When to go to hospital?

shan417 · July 2013

I would like to labor as naturally as possible, and I keep reading that one of the best tips is to labor at home as long as possible. It takes about 30-40 minutes to get to the hospital from my home, so how do you know when its actually time to go to the hospital? I would be too anxious with a home birth, and definitely don't want to give birth in the car on the way there!

jennychrm · July 2013

My midwife told me to go when I was having contractions about 5 mins apart consistently for an hour. I did that and was only 4 cm dilated when we got there. We were about 15 mins from the hospital.

dmhrn13 · July 2013

I tell all my patients if it takes you less than 10 minutes to get in the car- you are going too soon! Worry less about the timing of contractions & more about the intensity. When a woman calls me to come in in labor & wants natural childbirth, I tell her to call me back when she thinks she wants something for pain. Then it's time to come, and usually they are very close at that time.

A37licia · July 2013

dmhrn13 said:

I tell all my patients if it takes you less than 10 minutes to get in the car- you are going too soon! Worry less about the timing of contractions & more about the intensity. When a woman calls me to come in in labor & wants natural childbirth, I tell her to call me back when she thinks she wants something for pain. Then it's time to come, and usually they are very close at that time.

That's a great guideline.

Arielle27 · July 2013

I labored at home as long as possible with number 1 because the hospital was a ten minute walk away (took 30-40 in labor, however!). It was great! Arrived at 5 cm, had the baby a few hours later. With number two, we were 40 minutes driving from the hospital (up to an hour and a half with traffic), so I rushed to the hospital as soon as labor started. I did not like that at all. Even though the active labor time was shorter and the baby was much smaller, not OP or with a nuchal hand (as number 1 had been), and it started after a full night sleep (rather than going all night as it had happened with number1), the ordeal felt much longer, more painful and more tiring. I can't say that's it is all due to the fact that I was just in the hospital waiting for things to happen (I went in as soon as my water broke even though my contractions weren't that close together or that intense). I had a difficult last month of pregnancy with a lot of false labor and preterm labor, with a month of constant contractions... So I can't say it was a total mistake rushing to the hospital because after the preterm labor I was already and was 3cm dilated before labor started... So everyone thought the baby was basically going to just slip out! Well, she didn't, but I'm still glad I hadn't ended up in active labor for an hour in a car in traffic!!

SarahinMD · July 2013

I agree that it's best to look at the seriousness of them--we learned some great stuff from the Bradley Method books we used to prepare. My midwives require they speak to the patient on the phone, and they try to listen and talk through a couple contractions to get a sense of how serious they are. When I could not talk through them at all, we left for the hospital (well, really, I didn't care what she'd have said, I knew it was time to go). We are an hour from the hospital, and I was fully dilated once they checked me. This time I'll have to leave earlier since it went quickly the first time. You still want to be well-established though, because a long car ride can interrupt and pause labor, for some, if not well-established.

aylafsu88 · July 2013

It sounds weird to say but most woman just know when it is time to go. I labored at home for a long time. My contractions were erratic and never established a solid pattern. They did pick up in intensity and I finally decided I wanted to go to the hospital. My doula and H tried to talk me into stay home one more hour. I was dead set against waiting so we left for the hospital The drive was only 15 minutes. My water broke when I was in triage and I was 6 cm. In less than 2 hours I was holding LO. IMO emotional signposts are the most important in deciding when to go. If you cannot talk through a contraction it is time to go.

nicholssquared · July 2013

I had a 40 minute ride as well, and I waited until contractions were three minutes apart and a minute long for an hour. I got there dilated somewhere between a six and a seven and was almost in transition.

Second time, I did the same, but I was a little more nervous because the contractions were as frequent, but the weren't as intense. I was a six when I got there.

This time, I'm going to wait even longer. I want to be almost ready to push when I get there. I'm thinking 2,1,1 and intense contractions.

GL!

atcwag · July 2013

Typically, OBs say to go when you are 5-1-1 (5 min apart, lasting 1 min for 1 hour), but this is often too early, especially for first time moms. This timeframe can often leave a long labor in the hospital.

I am going to go by how I'm feeling and just kind of "wing it"....we're only about a 2 min. car ride from the hospital.

I'm apprehensive because a coworker of mine just had a VERY short labor - like, crowning in the car, born in triage, Dr. didn't get there in time labor. Her contractions never established a true pattern and she stayed at home because they weren't intense at all. She never felt pressure or true pain.

robyn2201 · July 2013

I wouldn't go with timing of your contractions. Obviously keep it in mind, but just because you are having contractions every 5-1-1 or even 3-1-1, it doesn't necessarily mean it's time to go. With both of my labors, contractions started out right away at 3-1-1 and just changed in intensity. DD1, I arrived at the hospital after several hours at home and I was only 5 centimeters and it was still another 5 hours till she was born.

