When to Go to Hospital with Contractions

The honest answer is that your maternity unit would rather you called and were sent home than stayed home worrying. They take these calls constantly and nobody there considers it a nuisance.

That said, here is how to read what is happening so the call is a useful one.

Practice contractions versus the real thing

Braxton Hicks contractions are the rehearsal. They tend to be irregular, do not get closer together, are usually felt at the front, and often stop if you change what you are doing: move position, have a bath, drink some water, lie down.

Established labour contractions do the opposite. They get longer, stronger, and closer together over time, and they keep going regardless of what you do. Many people describe them starting in the back and wrapping round. The single most useful test is whether they carry on when you try to make them stop.

Timing them properly

Two numbers matter, and one of them is commonly measured wrong.

• Duration: how long one contraction lasts, from the moment it starts building to the moment it eases off.
• Interval: from the start of one contraction to the start of the next. Not from the end of one to the start of the next. This is the number your maternity unit will ask for.

Timing by hand while having contractions is harder than it sounds, which is what the contraction timer is for: one button, and it works out both numbers for you.

The 5-1-1 guideline

A widely used prompt for making contact is 5-1-1: contractions about five minutes apart, each lasting about one minute, sustained for one hour. Some units use 3-1-1, and units often advise coming in earlier for a second or later baby because labour tends to move faster.

Treat it as a prompt, not a threshold. Your own unit's advice always outranks a general rule, and if you were given specific guidance at an appointment, follow that.

Call now, without timing anything

Stop reading and phone your maternity unit if:

• Your waters break, particularly if the fluid is green, brown, or bloody, which needs assessment straight away
• You have any vaginal bleeding
• The baby's movements have reduced or changed. This one is often downplayed and should not be. Do not wait until morning
• You are under 37 weeks and having regular contractions
• The pain is severe and constant rather than coming in waves that build and fade
• You have a severe headache, visual changes, or sudden swelling
• Something feels wrong. That is a sufficient reason on its own

When you do call

Having these ready makes the conversation quicker:

• How many weeks you are
• How far apart the contractions are and how long each lasts
• How long the pattern has held
• Whether your waters have broken, and the colour if so
• Whether the baby is moving as usual
• Anything in your notes they should know, and your hospital number if you have one

Being sent home is not a failure

Plenty of people are assessed and sent home in early labour, and it is a completely normal part of the process rather than a wasted trip. Early labour can last a long time, and for most people it is more comfortable at home. Going in and coming back is not something to feel embarrassed about.

Time them with the contraction timer, or read about what to expect in the third trimester.