An average pregnancy lasts 280 days, i.e. 9 months and 10 days, therefore 40 weeks from the first day of the last menstrual period. This means that a woman can normally give birth at the 37th week and even arrive at the 41st and beyond: the pregnancy that continues beyond 42+0 weeks (294 days) of gestational age is defined as protracted. To find out when the time has come to go to the hospital for the happy event, the best thing would be to contact your trusted doctor and get in touch with the birth point of the chosen hospital. Normally, in order to plan the times and ways of accessing the hospital and to personalize labor assistance, around the 37th / 38th week of gestation, the woman is admitted to the birthing center clinic. On this occasion, she may also be present with her partner, will have an interview with a pediatric nurse, who will prepare the medical record of the unborn child and provide all the necessary information on the case. In any case, apart from this, some general information that we will give in our article may also be useful to a pregnant woman.
How the contractions in preparation for childbirth feel
When you have a contraction, your womb tightens and then relaxes: in some cases – but not necessarily – these contractions may feel like “extreme” period pains.
As labor progresses, the rhythmic and involuntary uterine contractions that cause the neck to smooth out and dilate and end in delivery become longer, stronger and more frequent.
- During these contractions, the muscles stiffen and the pain increases: if you put your hand on your stomach, you will be able to feel that it is more contracted.
- As the muscles relax, you will feel the contractions ease and the pain go away.
These contractions have the purpose of moving the baby downwards so as to be able to dilate: the muscles of the uterus work in thrust while those of the cervix relax: in fact, the cervix must be soft and must relax in order to dilate in order to open the path from the uterus to the birth canal, and that the unborn child may come into the world.
Braxton Hicks contractions, also called false contractions
The so-called Braxton Hicks contractions are contractions prodromal to actual labor (that is, preceding) and childbirth. That is, they prepare the woman’s body for the happy event. Someone calls them “practice contractions”, in the sense that it is the uterus that is “practicing” the stiffening and contractions of labor.
These contractions often occur in the final weeks of pregnancy and are usually painless. They are part of a normal pregnancy. Contact your doctor or hospital only when these Braxton Hicks contractions/false contractions become painful or frequent.
When to go to the hospital
The periods between the prodrome phase and the moment of delivery can be very variable in time.
- They can be several hours: in women who have not had children, even days.
- In women who have already given birth at least twice, labor usually begins earlier.
- These times can be different from woman and essentially depend on the more or less favorable conditions of the uterus for labour.
However, since it is the baby who “decides” when it should be born, especially if you are in your first pregnancy, you may not know when it is time to go to the hospital. The best thing would be to get in touch with the hospital birth point:
- If your waters have broken, you’ll likely be asked to come in for a checkup.
- If it’s your first baby, if you’re having contractions but your water hasn’t broken, you may be advised to wait.
You will probably be asked to enter the hospital when the contractions are:
- regular,
- strong,
- at a distance of about 5 minutes from each other,
- with a duration of at least 60 seconds.
- If you don’t live nearby, you may need to get closer to the hospital before getting to this stage.
Being able to recognize the signs of labor and what happens during this stage will help you better understand what is happening in your body.
Second babies generally come into the world (as we said) faster than first ones, so it may be necessary to contact the hospital earlier than the previous time.
Sometimes, even if it is not a premature birth, the moment to go to the hospital can arrive even with a considerable advance: the date of the birth which is communicated to the pregnant woman during the check-ups is only indicative, and not infrequently it is also anticipated of a couple of weeks.
Waiting to go to the hospital
It is good to plan and prepare what is necessary to go to the hospital for the birth.
It is advisable to keep everything needed for hospitalization close at hand: documents, linen, personal hygiene products, clothes for the baby and something to pass the time, a book or headphones for music, for example.
The personal briefcase and a mini kit for the little one should be prepared about three weeks before the presumed date of birth, in order not to find yourself having to do everything at the last moment, with the risk of some forgetfulness.
A good thing would be to draw up a detailed memorandum a month in advance: if it were the first baby, you would need to ask for instructions from the maternity ward of the reference health facility, which usually offers assistance to expectant mothers, also advising them on how to deal with the moment of hospitalization with efficiency and serenity.
When it’s time to move urgently
It would be better to experience these early stages that precede labor at home, but you also need to know when it’s time to go to the hospital to give birth without waiting any longer.
Apart from that, sometimes some events may occur that require urgent hospitalization, even well in advance of the expected date. Situations in which you should immediately seek medical attention or the emergency room are:
- The sudden breaking of the waters even before the contractions. In the absence of amniotic fluid, in this case the baby is no longer adequately protected and remains exposed to the risk of infections from outside.
- The appearance of bright red blood loss. In this case, the bleeding may be due to placental abruption, which requires appropriate and immediate medical treatment.
Katherine Johnson, M.D., is a board-certified obstetrician-gynecologist with clinical expertise in general obstetrics and gynecology, family planning, women’s health, and gynecology.
She is affiliated with the Obstetrics and Gynecology division at an undisclosed healthcare institution and the online platform, Maternicity.com.