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Guide

Preparing for Labour: Everything You Need to Know

Last updated 6 April 2026
This content is for informational purposes only and does not replace professional medical advice. Always consult your midwife or GP.
At a glance

Medically reviewed content. Last updated: April 2026.

In this guide

Preparing for Labour: Everything You Need to Know

Medically reviewed content. Last updated: April 2026.

As your due date approaches, it is completely normal to feel a mix of excitement and nerves about labour. The more you understand about what lies ahead, the more confident you are likely to feel. This guide covers how to prepare practically, physically, and emotionally for labour and birth in the UK.

When does labour usually start?

Most babies are born between 37 and 42 weeks of pregnancy. Your estimated due date is calculated at 40 weeks, but only about 4% of babies arrive on their exact due date. First babies tend to arrive a little later, with the average being around 40 weeks and 5 days.

Labour can begin gradually over several hours or days, or it can start quite suddenly. Understanding the signs helps you recognise when things are getting started and when to contact your midwife or maternity unit.

What are the early signs that labour is approaching?

In the days or weeks before labour begins, you may notice some of these changes.

A "show"

The mucus plug that has sealed your cervix during pregnancy may come away as a small blob of jelly-like mucus, sometimes streaked with pink or brown blood. This can happen days or even weeks before labour starts, so it does not mean you need to rush to hospital. If you experience heavy, bright red bleeding, contact your maternity unit immediately.

Braxton Hicks becoming more frequent

You may have felt practice contractions throughout your third trimester. As labour approaches, these may become stronger and more regular, though they typically remain irregular and fade with rest or a change of position. True labour contractions build in intensity and do not go away.

Your baby "drops"

Also called lightening or engagement, this is when your baby moves lower into your pelvis in preparation for birth. You may find it easier to breathe but need to wee more frequently. In first pregnancies, this can happen two to four weeks before labour. In subsequent pregnancies, it may not happen until labour begins.

Nesting urge

Many people experience a sudden burst of energy and a strong desire to clean, organise, or prepare the house. While not scientifically proven to predict labour, it is commonly reported in the days before birth.

Loose bowels

Your body releases prostaglandins before labour, which can cause looser bowel movements. This is your body's way of clearing space for birth.

How do you know when labour has actually started?

True labour has three key features that distinguish it from pre-labour or Braxton Hicks:

  • Contractions become regular. They come at consistent intervals and gradually get closer together.
  • Contractions become longer. Each one lasts longer than the previous ones, typically building from 30 seconds to 60 seconds or more.
  • Contractions become stronger. They increase in intensity and do not ease off when you move, change position, or rest.

A common guideline is the 3-1-1 pattern (or 5-1-1 depending on your maternity unit's advice): contractions coming every 3 to 5 minutes, lasting at least 1 minute each, and continuing at this pattern for at least 1 hour. Your maternity unit will give you specific guidance on when to come in.

Your waters may also break before or during labour. This can be a sudden gush or a slow trickle. If your waters break, note the time, the colour (it should be clear or slightly pink), and contact your maternity unit for advice. If the fluid is green or brown, go to hospital straight away as this may indicate meconium.

How can you prepare physically?

Stay active

The NHS and RCOG recommend continuing gentle exercise throughout pregnancy unless you have been advised otherwise. Walking, swimming, and pregnancy yoga are all excellent options that help build stamina for labour. Staying mobile during labour itself is also associated with shorter labour and less need for pain relief.

Practice breathing techniques

Slow, focused breathing during contractions can help manage pain and keep you calm. Many antenatal classes teach specific breathing patterns for different stages of labour. Even simple techniques, such as breathing in for four counts and out for six, can be effective.

Try perineal massage

From about 34 weeks, perineal massage can help prepare the tissue between your vagina and anus for stretching during birth. A Cochrane review found that regular perineal massage from 34 weeks reduces the chance of perineal trauma requiring stitching, particularly in first-time births.

Pelvic floor exercises

Strengthening your pelvic floor muscles before birth can help during the pushing stage and aid recovery afterwards. Aim for three sets of exercises per day: squeeze and hold for up to 10 seconds, then release. Repeat 10 times. Your midwife can check you are doing them correctly.

What choices do you have about where to give birth?

In the UK, you typically have three options.

Hospital labour ward

Staffed by midwives and obstetricians with full medical facilities available, including epidural anaesthesia and surgical theatres. This is usually recommended for higher-risk pregnancies.

