Are you wondering how you're going to know when the time comes to go to the hospital for labor? Are you worried that you're not going to know if “this is really it”? Is timing labor contractions intimidating to you? Or are you unsure which contractions need to be timed in the first place? I've got you covered.
All the talk about how painful labor is, you'd think that you would know without a shadow of a doubt if it was happening to you or not.
Unfortunately, labor is not so simple. Nothing about motherhood is, is it? Not to worry, though, mama. After reading this post you are going to be really good at timing labor contractions and you will be confident that it's time to go to the hospital when the time finally comes.
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How to tell it's time to go to the hospital for labor
It's important to know when the most appropriate time to head to the hospital is. The first sign that labor might be starting is probably not a good time to head in. Instead, you're going to want to start timing your contractions and making sure that the contractions you're feeling are the real thing.
No one wants to be sent home from the hospital three times because they thought they were in labor but really weren't.
I'm going to be honest with you – that happens all of the time.
Don't worry about it too much. If this does happen to you and you end up getting sent home a time or two, don't feel bad. Figuring out when to head to the hospital for labor can be complicated. Especially for first time moms.
I'm going to try to make it a little more clear for you so that you can be confident that you're really in labor and it's time to go in.
True Labor Contractions
If you're going to start timing your contractions, you're going to need to know if your contractions are worth timing in the first place!
There are lots of different types of contractions that you might feel throughout your pregnancy, at different times in your third trimester, and even as labor progresses.
True labor contractions have one important attribute – they change your cervix. That's the key.
How will I know if my contractions are real?
True labor contractions can start slow but will eventually take on some kind of predictable pattern.
If you start noticing contractions when they are every 10-30 minutes apart and not developing a predictable pattern, you can be pretty confident that you are not in labor.
Those contractions need to get consistently closer together in order for you to even consider whipping out a timer.
Now, say you're feeling contractions on a regular pattern. Great! Are you in labor? Still, maybe not. These regular contractions need also to be painful.
You may have heard from someone somewhere that you can have a pain-free labor. Don't hold your breath (literally). It's going to hurt…even if your mom told you that she never felt any pain until her water broke and you came out 30 minutes later.
Having regular, painful contractions? Yes? Now we can talk labor.
- Related Read: 18 Vital Tips To Manage Labor Pains Like A Boss
Early Labor Contractions
If you have been having uncomfortable contractions for a few days and you feel like nothing is happening, your cervix isn't changing, and you're never going to have this baby, you're experiencing prodromal labor.
Although these early labor contractions can be very painful, they are not making progress to your labor, not dilating your cervix, and not an indication that you need to be admitted to the hospital.
I should warn you… early labor can last all day and night and then just completely go away. Don't get discouraged though. If you thought that you were going into labor and then suddenly it disappears, accept the rest. If it was true labor, nothing would be able to stop it and it would continue to progress until the baby was born.
Thankfully, eventually your early labor pains will progress into the real deal and things will start to change. When that happens, you need to know what active labor really looks (and feels) like.
That's what I'm here for, mama.
How many centimeters is active labor?
You might hear a few different answers to this question in your search for answers. The best answer is the one that your provider is giving you because that is what your labor is going to be measured against.
In the meantime, I still have a good answer for you based on my years of experience as a labor and delivery nurse.
As always when it comes to labor and delivery, the answer is not perfectly straight forward and written in stone.
You might be in your active labor phase if your cervix is between 4-6 cms dilated.
In order to decide whether or not you are in labor, there is more to it than JUST cervical dilation or JUST contraction pattern. There needs to be both.
If you arrive to the hospital contracting every two minutes, have to stop to focus and breathe through each one, and are dilated to 4 cms, you will probably be admitted for active labor.
On the other hand:
If you arrive at the hospital having occasional / irregular contractions that you can talk through (or just stare at the monitor through) and you are dilated to 4 cms, you will probably be discharged to continue your early labor at home.
How Long is Active Labor?
This is a tough one! The answer to this question depends on a few important factors such as what number baby this is for you and whether or not you're being induced.
So, the generalized answer is this:
Although it varies from person to person and each individual is unique in her labor process, active labor typically lasts anywhere from 4 – 8 hours. Of course, if you are being induced it may be longer and if this is not your first baby it may be significantly shorter.
Now, remember…active labor is only a piece of your labor. The longest part of your labor is going to be early labor, where you are trying to get from 1 cm to 5 cms dilated. This can take hours or days. Luckily, early labor is notably less intense and uncomfortable than active labor.
Once you are approximately 5 cms dilated, you can expect to be in active labor for somewhere around 4 – 8 more hours, depending.
How will I know when to go to the hospital for labor?
Every pregnant mama on the planet wants to know the answer to “How will I know when to go to the hospital for labor?”. Unfortunately the answer is not cut and dry. It's different for everyone.
In order to have the best idea about when to go to the hospital for labor, you have to consider three big things:
- Are your contractions adequate/productive?
- What is your medical history?
- How far are you from the nearest labor and delivery?
