Hailey Tran
Knowing when to go to the hospital during labour can be tricky. It's important to call your provider or head to the hospital right away if your water breaks and you notice meconium in your amniotic fluid, you have vaginal bleeding, constant and severe abdominal pain, or a fever. Usually, it's time to head to the hospital when your contractions have been coming at regular intervals of about four to five minutes, lasting about a minute each, for an hour or more. This is often referred to as the 5-1-1 rule. However, first-time mothers are typically advised to go to the hospital when contractions occur every three to four minutes for two hours.
| Characteristics | Values |
|---|---|
| Time between contractions | Every 3-5 minutes |
| Duration of contractions | 45-60 seconds |
| Total duration | 1 hour |
| Water breaking | Yes |
| Vaginal bleeding | Yes |
| Severe abdominal pain | Yes |
| Fever | Yes |
| Mucus plug loss | Within a few hours |
| Nausea | Yes |
| Diarrhea | Yes |
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What You'll Learn
The '5-1-1 rule'
Knowing when to go to the hospital during labour can be tricky. False labour, also known as prodromal labour, is fairly common and can be pretty convincing. However, there are some guidelines to help you assess whether you are experiencing true labour contractions.
The 5-1-1 rule is a tool for assessing the difference between warm-up contractions and actual labour contractions. It is also a good indicator of labour progress because it reflects a pattern typical at the end of early labour and the beginning of active labour.
The rule states that you should head to the hospital when you're having contractions five minutes apart, lasting one minute each, and they've been coming for at least one hour. This rule can also be modified to 4-1-1, 3-1-1, or 3-1-2, depending on your specific situation. For instance, if you live far from the hospital or have other special concerns, you may need to leave sooner.
It is important to note that labour is not linear, and contraction patterns can vary. They may get longer, stronger, and closer together, or they may spread out to be further apart. Braxton Hicks contractions can also be misleading, as they can sometimes be triggered by dehydration, a full bladder, or sexual activity.
If you are unsure, it is always best to contact your prenatal healthcare provider for guidance. They will be able to advise you based on your individual situation and provide clear guidelines on when to head to the hospital.
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Braxton Hicks contractions
It is important to note that Braxton Hicks contractions do not mean that labor is starting. They can occur weeks or even months before real labor begins and do not cause labor. However, as you get closer to your due date, Braxton Hicks contractions will become more frequent and intense, and may even be referred to as false labor. If you are unsure whether you are experiencing Braxton Hicks or true labor contractions, contact your doctor or midwife.
There are some things you can do to feel more comfortable during Braxton Hicks contractions. For example, taking a walk or changing positions can help ease the discomfort. It may also be helpful to practice your breathing exercises during these contractions. Braxton Hicks contractions are normal and common, and there is no need to worry or seek treatment unless you feel uncomfortable.
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False vs true labour
False labour, also known as Braxton Hicks contractions, is when your body gets ready for true labour. They are often painless, described as a tightening in the belly that comes and goes, and may feel like mild menstrual cramps. They do not cause labour or open the cervix. False labour contractions do not have a pattern and do not get closer together. They may stop when you walk or rest, or change positions. They are usually weak and may be strong at first and then get weaker.
True labour contractions come at regular intervals and last about 30 to 70 seconds. They get stronger and closer together over time. True labour contractions continue even after you move, change positions, or try to rest. They get stronger at a steady pace. You may feel pain in your belly and lower back. This pain doesn't go away when you move or change positions. You may also have an increase in vaginal discharge that can be clear, pink or slightly bloody.
If you are experiencing true labour, it is time to go to the hospital when your contractions are five minutes apart, lasting for one minute, and have been consistent for at least one hour. This is called the 5-1-1 rule. However, some doctors or midwives may recommend a different guideline, such as 4-1-1, 3-1-1, or 3-1-2. It is important to contact your doctor or midwife when you begin experiencing contractions, and they will instruct you on when to leave for the hospital.
There are other times when it is important to go to the hospital right away, regardless of your contractions. For example, if your water breaks and you notice meconium in your amniotic fluid (which may appear greenish, brown, yellow, or streaked with these colours), this may indicate that your baby is under stress. Vaginal bleeding, constant and severe abdominal pain, or a fever may be signs of a problem with your placenta, such as placental abruption or an intrauterine infection. If you have symptoms of preeclampsia, such as abnormal swelling, severe or persistent headaches, vision changes, intense pain or tenderness in your upper abdomen, dizziness, or difficulty breathing, it is important to seek medical attention immediately.
