What are the first signs that labor is starting?

The HHS Office on Women's Health lists contractions that become stronger at regular and increasingly shorter intervals, lower back pain and cramping that does not go away, your water breaking (a large gush or a continuous trickle), and bloody or red-tinged mucus discharge (the mucus plug). Lightening (the baby dropping) and nesting can come days or weeks earlier.

How do I tell true labor from false labor?

MedlinePlus: false labor (Braxton Hicks) contractions are typically short, not painful, irregular, and come without bleeding or fluid leaking. True labor contractions come regularly and get closer together (about 5 to 10 minutes apart), last 30 to 70 seconds and get longer, grow stronger over time, and stop you from talking through them.

When should I go to the hospital for contractions?

MedlinePlus advises contacting your provider or going in when you have regular, painful contractions every 5 to 10 minutes for 60 minutes, or contractions lasting 60 to 90 seconds; also right away if your water breaks, you have bleeding beyond light spotting, or your baby is moving less. Many units summarize this as the 5-1-1 rule.

How long does labor last?

Per HHS: the first stage (from the start of labor until the cervix is fully open) is the longest at usually about 12 to 19 hours; the second stage (pushing and birth) usually lasts 20 minutes to two hours; the third stage (delivering the placenta) is the shortest at five to 30 minutes.

Signs of Labor: The Early Signs, True vs. False Labor, and Exactly When to Go In

Janeen Team · Sourced from HHS Office on Women's Health, MedlinePlus (NIH) and NICHD · Sources reviewed September 8, 2026 · 7 min read

The signs that labor has started are contractions that get stronger, regular and closer together, lower back pain and cramping that will not go away, your water breaking, and bloody or red-tinged mucus (the mucus plug). Lightening and nesting are "getting close" signs that can come days or weeks earlier. The rule for going in, from MedlinePlus: regular, painful contractions every 5 to 10 minutes for 60 minutes, or contractions lasting 60 to 90 seconds, or right away if your water breaks. Before 37 weeks, any of these means call immediately.

Early signs: labor is approaching (days to weeks away)

Lightening: the baby's head drops into the pelvis. Your belly sits lower, breathing gets easier, and you urinate more often. Often weeks before labor in a first pregnancy, sometimes not until labor in later ones.
Nesting: a sudden burst of energy and the urge to clean and prepare. Real, common, and not a timing tool.
Losing the mucus plug: thick, jelly-like discharge, possibly streaked with blood. It means the cervix is ripening; labor may follow in hours or in weeks (how to read it).
Loose stools, cervical changes found at an exam: the body preparing, not the start.

Signs labor has actually started

The HHS Office on Women's Health says to call your doctor or midwife when you have any of these:

Contractions that become stronger at regular and increasingly shorter intervals
Lower back pain and cramping that does not go away
Your water breaks, as a large gush or a continuous trickle
Bloody or red-tinged mucus discharge (bloody show)

Waters can break before contractions start. That still counts as labor beginning: contact your maternity unit even without contractions, and urgently if the fluid is green or brown.

True labor vs. false labor (Braxton Hicks)

Feature	True labor	False labor
Rhythm	Regular, getting closer (about 5 to 10 minutes apart)	Irregular, no pattern
Length	30 to 70 seconds, getting longer	Typically short
Strength	Grows stronger; you cannot talk through them	Not painful, stays mild or fades
Location	Often starts in the back and wraps forward	Front of the belly
With movement or rest	Continues regardless	Often eases with a walk, rest or water
Bleeding or fluid	Bloody show or waters may accompany	None

Deeper comparison in Braxton Hicks vs. real contractions.

When to go to the hospital

MedlinePlus gives a clear threshold: contact your provider or go in when you have regular, painful contractions every 5 to 10 minutes for 60 minutes, or contractions lasting 60 to 90 seconds. Many maternity units shorten this to the 5-1-1 rule: every 5 minutes, lasting 1 minute, for 1 hour. Go sooner if you live far away, had a fast previous birth, or your provider gave you a different plan.

Time contractions the easy way ⏱️

Janeen's contraction timer logs each one with a single tap, tracks duration and spacing, and applies the 5-1-1 rule for you, so you know when it is really time.

Download Janeen free

Go in right away, regardless of contractions, if: your water breaks, you have bleeding beyond light spotting, or your baby is moving less than usual. MedlinePlus adds: call for any other reason if you are unsure what to do.

The three stages of labor and how long they last

Stage	What happens	Usual duration (HHS)
First	From the start of labor until the cervix is fully open (10 cm). Early labor is long and mild; active labor is intense.	About 12 to 19 hours, the longest stage
Second	Pushing and the birth of the baby	20 minutes to two hours
Third	Delivery of the placenta	Five to 30 minutes, the shortest

Your baby should stay active through labor. Reduced movement is never a normal pre-labor sign; see the kick counter guide.

Preterm labor: signs before 37 weeks

Before 37 weeks, do not wait for any timing rule. Call your provider right away for (NICHD):

Contractions every 10 minutes or more often
Change in vaginal discharge (leaking fluid or bleeding)
Pelvic pressure, as if the baby is pushing down
Low, dull backache
Cramps that feel like a period
Abdominal cramps with or without diarrhea

Early treatment can slow or stop preterm labor and improve outcomes, so the threshold for calling is deliberately low.

Frequently asked questions

Can labor start without my water breaking?

Yes, and that is the most common way. Waters break before contractions in only a minority of labors; often they break during labor or are released by your provider.

I lost my mucus plug but have no contractions. What now?

Watch and prepare. Labor may be hours or weeks away. Call only if you also have regular contractions, fluid leaking, or bleeding heavier than streaks.

Do early-labor contractions hurt?

Early first-stage contractions are usually mild and spaced out and can go on for many hours, especially in a first birth; that is normal and best spent resting at home.

Does walking or eating certain foods start labor?

Evidence for home methods is weak. Nothing reliably opens the cervix before the body is ready; ask your provider before trying anything.

The bottom line

Regular, strengthening contractions, waters breaking, or bloody show mean labor has started; lightening and nesting mean it is getting close. Use the timing rule to decide when to go, call immediately before 37 weeks, and never wait on reduced movement. The Arabic version of this guide, with the 5-1-1 rule, is at علامات الولادة.

Official sources

HHS Office on Women's Health: Labor and birth — accessed September 8, 2026.
MedlinePlus (NIH): Am I in labor? — accessed September 8, 2026.
NIH, NICHD: What are the symptoms of preterm labor? — accessed September 8, 2026.
CDC HEAR HER: Urgent maternal warning signs — accessed September 8, 2026.

Educational content based on the official sources above — not medical advice and not a substitute for your care team.