Categorized | Birth, Featured

When to go to the hospital to give birth?

Posted on 28 January 2016 by Kristrun

Midwife with woman during labour

Midwife with woman during labour

It is usually best to wait until you are in active labour before going to the hospital, or around 3cm dilated or if the membranes have ruptured (breaking waters).

This is for a number of reasons. Firstly, some hospitals have a policy where until you are at least 3 cm dilated, you do not go to a birthing (delivery) room. Whilst the policy is good, the implementation is not always optimal.

Labouring women tend to be more comfortable in their own environment. Remember how the hormones work – this will promote the endorphins and oxytocin, which will result in a shorter, less painful labour.

Added to this, until you are in active labour we have no idea of how fast your cervix will open. Getting to 3cm could take 2 hours or 22 hours and once you are in hospital there will be an expectation that you will progress and if you do not, someone will want to help you. This is where the cascade of intervention plays a role. Research has shown that whenever a form of intervention is utilized in your labour, there will be an increased chance of further interventions. Once you are in active or established labour, it is likely that your labour will continue to progress and there will be less likelihood of further intervention or a cascading scale of intervention.

A possible (but not inevitable) example would be that you are at the hospital in early labour and your cervix is open about 1 cm. After 4 hours the cervix has thinned out but is only open 2cm now. You are advised that your membranes should be ruptured to speed up labour, by approximately 30-60 minutes for a first time mum. Evidence tells us that having your membranes ruptured increases pain for the mother, so you choose to have an epidural. Evidence also tells us that the baby has an increased chance of demonstrating a concerning fetal heart rate pattern (CTG) – you are then advised that the baby is distressed and needs to be born imminently. Assuming the cervix is completely open and the baby is in a good position, a vacuum birth is safely attended, with an episiotomy. The baby is born in good condition, but subsequently develops jaundice, which requires photo-therapy and an artificial milk formula to clear the jaundice and you then develop problems with breastfeeding!

Other reasons to go to hospital would be:

  • Amniotic fluid is leaking
  • Concerns about baby’s movements
  • Bleeding, not mixed with mucous
  • Contractions 3-5 min apart, regular in length, strength and frequency
  • You do not feel comfortable at home

You are not trying to avoid the hospital, but trying to identify when there is a real need to go.  If labour comes on very quickly, sometimes there is also a need to move swiftly as you do not want to be on your way to the hospital with very strong contractions – better to have settled into the labour ward nicely.   Any woman with a high risk pregnancy, or if it is a second or third baby, needs to go into hospital as soon as the labour starts.

Please let us know if we can help!

The midwives

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