When should I go to the hospital in labor?
This is the most commonly asked question that I get from labor clients.
There are so many things to consider leading up to the birth of your baby/babies. But the question of “when to go to the hospital?” doesn’t have to induce panic.
After reading the four key ideas below, you’ll have a plan to follow. You’ll keep your body’s fight or flight response from taking over. After all, fear can inhibit the labor process itself. Adrenaline interrupts the flow of oxytocin, the hormone that causes the uterus to contract. When you’re in labor, it is an opportunity to remember your inner confidence and strength.
So inhale courage, exhale fear and check out the guidance for when to go the hospital….
#1. Call your provider (OB, midwife) if you’ve experienced spontaneous rupture of membranes (aka your water breaking) with a trickle, pop, or gush of fluid. Your provider may or may not have you come in to test the fluid to see if it is amniotic fluid.
#2. Call your provider when the timing of your contractions follow the “5-1-1 (or 4-1-1) rule.” This is usually a time when providers recommend you go to the hospital.
5-1-1: Contractions are 5 minutes apart (from the start of one contraction, to the start of the next one). Contractions last about 1 minute. This pattern continues for at least 1 hour.
4-1-1: Contractions are 4 minutes apart (from the start of one contraction, to the start of the next one). Contractions last about 1 minute. This pattern continues for at least 1 hour. *Some people who want to avoid spending more time in the hospital use the 4-1-1 rule.
Some people wonder, “but when should I start timing my contractions?”
Don’t obsess. Just start timing when they start interrupting your conversation or taking your breath away. You do not need to time every contraction. Record 5-6 contractions in a row, then stop for a while. When the pregnant person thinks contractions have changed or is experiencing signs of labor, time and record another 5-6 contractions.
There are some apps for tracking/timing contractions: BabyCenter, WebMD Pregnancy App, Full Term Contraction Timer. Or you could do it the old fashioned way (pen and paper):
Note the time each contraction begins.
Time the length of contractions in seconds. It can be tricky to know when a contraction ends. Let the laboring person signal when the contraction has started and ended.
Note the interval (the start of one contraction to the start of the next contraction). Contractions about 4-5 minutes apart are usually a sign of active labor. As you progress in labor, contractions get longer, stronger, and closer together over time.
If your contractions are intermittent or more than 5 minutes apart you are likely still in “early labor” which can last on average 12-24 hours for first-time birthing persons. In early labor, it is best to get rest, eat when you’re hungry, drink when you’re thirsty, watch your favorite shows, and go about your normal day.
Okay, you’ve got this. Last two tips for when to go to the hospital….
#3. Listen to YOUR INSTINCTS. How are you feeling (physically and emotionally)? It is ALWAYS up to you when you can go.
#4. If you’re still not sure, TALK IT THROUGH WITH YOUR SUPPORT PEOPLE (partner, doula, etc).
A NOTE ABOUT PRE-TERM LABOR: If you are less than 37 weeks pregnant and experience 4 or more noticeable contractions in 1 hour for more than 2 hours combined with any other possible labor signs like a trickle or gush of fluid or blood-tinged mucus discharge, consult your provider. This may be premature labor, which can sometimes be stopped if caught early. They may ask you to go in and be checked, to drink some fluids, lie down to see if contractions stop. If they don’t stop, they’ll ask you to come into their office/hospital to determine if it’s preterm labor.
About the Author: Kathleen Stern, the founder of Boston Area Doulas, is a certified labor and postpartum doula. She supports birth clients at hospitals all over Boston, including but not limited to Beverly Hospital, North Shore Birth Center, Winchester Hospital, Salem Hospital, MGH/Mass General, Mount Auburn Hospital, Brigham and Women’s, Beth Israel, CHA Cambridge Hospital, MelroseWakefield Hospital.
