When Do I Actually Need to Go to the Hospital or Birthing Center?

Hospital Birthing Center

During the third trimester of pregnancy, hormones prepare a mother’s body for giving birth. The level of prostaglandin increases, causing the cervix to soften and thin, while the hormone oxytocin triggers contractions. Such increases can happen weeks before the actual delivery date and prompt symptoms that seem like labor is about to begin. Your due date is actually approximate and your baby’s delivery can happen as much as three weeks earlier and two weeks later than the assigned date.

There are a few signs that labor is approaching, but they don’t all indicate that it’s time to head  to the hospital or birthing center.

In the weeks before delivery many women experience a sensation known as lightening, which happens as the baby’s head settles lower in the pelvis in preparation for birth. It feels as if the pregnancy weight has shifted and there may be more pressure on your bladder. Lightening can happen weeks before the delivery for first-time moms but tends to happen closer to delivery in mothers having a second baby.

You may also have mild contractions up to a month before your delivery date. These contractions, known as Braxton Hicks contractions, are milder than actual labor contractions,but they are different in intensity, consistency and frequency. Labor contractions last longer, and come at regular intervals.  A good way to distinguish between Braxton Hicks and regular labor contractions is to time them. Once you have contractions that are about five minutes apart and last for between 30 and 70 seconds or longer, consistently for about an hour, it’s time to call your healthcare provider and discuss heading to the hospital or birthing center.

Another sign of labor is when you notice a small amount of blood or blood-tinged mucus. It can occur before labor or when labor starts but it usually happens within days. A more obvious sign of labor is when your water breaks. It is referred to as “water breaking,” because most women experience it as a gush of clear fluid, but that fluid is from the amniotic sac as it ruptures in preparation for labor. In most women, labor starts within 24 hours of the amniotic sac breaking.

In about one in 10 women, the membranes break a few hours before labor but on rare occasions it can even happen days before.

If any or all of these things happen, it may seem like you’re hours away from meeting your new baby, but that’s not necessarily so. Braxton Hicks contractions, a bloody show or your water breaking can happen a day or more before the delivery and you may as well consult your doctor and relax comfortably at home rather than lie in a hospital bed. Any of these signs are, however, a good reason to talk to your health care provider right away.

Here are some signs that mean it is definitely time to go to the hospital or birthing center:

  • Your contractions are painful, regular, occur five minutes or less apart and have been doing so for at least an hour. If it’s your second baby, you can head in when contractions are about seven minutes apart.
  • Your contractions are so painful it’s hard to talk.
  • You feel like pushing.
  • If you’re having more than one baby, talk to your healthcare provider as soon as you notice any symptoms. Preterm labor is more common with twins.
  • You are less than 38 weeks pregnant.
  • Your first labor happened very quickly.
  • There are medical complications such as gestational diabetes or preeclampsia.
  • You’re having a breech baby
  • You’re far from the hospital

If you get to the hospital and your contractions slow down or even stop, don’t feel bad. It’s not unusual for women to arrive at the hospital convinced they are in labor, only to be sent home for another day or more. You’re experiencing signs of early labor and the only way to be sure how far along you are is by doing a vaginal exam.

Joan MacDonald
Joan Vos MacDonald has written about health and fitness for newspapers, magazines and websites. She is a member of the National Association of Science Writers and the author of two books on health-related topics, "Tobacco and Nicotine Dangers," for young adults, and "High Fit Home," a design book about fitness and architecture. She lives in upstate New York near her children and grandchildren.

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