Knowing if You're in Labor Isn't an Exact Science

Recently, a mother in labor in Virginia was told to go back home when she showed up at the hospital in labor and she was asked to return when she couldn't "talk or walk during contractions." After driving back, 25 minutes away, she proceeded to give birth to her baby in the bathtub at home. Thankfully, mom and baby boy were both healthy after the birth. But it begs the question that alllll pregnant parents want to know: how will I know I'm in labor?! 

This mother reported that she had a high pain tolerance and so did not find the contractions  painful or intense enough to not be able to talk or walk through them, even though that is a hallmark sign for most people that they are in active labor. The truth is, everyone has a slightly different experience with how they feel or register contractions. This means that knowing when you're in labor is more of a guessing game or gut feeling than an exact formula. In this post, we're going to look at some of the ways you can tell you're in labor, and perhaps more importantly -- what to do if you arrive at the hospital too early and/or are told to come back when you're further along.     

Your contractions feel different. 

Maybe they're stronger, maybe they're more in a pattern, maybe you have to stop doing what you were doing when a contraction comes on. If you're contractions are noticeably different, and you've had a few or more in a row like them, you may be in labor and it may be time to at least call your care provider or maybe head to your place of birth. 

You notice a pattern.

Many care providers tell you to follow the 5-1-1 or 4-1-1 rule of when to go to the hospital in labor. This means that your contractions have gathered strength and consistency and are either 4 or 5 minutes apart, last at least one minute long, and have been in that same patter for about an hour. If you've hit the 4/5-1-1 pattern, you may be in labor and it may be time to head to your place of birth. 

You've talked to your doula and/or care provider on the phone. 

Everyone's situation is unique. When you think you may be in labor, call your midwife or doctor and your doula, if you have one. Spend some time talking with them about what's been going on. Their assessment may help you to know if you are in labor and should go to your place of birth. It's impossible to predict for sure based on a phone call, but it can help. 

You've had a cervical exam. 

Cervical exams aren't always accurate or even indicate that you are definitely in labor, however, having a cervical exam that finds you are 6cm dilated and you're having consistently strong and close together contractions, for example, can give you fairly definitive information on whether you want to stay at the hospital or go back home. 

Your gut tells you. 

Never dismiss your gut instincts. We all have them, and while some of us are better at "reading" our gut than others, it's a good idea to pay attention when you think something is true. Unfortunately, in the case of labor and birth, it's easy to dismiss gut feelings when a person in a powerful position (like a midwife, nurse, doctor) tells us something they believe to be true but goes against our gut. 

If you follow one of the above signposts and arrive at the hospital or birth center and find out that you're still too early to be admitted and are told to come back later, you have options that don't include going home. You can stay in the hospital's lobby or waiting room and labor there or you can go to a place near by (coffee shop, grocery store, park, or even the hospital parking lot) to continue laboring while remaining close to the hospital. Even though you may not be far along enough in labor to be admitted right away, your body is still doing important work for your eventual labor. Stay encouraged -- your body is gearing up now for the work of labor that will eventually come.