Contractions: when should I go to the hospital?

The short answer

The right time to leave depends on your situation and the instructions from your doctor or midwife. For a first birth, Quebec’s Mieux vivre avec notre enfant guide says to go to your place of birth when contractions are regular and come every 5 minutes or less for 1 hour. If this is not your first birth, the instructions may be different. Travel distance and your health also matter.

If you are unsure what to do, call your midwife or the obstetrics department at the hospital where you plan to give birth. For a non-urgent health concern, you can also call Info-Santé 811, option 1. In an emergency, call 911.

That timing is a general guide for a first birth, not a rule that applies to everyone. Your care team may give you different instructions based on your pregnancy and circumstances. If the advice you have received differs from general information online, follow your care team’s instructions. If you cannot reach them and are worried, call 811 for guidance.

How can I tell if contractions are labour?

During a contraction, your belly tightens and feels hard. The pain may feel like menstrual cramps and may be felt in your lower belly or lower back. Everyone experiences contractions differently, and sensations can vary from one birth to another.

Labour contractions tend to become regular and stronger over time. To keep track of their pattern, note when each contraction starts and how long it lasts. Measure the interval from the start of one contraction to the start of the next. You can use a watch, your phone or whatever notes work for you. The important thing is to be able to describe what you are noticing to your care team.

In early labour, contractions may be irregular and less intense. Sometimes people go to the hospital while labour is still in its early stages. The team may suggest going home and returning later. That does not mean you did anything wrong: the team has assessed the situation and will explain what to do next. If you are sent home, ask what changes to look for and who to call if you have questions.

For more detailed guidance, see the official pages Recognizing the start of labour and When to go to your place of birth from Mieux vivre avec notre enfant.

When should I go without waiting for contractions?

Some signs mean you should not wait for contractions to follow the usual pattern. The Quebec guide recommends going to your place of birth right away if:

• your waters have broken, even if you are not having contractions;
• you are bleeding;
• you can no longer feel your baby moving.

Also call your place of birth or midwife to find out what to do. It can sometimes be hard to tell whether fluid is amniotic fluid or another kind of discharge. If you think your waters may have broken, or you are unsure, ask for advice rather than trying to decide on your own.

When you call, explain what you have noticed and when it began. Mention how many weeks pregnant you are, whether you are having contractions, and any changes in your baby’s movements. These details can help the team guide you on where to go and what to do next. If you feel the situation is an emergency, call 911.

What if contractions start before 37 weeks?

Contractions can happen during pregnancy without labour having started. However, before 37 weeks, regular or frequent contractions may be a sign of preterm labour, especially if they come with increased vaginal discharge. Contact your pregnancy care team or place of birth promptly so they can assess the situation. Do not rely only on a timing rule intended for a birth at term.

Other signs during pregnancy also call for prompt assessment, including bleeding, leaking amniotic fluid, severe abdominal pain, or not feeling the baby move after 26 weeks. The official page Warning signs during pregnancy describes these signs. If you are unsure, call your care team or place of birth.

When you contact them, share what you are experiencing and how far along you are. If you cannot reach your usual team and have a non-urgent health question in Quebec, call Info-Santé 811, option 1. If you think you need emergency help, call 911.

Before you leave: follow your care team’s instructions

As your pregnancy gets closer to the end, ask your doctor or midwife when to leave and which number to call. The timing may depend on the distance to the hospital, previous births, your health and details of your care. If you live far away, have had a quick previous birth or have been given specific instructions, follow those rather than a general rule you found online.

If contractions begin and you are not sure whether labour has started:

• call your hospital’s obstetrics department or your midwife;
• tell them how many weeks pregnant you are, whether this is your first birth and how often the contractions are coming;
• mention any bleeding, fluid loss or change in your baby’s movements;
• ask clearly whether you should leave now and where you should go.

You can keep these details handy before labour begins, along with the phone number for your place of birth and your plan for getting there. If your support person or family is helping, let them know where to find the information and how you would like them to support you.

For a non-urgent health question in Quebec, Info-Santé 811, option 1, connects you with a nurse. If the situation seems urgent or someone’s life is in danger, call 911. This article does not replace instructions from your care team. If their advice differs from a general guide, follow the instructions they gave you for your pregnancy.

Frequently asked questions

This article is for information; it does not replace advice from a health professional. In Québec, call Info-Santé 811 when in doubt (elsewhere in Canada, your provincial health line). In an emergency, call 911.

Sources

1. Info-Santé 811, Gouvernement du Québec
2. Quand et comment utiliser le 911 au Québec (in French), Gouvernement du Québec