As you near the end of your pregnancy you can become anxious and eager to see the baby. You may have been experiencing signs and symptoms that may seem like labor, such as Braxton Hicks contractions, what I call “warm-up” contractions. These can begin days or weeks before you actual go into labor. So, what at what point does that warm-up turn into the real thing?

Remember labor has three stages and for some mothers the shift from warm-up to active labor happens so gradually you’re well into active labor before you realize it. For others you may have a prolonged period of early labor before things shift into a higher gear. This is normal, but can be exhausting. Here are some signs and symptoms of impending labor to help you know how best to communicate with your health care provider.

Lightening or Engaging: Lightening is when the baby drops into the pelvis and is often called “engaging”. A mother will feel more pressure in her pelvis but find her lung capacity has returned to a more normal state. For primiparas (first time mothers) the baby can drop several days before labor begins but for multiparas the baby may not drop until labor has already started.

Nesting Instinct: This surge of energy is thought to be triggered by a flush of hormones when both the baby and mother are preparing for labor. Often this may include last-minute decorations to the baby’s room, one final shopping spree for last-minute baby items, and cleaning the house.  We encourage women to make sure they still get plenty of sleep to make sure they have lots of energy for labor.

Loss of the Mucus Plug: The mucus plug blocks the opening of the cervix throughout the pregnancy, to prevent bacteria, or other infection agents, from reaching the baby. As the cervix begins to soften, thin, and open the mucus plug will fall out. With a first time mother this usually happens in early labor, but some women loose their mucus plugs many days before labor begins.

Bloody Show: This phenomenon can happen at the same time the mucus plug falls out, or happen later as the cervix begins to dilate during early labor. For many women, the cervix dilation causes tiny capillaries to break, causing a small amount of bleeding that just looks like pinkish discharge.

Loose Bowels: A natural cleansing in preparation for childbirth, many women have diarrhea right before their labor begins, or during early labor. This natural cleansing is one reason why most hospitals no longer do routine enemas.

Early Labor Contractions: In general, early labor contractions get longer, stronger and are more regular than the pre-labor, or Braxton Hicks, contractions that women experience throughout pregnancy. Usually, early labor contractions will not stop even if a woman eats, sleeps, bathes or walks around. When a laboring woman does all these things, and still experiences contractions, she can be confident that her early labor has begun. One common rule-of-thumb is the 4-1-1 rule – contractions closer than 4 minutes, lasting for 1 minute each, for 1 hour, but check with your health care provider about their preference.

Breaking of the Waters: Less than 10% of women will have their membranes rupture before the onset of labor and, for those few women, most will begin active labor within 24 hours.

Stay in contact with your health care provider as you get closer to the end and remember that not every woman experiences every sign each time. Every labor is unique just like every mother and every baby is unique. Certain things like GBS positive status, or a history of quick births, might be a reason your health care provider would want you to call sooner than later.

Experiencing any of these signs and symptoms of labor can mean your childbirth time has arrived, or that your body is preparing and labor will begin soon. Try to rest, eat well, and finish any last-minute chores. Pack your labor bag and grab your labor affirmation cards because you may be calling your doctor or midwife soon to let them know your labor has begun!