Read up on the emotional signposts that you should look out for. Another tip is wait at home until the thought of getting into the car is the last place you want to be.

sschwege · July 2013

As annoying as this answer is, a lot of women just know. With my first, my contractions were 3.5-1-1 for awhile. I knew I wasn't super close, but knew I was far enough along. Arrived at 6cm and had DD 7 hours later. With my second I wanted to get there closer to the end, so I waited, waited, waited, ignored what my body was telling me, which was that I was really close. I kept telling myself that I hadn't been having strong contractions for that long, and it was basically all in my head. Finally left for the hospital and DS was born in triage. A little too close for comfort. Had I listened to my body, I could have saved myself the panic I felt as I realized this baby was going to born very soon and we were still in the car!

janelleashu · July 2013

nicholssquared said:
I had a 40 minute ride as well, and I waited until contractions were three minutes apart and a minute long for an hour. I got there dilated somewhere between a six and a seven and was almost in transition.

Second time, I did the same, but I was a little more nervous because the contractions were as frequent, but the weren't as intense. I was a six when I got there.

This time, I'm going to wait even longer. I want to be almost ready to push when I get there. I'm thinking 2,1,1 and intense contractions.

GL!

What was that car ride like? I want to labor at home a long as possible but I am dreading bein in transition during the car ride. That sounds just awful to me.

JCWhitey · August 2013

OK, my case is really rare, but IMO going right away when my water broke was wise. I didn't want to go, especially since contractions hadn't started yet, but DH was really uncomfortable not going right away. I ended up stalling for an hour, but by the time we were in the car my contractions were 1 minute long and 1 minute apart. By the time we got within eyesight of the hospital I was doubling over through the contractions. I am SO happy I didn't wait longer, the car ride would have been unbearable. Our son was born 3 hours after we arrived at the hospital and I pushed for 45 minutes of that. Contractions were never more than a minute apart.

Again, my case is rare, but next time I plan to go right away and if things haven't progressed to where I want them to I will leave and go get a hotel.

A37licia · August 2013

aylafsu88 said:

It sounds weird to say but most woman just know when it is time to go. I labored at home for a long time. My contractions were erratic and never established a solid pattern. They did pick up in intensity and I finally decided I wanted to go to the hospital. My doula and H tried to talk me into stay home one more hour. I was dead set against waiting so we left for the hospital The drive was only 15 minutes. My water broke when I was in triage and I was 6 cm. In less than 2 hours I was holding LO. IMO emotional signposts are the most important in deciding when to go. If you cannot talk through a contraction it is time to go.

I agree with this for the most part, but there are more than enough women who do go in too early. Sometimes their DH worries it's getting too close (or another involved relative) and pressures to go in. If she listened to her own body, perhaps she'd stay home, but sometimes that's hard for a woman to do, especially a FTM who hasn't been through it before. I'd hesitate to leave it at "you'll know". I very much recommend having some outside guidelines to compare one's own feelings (emotional or physical) to in order to know if your body is in active labor or not. Ditto the mention of the Bradely materials...even if you aren't seeking a natural birth, if you want to get to the hospital in active labor, going by their suggestions will help discern that time.

mlrafiki · August 2013

I think I'm in the minority here, but my vote is "go with your gut," even if you're an FTM. If you're targeting a natural birth, odds are you've done enough research to have an idea of what to expect, which makes you less likely to be the type to rush to the hospital the minute you feel a contraction. There's no guarantee that your body will behave like the statistical majority, so even if you go in "too early," you might progress really fast.

This is what happened to me: I'd been having contractions for 6 hrs and they'd gotten to about 1.5min apart. I was hanging out in the tub at home and while I had to focus exclusively on my breathing, I was handling them pretty well. My doula came over to observe and gently warned that it was probably too early to go to the hospital. I actually thought she was right, but for some reason I still wanted to go. We got there and I was only 2cm, so the nurse told me to go home. Next thing we know, I'm fully-dilated and bearing down! My doc barely made it in time to catch the baby. If I had stayed home, I very well may have ended up with an unassisted birth!

Guess that puts me in the "you'll know" camp. But don't worry if it turns out you went too early. Just have a contingency plan, like a place you can hang out near the hospital if you don't want to keep laboring there with all their monitors and junk.

Cooper611 · August 2013

I always assumed that I'd labor for a while at home. That wasn't the case. My labor progressed quickly. The advice I would give would be to focus on how close together your contractions are. If they are less than 5 minutes I'd head in. Don't worry, you always have the right to leave/labor in a family room or waiting area. Believe me, people will give you privacy. Most people run the other way at a woman in labor!

skio · August 2013

I had a medfree VBAC for my second birth. I wanted to stay home as long as possible to avoid intervention, because intervention was what caused the downward spiral of my first labor.

My first labor: I was dilated 1c and 50% effaced at 39w1d and went into labor four days later. I stayed at home for 7 hours. Contractions were 5-6 minutes apart for about two hours at that point but manageable. I was only 2c when I got to the hospital and progressed to 10c over 12 hours with help from pitocin. Total labor was 23 hours before c/s.

Second labor: I was dilated 4c and 80% effaced at 40w and went into labor the next day. I stayed home for six hours. Five hours into labor, I couldn't walk or talk through contractions, I had to breathe through them. They were 3-5 minutes apart. A half hour later, I must've hit transition, because they started coming 2-3 mins apart, I was shaky, and I had to vocalize through them. I couldn't keep quiet. When I got to the hospital, I was 9c. Delivered 4 hours later.

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