This is a BIG question that everyone wants to know. The following is a guide only, not intended to supercede the guidelines from your midwife or OB/GYN. Please be aware of the instructions from your care provider about when your should call and when you should go.
IS IT REALLY TIME?
Most providers ask mothers to use the following formula: "When contractions are three to five minutes apart for one hour, each lasting one minute, come to the hospital." This is sometimes known as the 3-1-1 rule or the 5-1-1 rule. The most important element to this equation is that it's usually necessary for the contractions to be a full one minute long. (This is along with contractions coming three to five minutes apart.) If it seems that contractions are indeed one minute long, but they're only coming every ten minutes, it's not likely that labor is active. Also, contractions that are five minutes apart but only last a few seconds are not likely to be active labor.
CAN YOU TALK?
Many providers and childbirth classes advise women to wait to leave home until they feel unable to talk during contractions. But often, this is still too early to go. At some point, the mother will begin to feel she's lost interest in talking between contractions as well. THIS is a better indicator that labor is entering the active phase. At this point, contractions will be close enough together, and long enough, that keeping up with conversation is not really comfortable anymore. Once you've been feeling this way for an hour or two, go ahead to your birth place. For a first baby, these signs usually indicate the beginning of active labor, not the end, and you should still have plenty of time to settle in to the hospital or birth center without missing your chance to get there in time.
ABNORMAL SYMPTOMS IN EARLY LABOR
Research supports the safety of staying home in early labor for healthy pregnant women. However, the following symptoms mayindicate that labor is proceeding abnormally. Contact or go to your hospital if you experience the following:
- You have bleeding as heavy as a menstrual period.
- You have pain in the abdomen between contractions.
- The baby is not making its normal movements.
- When your water breaks, it is green or brown rather than clear.
- When your water breaks, you feel the baby's umbilical cord slip down in your vagina.
- You have an intuition that something is wrong.
WHEN TO GO TO THE HOSPITAL
- When contractions are three to five minutes apart, lasting one minute each, for one hour (the 3-1-1 rule)
- For mothers having their second or subsequent baby, when contractions are five to seven minutes apart
- When you can no longer talk between contractions, not just during contractions
- If you feel the urge to push
- If you have heavy bleeding, pain between contractions, if green or brown fluid is leakin from your vagina, it the baby is not moving, or ithe baby's umbilical cord slips out of your vagina
- If your intuition tells you to go, regardless of other signs
- When in doubt, or if you are high risk, consult with your medical provider
From The Doula Guide to Birth by Lowe and Zimmerman