Knowing when to call your midwife takes the guesswork out of labour. Call too early and you may feel you are wasting her time. Wait too long and you risk a rushed birth or a missed warning sign. Here is a clear guide to the signs of labour, the timing that matters and the symptoms that need a call straight away.
The short answer: call your midwife when you think labour has started, when contractions come every 5 minutes or closer, or any time you feel unsure. Call immediately, day or night, if you notice any warning sign listed below.
Early Signs Labour Is Starting
Labour rarely starts with one dramatic moment. Most mothers notice a mix of these signs over hours or days, according to the NHS:
- Contractions or tightenings that grow longer, stronger and closer together
- A show, a plug of mucus that may be pink or streaked with blood
- Backache or a heavy, aching feeling low in your belly
- An urge to use the toilet, caused by your baby’s head pressing on your bowel
- Your waters breaking, as a trickle or a gush
Real Labour vs Practice Contractions
Practice contractions, called Braxton Hicks, are common in the last weeks of pregnancy. Use this comparison to tell them apart:
| Practice contractions | Real labour |
|---|---|
| Irregular, with no pattern | Regular, with a clear pattern |
| Stay the same strength | Grow stronger over time |
| Ease when you rest, walk or change position | Continue whatever you do |
| Felt mostly in the front of your belly | Often start in your back and wrap to the front |
When to Call Your Midwife
Call your midwife for guidance when:
- You think you are in labour
- Contractions are regular and come every 5 minutes or more often
- You feel unsure or worried about anything
Many midwives use the 5-1-1 guide for first babies: contractions every 5 minutes, each lasting about 1 minute, for 1 hour. If this is not your first baby, labour is often faster. Agree with your midwife during pregnancy on the exact point she wants you to call.
Call Straight Away, Day or Night
Do not wait for a pattern if you notice any of these signs. Call your midwife immediately:
- Your waters break, especially if the fluid is green, brown, smelly or mixed with blood
- You have vaginal bleeding more than a small streak
- Your baby moves less than usual
- You are under 37 weeks and think you are in labour
- A single contraction lasts longer than 2 minutes
- You have 6 or more contractions in 10 minutes
- You have a severe headache, blurred vision or sudden swelling of your face, hands or feet
- You have a fever, chills or constant severe pain in your belly
Source: NHS, signs that labour has begun.
If you see or feel the umbilical cord at your vagina, or you feel a strong urge to push before your midwife arrives, call 10177 for an ambulance or 112 from any cellphone, then call your midwife.
How to Time Your Contractions
- Note the time a contraction starts.
- Note the time it ends. This gives you the length.
- Note the time the next contraction starts. The gap from start to start is the frequency.
- Track at least 4 or 5 contractions in a row on paper or a free timer app.
Your birth partner can do the timing so you can focus on breathing and moving.
What to Tell Your Midwife on the Phone
Keep these details ready so the call is quick and useful:
- Your name and how many weeks pregnant you are
- How often your contractions come and how long they last
- Whether your waters have broken, what time and what colour
- Any bleeding
- Your baby’s movements today
- How you are coping with the pain
- Your address and gate access, if she needs to come to you
What to Do in Early Labour at Home
Early labour can last many hours, especially with a first baby. Use this time well:
- Rest or sleep between contractions if you can
- Eat light food and sip water often
- Take a warm shower or bath to ease the pain
- Walk, sway or lean forward over a chair or birth ball
- Empty your bladder every hour or two
Our guide to natural pain relief options covers more drug-free ways to cope. If you are planning a home birth, check that your supplies are ready with our home birth checklist.
What Happens After You Call PMBcare
Sister Dikeledi listens to your symptoms and decides on the next step. For a home birth, she tells you when she is on her way. For a birth at our Fordsburg centre, she tells you when to come in. If a warning sign points to a problem outside normal labour, she arranges hospital care without delay.
Frequently Asked Questions
Should I call my midwife if I am not sure I am in labour?
Yes. Midwives expect these calls. A short conversation helps you decide whether to rest at home, wait or prepare to meet her.
My waters broke but I have no contractions. Do I call?
Yes, call straight away. Your midwife needs to know the time and the colour of the fluid, even if contractions have not started.
Is it okay to call my midwife at night?
Yes. Labour does not keep office hours. Never let the time stop you from calling, especially if you notice a warning sign.
How long does early labour last?
It varies. For a first baby, early labour often lasts many hours. Second and later labours tend to be shorter, which is why you should call earlier.
Save Our Number Today
Save PMBcare’s number in your phone and your partner’s phone now: 060 830 7432. You can also reach us on WhatsApp at wa.me/27608307432. Not booked yet? Book your consultation and talk through your labour plan with Sister Dikeledi.
This article is general information and does not replace advice from your midwife or doctor. In an emergency, call 10177 or 112.