Ethan Rhodes
There are several factors to consider when deciding whether to call the hospital when in labour. For first-time mothers, it is recommended to go to the hospital when contractions are three to four minutes apart for two hours. If you've given birth before, it is suggested to go to the hospital when contractions occur every five minutes for one hour. Other signs that indicate it's time to go to the hospital include your water breaking, vaginal bleeding, decreased fetal movement, and dilation of the cervix to more than 4 cm. It is always better to err on the side of caution and seek medical advice if you are unsure or concerned about your labour progress.
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What You'll Learn
When to call your midwife or hospital
It is important to know when to call your midwife or hospital during labour. Here are some guidelines to help you navigate this:
- Early labour signs: Call your midwife or hospital immediately if you experience any early labour signs, such as your body feeling energised, contractions, or carrying your baby lower in your belly. They can provide guidance and instructions to help you through this stage.
- Water breaks: If your water breaks, call your midwife or hospital for instructions. They may advise you to come to the hospital to reduce the risk of infection and prepare for delivery.
- Contractions: Timing your contractions is crucial. If they occur regularly, last for at least one minute each, and happen every five minutes or less for at least one hour, it's time to call and consider heading to the hospital. This is often referred to as the 5-1-1 rule.
- Cervical dilation: If your cervix has dilated to more than 4 cm, indicating active or established labour, call your midwife or hospital. At this stage, you will experience stronger, longer, and more regular contractions.
- Vaginal bleeding: Contact your midwife, doctor, or hospital immediately if you experience vaginal bleeding that is more than just spotting.
- Baby's movements: If you notice a significant decrease in your baby's movements, get in touch with your midwife or doctor, or go to the hospital right away.
- Health concerns: If you have any concerns about your health during pregnancy or labour, don't hesitate to seek advice from your midwife, doctor, or healthcare provider.
Remember, every labour is unique, and it's always better to err on the side of caution. Stay in close communication with your midwife or healthcare provider, who can guide you through the process and advise you on when to head to the hospital or birthing centre.
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False labour vs true labour
False labour, also known as Braxton Hicks, can feel a lot like true labour and can be confusing. It is common for women to mistake false labour for true labour and proceed to the hospital. However, there are some key differences between the two.
Braxton Hicks contractions are often referred to as "false labour" or "prodromal labour". They are real in the sense that your body is producing the sensations you feel, but they are usually mild and painless. They are unpredictable and irregular, and they do not result in any changes to the cervix. They can be managed with rest and fluid intake and may even stop with a change in position or movement.
On the other hand, true labour contractions are intense, regular, and progressive. They occur at regular intervals, getting closer together and lasting longer. They are not affected by rest, hydration, or changes in position or movement. True labour contractions cause cervical changes, including dilation and effacement, which are necessary for vaginal delivery.
It is important to note that every pregnancy and labour is unique, and it can be difficult to determine what is "normal" for an individual. If you are unsure whether you are experiencing false labour or true labour, it is always a good idea to call your doctor or midwife. They can evaluate your symptoms and determine if you need to seek medical attention.
Additionally, there are other signs that may indicate true labour has begun, such as bloody discharge or your water breaking. It is important to monitor your contractions and any other symptoms to help determine if you are in true labour.
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Water breaking
The exact timing of water breaking varies depending on how far along the pregnancy is and whether there are any health conditions present. For most people (up to about 90%), labour starts before their water breaks. However, in some cases, the water breaks first, and then contractions may not start immediately. This can be perfectly normal, and it just means that the body needs some time to kick into labour.
If your water breaks at home, there is no need to rush to the hospital immediately. However, it is important to call your healthcare provider right away and follow their instructions. They may advise you to stay home and wait for contractions to start or they may want you to come in for an evaluation. If you are uncertain for more than a couple of hours, it is recommended to get checked out at your doctor's office or the hospital.
If your water breaks before 37 weeks of pregnancy, it is considered preterm and you should head to the hospital right away, regardless of whether you are having contractions or not. Your healthcare provider may be able to use medication to delay delivery, but this usually requires careful monitoring in the hospital.
It is important to note that the amniotic membrane protects the baby from infection. Therefore, if the membrane is broken, the risk of infection increases. As a precaution, some doctors recommend avoiding taking a bath after your water breaks to reduce the risk of infection.
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Contractions
Knowing when to go to the hospital can save you from getting there too soon or not soon enough. If you're in early labour, it's best to stay at home and rest. During this stage, contractions are mild to moderate, coming more than five minutes apart (and up to 20 minutes apart), lasting 30 to 45 seconds each. False labour, or prodromal labour, is fairly common and can be pretty convincing. You may feel contractions, but your cervix is not dilating or effacing.
If you're in active labour, it's time to head to the hospital, especially if you've been pregnant or given birth before. A good rule of thumb is the 5-1-1 rule: contractions happening at least every 5 minutes, lasting for 1 minute each, and have been consistent for at least 1 hour. For first-time mothers, healthcare providers typically recommend going to the hospital once contractions are three to four minutes apart for two hours. If you've given birth before, your labour is likely to progress more quickly, so it's suggested you go to the hospital once contractions occur every five minutes for one hour.
If you're unsure whether you're in false labour or true labour, it's best to call your doctor or midwife, who can advise whether you need to go to the hospital. It's healthier for you and your baby to err on the side of caution. If your water breaks, whether you're experiencing contractions or not, go to the hospital to reduce the risk of infection. Note the colour, odour, and amount of fluid.
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Vaginal bleeding
In early pregnancy, light bleeding, known as "spotting", is common and harmless. This occurs when the embryo implants itself in the womb wall. However, during the first 12 weeks, vaginal bleeding can indicate a miscarriage or ectopic pregnancy. If bleeding occurs at this stage, contact your midwife or GP immediately. An ectopic pregnancy is a dangerous situation in which the fertilised egg implants outside the womb and cannot develop properly.
Later in pregnancy, vaginal bleeding can be a sign that labour is approaching. This is known as the "bloody show", when the cervix begins to open and the blood vessels rupture. It can also be caused by sex, as the cervix thins and dilates in the final weeks of pregnancy. If you experience heavy vaginal bleeding, contact your healthcare provider.
Placenta praevia is a rare condition where the placenta lies low in the uterus and may cover the cervix. It can cause intermittent bleeding in the final months of pregnancy. When labour occurs, the placenta may slip and peel off, resulting in severe bleeding. Placenta accreta is a similar condition where the placenta does not separate after the baby is delivered. This can cause bleeding, depending on the extent of the placenta.
If you are experiencing vaginal bleeding, your doctor will perform tests to determine the cause, including an ultrasound and pelvic examination.
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Frequently asked questions
Call your midwife, hospital, or doctor straight away. You will usually be assessed over the phone.
You may be in labour if you experience regular, painful contractions lasting one minute each and occurring at least every five minutes for more than two hours. This is the transition from early to active labour.
If your water breaks, whether you're experiencing contractions or not, go to the hospital to reduce the risk of infection. Note the colour, odour, and amount of fluid. If the fluid looks green or brown, call your doctor right away.
If you're unsure whether you're in labour, it's best to call your midwife, doctor, or hospital. It's healthier for you and your baby to err on the side of caution.