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When to call your doctor
It is important to be aware of the signs that indicate when to call your doctor or midwife. Firstly, if you are experiencing early contractions, it is recommended that you contact your doctor or midwife for guidance. They may advise you to rest at home and let your body progress naturally, which may help you deliver vaginally. If you are experiencing false labour, which is fairly common, you may feel contractions but your cervix will not be dilating. You might be able to tell if you are in false or true labour by checking your symptoms. For instance, if you lose your mucus plug, it could be a sign of labour within a few hours or days, or it may not be related at all. Nausea and diarrhoea can also be signs of approaching labour, but they are not reliable indicators on their own.
If you are in true labour, you will experience regular contractions that become more frequent as labour progresses. You should time your contractions and contact your doctor or midwife when they are occurring at regular intervals of around five minutes apart, lasting for a minute each, and have been consistent for at least an hour. This is known as the 5-1-1 rule. However, some doctors or midwives may recommend different guidelines, such as the 4-1-1 or 3-1-1 rule, or even suggest that first-time mothers stay at home until it becomes difficult to breathe through the contractions. If you are experiencing irregular contractions or Braxton Hicks contractions, you can try drinking water, changing your activity or position, or using tennis balls to roll across your back for relief.
In addition to contractions, there are other signs that indicate you should call your doctor or midwife. If your water breaks, you should contact your provider, especially if you notice meconium in your amniotic fluid, as this may be a sign of stress for the baby. Vaginal bleeding, constant and severe abdominal pain, or a fever could indicate a problem with your placenta or an intrauterine infection, so you should seek medical advice. If you are experiencing symptoms of preeclampsia, such as abnormal swelling, severe headaches, vision changes, intense pain in the upper abdomen, dizziness, or difficulty breathing, it is important to call your doctor immediately.
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Signs labour is 24-48 hours away
While it is challenging to predict the exact time of labour, there are some signs that indicate it is 24 to 48 hours away. Here are some of them:
Weight Loss: It is common to lose 1 to 3 pounds a day or two before going into labour. This weight loss is due to the body shedding excess water weight as a result of decreased amniotic fluid and increased urination as the baby drops in preparation for labour.
Nesting Instinct: An overwhelming desire to prepare the house for the baby is known as the nesting instinct. This is common during the third trimester, and you may find yourself cleaning, organising, and setting up the nursery. However, 24 to 48 hours before labour, your body may go into panic mode, resulting in a sudden burst of energy.
Low Back Pain: As the baby's head moves towards the birth canal, you may experience low back pain. This pain may worsen and radiate to the pelvis area, and changing positions may not provide relief.
Water Breaking: The rupture of the amniotic sac, or water breaking, is a sign that labour is imminent. It can happen naturally due to the increased pressure from the baby's head or artificially by your doctor. The discharge will be more watery than usual and can be clear, pink, yellow, or brown.
Contractions: In the early stages of labour, you may experience contractions that are five to fifteen minutes apart and last about a minute. As labour approaches, the frequency and intensity of contractions increase, occurring every four to five minutes. This is a sign that labour is within 1 to 2 days.
If you are experiencing these signs and are within 24 to 48 hours of your predicted labour, it is important to contact your healthcare provider for guidance and instructions. They will provide specific recommendations based on your individual situation and pregnancy history.
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Frequently asked questions
This depends on the stage of labour, contraction pattern, dilation and fetal heart tracing. Most obstetricians and midwives suggest contacting them when your contractions are five minutes apart, lasting 45 to 60 seconds each, and have been consistent for at least an hour. This is known as the 5-1-1 rule.
False labour contractions won't cause your cervix to open. You might feel contractions, but your cervix is not dilating or effacing. False labour is fairly common and can be caused by dehydration.
Losing your mucus plug, nausea and diarrhoea can be signs that labour is approaching. However, these signs could also be unrelated to labour. Regular contractions are a more definitive sign that the early stage of labour has begun.
If your contractions are irregular or seem to be slowing down, try getting some light activity. Walking around can help encourage more contractions.
Aside from contractions, you should go to the hospital right away if your water breaks, you notice meconium in your amniotic fluid, you have vaginal bleeding, constant and severe abdominal pain, or a fever.
