What does labour feel like? Early, active and pushing contractions in plain words, and when to call the hospital

What does labour feel like? Most women describe early contractions as period cramps that come and go, with a low backache. KKH's doctors describe real contractions as menstrual cramps "but much worse", building to a peak and fading, while your bump goes as hard as a rock. In active labour they get stronger, closer together and harder to talk through. When your cervix is fully open you feel an urge to bear down that KKH compares to needing to do a poo, then stretching as your baby's head comes down. Pain is personal, and how much you feel depends on your labour and the pain relief you choose. Go to the hospital when the pain is persistent and getting steadily worse, and go straight away if you bleed, leak water, or your baby moves less.

Every labour is different, and first ones usually take longest. Here is what each stage tends to feel like, in the words Singapore's hospitals use and one Singapore mum's, plus how to tell real labour from practice tightenings and when to call.

What contractions feel like

A contraction is your womb muscle tightening to open your cervix and push your baby down. HealthHub describes contractions as waves of muscular pulling, sometimes like period cramps or like needing the toilet, that get stronger, peak and then fade before the next one. Between them you get a break, which shortens as labour moves on.

• Where you feel them: SingHealth says the pain is in your lower abdomen and sometimes your back.
• How they start: KKH's doctors say labour contractions begin briefly and more than 30 minutes apart, then get closer and last longer. A real contraction lasts about a minute.
• What your bump does: it tightens and feels hard to the touch during each one.
• What else you may feel: heaviness in your pelvis and lower back pain as your baby's head moves down into the pelvis.

Hannah Loke, a first-time mother interviewed by The Straits Times in an article SGH republished, compared her early contractions to mild period cramps that intensified as labour progressed. Many mums say much the same.

What labour feels like at each stage

Early labour

At the start you may feel low backache and on-off contractions, HealthHub says. The latent phase can last many hours, and the contractions are usually not so painful at this stage. Most women can walk around, eat lightly, rest and even sleep between them. Some get a show, a bit of blood-stained mucus. Our contraction timer helps you see whether they are settling into a pattern.

Active labour and transition

As contractions get stronger and more regular you move into active labour, and HealthHub says this is when you need to be in the labour ward. Each contraction takes your full attention: you will probably stop talking, lean on something or someone, and breathe through it. After about 4cm, KKH's rough guide is that your cervix opens about 1cm an hour. The last few centimetres before full dilation, often called transition, are when contractions are at their strongest and closest together. Some women feel shaky or sick here, or say they cannot go on, and that is often a sign the pushing stage is close. This is when most women in Singapore ask for pain relief, if they have not already.

Pushing and the birth

When your cervix is fully open, your body gives you an urge to bear down. KKH describes it as the same sensation as needing to do a poo, because your baby's head is pressing on your back passage. SingHealth says this bearing-down pressure pushes your baby down the birth canal, and the muscles and tissues of the vagina stretch as it does. Some women find pushing easier to bear than late active labour, because they can work with each contraction. You may feel a stinging stretch as the head is born. Our guide on how to push during labour covers breathing and positions.

After the birth

The placenta comes out after your baby, usually within 5 to 30 minutes, SGH says. HealthHub notes most mothers are so busy cuddling their baby that they barely notice this stage. You will feel the midwife or doctor press on your tummy, and any stitches. Over the next few days, afterpains, a mild ache in your lower abdomen as your womb shrinks, are common and feel stronger when you breastfeed.

Real labour or Braxton Hicks?

From around 28 weeks many women feel practice tightenings called Braxton Hicks. KKH's doctors describe them as coming at irregular times and classically feeling like painless tightenings. Real contractions feel like your usual period cramps but much worse, get progressively stronger, and come closer together.

Preterm labour can feel milder than you expect: KKH warns it may feel like mild period cramps or a backache. Regular, painful tightenings before 37 weeks need checking. Our signs of labour guide and premature labour signs guide go through this in more detail.

How much does labour hurt?

There is no honest single answer. KKH's anaesthetists say each woman feels labour pain differently, depending on her past experience, how long labour lasts and whether drugs are used to speed it up. Most women in Singapore use some pain relief: at SGH's labour ward, between 56% and 65% of women took an epidural from January to July 2024, according to a Straits Times report the hospital published, and KKH's head of women's anaesthesia says the epidural is the most preferred pain relief there. KKH's anaesthetists say laughing gas (Entonox) satisfies up to half of the women who use it. An epidural reduces the pain a great deal. Some women still feel pressure while pushing.

Hannah Loke, who gave birth without medication, used low sounds to stay relaxed. "High-pitched sounds tense up the muscles, but low sounds help you relax," she said. Breathing, moving and warm water all help in early labour, whatever you plan to do later. Our epidural and labour pain relief guide compares the options, and our guide to stages of labour and dilation explains what is happening at each point.

When the pain means call the hospital

For normal labour, Singapore hospitals give slightly different rules of thumb:

• HealthHub: wait a while if you are not sure; go when the pain is persistent and getting progressively worse.
• SGH: for example, contractions every 10 to 15 minutes for more than 2 hours.
• KKH (HealthXchange): contractions about 5 minutes apart and persistent for more than 2 hours.
• NUH: regular contractions 5 to 15 minutes apart.

If this is your first baby and you are unsure, call the delivery suite. After a check, KKH says you may be admitted or advised to return home, which is common in early labour and nothing to be embarrassed about.

Frequently asked questions

Do contractions feel like period cramps?

Often, at first. KKH's doctors say real contractions feel like your usual period cramps but much worse, and they keep getting stronger and closer together.

Does labour feel like needing a poo?

In the pushing stage, yes. KKH describes the urge to push as the same sensation as needing to do a poo, because your baby's head presses on your back passage.

How long does each contraction last?

KKH says a real contraction lasts about a minute. They start more than 30 minutes apart and get closer together as labour goes on.

Can you be in labour and not know it?

In early labour, sometimes. KKH notes that early labour can feel like mild period cramps or a backache. If tightenings become regular or painful, or you are under 37 weeks, call your hospital.

Will the hospital send me home if I go in too early?

They may. KKH says that after you are assessed you may be admitted to a delivery room or antenatal ward, or advised to return home. Going in to be checked is still the right call if you are unsure.