Your delivery day is fast approaching. You’re still not sure what signs to look out for that will tell you when to head to the hospital. How do you know if your contractions are a false alarm? Should you wait for your water to break before leaving the house?
Knowing when to go to the hospital is tricky business. If you go too soon you risk being turned away and told to come back later. If you don’t go soon enough, you may miss the window to get your epidural (if you’re scheduled to have one). Going too late might also mean that you don’t get to the hospital soon enough.
Here are the top 3 signs it’s probably time for you to grab your hospital bag (which should be ready-to-go) and head off to the hospital.
1 – Contractions
Braxton hicks contractions
Braxton hicks contractions are not a sign of impending labor. Yet, it’s good to have some background knowledge about them. Sometime during the third trimester, many women will start experiencing Braxton Hicks contractions. These are normal ‘mini’ contractions, perhaps the body’s way of preparing you for labor. They can be considered a test run1. Braxton Hicks contractions are harmless -they are not harmful to either mother or the baby. Although they cause the uterus to contract, they do not dilate the cervix (which itself is a sign of labor).
The problem occurs when Braxton Hicks contractions start happening around your due date. So how do you know if the contractions you’re having are Braxton Hicks contractions or if they’re the real thing?
The answer: Timing.
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The Real Deal
Contractions (the real ones) are the best and most accurate sign of impending labor. Regular contractions are those that are strong (ie. very painful) and don’t go away regardless of what you do. It can be hard to tell if you are having true contractions or Braxton Hicks contractions2. Here are some ways to help tell the difference:
- True contractions come every few minutes and get more frequent over time. Braxton Hicks contractions can come every few minutes, but they don’t become more frequent.
- True contractions don’t go away, even when you rest. Braxton Hicks contractions usually go away with rest.
- True contractions will get stronger and more painful over time. Braxton Hicks contractions usually don’t get stronger or more painful.
- True contractions come at regular intervals over a long period of time and continue.
If you are still not sure whether you are having true contractions, call your doctor or midwife.
Whenever you start having contractions, you should time them to see how far apart they are. That way, you can tell if they get more frequent. You can time your contractions by writing down the time when each contraction starts2. If you have a clock with a second hand, you can also time how long each contraction lasts2.
If your contractions are mild to moderate and coming 5 to 20 minutes apart, you’re likely in early labor. This is also called the latent phase. This stage of labor begins at the point which a woman perceives regular contractions. It just so happens that this is also the time when many women go to the hospital but are sent back home. That’s because this stage of labor can last anywhere from a few hours to more than a day , especially if it’s your first child.
While maternity wards today are much more comfortable than they used to be, there is no place like home during this first phase of labor. Since it can be a lengthy period of time, the longer you’re able to stay at home before active labor, the better. While you’re at home, you can try to keep yourself distracted by
- walking around,
- eating small snacks,
- or taking a nap (since you’ll need plenty of energy for pushing later).
Labor is like running a marathon -save your energy spurt for when you are in active labor.
When your contractions are regular and strong and coming every four to five minutes for one to two hours, call your midwife or doctor. Ultimately, only a vaginal exam can indicate whether your cervix has dilated and you’re in true labor. Still, your doctor/midwife will ask you will help determine when it’s time to go to the hospital.
2 – When your waters break
While in the stomach, your unborn baby is floating around in a bubble of fluid called the amniotic sac. The bubble helps cushion and protect the baby from blunt trauma, infections, and just about everything else. When your water breaks, the bubble bursts. The rupture of the amniotic sac may feel like a sudden gush of fluid or a trickle that leaks steadily and uncontrollably3.
The fluid is usually odorless and may look clear or straw-colored. Sometimes it’s difficult to tell amniotic fluid from urine. If your water breaks, write down the time this occurs and what the fluid looks like. Then, notify your doctor or midwife3. Tell them immediately if the water is smelly or colored, or if you’ve lost blood. This could mean you and your baby require urgent attention. Although labor may not start immediately after your water breaks, delivery will occur within the next 24 hours.
3 – Passing of the mucus plug
Another good but somewhat less reliable sign of labor is the passing of the mucus plug. While you are pregnant a mucus plug accumulates at the cervix. As the cervix begins to widen, the plug dislodges. Just before labor starts or in early labor, the plug comes out. A small amount of fluid may pass that is clear, pink, or slightly bloody. This is called a show. It indicates that the cervix is starting to open and labor may follow quickly.
However, although labor may begin soon after the mucus plug discharges, it can take a few days or weeks for labor to start1. Some women do not have a show at all.
A small amount of blood is normal. If you lose more blood, it may be a sign that something is wrong. Call your hospital or midwife immediately to be certain.
All the above signs should only be viewed as guidelines. Every woman (along with every birth) is different. Some of the signs may come in quick succession, some slowly, and some not at all. If ever in doubt, go to the hospital (or wherever you are going to give birth), and trust your instincts. You may get sent home, but you can just go back later. At the least, if you’re still unsure about any of the signs or symptoms, call your doctor or midwife.
NOTE: If you start having any symptoms of labor before 37 weeks, call your doctor right away.
1) WebMD. Pregnancy and Signs of Labor. WebMD Medical Reference Reviewed by Kecia Gaither, MD, MPH on September 18, 2014. http://www.webmd.com/baby/labor-signs#1
2) Uptodate. Latent phase of labor. Sept 2016. https://www.uptodate.com/contents/latent-phase-of-labor?source=search_result&search=braxton%20hicks%20contractions&selectedTitle=1~12
3) Cleveland clinic. Labor and delivery. Copyright 1995-2016 .The Cleveland Clinic Foundation. https://my.clevelandclinic.org/health/diseases_conditions/hic_Am_I_Pregnant/hic_Labor_and_Delivery