First thing to consider – Are your contractions adequate?
If you're considering heading to the hospital because you might be in labor, the first thing that you have to evaluated is how effective your contractions are.
Having contractions is not a reason to be admitted to labor and delivery if you are 37 weeks along or further. These contractions have to actually be productive if you want to get admitted.
Productive contractions that are likely to change your cervix are:
- About a minute long – most commonly labor contractions will be 45 -90 seconds. Don't fret if your contractions are even longer than 90 seconds. It happens. Less than 45 seconds? You might just be feeling Braxton Hicks.
- Regular – Contractions that are coming after 5 minutes then 10 minutes, then 6 minutes, then 12 minutes, then 7 minutes are probably not active labor contractions. A predictable pattern should be seen. A pattern that might be considered active labor might look like a contraction after 3 minutes, 5 minutes, 4 minutes, 3 minutes, 4 minutes, 5 minutes. See the difference?
- Frequent – Most of the time, the hospital you deliver at will advise you to consider coming to the hospital for labor if your contractions have been coming every 3-5 minutes for the past 1-2 hours. Contractions that are consistently far apart (10 minutes or more), you can usually expect to have some time before your cervix makes any change.
- Painful – Adequate contractions will stop you in your tracks, take your breath away, and demand your attention every single time. You won't be able to talk and breathe normally through active labor contractions.
Second thing to consider – Your (and your baby's) medical history
You have to consider the health of you and your baby before deciding how long to wait it out at home before going to the hospital for labor.
The list is endless, but here are a few reasons why your answer to “when should I go to the hospital for labor contractions” might be different from the next person:
- You have a history of precipitous deliveries in the past
- You've had multiple babies vaginally in the past
- You've had a cesarean in the past and are attempting a TOLAC (VBAC)
- You are preterm
- Your baby has a diagnosis that requires NICU to be at delivery
Like I said, there are plenty more reasons why timing labor contractions might be different for you. Make sure you talk to your provider during one of your prenatal appointments to determine what is the best for you and your baby.
Third thing to consider – Your location
Five minutes from the hospital you plan to deliver at? Or an hour and a half drive from the nearest labor and delivery?
These two scenarios will require very different durations of timing labor contractions.
When you are timing your labor contractions at home, make sure you consider the drive you will have to take when the time comes. Talk to your doctor or call labor and delivery to determine what might be best for you regarding timing labor contractions from where you're located.
When to go to the hospital during labor
Head to the hospital when you are confident that you are in active labor. If you go to the hospital in early labor and are not yet active, you will likely be sent home anyway. No one wants that!
On the flip side, you don't want to wait too long and head to the hospital when you are in transition because transitional labor is a whole other ball game.
So, what's the trick? How can you be sure?
What I tell my patients is this:
- 4 – Your contractions are at most 4 minutes a part
- 1 – Each contraction lasts at least 1 minute
- 1 – This pattern has lasted for 1 hour or more
It sounds simple, but many mamas can get tripped up on when exactly is time to go to the hospital. These are the common mistakes that new mamas make when timing labor contractions:
- When they begin to have contractions 3-5 minutes apart, they come to the hospital instead of timing labor contractions for an entire hour while they are 3-5 minutes apart consistently.
- Their contractions are regularly 5 minutes apart but they are less than 45 seconds long and only mildly uncomfortable. Labor contractions should be regular AND intense.
- They have been having regular, painful contractions for 2 hours but most of them have been 10 minutes apart with an occasional couple that is 4-5 minutes apart. You want each set of contractions to be regularly 3-5 minutes apart throughout the entire hour.
So, as long as you are listening to your body (and your own provider), typically in these situations, we would advise that you continue to keep timing labor contractions until you meet these recommendations.
How to time labor contractions
Timing labor contractions isn't as simple as it sounds. You wouldn't believe how many people come into labor and delivery unaware that they had been timing their contractions all wrong the whole time.
In order to correctly and accurately time your contractions, you're going to need to take note of three important things:
- The time your contraction starts
- The amount of time that passes before the next contraction starts
- How many seconds each individual contractions last
Did you read that right? Counting labor contractions correctly means that you are recording the time between the beginning of one contraction to the beginning of the next contraction.
So, to find out how far apart your contractions are, you are not measuring the time between contractions. You are measuring the time from start to start.
There are two easy ways to track your contractions:
- My favorite way to track contractions is with paper and pen. There is a contraction tracker sheet for you to print (and reprint as much as you need) in the Ultimate Pregnancy Journal.
- A contraction tracking app on your smart phone
As you time your contractions, pay attention to a pattern. In order to be confident that it's time to go to the hospital for labor, your contractions should be progressively lasting longer, getting closer together, and becoming more painful.
When to go to the hospital for labor with your second baby
If you are pregnant with your second baby (or third, fourth, etc) timing labor contractions might be quite different from your first time around.
Even if you had a three-day long induction with your first baby, this time might be fast and furious. You won't know until the time comes.
