When to go to the Hospital

Deciding when to go to the hospital can cause laboring couples a lot of stress. If you get there too early, you may get sent home or you run the risk of labor slowing down or stopping. If you go in too late, you run the risk of not making it. So when is the best time?

Well, for most first time couples the chances of not making it to the hospital in time and delivering in the car or at home are pretty slim. That’s a much more likely scenario with subsequent births, but for most first timers labor is long enough and the signs are pretty clear when it is time to go. Here are the signs to look for:

  1.  Contractions are strong. What does that look like? Mom has to stop during a contraction and pay attention to it. She can’t walk or talk through her contractions very easily and needs to do something to cope with them, like breathe and sway. Most likely at this point she will also not feel very comfortable sitting or lying down during a contraction.
  2. Contractions are long. Contractions can start to be considered long when they last close to 60 seconds. It can be good to get a contraction timer app so you can be accurate with this when it comes time to measure them.
  3. Contractions are close together. You don’t need to worry about timing the contractions with the app until you feel like the contractions are consistently under 6-8 minutes apart. It may make you feel better to start measuring earlier, but you shouldn’t do it if it stops you resting or keeping distracted with other activities until the contractions hit that 6-8 minute mark. Even then, you have time. You’re looking for the contractions to be 4-5 minutes apart and staying that way for at least one hour.

Put them all together and you get a simple formula: You don’t need to think about going to the hospital until after you have seen strong, long contractions that are 4-5 minutes apart for at least an hour. Once you reach that point, it’s time to think about making your move.

Pro tip:  If discussing going to the hospital makes your contractions space back out, wait a little bit before going. If the stress of talking about going is enough to slow them down, then she is probably not quite ready.

Of course if your water breaks, you have a fever, excessive bleeding, sharp pain, or anything else you are worried about, be sure to call your doctor and get their opinion on when to go in.

People need people – Find your laboring tribe

We all need a community; friends, family, the guy who makes our coffee. But when you are pregnant and preparing for the big life change that comes with labor and birth, human connections are especially important.

Pregnancy, labor, and becoming a parent all have steep learning curves associated with them and one of the best ways to not be overwhelmed is to surround yourself with those who are on the same journey. Being around others who are in your same boat will help decrease anxiety and increase your enjoyment as you sail through this time.


Where can you begin to look for this tribe? Prenatal yoga classes are a good way to prepare physically for birth and connect with other moms in a relaxed, consistent way.  Pregnancy support groups are also becoming more common in hospitals and birth centers. If your physician group offers prenatal appointments in a group centering format, that can be an excellent way to meet others. And mom’s groups in your area might offer pregnancy meet-ups.

Look around, each community is different. But finding ways to connect with other expectant moms and couples can ease the transition – and sometimes lead to lasting friendships that you will treasure as your kids grow older.

Photo by Julie Johnson (@thirdwheelphoto at Unsplash)

A VBAC Story

I recently had the experience of helping a wonderful couple achieve their goal of a VBAC (Vaginal Birth After Caesarean). When they hired me, they explained that for their first birth they had not taken any classes and had not prepared for the birth, trusting that the hospital staff would tell them what to do.

The thing is, that isn’t really the staff’s job. They are supposed to keep mom and baby healthy, which of course is extremely important. But they won’t necessarily suggest positions to help baby move down, offer ideas for staying comfortable or strategies for making make labor efficient, although some do all that and more.

So when this first-time laboring mother told the nurse she was feeling uncomfortable and anxious, the nurse advised her to get an epidural, even though it was very early in the labor and the mom wasn’t then able to be up and changing positions to help move baby down. Next, when the mom was fully dilated and couldn’t feel any urge to push, no one suggested to turn the epidural down. Almost inevitably, a C-section followed.

This couple felt that perhaps the surgery was avoidable and so to their credit, when they became pregnant a second time, they spoke with their doctor about a VBAC, took classes, read books, and hired support.

She went into labor a few days before her due date and after a few hours at home contractions were close enough to go to hospital. When we arrived, the couple’s doctor was not on call. The doctor who met them was more conservative and told them that he thought she was not a good candidate for a VBAC and that they should just do another surgery.  They talked about it and because they had done lots of research and had spoken at great length with their OB, who thought they were good candidates, they felt strong enough to say they wanted to proceed with trying for a vaginal delivery.

The mom, who thought she had a low pain tolerance, handled contractions beautifully without any medication and gave birth in 5 hours. The first time she said she didn’t really push because she couldn’t feel any urge and didn’t really know what to do. This time the baby was born with about 20 minutes of pushing that she instinctively did perfectly. After the birth, the doctor told them they had made the right decision.

Being a doula is amazing because I get to help people do the things that they didn’t believe they were capable of doing. With a little bit of support and education couples can access their own strength and realize that they are capable of much more than they might have believed – and that can help them on more than just their labor day.

Virtual Doula

baby feet

A few months ago a former doula client asked if I could be an “e-mail doula” for a friend of hers. This friend, also named Julie, wanted a VBAC with her second baby but was living in Portugal and didn’t feel like she had much information or support on how to do it. This was a first for me and I was excited to help.

I was introduced virtually to Julie and her husband, Daniel, and we went through several rounds of emailed questions and answers about how they could give Julie the best chance of achieving the birth experience she was hopping for. They were a lovely couple – with lots of motivation and faith in themselves, the process, and God. It was a real pleasure to help them.

Last week I received an email from them with the good news: Julie had successfully delivered a healthy baby boy naturally and without medication. If you have time to read their birth story, it is inspirational and brought tears to my eyes.

Julie and Daniel also read Deliver!, my book about labor support, which seems to have really helped set them up for a positive outcome. Here’s part of what Julie shared with me:

“My husband and I read your book very slowly and carefully and were completely in sync and confident largely due to this. We really can’t thank you enough for your book! And of course your consulting by email. I was able to walk, take a shower and breathe during contractions and didn’t get an epidural… all in a pretty hostile environment, so your chapter on the birth team really helped too.”

I couldn’t be happier since this is the reason we wrote Deliver! in the first place: to help and support couples to find the power to have the kind of birth they want. Congratulations Julie and Daniel on your beautiful, growing family!

Birth needs Supporters not Spectators

Has birth become a spectator sport? asks Jacoba Urist at Today.com.

Apparently, says Urist, “These days, delivery rooms can be rife with drama as grandparents-to-be vie for the best camera angle, or a mother-in-law angles to be the one feeding ice chips between contractions.”

Here’s my take: A woman in labor needs to feel safe emotionally and physically before she can let go and get her birth-enabling hormones to do their work.

On the other hand, adrenalin – a birth inhibitor – is produced by any kind of stress. Whether it is due to worrying about the baby or worrying about your mother-in-law, that will make labor slower and more painful.

So, if a woman is comforted by someone’s presence at the birth, they are a good addition to the birthing room. But if that person makes her feel like she needs to take care of them, then the visitor needs to wait to meet the baby later.