When to Go to Hospital for Labor: Signs It's Time

Why Should You Call Before Going to the Hospital?

You should always call the labor ward or your midwife before leaving for the hospital. The healthcare team can assess your situation over the phone, give personalized advice about timing, and prepare for your arrival. This helps ensure you receive appropriate care and aren't sent home unnecessarily.

Calling ahead serves multiple important purposes. First, it allows an experienced midwife or nurse to evaluate your symptoms and provide guidance specific to your situation. They will ask about your contraction pattern, whether your water has broken, your pregnancy history, and how you're feeling overall. Based on this conversation, they can advise whether it's time to come in or whether you might benefit from staying home a bit longer.

Second, calling ahead allows the hospital to prepare for your arrival. If the labor ward is particularly busy, they may direct you to a different facility or ensure adequate staffing is available. This communication helps the healthcare system function more efficiently and ensures you receive timely attention when you arrive.

Third, if there are any concerning signs in what you describe, the healthcare team can advise you to come immediately or even send emergency services to you. This is especially important if you're experiencing symptoms that could indicate complications requiring urgent intervention.

If you're unsure which hospital or birth center to contact, this information should have been provided during your prenatal care. Check any paperwork from your prenatal appointments, or contact your regular healthcare provider for guidance. Many regions also have dedicated maternity helplines available 24/7.

How Should You Assess How You're Feeling?

The most important factor is how you, the person giving birth, feel. If you're anxious, struggling to relax, or sense that something isn't right, it's appropriate to go to the hospital for evaluation. You can always be checked and go home if labor hasn't progressed enough - this is completely normal.

While timing contractions and watching for specific signs provides helpful guidance, your own intuition and comfort level matter tremendously. Childbirth is not just a physical process but also a deeply emotional and psychological experience. Feeling safe, supported, and in control can actually help labor progress more smoothly.

If you find yourself unable to rest or relax at home, if anxiety is overwhelming, or if you simply feel that something is different or wrong, these are valid reasons to seek evaluation. Healthcare providers understand that peace of mind is important, and they would rather check on you and find that everything is normal than have you struggling alone at home.

Being sent home from the hospital is not a failure or embarrassment. It happens frequently, especially with first pregnancies when distinguishing between early labor and active labor can be challenging. Many people make multiple trips before being admitted, and this is considered completely normal. The healthcare team's goal is to ensure both you and your baby are safe, and sometimes that means confirming that you're not yet in active labor.

Some people prefer to labor at home as long as possible, finding their own environment more comfortable and relaxing. Others feel more secure being at the hospital early. Both approaches are valid, and you should discuss your preferences with your healthcare provider during pregnancy so they can help you develop a plan that feels right for you.

What Factors Affect When You Should Go?

Several factors determine optimal timing for hospital arrival: contraction frequency and intensity, whether your water has broken, whether you've given birth before, distance to the hospital, any bleeding or unusual symptoms, and any special guidance from your healthcare provider based on your pregnancy.

Understanding these factors helps you make informed decisions about when to leave for the hospital. While the 5-1-1 rule provides a general framework, your individual circumstances may require adjusting this guideline.

Contraction Patterns

Contractions are the rhythmic tightening and relaxing of the uterine muscles that help push your baby down and dilate your cervix. In true labor, contractions become progressively stronger, longer, and closer together. Timing your contractions from the start of one to the start of the next helps you track this progression.

Early labor contractions may be irregular, relatively mild, and spaced 15-30 minutes apart. As labor progresses, contractions typically become more regular, more intense, and closer together. When they reach a pattern of approximately every 5 minutes, lasting about 1 minute each, and this pattern has continued for at least an hour, most first-time mothers are advised to head to the hospital.

Previous Birth History

If you have given birth before, subsequent labors typically progress faster. Your body has already gone through the process, and the cervix often dilates more quickly. For this reason, people who have previously given birth vaginally are often advised to come to the hospital earlier - sometimes when contractions are still 7-10 minutes apart.

If you had a particularly fast labor previously (under 3-4 hours from first contraction to delivery), you should discuss this with your healthcare provider and plan to leave for the hospital at the earliest signs of labor. Precipitous labor (very rapid delivery) can be dangerous if you're not in a setting where emergency care is available.

