A woman should talk to her doctor about what the signs of the start of labor are. These include:
- Back pain
- The appearance of bloody show (the discharge of a small amount of blood and mucous from the cervix), which may happen as early as three days before labor starts
- Irregular contractions of varying intensity. The contractions get more regular, are longer, stronger and happen more often as labor continues.
- Breaking of the membranes of the amniotic sac (which lines the woman's uterus and contains the baby during pregnancy). This causes amniotic fluid to leak through the cervix and vagina. When this happens a woman should call her doctor right away. Between 80 and 90% of women with ruptured membranes go into labor within 24 hours. If this doesn't happen and the baby is due, labor is induced to reduce the risk of infection.
When a woman in labor arrives at the hospital, her blood pressure, heart and breathing rates, temperature and weight are recorded. She will be checked for signs of swelling. Blood and urine tests will be given. A physical examination will be done.
The doctor will estimate the size, position and orientation of the baby. He or she will check for the baby's heart sounds. Additionally, the doctor will take note of how long, how intense and how often the contractions are coming.
If labor is active and the baby is due, a labor-and-delivery nurse or a doctor will do an internal examination with a gloved hand to evaluate how the labor is going. This exam maybe delayed if there is heavy bleeding.
If the waters have broken (the amniotic sac's membranes have broken), the doctor or nurse will look for any greenish discoloration that might be a sign of fetal distress.