Labour day: when to call, when to go in, and when not to wait

You have packed the bag, saved the numbers and practised the route. Now the contractions have started, and the big question arrives: should we go now? Going in too early can mean being sent home; leaving it too late can be stressful or unsafe. Here is a simple guide. Every hospital has its own advice, so ask your midwife at your next appointment what they want you to do, and write it down.

Rule one: call before you go

Where possible, phone your maternity unit, labour ward or midwife before you set off. They will ask you some questions, such as how often your contractions come, how long they last, whether your waters have broken and how your baby is moving. They can then tell you whether to come in or stay at home a little longer. In places where there is no phone line to call, agree a plan in advance with your clinic.

Rule two: know the usual guide

For a first baby, many hospitals suggest coming in when your contractions are:

• regular
• strong enough that you need to stop and breathe through them
• coming about every five minutes
• lasting around a minute each

If you have had a baby before, labour is often quicker, so you may be advised to come in sooner. You may also be told to come earlier if you live a long way from the hospital, have a long journey in traffic, or have a medical condition that needs closer monitoring.

Rule three: some things mean go now

Do not wait for contractions to settle into a pattern if any of these happen. Call your maternity unit and go in straight away, or call your local emergency number:

• your waters break, especially if the fluid is green, brown, smelly or bloodstained
• you have vaginal bleeding beyond a small streak of mucus
• your baby is moving less than usual, or differently
• you have constant, severe tummy pain that does not ease between contractions
• you have a severe headache, blurred vision, flashing lights or sudden swelling
• you have a fever, or feel shivery and unwell
• you are in labour before 37 weeks
• you feel a strong urge to push
• you are worried, even if you cannot explain why

If you have been told you need to come in early in labour for a particular reason, follow that advice.

Getting there

• Plan your transport in advance, including a back-up if your first plan falls through. Keep money for transport ready.
• Do not drive yourself while in labour.
• Arrange childcare for older children, with a back-up for the middle of the night.
• Keep your bag, maternity notes and phone by the door.
• If birth is happening fast and you cannot get to hospital, call your local emergency number. They will guide you until help arrives.

If you are sent home

It can be disappointing to be told you are in early labour and should go home for now. It does not mean you did anything wrong. Early labour can be long, and many women are more comfortable at home. Ask what signs should bring you back, and call again whenever you are unsure.

For your birth partner

If you have a husband, partner or friend who will be with you, go through this guide together. Their job on labour day includes timing contractions, making the calls when you cannot talk, keeping calm and speaking up for you.

He goes ahead of you

When the moment comes to walk out of your front door, you might pray this promise, given to Joshua as he faced the unknown:

“And the LORD, he it is that doth go before thee; he will be with thee, he will not fail thee, neither forsake thee: fear not, neither be dismayed.” (Deuteronomy 31:8)

God goes before you into the labour ward. He will already be there when you arrive. Whatever time of night it is, whoever is on shift, whatever the day holds, you will not walk into that place alone.

A prayer for the journey in

Lord, You go before me today. Give us wisdom about when to leave and a safe journey to the hospital. Prepare the midwives and doctors who will care for us, and be with me in every moment of this birth. Amen.