Monitoring Contractions: Hospital Methods And Tools

When a pregnant person goes into labour, their cervix dilates (opens) and effaces (thins out), and the muscles around their uterus contract to help the baby move down and through the birth canal. The frequency and duration of contractions are measured to determine the stage of labour and whether it is time to go to the hospital. This can be done at home or in the hospital with a contraction monitor.

Frequency: the time from the start of one contraction to the next

Frequency is the time measured from the start of one contraction to the start of the next. This includes the contraction and the rest period until the next contraction begins. It is measured in minutes.

When you call your healthcare provider or hospital, you will need to provide information about the frequency of your contractions and how long this has been the pattern. Regular contractions are when the duration and frequency are stable over a period of time. For example, contractions lasting 60 seconds and coming five minutes apart for an hour. Irregular contractions are when there isn't a stable pattern. For example, a series of three contractions lasting between 30 and 45 seconds and coming 10, seven, and then 15 minutes apart.

Over the course of labour, contractions get longer, stronger, and closer together. This means that in early labour, contractions are spaced further apart, and as labour progresses, they become closer together. This is an indication that the cervix is opening and softening.

Frequency is the most important measurement for knowing when to call your healthcare provider. If contractions are 5 minutes apart or rapidly increasing, or you are already dilated to 5 cm or more, it is time to call. If you have fast deliveries, it would be a good idea to call closer to 6-minute intervals.

Duration: how long each contraction lasts

During labour, it's important to keep track of the duration and frequency of your contractions. Duration refers to how long each contraction lasts, from the moment it begins to the moment it ends. This is typically measured in seconds.

In the early stages of labour, contractions tend to be shorter and spaced further apart. As labour progresses, contractions generally increase in duration and frequency. They may become longer, stronger, and closer together, indicating that the baby is on the way.

The duration of contractions can vary, and there is no set pattern. They may last anywhere from 30 seconds to 2 minutes. In active labour, contractions typically last about 45 seconds to 2 minutes and can be as close as 3 minutes apart. During this stage, labour can last from 4 to 8 hours.

It's important to monitor the duration and frequency of contractions to determine when to seek medical assistance or go to the hospital. If contractions are 5 minutes apart, lasting for 1 minute each for 1 hour or longer, it's generally recommended to head to the hospital. Additionally, if you feel the urge to bear down and push, it's an indication that labour is progressing, and you should contact your healthcare provider.

Intensity: how strong each contraction is

When measuring the intensity of contractions, healthcare providers will look at how strong each contraction is. This is one of the three features, along with frequency and duration, that is used to evaluate whether true labour is progressing.

The intensity of contractions is measured on the vertical axis of a contraction monitor. Each small block on the monitor represents 10 seconds, while each bold line represents one minute. The higher the peaks on the monitor, the greater the cervical change (dilation). If contractions are peaking regularly near 75, labour is progressing. If the patient is on Pitocin, higher intensities can be expected as the dosage increases.

The intensity of contractions can also be assessed by palpating the woman's abdomen in the area of the fundus (top) of the uterus. In between contractions, when the uterus is relaxed, the fetal parts can be felt. However, when a strong contraction occurs, the abdominal wall over the uterus becomes very tense and painful, and the fetal parts can no longer be felt.

Another method for assessing the intensity of contractions is electrical uterine monitoring (EUM), which measures numerous points on the uterine surface, allowing for the evaluation of the progression of the contraction wave. EUM has been found to be a sensitive method for improving external uterine monitoring during term labour for both non-obese and obese women. However, it is important to note that EUM may not be suitable for all patients, and other methods such as intrauterine pressure catheter (IUPC) may be used in certain cases.

True vs false labour: true contractions get stronger over time

True labour contractions are those that cause cervical dilation or effacement. They get longer, stronger, and closer together as labour progresses. In true labour, contractions last about 30 to 70 seconds and come about 5 to 10 minutes apart. They are so strong that you cannot walk or talk during them. The pain doesn't go away when you move or change positions.

False labour contractions, on the other hand, do not cause cervical dilation or effacement. They are often described as irregular and do not get closer together or stronger over time. False labour contractions can begin in the second or third trimester and can range from a completely painless tightening to a jolt that takes your breath away. They can sometimes increase in frequency as the due date approaches.

It can be challenging to distinguish between true and false labour contractions, especially if it is your first pregnancy. If you are unsure, it is always best to consult a healthcare professional. They will be able to evaluate your contractions and determine if you are in true labour.

To measure contractions in a hospital, healthcare professionals use a contraction monitor. This tool helps to time the contractions and determine their frequency and duration. The monitor displays a graph with small blocks, each representing 10 seconds, and bold lines representing one minute. The vertical axis measures the intensity of the contractions, indicating the length of each contraction.

When to go to the hospital: if contractions are 5 mins apart, lasting 1 min, for 1 hour or four or less contractions per hour

Timing your contractions is a good way to know when to go to the hospital. You should measure the duration of your contractions (how long each contraction lasts) and their frequency (how close together they are). Duration is measured from the beginning of a contraction to the end, usually in seconds. Frequency is measured from the start of one contraction to the start of the next and is measured in minutes.

If your contractions are 5 minutes apart, lasting for 1 minute each, and have been consistent for at least 1 hour, it's generally recommended that you go to the hospital. This is known as the 5-1-1 rule. If you're unsure, it's always best to call your healthcare provider for guidance. They may recommend a different guideline, such as the 4-1-1 rule (contractions every 4 minutes) or 3-1-1 rule (contractions every 3 minutes).

It's important to note that labour can be different for everyone, and it may be tricky to recognise true labour. False labour, or Braxton-Hicks contractions, can happen close to your due date and may exhibit regular intervals. However, false labour contractions will not cause your cervix to open up. During early labour, you may feel achy and uncomfortable, but it's generally too soon to go to the hospital. As labour progresses, contractions usually get longer, stronger, and closer together.

If your water breaks, you should call your healthcare provider. They may advise you to wait at home or go to the hospital, depending on your individual situation. It's recommended that you start timing your contractions when you think labour has started to see if there is a pattern. This can help you decide when to go to the hospital.

Frequently asked questions