If this is not your first baby, talk to your provider about how far apart your contractions should be and how long you should time them before getting evaluated.
Most of the time, a first time mom is in active labor when her contractions are coming every 3-5 minutes, lasting a minute, for 1 -2 hours. A second time mom, on the other hand, should usually be checked when her contractions are coming every 5 minutes, lasting a minute, for 1 hour. The difference isn't huge but it can make a huge difference (you like that? 😉).
This goes for every mom, but especially a experienced mom – listen to your body! Things can go really fast for women who have delivered babies vaginally before. If you are having very regular, very painful contractions that are coming frequently and you feel like things are moving quickly, go ahead and make a trip to labor and delivery just to be sure.
Other reasons to head to the hospital during labor
Contractions are not the only reason you might want to head over to the hospital during labor.
Your water breaks
If your water breaks before active labor starts, it is a good idea to call your provider (or labor and delivery) to find out what their policy is during this situation.
Many providers want you to come in to be evaluated as soon as possible once your water breaks because the longer your water is broken, the higher the risk of infection becomes.
On the other hand, some providers offer you the option of staying home for a couple of hours to see if labor progresses on it's own before coming in to labor and delivery.
Before you make the decision to stay home a little while while your water is broken, consider these things:
- Your water should be clear or slightly pink. If you are having yellow, green, or brown fluid you need to go to the hospital right away.
- You should not be experiencing heavy bleeding after your water breaks. If you are having heavy bleeding (it's running down your leg like a period or more), you need to call 911 or get to the nearest hospital right away.
- Your baby should continue to move. Although it is difficult to feel baby's movements during contractions, their movements should not be gone all together. Between contractions you should still be able to feel/see baby movements. If you are experiencing decreased fetal movement after your water breaks, get to the nearest hospital right away.
- Your umbilical cord can prolapse. If you see or feel your umbilical cord in your vagina after your water breaks, get on your elbows and knees and call 911 immediately.
- Check your temperature. Developing a fever during labor after your water breaks can be a sign of infection. Please go to labor and delivery to be evaluated if you have a fever.
Decreased Fetal Movement
At any point in your pregnancy, if you are experiencing decreased fetal movement, you should make a trip to labor and delivery as soon as possible. You should be continuing to do your kick counts all the way through your third trimester.
Even though in labor, it is not possible to do accurate kick counts anymore, you should still feel occasional movements throughout labor. If you ever feel that your baby has stopped moving, go to labor and delivery to get evaluated regardless of how progressed you are in your labor.
Your intuition tells you that something is wrong (or that it's time)
There is no way that anyone could list all of the possible reasons why you might go to the hospital during labor. Sometimes you just know that something feels off and you want to be checked out. This is called a mother's intuition and should not be ignored.
If you do not meet the criteria for labor but you don't feel well or you feel like something just isn't right, go to the hospital right away.
Even if there is nothing wrong and they send you home, at least you got reassurance that everything is fine. There is no shame in making sure things are OK when you have yourself and your baby to worry about.
Can I be in labor and not know it?
It is possible for your cervix to dilate slightly without having any awareness of anything going on. It's quite common for women to show up to their 39 week prenatal appointment already 1-3 cms dilated and completely comfortable. Although your cervix is dilated, this does not mean that you are in labor.
Beyond 3 cms dilated, it would be highly unlikely that you would have no pain whatsoever. Typically, a first time mom's cervix will only dilate past three centimeters with painful contractions.
So, you can rest your mind a bit, especially if you are a first time mom. You probably don't have to worry about your cervix melting away without your knowledge (and your baby certainly won't fall out without any effort on your part).
- Related Read: 21 Helpful Pieces of Labor Advice for First Time Moms
When to go to the hospital for labor
So, now you understand what real labor contractions are, what is expected of you in order to get admitted to the hospital for active labor, and what it might take to get there.
Just remember, you need to know your own body. Always pay attention to what your body is telling you and never ignore your mama instincts.
Your health, your history, and your plan should remain factors in deciding when to go to the hospital.
- Related Read: The Best Way To Make Your Birth Plan Your Reality
Don't Get Too Caught Up In Timing
It can be thrilling to finally start having contractions worth counting, I know. I went over due with both of my babies and having those first few contractions was so exciting!
Just be careful not to get hung up on how close your contractions are and if they are getting closer before it matters.
If you find yourself timing your contractions all day long or even for the past couple of days, you are putting too much weight on the distance between your contractions.
You should only have to time your contractions for 2-4 hours before you know if it's time to go or not.
When you start having contractions, don't immediately start recording them. Begin recording contractions after you have noticed a change in them. Have they become significantly more painful than they were when it all started? Have they seemed to have been coming closer together than they were before? Yes? Well then now is a good time to start timing them.
There's never a guarantee in labor
There is never a guarantee when it comes to labor because all labors are different. The only guarantee is that it won't last forever. You will not be pregnant forever. That is the only thing that I can promise you!
Good luck, mama! Whether you labor for two hours or two days, you're a rock star.