Trying to decide when it’s time to leave for the hospital can be a bit confusing, especially for first-time moms. Labor & birth are usually depicted so unrealistically on TV and in movies, and often, that’s the only “labor” many of today’s preggies have seen. The labor scenes usually go something like this, “It’s TIME! We need to go NOW!” The laboring mom is typically writhing and clutching her abdomen, and her family members or friends are in a state of total panic. That can make for some entertaining (and often funny) TV episodes, but it’s not a very good example of real life.
Although it’s possible for labor to progess very rapidly from the beginning, contractions usually start off lasting about 30 seconds and are spaced several minutes (sometimes 10-20 minutes) apart. Those early labor contractions may continue in that same pattern for hours, without any noticeable change, so arriving at the hospital in that stage of labor can lead to a very long (and more uncomfortable) stay. If there are no other indicators of an active labor pattern, moms in early labor are often sent back home. While that is sometimes disappointing for preggies who hoped to be admitted and have a baby, the L & D triage nurses and docs knows that the early laboring mom will rest better at home, and they need to reserve the L & D rooms for moms who are in active labor.
So, how can a pregnant woman and her partner tell the difference between early labor and active labor? Understanding the pattern of active labor can help you know when it’s truly time to head for the hospital (if that’s where you are giving birth). Contractions in active labor do three things–become stronger, last longer and get closer together. Having a consistent pattern of those three changes is the best indicator of how to know when to go.
In my childbirth classes, I always remind my students to expect some variability in length, strength and intensity of contractions during the course of labor, but even with some fluctuations, a relatively consistent labor pattern will emerge. Once that pattern is recognizable (for instance, say contractions are about 10 minutes apart, 30-40 seconds long and strong enough to make mom take notice and momentarily stop whatever she is doing), that’s when you want to take note of changes in the three areas I mentioned earlier. Those changes are often gradual, and if a mom and her supporting partner (her husband, mother, friend, etc.) are well-prepared, those changes are anticipated and understood so they don’t produce as much anxiety.
Often, the frequency of contractions will go from 10 minutes apart to 8 minutes to 7 minutes to 5 minutes and so on, and with that increasing frequency, the length of the contractions also increases. So instead of lasting 30 seconds, the contractions begin to last 45 seconds long to 55 seconds to 60 seconds to 70 seconds, etc. (Not necessarily in those increments, but hopefully you get the idea.) With the increased frequency (how close together they are) and increased duration (how long they are lasting) comes an increased intensity (how strong they feel). I’d like to talk about that in a bit more detail.
The intensity factor is the most subjective of the three changes to watch for, but it can be the best indicator of how to know when to go. Until a woman actually experiences a labor contraction, it is a bit difficult to describe or anticipate how that contraction will feel to her. There are so many factors that play into the perception of discomfort or pain in individuals, and adding a weighty uterus, strained supporting ligaments and the pressure of a full-term baby in the mix can create some very distinctive sensations during labor. (Did you experienced moms like the tactful way I stated that? 🙂 ) Truly, labor can feel quite different to different women due to many factors, but what is important to note is how the intensity level is changing for the mom in question.
It is very common for first-time moms in labor to feel that her contractions are intensifying quickly and are surely at the “I’m about to have a baby!” level quite awhile before they actually are. Having never felt anything like that before, it’s understandable to have some confusion about what “intensity in labor” really means. In my experience, when contractions are phasing from an early labor stage to an active labor stage, that is when most women tend to first feel like it’s time to go to the hospital. However, going at that point is often early in the active labor game and can lead to a few hours in triage or walking the halls of the hospital, waiting for a stronger active labor pattern to kick in. Of course, it is perfectly okay to go to the hospital to be checked at any time you feel like you should, but I’m writing this article for those moms who would rather not go too early and then be sent back home, if that can be helped.
So, the key to look for is a pattern of increasing intensity in how the mom perceives the contractions. She may say, “Oh yes, these contractions are definately stronger….” but if the intensity level stays at that point, with the frequency and duration of contractions also fairly constant, then it is usually safe to stay home until the mom and her partner definitely sense that the contractions are getting much stronger and require noticeably more effort to relax, maintain concentration, etc. If a mom has received good information on the process and progress of labor (hopefully by attending thorough childbirth education classes and reading detailed books on the topic), then she will likely be utilizing many of the comfort measures during her contractions that she has been taught. Doing that will help her have a more clear sense of how much her contractions are increasing. When a particular comfort measure that was previously effective no longer seems to help much, that is a good sign that the contractions are increasing significantly.
If there has been a noticeable, consistent change in how close together the contractions are coming, how long they are lasting and how strong they are feeling…those three factors are a good indicator of how to know when to go to the hospital. 🙂
Hope this helps!