When to go to the hospital for labor

When to go to the hospital for labor

It depends, but for women with an uncomplicated pregnancy, it's usually time to go to the hospital when your contractions have been coming at regular intervals (such as every four or five minutes), lasting about a minute each, for an hour or more. The goal is to go when you're in active labor.

Toward the end of your pregnancy, your doctor or midwife will most likely give you clear guidelines about when to let them know that you're having contractions, and when to grab your hospital bag and head to the hospital or birth center.

Your instructions will depend on your individual situation – such as whether you have a high-risk pregnancy or other complications, if this is your first baby, if you've had fast labors in the past, if you're planning a cesarean delivery, if you're group B strep positive, and how far you live from the hospital or birth center.

If you're unsure whether it's time, go ahead and call. Doctors and midwives are used to getting calls from women for guidance about whether they're in labor.

When you call, your doctor or midwife will get some clues about your condition from the sound of your voice. They'll want to know:

• How close your contractions are
• How long each contraction lasts
• How strong the contractions are
• If you think your water has broken
• If you're having vaginal bleeding
• If you're feeling your baby move normally

What do early contractions feel like?

A contraction is a tightening and relaxing of the uterine muscles, stimulated by the hormone oxytocin. For some women, contractions begin slowly and feel like mild cramps, similar to a menstrual period or gas pain. For others, contractions are intense – clenching and painful – and hit suddenly and hard from the get-go.

As they progress, you'll feel the contractions coming in waves – building in intensity, peaking, and fading. The time between contractions will shorten as your labor progresses.

Women often feel the tightening start in the back and move to the front. Some women just feel some pressure in the back. During a contraction, your abdomen will become hard.

Read more about what contractions feel like during labor.

How to count contractions

Counting your early contractions provides valuable information about how far along you are in your labor.

Your doctor or midwife may recommend the 5-1-1 guideline, which means you should head to the hospital when you're having contractions five minutes apart, they're lasting one minute each, and they've been coming for an hour. Or they may recommend another guideline, such as 4-1-1 (contractions every four minutes), 3-1-1 (contractions every three minutes), or even 3-1-2 (contractions every three minutes lasting about a minute each, for about two hours).

Here's how to count contractions:

1. Start counting as soon as you've had a few contractions. Write down the time so you can keep track of when the contractions started.
2. When a contraction starts, count the number of seconds it lasts. (You can use the stopwatch on your phone.) When contractions start, they may last about 30 seconds but get increasingly longer and stronger.
3. Note when a new contraction starts. Measure the amount of time between contractions from the beginning of one to the beginning of the next. (It's not the time between when one stops and the next one starts.)

To make things easier, there are many apps you can use for timing your contractions. BabyCenter's Pregnancy Tracker includes a contraction timer, along with many other helpful resources.

If your contractions are irregular or seem to be slowing down rather than speeding up, it may help to get some activity. For example, walking around sometimes helps encourage more contractions.

Real contractions vs false labor

Braxton Hicks contractions can trick you into thinking you're in labor when you're not. But there are ways to tell whether you're having real labor contractions or false labor.

For example, Braxton Hicks contractions:

• Usually aren't painful (though they can be)
• Are irregular, with no pattern
• Usually taper off rather than gain strength
• Are felt only in the front (real labor contractions often start in the back and move to the front)
• Are infrequent
• May stop when you change positions or move around

To ease Braxton Hicks contractions, you might try drinking some water (they're sometimes brought on by dehydration) or changing activity or position. Having a full bladder, being very active, and having sex can also trigger false labor.

If you're having regular, persistent contractions of any kind, call your midwife or doctor, especially if you aren't yet 37 weeks pregnant.

What if I'm having contractions but my water hasn't broken?

Movies and TV shows often show a pregnant woman's water breaking dramatically when she starts having contractions. But that's not usually how it happens.

In fact, your water can break before labor begins, while you're having contractions, or even right before you deliver your baby. If you're having a cesarean delivery, your water may not break at all.

If your water breaks before you're 37 weeks pregnant, it's called preterm premature rupture of the membranes, or PPROM. If this happens, contact your provider right away.

Sometimes, if your water doesn't break on its own and you're already at the hospital for labor, your doctor or midwife may recommend breaking your water by piercing the amniotic sac with a thin tool. This is called an amniotomy, and it doesn't hurt.

Learn what it feels like when your water breaks and what to do.

When to call your provider or go to the hospital right away

There are times when it's important to call your provider or head to the hospital right away, no matter how many contractions you are or aren't having.

Take action immediately if:

• You have signs of labor and have been having pregnancy complications
• You have signs of labor before 37 weeks (preterm labor)
• Your water breaks and you notice meconium in your amniotic fluid (it looks greenish or is streaked with green, brown, or yellow). This may be a sign that your baby is under stress.
• You notice that your baby is less active
• You have vaginal bleeding, constant and severe abdominal pain, or a fever. These may be signs of a problem with your placenta, such as placental abruption or an intrauterine infection.
• You have symptoms of preeclampsia (a very serious blood pressure disorder) such as abnormal swelling, severe or persistent headaches, vision changes, intense pain or tenderness in your upper abdomen, dizziness, or difficulty breathing.

If your water breaks, call your provider. They may have you wait at home until you have regular contractions or a certain amount of time has passed (the risk of infection increases 6 to 12 hours after your water breaks). Or, they may want you to head to the hospital. If you tested positive for group B streptococcus, for example, your provider will want you to go to the hospital as soon as your water breaks so you can start receiving antibiotics.

Learn more:

• When will my baby drop?
• How to push during labor
• The stages of labor and delivery
• What happens to your baby right after birth