Signs and Stages of Labor: When To Call your Provider  

As a certified nurse midwife at The Birth Place at Southern New Hampshire Medical Center, I am often asked, "How will I know when I am in labor?" Understanding the signs and stages of labor can give you confidence in deciding when to come in, ensuring you are safe and comfortable in the right place. We want you to arrive at the hospital at the right time—neither too early nor too late. 

Early Signs of Labor You May Notice While You’re at Home

The first stage of labor can last for hours or even days. This does not require a phone call to your provider. At this stage, it’s best to hydrate and rest. You will do best during this stage in the comfort of your own environment, where you feel safe and comfortable. Early signs of labor include: 

• Mild contractions that may feel like period cramps. These may be felt in your back, thighs, or lower abdomen. It is not uncommon for contractions to get closer together and then space back out. 
• A mucus-like discharge, sometimes tinged with blood (called "bloody show"). People most often notice this when they wipe after going to the bathroom. Seeing blood can be worrisome, but rest assured, there is no need to call if the bleeding does not require a maxi pad. 

When to Call Your Provider 

• If any of the above symptoms occur prior to your 37th week of pregnancy 
• Contractions become stronger, longer, and more regular. Watch for contractions that last about 60 seconds and come every 3-5 minutes for a two-hour period. Contractions should also increase in intensity over the two hours. 
• Constant pain with a firm abdomen 
• Trouble talking through contractions 
• Bleeding that requires a maxi pad 
• If you think your water has broken, this may be a large gush or a small trickle 
• Decreased fetal movement: If you feel like your baby is not moving appropriately, we recommend drinking a glass of water, resting on your left side, and counting for 8 fetal movements in a 2-hour period. If this is not achieved, call your provider. 

When to Go to the Hospital

Always call your provider’s office (where you receive your prenatal care) with the above symptoms. If it is after hours, your provider’s answering service will page the on-call midwife, who will return your call. Every labor is different, so trust your instincts. If you’re unsure about what you’re experiencing, we’re always a phone call away, 24-7 and are happy to guide you. We’re here to help you have a safe and smooth birth experience! 

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 Briana Orrico is a certified nurse midwife at The Birth Place at Southern NH Medical Center.