual to another and may differ even between pregnancies for the same woman. In the ninth month, it may take several hours or even days for early signs of labour to become noticeable.
The initial stage, known as the latent phase, is when the cervix begins to soften, thin out, and gradually open (dilate) in preparation for birth. In this article, we will explore some of the common signs that may indicate labour is approaching, along with useful tips for expectant mothers1.
Although it is difficult to precisely predict the onset of labour or how long a woman’s labour will last, there are a few common signs of labour that are initiated when the foetus produces certain hormones. Here are 5 popular signs of labour every expecting mother should know:
One of the lesser-known signs of labour experienced early on by first-time pregnant mothers is what doctors refer to as “lightening”. When the baby is preparing for birth, it slowly moves into a head-down position. This typically occurs a few weeks before labour in first-time mothers. In subsequent pregnancies, it may happen much closer to labour onset or even during active labour2.
Lightening eases the pressure on a mother’s diaphragm and makes it easier for her to breathe, but it also puts more pressure on her pelvis and bladder. Mothers who have previously given birth, may or may not have this delivery symptom until right before labour begins. Either way, the mother’s belly may appear lower and more protruding and result in frequent bathroom visits.
Towards the end of pregnancy, you may experience true labour contractions, which become more intense, regular, and closer together. These contractions help push the baby down through the birth canal. If you’re having contractions that are regular (e.g. every 5 minutes), last at least 30–60 seconds, and don’t subside with rest, it’s likely true labour Some women may first experience “Braxton Hicks” or false labour contractions, which are irregular and usually subside with rest or hydration3.
An unborn baby in the uterus is surrounded by a protective liquid called amniotic fluid. When this amniotic fluid sac ruptures, the mother experiences a gush of liquid or in some cases a slow trickle, this type of discharge before labour is called a water break4. When the amniotic sac ruptures, it may be experienced as a sudden gush or a slow, continuous leak of clear or straw-coloured fluid. If the fluid is green, brown, foul-smelling, or if you see blood, inform your doctor immediately.
For some women, water breaking signs may not happen at all, in which case an obstetrician or midwife will break it during the delivery, while for others the water may break during labour or some time before it. Once the mother experiences water breaking signs, the baby is no longer protected by the amniotic sac and is vulnerable to infections, so make sure you head to the hospital or call your doctor right away.
A pregnant woman may notice an increase in a type of vaginal discharge with blood before labour’s onset or several days before it5,6. This is called a bloody show, which refers to the passage of the mucus plug mixed with blood. It indicates that the cervix is beginning to dilate and soften.”
Some women experience abdominal cramps, nausea, vomiting, or loose stools in early labour due to hormonal changes and increased pressure on the pelvic organs. These symptoms, while not universal, may accompany the onset of labour4,7.
Women will often self-present to obstetrical triage with concern for the onset of labour. Common chief complaints include painful contractions, vaginal bleeding/bloody show, and fluid leakage from the vagina10.
Dr. M.G. Kartheeka, MBBS, MD(Pediatrics)
Pharmeasy Tips: If you are excessively anxious and worried about the birthing process and labour pain, follow these tips:
If you are fewer than 37 weeks pregnant and experience any these signs of labour, contact your healthcare provider immediately, as they may indicate preterm labour, which requires medical evaluation11.
Dr. Ashish Bajaj, M.B.B.S., M.D. in Clinical Pharmacology and Toxicology
Stay hydrated with water or doctor-approved fluids. Consult your healthcare provider about food intake during early labour, as hospital protocols vary. Preparing for early labour involves more than just physical readiness; it also requires emotional support and self-care. Staying well-hydrated with water or fluids approved by your doctor is important, and you should speak with your healthcare provider about eating during early labour, as hospital rules on this can differ. A supportive birthing partner can make a big difference by helping with calming routines such as yoga, back massages, and other stress-relieving activities. If the pain becomes too strong early on, practicing breathing exercises with your birthing partner can help you manage contractions as they become more frequent and intense. Taking these steps can make early labour a more manageable and less stressful experience8,9.
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Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
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2Each woman’s experience with pregnancy is unique. Some women may have a feeling they’re pregnant as early as the first few weeks of their pregnancy, while others may not realise they are pregnant until they miss their period. Let us understand some of the early signs that may indicate a pregnancy before a missed period.
Extreme weariness or exhaustion is one of the most common early signs of pregnancy. Even if you have had 7-9 hours of sleep, activities that have never affected you before may exhaust you. During pregnancy, the body’s increased metabolic demand might cause fatigue and increase your nutritional needs. The fatigue may also be caused by increasing progesterone levels and changes in blood volume1. This symptom may normally last during the first trimester and may be managed with dietary changes and supplements. However, if the fatigue is severe, it is recommended to get a complete blood count to rule out anaemia and thyroid profile.
