Angie The Doula – Guide on When To Go To The Hospital

If you’re planning a hospital birth then you have to figure out when to go. This guide will help you make that important decision.

Most people don’t know that the majority of naturally-starting labours are usually done at home. Some people want to get to the hospital later in the birth process. They know the longer they’re in the hospital, the more likely they are to have interventions as part of their birth. Other birth mothers simply enjoy being at home more. 

One of the benefits of working with a doula is that we help clients decide when to go. We will let you know that you won’t be officially admitted if you aren’t “far enough along” in labour. Most first time birthers without professional guidance go far too early, often by many hours. This leads to the disappointment of being sent back home. 

Please note that this is a general guide. At your prenatal appointments, ask your medical care provider if there are any specific recommendations for when you should go in. Some pre-existing conditions or medical issues lead to different recommendations from those below.

When to go to hospital

Unless you’ve been told otherwise by HCP…

• Pattern of sensations or contractions (explained below): 311 for a first birth or 411 for subsequent births; even sooner in labour if you have a history of fast birthing.
• Can’t walk or talk through sensations that fall into the pattern above
• Tip: If you feel like eating, then it’s likely too early, based on labour pattern alone
• Lots of pressure and contractions end with a grunt, the urge to poop, bear down or “push”. 
• Signs of labour or waters releasing before 37 weeks
• Any health concerns (some “warning signs” are below)
• Decreased fetal movement that isn’t remedied by eating and resting
• When waters release? Maybe, maybe not.
• If there’s a colour (yellow, brown, green) or foul odour when waters release
• Want pharmaceutical help coping with pain
• Feel safer at the hospital or want reassurance about your own or baby’s health (will be sent home if not in ‘active labour’)

Before heading in:

• Have some juice or snack (unless you’ve been instructed to not eat e.g. schedule c/s)
• Pee before heading out the door
• Bring:
  • Health Card
  • Envelope with your prenatal records & birth-plan
  • Any prescription medications
• Bonus: lip-balm and a hair-tie
• Be ready to answer these 3 questions:

1.    What’s the labour pattern

2.    Have waters released? If so was there a colour? 

3.    Is the baby moving normally?

• 

Warning Signs

This is a partial list. Warning signs are covered in detail in prenatal classes and health region documents.

Seek medical attention (do not sleep on these signs or wait in hopes that they pass):

• Decreased fetal movement
• Visual disturbances
• Sudden and severe headache
• Pain in upper abdomen that doesn’t pass
• Maternal fever

911 call:

• Red, flowing bleeding or clots
• Sudden, severe / intense / sharp pain that brings you to your knees and doesn’t pass
• Cord prolapse when waters release

A note about “being sent home”: It’s OK. Perhaps it’s inconvenient but it can be reassuring to get checked out, be found healthy, and then be sent home. I’ve met a lot of nice staff at various hospitals who will tell you it’s better to come in for nothing than to miss a problem.  

Note about the contraction pattern: 

• 311 means 3 minutes between the start of one contraction and the start of the next; 1 minute from start to end of the contraction; at least 1 hour of that pattern consistently. (411 is the same except 4 min between contractions.) 
• Use 411 as your guide if you wish to get there soon into active labour, and likely stay but maybe sent home . 
• Use 311 as your guide if you want to be more certain of being admitted and have no need or desire to go earlier in the process

I teach a variety of Child Birth Education classes and prenatal workshops online for people all over.  I have been a birth doula since 2002, and have helped over 300 clients with their births and over 1000 through prenatal classes. Learn more about my birth doula services, and contact me with any questions you may have.