Wednesday, 21 January 2009
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Labor -When to Go to the Hospital?
by Nurse Jenna 
It is often difficult to know exactly when you should go to the hospital when you think you may be in labor. Usually two scenarios play through everyone’s mind: On one hand, you don’t want to get there only to find out that you are still 1cm dilated, just like you were the other two times you went in. You find yourself perplexed and swearing under your breath that these painful contractions have to be doing something!
On the flipside, you really don’t want your husband trying to deliver the baby from the back seat of the car. It would uncomfortable, he would be nervous, and the leather seats would never be the same again.
If you wrestle with these two ideas long enough, or if your husband has any say in it, you will probably wind up heading into the hospital with the first contraction. The whole drive will be spent assuring your hubby that he can drive the speed limit and he will not need to be some super-hero who pulls out his cape and transforms into Obstetrician-Man, there to save the day.
There is a happy middle and these are some guidelines to help avoid becoming a frequent-flyer in triage, yet still allowing time to get to the hospital without anyone panicking.
-For a first baby, contractions should be at least 5 minutes apart for a full hour. They should be strong enough so that find yourself breathing through them. Being at home in early labor is better than at the hospital if you have a normal, healthy pregnancy.
-For a second baby, come in when contractions are regular for an hour and are at minimum 7-8 minutes apart. Second babies can come quickly, so this allows for more time to get to the hospital.
-For a third baby or more, you know what labor feels like now. Things can happen fast. If you are contracting regularly every 8-10 minutes, you should get your things ready and come in.
You should also come in if you think your bag of water has broken. This may not be a huge flood that hits the floor and may just be a steady leaking over a period of time. You should not wait to start contracting if you think your bag of water has ruptured, you should go in to be evaluated.
You should also go in to be seen if you have any bright red bleeding. It is normal to have some dark spotting if you have recently had a cervical exam or intercourse, but bleeding that is more similar to a period needs to be addressed immediately.
And finally, if your baby is not moving, or not moving as much as normal, you need to be seen. Read here, for more on the importance of fetal movement as an indicator of fetal well-being.
When did you go to the hospital? Was it too early, or late, or right on time?
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Comments (12)
Lol bag of water.
Sounds like okay advice, I'll be sure to take it...
I guess I would add that if you really just have that feeling that something is not right, follow your instincts as they are often right. That is the experience I had with my first. I had been having regular but very spaced out contractions for a couple days and finally decided to go into the hospital around 8 am on a Monday morning. As it turns out, his heart rate was dropping into the 40's with contractions - which was 'fixed' by me laying on my left side in bed until he was born ... at 11pm that night. So, I was in the hosptial much longer than I would have preferred, but it was needed for that one.
The second once was just about perfect. I don't remember really how long I was there I guess, but I know it wasn't too long.
And the third ... well, I guess I cut that one a bit close. I didn't think I needed to go in yet as the first two took more than 24 hours each and were a week late. This one was the day before his due date and contractions had just started around 6 that morning. He was born before noon ... about an hour after I got the the hospital. So, you can't always rely on your past experience and expect the next ones to be the same!
I teach Lamaze classes, and for first time moms we give them this general guideline: it's called the 4-1-1 Rule. Time to go to the hospital when your contractions are 4 minutes apart, lasting for 1 minute, for a duration of 1 hour (of consistent 4 min apart 1 min long contractions) ......... you can go in with contractions that are 5 minutes apart, but if they're only 20-40 seconds long, you're not in established active labour yet. There are always exceptions to every rule, so we also tell them "if your gut is telling you to go despite not being in the 4-1-1 rule, then go .........." We also advise them to call their midwife or doctor or maternity ward when their water breaks at any time to get advice. Just because the water is broken, does not mean you need to make the trek. HEre in Canada, they don't want you in unless you're strep B positive and need antibiotics. If your water breaks, and you're strep B negative and contractions haven't started, and you feel the baby moving, they'l ask you to wait until contractions start or come in after 8 hours. It also does truly vary on the policies of each hospital and caregiver.
I was induced. But when I got to the hospital I was already having contractions, so I think I would have gone into labor that night anyway. I was at 41 weeks on the dot. It was a wonderful experience for me.
With my first, I was on hospitalized bedrest when labor started, with my 2nd, I did go in too early, although my contractions were 5 mins. apart, I was only at 3, and it took quite a while. With my 3rd, I was totally planning on waiting longer, but I had a bad headache and was dizzy, and when I called, they wanted me to go in and get my blood pressure checked. Turns out it was fine, but I was dilated to a 4, so the kept me obviously. However, the darn doctor decided to break my water, which meant I couldn't walk around, and labor basically stopped, until they started pitocin. I was so mad that I had gone in early.
The only thing I would add would be to contact your doctor or midwife before going to the hospital. They can give you suggestions to determine if it is true or false labor. I know some people come into triage just dehydrated and once they are given fluids the contractions stop. While I was pregnant I would try some of these things. When I started having contractions I would go get a glass of water, drink it, lay down, or just get off of my feet and then time my contractions. Since I wasn't in true labor my contractions stopped and it saved me a trip to the hospital. I did worry that I wouldn't make it in time but each week I went to my doctor and I wasn't any further dilated so it really wasn't a possibility.
@happygirl7798@xanga - I totally agree! I have been severely dehydrated before and thought I was in labor.... with my SECOND child. You would think I would have known what labor felt like by then! LOL!
Oh my, I went into the hospital a few days before my baby was born 'cuz I thought I was in labor, when I got in I was only dilated 1 cm and my contractions stopped! Well, when I went into actual labor a few days later by contractions were only 10 minutes apart, for over 24 hrs. I waited for a long time 'cuz I didn't wanna go in 'til they were 5 minutes apart. I even called my midwife and she said not to come in 'til they were 5 minutes apart. So,I endured these hard contractions for another 10 hours.... then I started throwing up everything I put in my mouth, so I called again and the midwife said to come in. Anyway, when I got in there I was 6 cm and definitely in labor. My contractions didn't get closer than 10 minutes apart 'til about a half hour before I was ready to push!!! So, the waiting 'til they were 5 min apart didn't work for me!!
I've been trying to read up on a lot of stuff about labor, since I will be going in within the next few weeks (due date's a little over 3 weeks away, at Valentine's Day). At my appointment on Monday, he said I was 50% effaced but hadn't started dilating yet. And my mom made the comment that it looks like the baby started dropping. So we shall see.
Anytime I'm with my mom and I make a face of pain or discomfort, she freaks out. It's usually my tooth the dentists won't fix until I have the baby, even though my dr. gave them clearance to fix it for real because he said the pain alone could cause me to go into labor.
I also was induced (at just over 41 weeks) so I obviously was in the hospital "early". However, after the first 9 hours of pitocin I still had no painful contractions. I was nauseated (had Hypremisis....) so they gave me drugs and let me sleep that night. In the morning (about 7am?) they started up the pitocin again. It still took a while to "get going" but once things started happening they happened quickly. As soon as a new doctor was on call and came to check on me I was ready to push. That lasted a short 15 minutes (max). My son was born at 6:15 pm.
I was never worried about getting there on time. Although I did worry there would be a snow storm when I went into labor (Feb. 18 due date). As it turned out, there was a snow storm when I was in Labor. But we were already in the hospital. :)
please help me, ive been having really really painful contractions lasting about a minute or so but irregular usually between 13-18 minutes all day, they havent been coming closer together but they are becoming MUCH more painful and lasting longer i dont i can handle this pain much longer! it feels like with each contraction, the baby's head is geting pushed down, theres more pain than tightening of my uterus, help! what do i do?
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