I recently invited women attending my Pregnancy Yoga class or Active Birth Workshop to ask me a question. My plan is to start a regular newsletter called ‘Ask me anything’ and some great questions have already come in. The first is from Laura and thank you for this question:
In labour – when should I go to the hospital or birth centre?
I’m sure this is something most of you want to know, including when to call the midwife if you are planning a home birth.
So, my answer started with:
How will you know you are in labour – what are the signs?
- Contractions or tightenings in the lower abdomen that come and go, are the most common sign of labour starting. They may be crampy like the start of a period and can also be felt as an ache in the lower back.
- You may have a ‘show’ when the mucous that seals the cervix or entrance to the uterus comes away.
- You may need to empty the bowel.
- Your waters might break.
- There are a few women who don’t feel anything, but this is very rare.
There is no need to panic – the early stages of labour usually take a long time. Also, labours do stop and start – often with contractions coming and going several times over a few days before becoming regular.
Every labour is unique, so Laura has asked a good question. These are some general guidelines that can help you find your way. Most women ‘know’ when they need to get to the birth unit or get the midwife to get to them, but if you feel unsure, and even if you don’t, you may need help from the midwives making this decision.
The first thing to do is to ask your midwives, birth centre or hospital for advice ahead of time when you have a late pregnancy check-up.
Ask what their policy is and when they would like you to come in.
When labour starts, call the midwives!
Make sure you and your birth partner have the right phone number to call.
If this is your first baby, or if a previous birth was very fast, you may be feeling unsure. You or your partner will need to talk to them on the phone, so don’t worry and don’t hesitate to call.
Do be sure to tell them if you have been doing yoga or hypnobirthing as you may be calm and relaxed and further on than it seems.
Most birth units prefer women to come in when labour is well established, and contractions are strong and regular. If you go in too early, you may need to go home again and wait for things to build up and this can be disruptive.Generally, the guidance is that contractions should be about 5 minutes apart and lasting about 45-60 seconds. This can be quite a conservative estimate and you may still have a way to go. Some women have a pattern of contractions 5 minutes apart from the beginning and may still have a long labour, but usually these early contractions last about 30 seconds. Later, they may last up to 90 seconds. I think it’s more significant how long they last, how strong they feel, and whether they are regular – than how far apart they are.
Many busy birth centres ask women to come in when there are three contractions every 10 minutes (3 in 10), counting from the beginning of the first contraction to the beginning of the third. These would last 45-60 seconds each. I would say this is the very latest you should go in and would hope you are through the first part of labour and getting into strong active labour when you get there. In terms of dilation, about 5-6cms.
How far is your home from the place you are giving birth?
If you do not live near to your birthplace you may need to leave earlier, especially if you have had a previous fast birth.
If you are giving birth at home, discuss this with your midwife or midwives ahead of time and let them know when you start labour, so they can keep in touch and work out when you should come in.
How are you planning to get there?
Have you made a trial run to see how long it takes, where to park and if there is a drop off point or different entrance during the night.
A few factors are important:
Have your waters broken?
If they have, you may be asked to go in to be checked and can then go home and relax. Labour may not start immediately.
If they have not broken, you may be asked to stay at home and wait for labour to build up. Only about 20% of labours start with waters breaking – its more common for them to break towards the end of labour.
A ‘show’ can happen before or during labour and if your membranes haven’t broken there is no reason to go in.
Is this your first or consequent baby? If you have given birth before how long was your labour?
Second or consequent babies often arrive more quickly (although it’s not guaranteed) so you may need to get there earlier.
Some useful tips:
- Pack a bag with things you need during labour – and a separate bag for after which can be brought in later.
- Don’t forget to pack your notes and your birth preference list.
- Make a sign to leave on the dashboard of the car “Just dropping off a woman in labour – I will be back to move and park the car. “(A smiley face will help!)
- Make sure there is petrol in the car!
I hope this info is helpful to you and you arrive in good time – not too early and not too late!
And good luck for the birth!
Active Birth is designed for mothers who wish to give birth naturally and have had a healthy pregnancy and no medical complications during labour and birth. Aspects of an Active Birth can also sometimes be used in combination with medical interventions. The website and newsletters offer general information only. They are not a substitute for the professional advice, diagnosis or treatment offered by your midwives or doctors. The Active Birth Centre/ Janet Balaskas in general, accept no liability for the guidance herein, and advise that you do not disregard professional medical advice and inform yourself with other trusted evidence-based sources of information when making your decisions.