Navigating the final stages of pregnancy often involves uncertainty about when to contact the Labor and Delivery (L&D) unit. These guidelines clarify the signs and symptoms that generally warrant a phone call, helping ensure timely and appropriate care. While your provider may have specific instructions based on your medical history, understanding these general criteria is essential. Accurate communication about the onset and progression of labor makes a significant difference in the birthing experience.
Tracking Contractions: The Threshold for Calling
True labor contractions are distinct from Braxton Hicks, which are practice contractions that are typically irregular, do not intensify, and often subside with a change in activity or hydration. Real labor contractions demonstrate a pattern of increasing duration, intensity, and frequency, signaling that the body is actively working toward delivery. Start timing contractions when they become regular and require focus to breathe through.
The most commonly used guideline for a full-term pregnancy is the 5-1-1 rule, which serves as the benchmark for contacting L&D. This means contractions are approximately five minutes apart, each lasting for one minute, and this consistent pattern has been maintained for at least one hour. Some providers may use a slightly more conservative 4-1-1 rule, especially for those who have had previous births, as labor often progresses more quickly in subsequent pregnancies.
Contractions meeting this threshold usually indicate that the cervix is beginning to dilate and efface, moving labor from the early, latent phase into the active phase. If contractions are so painful that you cannot talk or walk through them, call L&D, even if the timing does not perfectly align with the 5-1-1 rule. If you are less than 37 weeks pregnant and experience regular, frequent contractions, call immediately, as this could indicate preterm labor.
When Your Water Breaks: Assessing Rupture of Membranes
The rupture of the amniotic sac, commonly called the water breaking, is a clear sign that labor is imminent or underway and requires a call to L&D. This event can manifest as a subtle, continuous trickle of fluid or a sudden, uncontrollable gush. To determine if the fluid is amniotic fluid rather than urine or discharge, note its characteristics.
Amniotic fluid is typically clear or straw-colored and may be odorless or have a slightly sweet scent. If the fluid is green, brown, or has a foul odor, inform the L&D unit immediately. Discoloration can indicate the presence of meconium (the baby’s first stool) or a potential infection. The amount of fluid lost varies depending on the location of the tear and whether the baby’s head is low in the pelvis, which can sometimes act like a plug.
Once the membranes have ruptured, the protective barrier around the baby is gone, increasing the risk of infection. Timely contact with your care team is necessary. The L&D staff will need to know the time the rupture occurred, your Group B Streptococcus (GBS) status, and whether you are having contractions. Avoid taking a bath or using a tampon after the water breaks to minimize the risk of introducing bacteria.
Urgent Non-Labor Symptoms Requiring Immediate Contact
Some symptoms require immediate contact with the L&D unit, as they may signal a complication needing urgent medical attention, regardless of whether labor contractions have started. A significant decrease in the baby’s movement, often called decreased fetal movement, is a serious concern. If you notice a marked reduction in activity or the baby is moving less than usual, call your provider right away.
Heavy vaginal bleeding necessitates immediate contact, especially if it is bright red and heavier than typical spotting or “bloody show.” While a small amount of mucus tinged with blood can be a normal sign of cervical change, profuse, continuous bleeding can signal placental issues and requires urgent evaluation.
Symptoms indicating the development of preeclampsia, a serious blood pressure disorder, also warrant an immediate call. These signs include a severe, persistent headache that does not improve with pain relievers, sudden changes in vision (such as seeing spots or flashing lights), and abrupt swelling in the face or hands. A persistent fever, particularly if accompanied by chills, should also be reported to L&D, as this could signal a maternal infection.
Preparing for the Call: Essential Information L&D Needs
When calling the Labor and Delivery unit, having specific information ready allows the nurse to quickly assess your situation and provide guidance. Be prepared to state your full name, date of birth, and the name of your obstetrician or midwife. The staff will ask for your estimated due date and whether this is your first pregnancy, often using terms like gravida and para to note your total number of pregnancies and births.
Have your current medical status readily available, including whether you have tested positive for Group B Streptococcus (GBS). Clearly communicate the specific reason for your call, such as the exact timing of your contractions or the time your water broke. Providing a concise, accurate description of the fluid’s color, amount, and odor, or the details of any concerning non-labor symptoms, will help the L&D team determine the urgency of your arrival.