Distance to Hospital

The further you live from your delivery location, the earlier you should plan to leave. If your hospital is an hour away, you'll need to account for travel time and the possibility of traffic delays. Being in a car during active labor is uncomfortable and potentially dangerous if delivery happens en route.

Discuss your specific situation with your healthcare provider. They may recommend coming in earlier than the standard guidelines if you have a long journey. Some people in rural areas arrange to stay closer to the hospital as their due date approaches.

Special Circumstances

If you've received specific instructions from your healthcare provider due to conditions in your pregnancy - such as gestational diabetes, preeclampsia concerns, placenta position issues, or other high-risk factors - follow those instructions rather than general guidelines. Your provider knows your individual situation and may have very specific recommendations for when you should come in.

How Do Contractions Determine When It's Time?

True labor contractions become progressively stronger, longer, and more frequent. They typically start in your lower back and wrap around to the front, don't subside with rest or position changes, and cause cervical dilation. You should go to the hospital when they're about 5 minutes apart, lasting 1 minute each, for at least 1 hour.

Learning to time and interpret your contractions is one of the most practical skills for determining when to go to the hospital. A contraction is felt as a tightening sensation in your abdomen that builds in intensity, reaches a peak, and then gradually releases. In true labor, this pattern repeats regularly and progressively intensifies over time.

How to Time Contractions

To time your contractions, note when a contraction starts (when you first feel the tightening beginning). Then note when it ends (when the tightening completely releases). The duration is the time from start to end of that single contraction. The frequency or interval is the time from the start of one contraction to the start of the next one.

Many smartphone apps are available specifically for timing contractions, which can be easier than using a watch or timer. These apps automatically calculate averages and can help you identify patterns. However, a simple stopwatch or clock works just as well if you prefer not to use technology.

You don't need to time every single contraction once labor is established. Periodically checking the pattern every hour or so is sufficient, unless things seem to be changing rapidly. Focus on resting and conserving energy between timing sessions.

The 5-1-1 Rule Explained

The 5-1-1 rule is a widely used guideline to help first-time mothers know when to head to the hospital. It means your contractions are coming every 5 minutes (measured from the start of one to the start of the next), each contraction lasts about 1 minute, and this pattern has been consistent for at least 1 hour.

Some hospitals and healthcare providers use variations such as the 4-1-1 rule (contractions every 4 minutes) or the 3-1-1 rule, particularly for people who have given birth before. Check with your provider about which guideline they recommend for your situation.

It's important to understand that these rules are guidelines, not absolute requirements. Some people's labor progresses quickly and they need to go to the hospital before reaching the 5-1-1 pattern. Others may have contractions that fit this pattern but still be in early labor. The rules are meant to help you gauge when active labor is likely, not to replace clinical judgment.

Distinguishing True Labor from False Labor

False labor, also called Braxton Hicks contractions, can be confusing, especially late in pregnancy. These practice contractions help your body prepare for birth but don't cause cervical dilation. Understanding the differences can help you avoid unnecessary trips to the hospital while ensuring you don't delay when true labor begins.

True labor contractions follow a regular pattern and become progressively closer together. They increase in intensity over time, becoming stronger and more difficult to talk through. They don't go away when you change positions, walk around, or rest. True labor contractions are often felt in the lower back first, then radiate around to the front of the abdomen.

False labor contractions are typically irregular in frequency and intensity. They may stop when you change positions, drink water, or rest. They're often felt only in the front of the abdomen. While they may be uncomfortable, they don't progressively intensify and don't cause cervical changes.

If you're unsure whether you're experiencing true labor, timing your contractions over 1-2 hours can help clarify. True labor will show a pattern of increasing frequency and intensity, while false labor contractions tend to be erratic and eventually stop.

What Should You Do When Your Water Breaks?

When your water breaks, the amniotic sac ruptures and fluid leaks from your vagina. Note the time, color, and smell of the fluid. Contact your healthcare provider immediately. Most hospitals recommend coming in for evaluation when your water breaks, even if contractions haven't started, as this increases infection risk and labor usually begins within 24 hours.

The amniotic sac is a fluid-filled membrane that surrounds and protects your baby throughout pregnancy. When this membrane ruptures, the amniotic fluid drains out through the vagina. This is commonly called your "water breaking" and signals that birth will happen soon.