Midwife-led birth centre (alongside or freestanding)

Run by midwives in a more home-like environment. You may have access to birth pools, lower lighting, and more freedom to move around. Medical intervention is available quickly in an alongside unit, or by transfer in a freestanding unit. The Birthplace Study found that for second or subsequent babies, midwife-led units were associated with fewer interventions and similar safety outcomes compared to hospital labour wards.

Home birth

Supported by NHS community midwives who attend your home during labour. The Birthplace Study found that for women having their second or subsequent baby with no complications, home birth was as safe as hospital birth with fewer interventions. For first babies, there is a slightly higher rate of transfer to hospital.

Whichever option you choose, you have the right to change your mind at any point. Your midwife can help you understand the options that best suit your circumstances.

What should your birth plan cover?

A birth plan is a way of communicating your preferences to the people caring for you during labour. It does not need to be complicated. Key things to consider include:

  • Who you want as your birth partner (you can usually have one or two people with you)
  • Your preferences for pain relief, from breathing and movement through to gas and air, pethidine, or an epidural
  • Any positions you would like to try during labour
  • Whether you would like to use a birth pool
  • Your preferences for the third stage of labour (delivering the placenta)
  • Whether you want skin-to-skin contact immediately after birth
  • Your feeding intentions (breastfeeding, bottle feeding, or a combination)
  • Any cultural or religious practices that are important to you

Remember that birth is unpredictable, and flexibility is important. A birth plan is a set of preferences, not a script. The most important thing is that you and your baby are safe and well.

What pain relief options are available?

The NHS offers a range of pain relief options during labour, from natural techniques to medical interventions. You do not need to decide in advance, and you can change your mind at any point.

Non-medical options

  • Breathing and relaxation techniques. Useful throughout labour and can be combined with any other method.
  • Water (birth pool or bath). Warm water can ease pain during contractions and is associated with shorter first-stage labour in some studies.
  • TENS machine. A small device that sends mild electrical pulses through pads on your back. Most effective in early labour. You can hire or buy one in advance.
  • Movement and positioning. Staying upright and active can help manage pain and may speed up labour.
  • Massage and counter-pressure. Your birth partner can apply pressure to your lower back during contractions.
  • Hypnobirthing. A set of relaxation, visualisation, and breathing techniques that can help reduce anxiety and pain perception. Available through private courses, NHS classes, or self-study.

Medical options

  • Gas and air (Entonox). A 50/50 mix of nitrous oxide and oxygen that you breathe through a mouthpiece. You control the dose yourself, and it leaves your system quickly. Available in all birth settings.
  • Pethidine or diamorphine injection. Given as an injection into your thigh, these opioid painkillers take about 20 minutes to work and last 2 to 4 hours. They can make you feel drowsy and may affect the baby's breathing if given too close to birth.
  • Epidural. A regional anaesthetic injected into the space around the nerves in your lower back. It provides the most effective pain relief, blocking sensation from the waist down. An anaesthetist administers it, so it is only available in hospital. It can be topped up as needed. Potential side effects include a drop in blood pressure, reduced ability to push, and a slightly higher rate of instrumental delivery.
  • Remifentanil PCA. A newer option available in some hospitals, delivered through a drip that you control with a button. It provides rapid pain relief that wears off quickly between contractions.

How can you prepare emotionally?

Attend antenatal classes

Antenatal classes cover labour, birth, and early parenting. They are also a great way to meet other expectant parents in your area. Options in the UK include:

  • NHS antenatal classes. Free and available through your maternity unit. Ask your midwife about what is offered locally.
  • NCT classes. Paid courses run by the National Childbirth Trust. They typically cover labour, birth, and postnatal topics over several sessions.
  • Online courses. Many providers offer flexible online options, which can be helpful if your schedule or location makes in-person classes difficult.

Talk about your worries

Fear of labour is extremely common and completely valid. If your anxiety about birth is severe, you may have tokophobia, and your midwife can refer you for specialist support. For general worries, simply talking to your midwife, your partner, or other parents can help put things in perspective.

