When to go to the Hospital 7 Tips for Families and Doulas.

Using Timing Contractions to Decide When to go to the Hosptial

Understanding how to time contractions is recommended as you approach active labour. Your medical care provider will let you know when they’d like you to call or head to the hospital based on timing your contractions. They will give you a guideline of when you will be at 4cm based on your contraction pattern like 4-1-1 or 3-2-1, which means:

When your contractions are coming every 4 (or 3) minutes, lasting at least 1 minute, and have continued at that intensity for 1–2 hours.

These should be strong contractions—ones you can’t talk through and need to focus on or breathe through. You should not time all of your contractions just a few of them. 

How to Time Contractions:

You have two options for tracking the frequency of your contractions:

1. Option 1: Time how many contractions occur in a 10-minute period. This will give you an overview of the frequency.

   
   

   • If you get 2 contractions in 10 minutes, they are 5 minutes apart.

   • If you get 3 contractions in 10 minutes, they are 3 minutes apart.

     
     

2. Option 2: Start timing from the beginning of one contraction to the beginning of the next. This tells you the frequency.

   
   

Also, note how long each contraction lasts from start to finish. This gives you the duration.

Remember even when your contractions meet the 4-2-1 rule you might be 4 cm or less, you likely still have lots of time before you are fully dilated. 

When NOT to Time Contractions:

• Don’t start timing contractions that are too mild, irregular, or ones that you can easily talk, walk, or rest through. These are likely still early labour contractions.

  
  

• Avoid timing contractions too early in the process.

  
  

Stay calm and focused. If you feel that labour is progressing quickly—even if it doesn’t meet the timing guideline—trust your instincts and contact your medical care provider.

Important Situations During Pregnancy: When to Call Your Medical Care Provider Immediately

You should contact your medical care provider without delay if you experience any of the following:

• Ongoing and excessive vomiting

• Bleeding from the vagina

• Intense continuous pelvic or abdominal pain that does not improve with rest, warm baths, or heat application

• Repeated episodes of dizziness, fainting, or feeling confused

• Pain or burning when urinating

• Constant and intense pain in the middle of your back

• Sudden swelling of your hands or face

• A strong headache centered at the front of your head

• Blurred or altered vision lasting several hours

• Pain in the upper abdomen or chest between the ribs

• First-time appearance of blisters around the perineal or anal region in early pregnancy

• Fluid leaking or gushing from the vagina before 37 weeks (possible water breaking)

• Consistent and intensifying contractions before 37 weeks

• A temperature of 38°C (100.4°F) or higher, on two separate occasions at least four hours apart

• Any other significant concern or urgent issue

Early Labour: When and What to Expect

Signs that labour may begin soon include:

• A mucous discharge with streaks of blood (“bloody show”)

• Cramps similar to menstrual pain

• Frequent loose stools

• Intermittent backache

• Irregular, inconsistent contractions

  
  

These early signs are common and typically show up together rather than on their own. They don’t require an urgent call to your medical care provider. Early labour can last for many days, even weeks, and often includes irregular contractions that may come and go. Take care of yourself during this time—eat nourishing meals, get plenty of rest, sleep when you can, and continue your normal daily routine to help keep your mind occupied. Remember, your baby will arrive once you’ve entered active labour and you will be very busy! 

If you are worried about something, or think the labour is progressing rapidly—even if it doesn’t follow the 4-2-1 rules—please page your medical care provider.

How to Manage Early Labour

At night:

• Try to sleep—rest is valuable.

• Take a warm bath, dim the lights, light candles, or sip a glass of wine or warm milk.

• Consider taking Gravol (50–100 mg) to help relax and sleep between contractions.

• Use deep breathing, relaxation or meditation techniques, and apply warmth to your lower belly or back.

• Avoid notifying friends or family—this can cause unnecessary stress or pressure.

During the day:

• Eat and stay hydrated.

• Ignore contractions until they become intense enough to prevent talking.

• Stay active: go for a walk, work on a hobby, or watch a light-hearted film.

• Take a nap if possible.

If Your Water Breaks (Rupture of Membranes) Knowing when to go to the hospital.

If ALL of the following are true:

• Clear fluid is leaking or has gushed

• You are at or beyond 37 weeks

• Your baby is moving normally

• Your medical care provider has confirmed the baby’s head is engaged

• You are GBS negative

• You are not yet in active labour

• It’s during nighttime hours

  
  

Then you can wear a pad, rest, and contact your medical care provider in the morning—unless advised otherwise.

Call Your Medical Care Provider Immediately if:

• You are GBS positive

• The fluid is green, brown, bloody, or foul-smelling

• You feel feverish or unwell

• You are under 37 weeks pregnant

• You’re having regular, strong contractions

• Your baby’s movement has decreased

Post-Water-Break Instructions

• Avoid inserting anything into the vagina (no fingers, tampons, etc.)

• Do not engage in sexual activity

• Change pads every two hours

• Wipe after going to the washroom front to back

• Showers are fine, but avoid baths until active labour begins

• Take your temperature every four hours while awake; call your medical care provider if it rises above 38°C (100.4°F)

Monitoring Fetal Movement

Contact your medical care provider if you notice a significant change in your baby's normal movement patterns, such as:

• A decrease in movement over several hours

• No movement in response to eating, drinking, or rest

  
  

If concerned, eat or drink something, then rest quietly and count your baby’s movements for two hours. At least six movements in that time is considered normal. Later in pregnancy, fetal movements may become more gentle and slow, resembling rolls or stretches rather than sharp kicks.

Emergency: Umbilical Cord Prolapse ( Very Rare between 1 in 200 and 1 in 1000 births. )

If you feel or see something bulging from the vagina, especially if you suspect it’s the umbilical cord:

1. Immediately get into a knee-chest position on the floor.

2. Page your medical care provider.

3. If sure it’s the cord, call emergency services (911), then contact your medical care provider.

   
   

Other Reasons to Page Your Medical Care Provider

• You are experiencing bleeding

• You have an emergency health concern for you or your baby

• You have been in a car accident or sustained trauma to your abdomen

• You are planning to go to the Emergency Room or Maternity Unit for any reason

  
  

Please note: this is not a comprehensive list of reasons to page. If you're unsure, it’s always best to reach out to your Medical Provider. If you are concerned, don't worry about when to go to the hospital it is always open.