Labour & birth

Signs of labour and the 5-1-1 rule

By Nine Moons EditorialMedically reviewed by Professor Dr FarhatUpdated 9 Oct 20266 min read

Quick answer

Real labour contractions get longer, stronger and closer together over time. A common rule is to call your hospital when contractions are about 5 minutes apart, last about 1 minute, and have done so for 1 hour (5-1-1). Call sooner if your waters break, you're bleeding, your baby is moving less, or you're under 37 weeks.

Key facts

5-1-1 rule	5 minutes apart, 1 minute long, for 1 hour
Braxton Hicks	Irregular, don't get stronger, ease with rest
Waters break	Call your maternity unit, even without contractions
Before 37 weeks	Call straight away

Early signs that labour is near

A "show": a plug of mucus, sometimes blood-streaked
Lower backache or period-like cramps
Diarrhoea or an upset stomach
Waters breaking

Real contractions or Braxton Hicks?

	Braxton Hicks	Real labour
Timing	Irregular	Regular, getting closer
Strength	Stay the same or fade	Get stronger
With rest or a warm bath	Often stop	Continue
Where you feel them	Front of the bump	Often start in the back and wrap round

How labour progresses

The cervix opens to 10 cm. Sizes are drawn to scale. Established labour usually starts at about 4 to 6 cm, and a first labour from there often takes 8 to 18 hours.

Read the full guide to the stages of labour.

Timing your contractions

Time from the start of one contraction to the start of the next. That's how far apart they are. Use our contraction timer: it averages your last contractions and tells you when you're near the 5-1-1 pattern. Your partner can follow along in partner mode.

If your waters break

Put on a pad, note the time, and check the colour. Call your maternity unit even if you have no contractions. Go in straight away if the fluid is green, brown or smelly, or if you're bleeding.

When to go sooner

Your hospital may tell you to come in earlier, for example if it's not your first baby, you live far away, or your baby is breech. Follow their advice over any rule.

Be ready

Have your hospital bag packed by 36 weeks and the route planned.

Frequently asked questions

How long does early labour last?

For a first baby, the early phase can last many hours, sometimes more than a day. Rest, eat lightly and stay hydrated.

Is it 4-1-1 or 5-1-1?

Different hospitals use different numbers. Follow what yours tells you.

Sources

NICE NG235 Intrapartum care
ACOG: How to tell when labour begins
NHS: Signs that labour has begun

General information, not medical advice. Medical disclaimer · How we review content

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