What Water Breaking Feels Like

Water breaking can present differently for different people. Some experience a sudden gush of fluid that is unmistakable. Others notice a slow trickle that might initially be confused with urine leakage (which is also common in late pregnancy). The fluid is typically clear or slightly pink and has a mild, slightly sweet smell - it should not smell like urine or have a foul odor.

If you're unsure whether your water has broken, put on a clean pad and lie down for 30 minutes, then stand up. If fluid gushes when you stand, your water has likely broken. You can also try to stop the flow by tightening your pelvic floor muscles (as if stopping urination) - amniotic fluid will continue to leak while urine can be stopped.

When to Seek Immediate Care

While you should always contact your healthcare provider when you think your water has broken, certain situations require immediate emergency care. Go to the hospital immediately or call emergency services if the amniotic fluid is green, brown, or has a foul odor. Green or brown fluid indicates the presence of meconium (baby's first bowel movement), which can be dangerous if inhaled by the baby during birth. A foul odor may indicate infection.

You should also seek immediate care if you feel something in your vagina after your water breaks. Very rarely, when the water breaks, the umbilical cord can slip down ahead of the baby (cord prolapse). This is an emergency requiring immediate delivery, as the cord can become compressed, cutting off the baby's oxygen supply.

What Happens After Water Breaking

After your water breaks, labor typically begins within 24 hours if it hasn't already started. Many healthcare providers prefer to deliver the baby within 24 hours of water breaking to reduce infection risk, as the protective barrier around the baby has been compromised. If contractions don't start naturally, labor may be induced.

Even if contractions haven't started, most hospitals want to evaluate you when your water breaks. They'll confirm that it's amniotic fluid, check on your baby's well-being, and discuss the plan going forward. Depending on your situation and your provider's practices, you may be admitted to stay, or you may be sent home with specific instructions and told to return when contractions establish.

Does Previous Birth Experience Change the Timing?

Yes, if you've given birth before, labor typically progresses faster and you should go to the hospital earlier than first-time mothers. Second and subsequent labors are often significantly shorter. If you had a fast labor previously (under 3 hours), contact your provider early and leave for the hospital at the first signs of regular contractions.

Your body remembers the experience of childbirth. The cervix, which needed to thin and dilate for the first time during your initial labor, does so more efficiently in subsequent pregnancies. The birth canal has stretched before, and the pushing stage is often shorter. For these reasons, labor can progress more rapidly, sometimes catching people off guard.

While a first labor averages 12-18 hours, second labors often take 6-8 hours, and third or subsequent labors may be even shorter. These are averages, and individual experiences vary considerably, but the trend toward faster labors is well established.

Adjusting Your Departure Time

Given the faster progression, people who have given birth before are typically advised to head to the hospital earlier in the labor process. Rather than waiting for the 5-1-1 pattern, you might be told to come when contractions are 7-10 minutes apart and clearly intensifying.

If your first labor was particularly fast (precipitous labor, defined as total labor under 3 hours), you need to plan especially carefully for subsequent births. Discuss this with your healthcare provider early in pregnancy. You may be advised to come in at the very first signs of labor, to consider scheduled induction, or to have a plan in place for potential home birth if you don't make it to the hospital.

Keep in mind that while subsequent labors are typically faster, this isn't guaranteed. Each pregnancy and birth is unique. However, it's better to arrive at the hospital earlier than needed than to risk delivering without medical support.

What Happens When You Arrive at the Hospital?

When you arrive at the hospital, a midwife or nurse will evaluate how dilated your cervix is, check your baby's heart rate, assess your contraction pattern, and review your overall condition. You're typically admitted to stay when your cervix is dilated more than 3-4 centimeters. If labor is less advanced, you may be sent home to wait.

Understanding what happens when you arrive helps reduce anxiety about the process. The healthcare team's goal is to assess whether you're in active labor and to ensure both you and your baby are doing well.

The Admission Evaluation

Upon arrival, a midwife or nurse will ask about your contraction pattern, whether your water has broken, and how you're feeling. They'll review your prenatal records if available and ask about any concerns or complications in your pregnancy.

