Labor by definition occurs when regular contractions of the uterus lead to dilation and shortening, or effacement, of the cervix. Although preterm labor may be painless, most people have plenty of warning when they go into labor at term. As a matter of fact, with a first baby, moms are more likely to go into the hospital too early than to get there late.

About ten percent of moms break their water before labor starts. This may feel like a pop, followed by a big gush, or it may come as an on-and-off trickle. If you are not sure, you may want to put on a sanitary pad, lie down for a while, and then get up and walk around. If the pad gets wet, call your doctor or midwife.

Amniotic fluid has a characteristic odor, some say similar to Comet cleanser, so you should be able to distinguish it from urine or normal sticky pregnancy discharge. A small amount of bleeding, called bloody show, is normal near term, and may be seen a few days before labor begins. If you have any question as to whether you have broken your water, call your doctor or midwife for advice. Often an examination can answer the question.

Most commonly, though, labor starts with contractions. At first these may feel like menstrual cramps, or like the baby is balling up. Your whole uterus might become hard to the touch for half a minute, and then relax and get soft again. I usually tell my patients having a first baby not to time contractions until they are so intense that she needs to change activities in order to get through them, or intense enough that someone with her could tell something was going on by a change in facial expression or by her breathing. Strong contractions coming five minutes apart or closer for an hour usually mean labor has begun.

This description is just a guideline. Your doctor or midwife will give you specific recommendations for when to call, and when to head to the hospital or birth center.