When should I call my doctor or go to the hospital when labor begins?

Determining the right time to contact your doctor or head to the hospital is vital for the safety of both the mother and baby. While the due date is a general estimate, natural labor can begin anytime between the 37th and 42nd weeks of pregnancy [1]. It is important to pay attention to signs of true labor, which differ from false contractions (Braxton Hicks).

Signs of True Labor Requiring Medical Contact

Several signs indicate true labor and require immediate contact with your healthcare provider [2]:

• Regular, closely spaced contractions: If contractions begin occurring regularly, increasing in strength and frequency, and lasting between 30 to 70 seconds, this is a sign of true labor. Call your doctor if contractions become painful and regular, occurring every 5 to 10 minutes for an hour, or if they last 60 to 90 seconds [2].
• Rupture of membranes ("water breaking"): If you feel fluid leaking from the vagina, whether a light trickle or a gush, this may indicate the amniotic sac has ruptured. Even if contractions have not yet started, notify your doctor immediately, as most women begin labor within 24 hours of their water breaking [2].
• Vaginal bleeding: Any vaginal bleeding other than light spotting requires immediate contact with your doctor [2].
• Decreased fetal movement: If you notice a decrease in fetal movement, contact your healthcare provider immediately, as this may indicate a potential problem [2].

The Difference Between Braxton Hicks and True Labor

It is common for pregnant women to experience mild contractions before true labor begins, known as Braxton Hicks contractions. These are usually short, painless, do not occur at regular intervals, do not increase in strength over time, and do not cause cervical changes [2]. This contrasts with true labor, which features regular contractions that increase in intensity and frequency, and lead to cervical changes [1].

Other Signs That May Indicate Approaching Labor

Some women may notice other signs before actual labor begins, such as:

• Lightening: When the baby's head drops into the pelvis, you may feel like your belly has dropped lower, making it easier to breathe, but you may need to urinate frequently due to pressure on the bladder. This often happens weeks before labor for first-time mothers, and may not occur until labor starts for women who have previously given birth [2].
• Bloody Show: You may notice bloody or brown vaginal discharge, which may mean the cervix has begun to dilate. This can be a good sign, though active labor may still be days away [2].
• Diarrhea: Some women feel a frequent urge to empty their bowels, and stools may be softer than usual before labor starts [2].

Additional Tips

If you are unsure about any signs you are experiencing, it is always best to contact your healthcare provider for advice. They can evaluate your condition and provide necessary guidance. To learn more about natural childbirth and how to prepare for it, you can visit Natural Childbirth: A Comprehensive Guide to Preparation, Labor Stages, and Pain Relief Options (Arabic).

Medical references

• Childbirth
• Am I in labor?