You may notice an increased need to urinate1, not associated with a foul smell or burning sensation, even before you miss a period. If you experience a burning sensation or a foul smell with urination2, you should get a urine routine and culture done to rule out a urinary tract infection.
In the first few weeks after conception, you may also notice an increased cravings for certain foods. Some women also experience a sudden and increased sensitivity to smells and intense flavours along with food aversions that may or may not persist throughout the pregnancy. If you have severe food aversion with vomiting more than three times a day and weight loss, you may have hyperemesis gravidarum (severe and persistent nausea and vomiting during pregnancy)3. For a balanced nutritional intake, you should consult a dietician or your gynaecologist.
A week before the missed period, you may notice sore, painful, heavy breasts or darkened areolas. The breasts may become sore and painful due to increased oestrogen and progesterone levels after conception4. This symptom may also occur in the luteal phase of the menstrual cycle or if you have fibrocystic breast disease, in which case the tenderness may be localised or associated with lumps in the breast tissue.
Usually, your temperature rises before ovulation and returns to normal following the menstrual cycle. However, if the basal body temperature remains elevated for a longer time, it may be an early sign of pregnancy5.
Lightheadedness or dizziness is an early sign of pregnancy that affects many pregnant women. The discomfort may last for the first trimester and then gradually fade. However, dizziness may also be caused by anaemia or low blood pressure3. So you should get early pregnancy laboratory tests like complete blood count, monitor your blood pressure, and increase hydration to rule out other causes of dizziness.
An increase in vaginal discharge, along with a thicker consistency of the discharge, can be an early sign of pregnancy. However, if you experience a stinging sensation, itching, or soreness around the vaginal area along with discharge, you may have a vaginal infection, for which you should get checked by a doctor6. Also, a thick discharge is not always pregnancy-related, it could also be due to infection or hormonal changes.
Always, a pregnancy should be confirmed by a urine test and ultrasound abdomen by your obstetrician.
Dr. M.G. Kartheeka, MBBS, MD(Pediatrics)
Cramping is a common early pregnancy symptom and is often mistaken for premenstrual cramps or period-related discomfort. In early pregnancy, this cramping is usually mild and caused by increased blood flow to the uterus or implantation. However, it’s important to distinguish implantation cramping from signs of more serious conditions, such as a threatened abortion or ectopic pregnancy7. Cramping that is severe, localised to one side, or accompanied by vaginal bleeding can be considered a warning sign and needs immediate medical attention.
A week or so before your period is due, you may experience some discomfort and a slight vaginal discharge of light pink or brownish blood. This is called implantation bleeding or spotting, which occurs as the fertilised egg attaches to the uterine lining. Spotting may sometimes be mistaken for a period. Spotting may also be experienced in ectopic pregnancies or early miscarriage. Therefore, if spotting is accompanied by pain, dizziness, or heavy bleeding, you should get an ultrasound done8.
Bloating or stomach cramps are one of the most common pregnancy symptoms before a missed period. Progesterone, which increases in the initial stages of pregnancy, can slow down the movement of the gastrointestinal tract, causing bloating. Bloating can also occur with premenstrual syndrome (PMS), but unlike PMS-related bloating, which usually subsides once the period begins, pregnancy-related bloating may persist9.
Certain abdominal or ovarian cysts can sometimes cause symptoms or physical findings, like abdominal bloating or a palpable mass that may be mistaken for early pregnancy or, less commonly, a twin pregnancy. A detailed medical history and a thorough scanning technique are essential to diagnose or rule out pregnancy.
Dr. Ashish Bajaj, M.B.B.S., M.D., in Clinical Pharmacology and Toxicology
A home urine pregnancy test might be able to tell you if you are pregnant, but it’s not always 100% reliable10. To confirm the pregnancy and make sure it is not an ectopic pregnancy (pregnancy growing in the fallopian tubes), doctors often recommend an internal ultrasound at around 6 to 7 weeks. In some cases, like if the test result is unclear or if an ectopic pregnancy is suspected, a blood test called beta-hCG can give more accurate information.
You should see a doctor if you have light bleeding with pain, feel very dizzy or faint, or have ongoing vomiting. It’s also important to get checked if you have a positive pregnancy test with lower tummy pain, or if you notice burning, itching, or unusual discharge from your vagina. These signs may need early medical care to keep you safe and healthy.
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Many early pregnancy symptoms are similar to premenstrual syndrome or other health conditions, making it difficult to rely on symptoms alone. While these signs may give you clues, they are not diagnostic by themselves. The most reliable way to confirm a pregnancy is by taking a pregnancy test, especially if you’ve missed your period and suspect you might be pregnant. Always consult your gynaecologist for confirmation and further guidance, as early prenatal care plays a vital role in ensuring a healthier pregnancy journey for both mother and baby.
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
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