How to Tell When It's Time to Go to the Hospital for Labor

Sometimes it's tricky to decide when you should go to the hospital for labor. If you are carrying a full-term baby and your water has not yet broken, you could be experiencing Braxton Hicks contractions. These contractions are occasional, irregular cramps that may begin around the middle of your pregnancy, that generally subside on their own. (See below for how to respond to pre-term labor.)

The big question is how to differentiate between false labor and true labor. Toward the end of pregnancy, you may have many contractions that lead you to believe that you may be in labor. 

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Signs to Help Decide When to Go to the Hospital

There are a few different ways that your body signals true labor. As you approach your due date, your doctor or midwife should give you guidance on when to call and/or to go directly to the hospital. They may have special rules for you because of your medical history or some other reason.

You Are Having Contractions

When your contractions start as mild and irregular cramps but slowly progress to more painful and regular occurrences, that is when true labor has begun. When contractions are intense enough that you can’t talk through them or focus on anything else, they are more likely to be true labor contractions. 

Your doctor or midwife may give you a specific timing of contractions as your signal to go to the hospital. Many use the 411 method: Contractions 4 minutes apart, lasting at least 1 minute, for at least 1 hour are a signal that it's time to go to the hospital.

During true labor, you usually don't feel the baby move during the contraction. Contractions push the baby's head down and slowly thin out (efface) and open (dilate) the cervix. In false labor, you may be able to feel the baby moving. In true labor, this is unlikely.

Your Water Has Broken

If you suspect that your water has broken, call your healthcare provider to let them know. They may advise you to go to the hospital to confirm that indeed, your amniotic sac has ruptured. Or they may recommend that if you are not yet having contractions, you stay home for a time. If you cannot reach your provider, it is best to go the hospital to be evaluated.

You Are Bleeding

Vaginal bleeding at any point in pregnancy can be a sign of complication. Always call your doctor if you are bleeding. Depending on how far along you are, how much you're bleeding, and any other symptoms you may be having (such as contractions), your provider can advise you on what to do.

Your Pregnancy Is High-Risk

Contact your doctor or midwife immediately, at the first sign of contractions, if you are carrying twins or higher-order multiples or have other high-risk conditions. You will likely need to go to the hospital sooner in these special cases. Again, your health care provider will tell you what signs to look out for. If they don't, ask!

You Have Symptoms of Preeclampsia

Contact your doctor or midwife without delay or go directly to the emergency room if you experience any of the following:

  • Your face and hands swell
  • Blurred vision
  • Dizziness, headaches, or seizures
  • Severe stomach or abdominal pain or vomiting
  • Sudden weight gain (more than 4 pounds in a week)

These are all symptoms of preeclampsia, a potentially very dangerous complication.

How Long Should You Wait at Home?

When you are in true labor and have no complications, some doctors and midwives recommend that you don't go to the hospital right away. You are usually more comfortable in early labor in your own familiar environment. Going to the hospital too early has been linked to an increase in interventions, so your practitioner may also tell you to stay home a bit longer if you are planning on an unmedicated birth.

If You Are Pre-Term

Having contractions prior to 37 weeks could be a sign of pre-term labor. If you experience any of these symptoms, call your health care provider immediately. Don't wait until morning or your next appointment, and go to the emergency room if you can't reach your doctor or midwife.

  • Contractions or cramps (more than five in one hour)
  • Vaginal bleeding (bright red blood)
  • Sudden gush of clear, watery fluid from your vagina
  • Low, dull backache
  • Intense pelvic pressure

Sometimes pre-term labor can be stopped or at least stalled, and the sooner it's identified, the better.

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