I'm sure that most parents-to-be, that are planning on having their baby at hospital or in a midwife-led unit, will want to know the answer to this question and may even have some anxiety around when to make their way there. Labour can be an unpredictable journey, however, there are some common signs that labour is starting. One of these is a change in your baby's movement, for instance more pronounced movements or the feeling that your baby has 'dropped' into your lower pelvis. Lower back pain can be another sign, which may come and go like contractions. Another is your water breaking, as a sudden gush or a slow leak of fluid. You may have a 'show' when the mucous that seals the cervix or entrance to the uterus comes away. Finally, regular contractions, that might feel like strong menstrual cramps and increase in intensity over time, is another sign.
When labour starts, call the hospital or midwife-led unit to let them know, especially if your waters have broken If this is your first baby, this can also offer you some reassurance.
Midwives will generally encourage you to stay at home (or return home), if you are not deemed to be in 'active labour'. Active labour is a term used by the hospitals and is generally considered anything over four centimetres dilated and you are experiencing contractions every five minutes or less and each one lasting around 60 seconds. Please know, even if you are told that you are not in active labour, that doesn't mean that your body is not working hard and things are not progressing. It also does not tell you anything about when your baby is going to be born. It could be within two hours, it could be much longer. Hospital guidelines state that most people will dilate one centimetre per hour, but for so many people this is not the case and there is no 'one-size fits all' approach. Be sure to tell the midwives if you have doing Hypnobirthing, as you may be calmer and further on than it seems!
The reason active labour is defined as a separate phase by the hospital is because it is considered that once you are in this phase , it is unlikely that your labour will then slow down or halt. One of the biggest reasons that labour slows down or halts is due to an adrenalin spike, which interferes with oxytocin, the love hormone and the biggest driver of labour. Midwives are aware that the journey to the hospital can cause a spike in adrenalin, which is why you are encouraged to stay at home until you are deemed to be in active labour. There are a number of things that you can do to help minimise this from happening on your journey and these are included in most Hypnobirthing courses (including ours).
The biggest thing is trusting your instinct. If you feel like you need to be there then its time to go in. You may feel like you want pain relief, you may want reassurance or you may even just feel safer being in hospital, knowing that there are midwives and doctors around. Even if you have planned a homebirth and your instincts are telling you that you would feel better in a hospital environment, then it is absolutely ok to change your mind. You do not need to stick to what is written in your birth plan, if it no longer feels right to you.
If you are told to go back home and you do not feel like this is the right thing for you, please make your case and don't just accept their decision. You know your body better than anyone.
Some useful tips to prepare for your trip into hospital would be:
Reduce any feelings of apprehension by asking your midwife at your pregnancy check-up, what their policy is in respect of coming into hospital once you are in labour.
Do a test run to the hospital.
Find out where to park, parking costs and whether you will need money for parking and if so, have the money in your car ready.
Make sure there's petrol in your car.
Make a sign ahead saying 'Just dropping off a woman in labour- I will be back soon'. A smiley face might also help!
Pack your hospital bag and make sure you remember your notes and birth plan.
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