The moments when you suspect labour has finally begun can be a mix of adrenaline, excitement, and uncertainty. Knowing exactly who to call and what information they will need is the best way to ensure a calm transition into your birthing experience.
In the UK, the “triage” system is designed to provide 24/7 expert advice. Here is a comprehensive guide on the immediate steps to take, who to contact, and how to manage those early contractions at home.
When labour starts, it is important to directed your energy toward the right medical team.
Do NOT call your GP: General Practitioners do not manage active labour or emergency maternity care.
Do NOT go to A&E: Unless you have a non-pregnancy related life-threatening emergency (like a car accident), A&E is not the right place for a woman in labour.
Do NOT call your community midwife’s personal mobile: Most community midwives work daytime hours and are not “on call” for individual births unless you have a specific home-birth agreement.
Depending on your personalized birth plan, you will have a specific “First Point of Contact.” This is usually a 24-hour service staffed by experienced midwives.
Maternity Triage / Labour Ward
Every maternity hospital has a Maternity Triage or Maternity Assessment Centre (MAC). This is a dedicated emergency room for pregnant and postnatal women.
When to call: Call this number if you think you are in labour, if your waters have broken, or if you have any concerns about your baby’s movements.
Finding the number: This number should be prominently displayed on the front of your “Handheld Notes” or Digital Maternity App. If you cannot find it, call the hospital’s main switchboard and ask for “Maternity Triage.”
Home Birth or Birth Centre Team
If you have planned a home birth or a delivery at a standalone Midwifery-Led Unit (MLU), you will likely have a specific pager or mobile number for the “On-Call Midwife.”
When you call Triage, the midwife will perform a “telephone assessment” to determine how far along you are and whether it is time to come in. Be prepared to answer:
Contraction Pattern: How long does each contraction last (duration), and how many minutes are between the start of one and the start of the next (frequency)?
Gestation: How many weeks and days pregnant are you? (e.g., “39 plus 4”).
Baby’s Movements: Have you felt the baby move as normal in the last 24 hours?
Waters Breaking: Have you had a “gush” or a “trickle” of fluid? What colour was it? (Clear/pink is normal; green or brown requires immediate review).
Vaginal Bleeding: Have you noticed any blood or a “show” (the mucus plug)?
If your contractions are not yet frequent or strong enough, the midwife will often advise you to stay at home. This is because most women progress faster and feel more relaxed in their own environment during the early stages.
Tips for Early Labour Progress
The “4-1-1” Rule: A common guideline to head to the hospital is when contractions are 4 minutes apart, lasting 1 minute each, for at least 1 hour.
Stay Hydrated and Fuelled: Sip water or isotonic drinks and eat light, energy-giving snacks like fruit or toast.
Rest: If it is night time, try to sleep or rest between contractions to save your energy for the “active” phase.
Comfort Measures: Use a TENS machine, take a warm bath, or use a birth ball to help baby descend.
While the midwife may tell you to stay home, you should head to the hospital (or call 999) immediately if:
Your waters are green or brown: This may indicate the baby has passed meconium (their first poo), which requires monitoring.
You have bright red vaginal bleeding: More than a “show” or spotting.
The baby’s movements have slowed down or stopped.
You feel an irresistible urge to push: This usually means the second stage of labour has begun.
You are less than 37 weeks pregnant: This is considered preterm labour and needs immediate medical intervention.
| Step | Action | Why? |
| Check Timing | Note the length and gap of contractions. | Helps midwife assess your progress. |
| Call Triage | Use the number in your maternity notes. | To get professional advice on when to come in. |
| Check Waters | Look at the colour of any leaking fluid. | To rule out fetal distress (meconium). |
| Monitor Movement | Ensure baby is moving normally. | Movement is the best sign of fetal wellbeing. |
Trust your instincts. If you feel like something isn’t right, or if the pain feels unmanageable at home, call the Triage number. Midwives are used to “false alarms”—it is always better to be checked and sent back home than to worry in silence.
Have you already programmed the Triage number into your phone, or do you need help finding out which hospital you are officially “booked” into?
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