Prepare your birth partner

Your birth partner plays a vital role during labour. Encourage them to:

  • Attend antenatal classes with you
  • Read your birth plan and understand your preferences
  • Practice massage, breathing, and relaxation techniques with you
  • Know the route to hospital and where to park
  • Pack their own bag with snacks, a phone charger, and comfortable clothes

What to pack in your hospital bag

If you are giving birth in a hospital or birth centre, have your bag packed and ready from about 36 weeks. Essentials include:

  • Your maternity notes and birth plan
  • Comfortable clothes for labour (an old t-shirt or nightdress)
  • Dressing gown and slippers
  • Toiletries, hair ties, and lip balm
  • Snacks and drinks for you and your birth partner
  • Clothes and nappies for the baby
  • A going-home outfit for you and baby
  • Car seat if you are driving home
  • Phone charger

For a full breakdown, see our Hospital Bag Checklist guide.

What happens in the weeks leading up to your due date?

Midwife appointments

From 36 weeks, you will see your midwife more frequently (usually weekly or fortnightly). They will check your baby's position, your blood pressure, and your urine. They will also discuss your birth plan and answer any questions.

Baby's position

By 36 weeks, most babies settle into a head-down position (cephalic presentation). If your baby is breech (bottom or feet first), your midwife may offer external cephalic version (ECV), a procedure where a doctor gently tries to turn the baby by pressing on your abdomen. This is successful in around 50% of cases.

Membrane sweep

From 40 weeks (or 41 weeks in some areas), your midwife may offer a membrane sweep. This involves gently separating the membranes around the baby from the cervix during an internal examination. It can encourage labour to start naturally and may reduce the need for formal induction. It can be uncomfortable but is generally safe.

Key takeaways

  • Labour typically begins between 37 and 42 weeks, with most first babies arriving around 40 weeks and 5 days
  • Signs that labour is approaching include a show, more frequent Braxton Hicks, and your baby dropping lower in your pelvis
  • True contractions are regular, get longer, and get stronger over time
  • You have choices about where to give birth: hospital, birth centre, or home
  • A birth plan helps communicate your preferences but should remain flexible
  • Pain relief ranges from breathing techniques and water to gas and air, opioids, and epidurals
  • Antenatal classes, open conversations, and a prepared birth partner all help you feel more confident
  • Have your hospital bag packed and ready from 36 weeks

Sources

  • NHS. Signs that labour has begun. nhs.uk
  • NICE Clinical Guideline CG190. Intrapartum care for healthy women and babies. 2014, updated 2023
  • RCOG. Choosing to have your baby in a midwifery-led unit. 2023
  • The Birthplace in England Collaborative Group. Perinatal and maternal outcomes by planned place of birth. BMJ. 2011
  • Beckmann MM, Stock OM. Antenatal perineal massage for reducing perineal trauma. Cochrane Database of Systematic Reviews. 2013
  • NHS. Where to give birth: the options. nhs.uk
  • NHS. Pain relief in labour. nhs.uk

Frequently asked questions

When does labour usually start?

Most babies are born between 37 and 42 weeks of pregnancy. Your estimated due date is calculated at 40 weeks, but only about 4% of babies arrive on their exact due date. First babies tend to arrive a little later, with the average being around 40 weeks and 5 days.

What are the early signs that labour is approaching?

In the days or weeks before labour begins, you may notice some of these changes.

How do you know when labour has actually started?

True labour has three key features that distinguish it from pre-labour or Braxton Hicks:

What choices do you have about where to give birth?

In the UK, you typically have three options.

What should your birth plan cover?

A birth plan is a way of communicating your preferences to the people caring for you during labour. It does not need to be complicated. Key things to consider include:

What pain relief options are available?

The NHS offers a range of pain relief options during labour, from natural techniques to medical interventions. You do not need to decide in advance, and you can change your mind at any point.

How can you prepare emotionally?

### Attend antenatal classes

What to pack in your hospital bag

If you are giving birth in a hospital or birth centre, have your bag packed and ready from about 36 weeks. Essentials include:

Sources

  1. NHS. Signs that labour has begun
  2. NICE Clinical Guideline CG190. Intrapartum care for healthy women and babies. 2014, updated 2023
  3. RCOG. Choosing to have your baby in a midwifery-led unit. 2023
  4. The Birthplace in England Collaborative Group. Perinatal and maternal outcomes by planned place of birth. BMJ. 2011
  5. Beckmann MM, Stock OM. Antenatal perineal massage for reducing perineal trauma. Cochrane Database of Systematic Reviews. 2013
  6. NHS. Where to give birth: the options
  7. NHS. Pain relief in labour

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