Contractions, when should I go to hospital?

One of the biggest questions I get asked is how will I know when to go to hospital? If you have gone into spontaneous labour (which means your labour has started naturally outside of hospital) and your pregnancy is considered low risk most labour wards require you to be in ‘active labour’ in order to be admitted. The best way for you and them to know if this is the case is by monitoring your contractions.

A general rule of thumb is that contractions will start relatively mild in sensation and feel very similar to period cramps. The measurement of contractions tends to be that they initially are short in duration, mild in intensity and have lengthy gaps of time between each one which may or may not have any structure to them. As labour intensifies so will the contractions, meaning they will gradually increase in length, decrease in time between each one and become progressively more intense.

Contractions can actually be a very indecisive way of assessing how you are processing in labour, as they can be so variable from person to person and labour to labour.

Usually, the 3 in 10 rule is applied when trying to assess whether you should go into hospital. This means are you have 3 contractions within roughly 10 minutes. If you feel you are having frequent contractions that are feeling strong then you are advised to call the labour ward to advise them. The midwife on duty will ask to speak with you and will expect you to have a contraction whilst on the phone to them, this allows them the opportunity to assess how you are handling the contraction as to determine the length, strength and frequency. Based on this they will advise you on whether to come into hospital now or wait.

Timing your contractions can be a great way of understanding whether it is time to make that call, especially as contractions aren’t always linear so you might find that they are coming with a fair amount of frequency and then suddenly stop or slow down. This is very common so keeping a record of them is helpful.

You want to record 3 things:

  • The time each contraction starts
  • The duration of each contraction
  • The frequency between them

You can do this manually (always best to ask your birth partner to do this) or you can download some excellent Apps that will record them for you.

Knowing when you are experiencing a contraction and not general labour aches and pains or possibly Braxton Hicks can be confusing, especially to first time mums. The key difference is the graduation in intensity, length and the frequency. Remember that in-between contractions most women are in no pain at all which is a disguising factor from Braxton Hicks and general cramps. These tend to be more constant and don’t grow in intensity.

Contractions are for most women the first sign of labour starting however some women can have their first contraction days before they meet their baby and sometimes contractions can stop completely in early labour. It’s important to do all that you can to encourage your body to continue to release Oxytocin which is the natural hormone released in your body that initiates and maintains your labour. This coupled with staying active and calm will aid the release of oxytocin and promote baby to maintain or adopt an optimal position ready for birth.


By Ellie Dearden

Hypnobirthing Instructor at Born to Birth Company

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