A perfect mix of excitement, naiveté, and anxiety makes a first-time mother scurry to the hospital even before real contractions begin. Actually, it’s not just first-time moms. Even the multipara (mothers who have given birth multiple times) are not excluded from it.
It’s not your fault! The ‘when to go to the hospital for contractions’ question is one of the hardest questions. There are times when your body betrays you. You really just don’t know if it’s just a mere indigestion case from devouring one fourth of the restaurant’s menu for dinner or an honest-to-goodness uterine contraction.
A broken water bag is a clear marker that one should go to the hospital immediately. Some moms don’t experience that, though. They go through the whole labor with the water bag intact, and had to undergo amniotomy (artificially rupturing the water bag or amniotic sac). The latter would often base their decision to go to the hospital on the kind of contraction they are having.
True labor pain is when one should go to the hospital. How to know? A real mark of a true uterine contraction is based on three important factors: rhythm, gradual lengthening, and intensity.
Have you heard of a heart pacemaker? Your uterus has one, too. Each contraction starts at the uterotubal pacemaker then comes down to the uterus as waves. In the early phase of labor, the contraction doesn’t have a steady rhythm; it’s irregular, weak, and at times, strong. After a few hours, the rhythm harmonizes. It shouldn’t be confused with Braxton Hicks or false labor contractions. The latter doesn’t intensify and doesn’t cause cervical dilation.
Some women feel the pain at the lower part of the belly (lower uterine segment) while others at the upper part (fundus). Others point to the lower back as the area where the pain originated. It really differs from woman to woman.
Intensity and Gradual Lengthening
Each contraction has three phases – increment, acme, and decrement. Increment is increasing intensity of the contractions, Acme is the peak or when the contraction is at its strongest, and Decrement is when the contraction decreases.
At the onset of labor (Latent Phase), the contractions are mild and last for 20 to 40 seconds. To differentiate this from Braxton Hicks, the pain does not go away even if the woman stands up or walks around. Some women (who have a complication-free pregnancy) choose to stay at home during this time.
Most would go to the hospital during the next phase or the Active Phase where the contractions last for 40 to 60 seconds. By this time, the contraction’s intensity is strong, lasts longer, and is causing real discomfort on the woman. The cervical dilatation at this time is about 4 to 7 cm, vaginal secretions increase, and the spontaneous rupture of the water bag happens during this stage.
The contraction reaches its peak in terms of intensity during the Transition Phase. It occurs every 2 to 3 minutes, and last for 60 to 90 seconds. By the end of this phase, the cervix is fully dilated (10 cm.) and the irresistible urge to push is felt.
Just a friendly SmartMom reminder: Do not underestimate your contractions. If you feel any pain, it is okay to seek medical help immediately. You sometimes see in the movies when a pregnant woman gets sent home from the emergency room embarrassed because what she thought was real contractions were not. It is always better to be safe than sorry. No healthcare professional will question what you’re feeling because in the medical setting, “pain is whatever the experiencing person says it is.” We value that definition wholeheartedly.