when my labor start and what to do?

How can I tell whether my labor has actually started?
It's often not possible to pinpoint exactly when "true" labor begins because early labor contractions might start out feeling like the Braxton Hicks contractions you may have been noticing for weeks.

It's likely that labor is under way, however, when your contractions become increasingly longer, stronger, and closer together. They may be as far apart as every ten minutes or so in the beginning, but they won't stop or ease up no matter what you do. And in time, they'll become more painful and closer together.

In some cases, though, the onset of strong, regular contractions comes with little or no warning. It's different for every woman and with every pregnancy.

When should I call my doctor or midwife?
Toward the end of your pregnancy, your practitioner should give you a clear set of guidelines for when to let her know that you're having contractions and at what point she'll want you to go to the hospital or birth center.

These instructions will depend on your individual situation — whether you have pregnancy complications or are otherwise considered high-risk, whether this is your first baby, and practical matters like how far you live from the hospital or birth center — as well as on your caregiver's personal preference (some prefer an early heads-up).

If your pregnancy is uncomplicated, she'll probably have you wait to come in until you've been having contractions that last for about a minute each, coming every five minutes for about an hour. (Time the interval between contractions starting from the beginning of one and ending at the beginning of the next one.) As a rule, if you're high-risk, she'll want to hear from you earlier in labor.

Don't be afraid to call if the signs aren't clear but you think the time may have come. Doctors and midwives are used to getting calls from women who aren't sure whether they're in labor and need guidance. It's part of their job.

And the truth is, your caregiver can tell a lot by the sound of your voice, so verbal communication helps. She'll want to know how close together your contractions are, how long each one lasts, how strong they are (she'll note whether you can talk through a contraction), and any other symptoms you may have.

Finally, whether or not your pregnancy has been problem-free up to now, and whether or not you think you might be in labor, be sure to call your caregiver right away (and if you can't reach her, head for the hospital) in the following situations:

• Your water breaks or you suspect that you're leaking amniotic fluid. Tell your practitioner if it's yellow, brown, or greenish, because this signals the presence of meconium, your baby's first stool, which is sometimes a sign of fetal stress. It's also important to let her know if the fluid looks bloody.
• You notice that your baby is less active.
• You have vaginal bleeding (unless it's just bloody show — mucus with a spot or streak of blood), constant severe abdominal pain, or fever.
• You start having contractions before 37 weeks or have any other signs of preterm labor.
• You have severe or persistent headaches, vision changes, intense pain or tenderness in your upper abdomen, abnormal swelling, or any other symptoms of preeclampsia.
• Some women assume that various symptoms are just part and parcel of being pregnant, while others worry that every new symptom spells trouble. Knowing which pregnancy symptoms you should never ignore can help you decide when to call your caregiver.

That said, every pregnancy is different and no list can cover all situations, so if you're not sure whether a symptom is serious, or if you just don't feel like yourself or are uneasy, trust your instincts and call your healthcare provider. If there's a problem, you'll get help. If nothing's wrong, you'll be reassured.