A physical examination includes checking your blood pressure, temperature, and pulse. They'll monitor your baby's heart rate using a Doppler device or electronic fetal monitor. An internal examination assesses how dilated and effaced (thinned) your cervix is and determines your baby's position.

The cervical examination is a key factor in determining admission. The cervix needs to dilate to 10 centimeters before you can push your baby out. In early labor, the cervix may be only 1-2 centimeters dilated. Active labor is generally considered to begin around 6 centimeters, but many hospitals will admit you when you reach 3-4 centimeters if contractions are regular and progressing.

Being Sent Home

If your cervix is not yet dilated enough for admission, you may be sent home to continue early labor there. This is extremely common and should not be seen as a problem. Early labor can take many hours, and most people are more comfortable at home during this phase.

If you're sent home, the staff will give you specific instructions about when to return. They'll tell you what signs to watch for that would indicate you should come back immediately. Make sure you understand these instructions before leaving.

Being home during early labor allows you to rest, eat light snacks, stay hydrated, take warm baths or showers, and move around freely - all things that can be more difficult once you're admitted. Many people find that labor progresses more easily when they're relaxed in their own environment.

What Are the Emergency Signs Requiring Immediate Care?

Seek immediate emergency care for heavy vaginal bleeding, constant severe pain without relief between contractions, decreased or absent fetal movement, water breaking with green or brown fluid, severe headache with vision changes or swelling, fever over 38°C (100.4°F), or feeling the umbilical cord in your vagina.

While most labors progress normally, certain signs indicate potential emergencies requiring immediate medical attention. Don't wait for regular contractions or try to time anything - call emergency services or go directly to the hospital if you experience any of these symptoms.

Heavy Vaginal Bleeding

Some bloody discharge mixed with mucus (known as "bloody show") is normal in late pregnancy and early labor. This is different from heavy bleeding. Heavy bleeding means bright red blood that soaks through a pad within an hour, or passing blood clots larger than a golf ball. This can indicate placenta previa, placental abruption, or other serious conditions requiring immediate intervention.

Constant Severe Pain

Normal labor contractions come in waves with relief between them. You should have periods where the pain subsides and you can rest. If you have constant, unrelenting severe abdominal pain with no relief, this may indicate placental abruption (the placenta separating from the uterine wall) or uterine rupture (rare, but more common in people with previous cesarean sections). Both require emergency care.

Decreased Fetal Movement

While babies do tend to move differently in late pregnancy as they have less room, a significant decrease in movement can indicate fetal distress. If you notice your baby is moving much less than usual, try drinking cold water and lying on your side for an hour while counting movements. If you don't count at least 10 movements in 2 hours, or if movement is dramatically reduced from your baby's normal pattern, contact your healthcare provider or go to the hospital immediately.

Signs of Preeclampsia

Preeclampsia is a pregnancy complication involving high blood pressure that can become dangerous. Warning signs include severe headache that doesn't respond to pain relievers, vision changes (seeing spots, blurring, light sensitivity), upper abdominal pain (especially on the right side), sudden severe swelling in the face and hands, and nausea or vomiting after mid-pregnancy. If you experience these symptoms, seek immediate care.

How Can You Participate in Your Care Decisions?

You have the right to be involved in all decisions about your care during labor. Ask questions to understand your options, express your preferences, and request explanations for recommended interventions. Informed consent means understanding what's being proposed, why, and what alternatives exist.

While the healthcare team provides expertise and guidance, you are the central participant in your birth experience. Effective communication and shared decision-making lead to better outcomes and satisfaction with the birth experience.

Don't hesitate to ask questions. If something is recommended, ask why it's needed, what the alternatives are, and what happens if you wait or decline. Healthcare providers should be able to explain their reasoning in terms you understand. If you don't understand something, ask them to explain it differently.

Your preferences matter. While some situations require specific medical interventions for safety, many aspects of labor and birth offer choices. Your healthcare provider should discuss options with you and respect your informed decisions when safely possible.

If language is a barrier, you have the right to an interpreter. Most hospitals can provide interpretation services. You also have the right to have a support person with you during labor - this might be a partner, family member, friend, or professional doula.

If you have specific needs related to disability, previous trauma, cultural practices, or other factors, communicate these to your healthcare team. They should work with you to accommodate your needs when possible and help you feel safe and respected throughout your care.