Pregnancy When Should I Go to the Hospital for Labor? You may have a lot of questions about how to know you're actually in labor. Here's everything pregnant people need to know. By Jillian Pretzel Published on September 27, 2023 Medically reviewed by Kiarra King, M.D. In This Article View All In This Article How Do You Know You’re in Labor? What Is True Labor vs. False Labor? What About When Your Water Breaks? How To Know When It’s Time To Head to the Hospital What To Expect When You Arrive at the Hospital What Else To Keep in Mind About Contractions Trending Videos Close this video player Getty Images In the movies, pregnant people are often shown looking down (surprised!) to find that their water has broken, taking a cab straight to the hospital, and delivering a baby soon after. But labor, and knowing when to go to the hospital or birthing center, isn’t always so simple. Some people confuse Braxton-Hicks contractions with the real thing and go to the hospital only to be told they’re in “false labor” before being sent home. Others labor at home for too long and end up with an unplanned home, or even roadside, birth. So, when should soon-to-be parents head out the door? Overall, OB-GYNs say that every birth is different and advise patients to contact their providers if they are unsure about their symptoms. But experts say it’s still important to have an idea when labor has progressed to a certain point and to be able to identify red flags that could point to complications. How Do You Know You’re in Labor? It’s not uncommon to miss, or not experience, some of the many possible early signs of labor, such as lower back pain, lightning crotch, or losing the mucus plug. That’s why Jennifer Gilbert, DO, an OB-GYN of Axia Women’s Health in Paoli, Pennsylvania, says many first-time parents worry they’ll miss their chance to get to a hospital. But when labor really gets going, Dr. Gilbert says there will likely be no confusion. “We always say to patients, ‘When you know, you know,’” she explains. “Contractions are painful. And it's the pain of the contractions that lets us know that this is going to be true labor. We usually tell our patients, ‘If you can't talk, if you can't walk, if it stops your world for a minute, that’s a labor contraction.’” She also says that contractions are identifiable by where the pain is (they start in the front and wrap around the back) and by their frequency. “The contractions will get more intense and they’ll slowly get closer together,” she says. “True labor won't stop; it'll continue to progress forward.” What Is True Labor vs. False Labor? False labor, otherwise known as prodromal labor, pre-labor, and latent labor, “is defined as contractions that don't dilate the cervix,” Dr. Gilbert explains, adding, “Labor contractions open the cervix to allow the baby to pass through the birth canal, but when women have false labor, they don't have that dilation.” Experts don’t know what causes false labor, but Justine Kim, MD, FACOG, an OB-GYN with Westside in New York City, says they can often be easy to spot. “Usually, if you're having contractions, and if they're not painful, or if they go away with hydration and rest, it’s probably not labor, because labor has a snowball effect—the contractions will get more intense, more frequent, more regular, until you have the baby.” What About When Your Water Breaks? Dr. Gilbert notes that many patients think that water breaking will be the first indicator of labor, however, she says that most of her patients will labor until their cervix is dilated about 4 or 5 centimeters before their water breaks. Another misconception is that water breaking means pregnant people need to rush to the hospital. But Dr. Kim says that as long as the amniotic fluid is clear, and the parent-to-be has tested negative for Group B Strep (which calls for antibiotics during labor and delivery), pregnant people should have hours to get ready. “You can get your stuff ready and maybe take a shower,” she says. “Usually, you don't have to be in a mad rush to get to the hospital.” How To Know When It’s Time To Head to the Hospital Providers recommend following the 5-1-1 rule, which states that pregnant people should go to the hospital when: Contractions are five minutes apartEach contraction lasts for one full minuteAnd this pattern lasts for one hour Dr. Gilbert notes that once her patients reach this point, they typically deliver within 24 to 36 hours. However, if this is a pregnant person’s second baby, or any subsequent pregnancy, they typically deliver sooner. “I usually [tell those patients] as a general rule of thumb, cut that time in half,” she says. “So, when you start that labor pattern, it's probably going to take half the time.” What To Expect When You Arrive at the Hospital When at the hospital, people can expect to be triaged, which often involves heart rate monitoring, blood pressure testing, and more. “There are certain findings that reassure us that the baby's healthy, getting good oxygenation, and tolerating the contractions well,” Dr. Gilbert says. “Fetal monitoring is typically the first thing that will happen. We also monitor the contraction pattern because we want to see how often the patient is contracting, and how the baby is responding to the contractions.” Dr. Gilbert adds that most patients will get bloodwork done and will receive an IV for hydration, noting that labor is “like running a marathon.” She says that, at this time, patients will usually be offered an epidural. Meanwhile, those with a scheduled induction or C-section will typically be shown to their delivery room right away. “Instead of going to triage, you'll be put directly into a room,” Dr. Kim says. “And then after that, it's very similar. You'll be placed on the monitor. We get your history, we do an ultrasound, a cervical check, and then we get started with the induction.” Symptoms You Should Never Ignore Experts warn that there are several red flags to look out for at the end of pregnancy. It’s important, says Dr. Kim, to call your health care provider for any symptom you feel is unusual. But some big ones to look out for include: Heavy vaginal bleeding. While Dr. Gilbert says some pink mucus discharge is normal, large amounts of blood and blood clots are not. Feeling the baby moving less. Dr. Kim says that she usually advises patients to count kicks every day so they will know right away if there is a difference in movement. “If there's any change from the baseline of the baby's movement, I usually tell people to call us first,” she says. “We can add them to the office schedule for a quick ultrasound or go to the hospital for a full workup.” Abdominal pain Fevers Chills Feeling itchy. “Itchiness in their abdomen, or especially in their palms or soles, can be an indicator that a disease process is happening during pregnancy,” she says. It can be intrahepatic cholestasis, a potentially serious liver condition. Persistent headaches and/or vision changes. “If patients have headaches that don't go away with Tylenol and hydration, or if they have changes in their vision, or upper abdominal pain, those are signs of preeclampsia.” What Else To Keep in Mind About Contractions Every contraction doesn't mean your baby is coming. If in doubt, check in with your doctor or midwife to determine the next best steps. Also, feeling contractions is different if a person is preterm or before 37 weeks of pregnancy. If you notice contractions, especially every 10 mins for an hour, make sure to call your health care provider. Was this page helpful? Thanks for your feedback! Tell us why! Other Submit Sources Parents uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Prodromal Labor. American Pregnancy Association. Contractions and signs of labor. March of Dimes. 2018. Itching and intrahepatic cholestasis of pregnancy. NHS. 2023. What are the symptoms of preeclampsia, eclampsia, & HELLP syndrome? Eunice Kennedy Shriver National Institute of Child Health and Human Development. 2017.