Am I in Labor?
Generally, midwives recommend you call with any of these symptoms:
- Your contractions have been 5 minutes apart or less for at least 1 hour
- You experience several contractions that are so painful you cannot walk or talk during them
- Your bag of waters breaks
- You experience bleeding. Some bloody show is normal, but heavy bleeding can be a sign of trouble.
- You have not felt your baby move within the past hour or two. Baby’s activity may increase or decrease during labor, but you should still feel movement.
One of the most common questions that we midwives get asked is, how will I know if I am in labor? It can be confusing. Over the course of your pregnancy your body has been changing so much, so sometimes people dismiss early labor cramping as just another pregnancy discomfort. The important thing about labor is that it gets stronger over time and is eventually hard to ignore.
Some signs of labor:
Your contractions come and go in a pattern and are strong. Contractions cause the muscles of your uterus tighten up like and then relax. When you’re in true labor, your contractions last about 40 to 80 seconds and may start far apart (10-15 minutes) and then get closer together. When they are 5 minutes apart, lasting at least 1 minute for at least 1 hour (511), you are likely in labor. Remember 511 means call your midwife! In labor you may feel ok between contractions, but during the contractions they are so strong that you can’t walk or talk during them.
You have a bloody (brownish or reddish) discharge. This is called bloody show. It can be a sign that your cervix is starting to dilate. Call your midwife if you have any vaginal bleeding in pregnancy, even if it is just spotting. Heavy bleeding in pregnancy can be a sign of serious pregnancy complications and requires evaluation.
Your water breaks. Your baby has been growing in the bag of waters, which is known as the amniotic sac. When the bag of waters breaks, you may feel a big rush of water, or a trickle of fluid. The fluid is usually clear or pink-tinged, but in some cases is green in color. Call your midwife or doctor if you think your bag of water broke.
When should you go to the hospital/birth center?
Your midwife will advise you to come to the hospital or birth center for examination, if it sounds like you are laboring. If you are planning a home birth, your midwife team will make a plan to come evaluate you at home. It never hurts to call if you are not sure if the symptoms you are having are labor. I have had some patients who try to put off calling until the office opens, as not to bother their provider. It is our job to be here for you. It is better to call and get reassurance than to stay up worrying.
For more information, download an “Am I in Labor?” PDF from the ACNM or watch a video from the University of Minnesota School of Nursing below: