Is It Time?? When To Go To The Hospital
The question of "When do I go to the hospital?" gets asked many times. It's tough to differentiate between active labor and prodromal labor. The advice and suggestions you get may vary by the provider based on your medical history during this pregnancy. Going too soon could mean the possibility of unwanted interventions. Going too late could mean missing the window on an epidural, if that was your desire, or risking having an interesting non-hospital birth story to tell. Here, we're going to look at some key indicators to signal when it might be time to hit the road!
Your Water Breaks
Whether you suspect labor has begun or not, it's always safest to call your provider first if you feel your water has broken. Chances are your provider will suggest you go to the hospital to verify your membranes have ruptured if you are contracting or suggest you stay home for a little while if contractions have not started. The ultimate concern is making sure your baby does not spend too much time with little amniotic fluid in the sac if your water has broken and continues to leak. Also, remember the choice to get a vaginal exam after verifying your water is broken is optional (not mandatory)! The risk for infection is higher if vaginal exams are done after membranes are ruptured so informed consent is the way to go.
You Are Contracting
The general rule of contractions to determine active labor is the 4-1-1 pattern. This means you are contracting every 4 minutes, lasting at least 1 minute, for at least 1 hour. Some providers may suggest going to the hospital at a 5-1-1 pattern, but the overall key is this pattern lasts at least an hour. This choice is also up to you because contractions may be very manageable at this pattern. Another indication of when to go to the hospital may not be based on time but based on feeling. If contractions become difficult to handle and require more concentration and focus, that's a good sign to get in the car.
You Show Symptoms of Preeclampsia
Contact your provider or go straight to the hospital if you show signs of preeclampsia before or during labor. Preeclampsia can be a dangerous complication. Signs of preeclampsia include:
Dizziness
Nausea
Blurry vision
Excess protein in the urine
Swelling of the hands and feet
Abdominal pain
You Have Vaginal Bleeding
During labor, there is normal light bleeding and may come with the loss of the mucous plug or may occur after a cervical exam. You may notice bleeding when you wipe after using the restroom or see it on a sanitary napkin. Vaginal bleeding that is a cause for concern is heavy bleeding that soaks through a pad or more. This is an indication that you should go to the hospital to be examined. During labor, heavy bleeding is called intrapartum hemorrhage (IPH). After delivery, heavy bleeding is called postpartum hemorrhage (PPH).
Each person and each labor experience can be very different and should be treated on an individualized level. If there is a concern, always contact your provider first. When to go to the hospital could also depend on if you are considered low or high risk. The urgency to go to the hospital early in labor may come if you have had a high-risk pregnancy. Use your best judgment and intuition!