When to Go to Hospital With Contractions
How to time contractions properly, what the commonly taught 5-1-1 pattern means, and the situations where you go in straight away whatever the timings say.
Editorial draft: not yet reviewed by a clinician.
Call your midwife or maternity unit rather than trying to decide alone. NHS guidance suggests ringing once contractions come in a regular pattern, with a rough guide of contractions lasting around 60 seconds and arriving roughly every five minutes. But timings are overridden by a short list of situations, including waters breaking, bleeding and reduced movements, where you make contact immediately.
The first rule is to phone, not to judge
Whatever number you have in your head, the decision about when to come in is not yours to make alone, and it is not supposed to be. Maternity units triage these calls all day and night. They will ask what you are feeling, how often, for how long, and what your pregnancy has been like, and then they will tell you whether to come in, wait at home, or ring back in an hour.
If you have been given personal instructions that differ from anything in this article, use theirs. A previous fast labour, a long drive to the unit, twins, a planned caesarean, an induction already booked or a specific condition in your notes can all change the advice completely.
How to time contractions properly
Most confusion here comes from measuring the wrong gap.
- Frequency is measured from the start of one contraction to the start of the next. If one begins at 8:00 and the next begins at 8:06, they are six minutes apart, however long the pause between them felt.
- Duration is how long a single contraction lasts, from the first tightening to full relaxation.
- Trend is the thing your midwife will actually ask about: are they getting longer, stronger and closer together?
Time several in a row. One measurement tells you almost nothing, because early contractions are commonly irregular, and a single six-minute gap between two random tightenings is not a pattern.
| What to note | How to measure it | Why it matters |
|---|---|---|
| Frequency | Start of one to start of the next | Shows whether a pattern is forming |
| Duration | First tightening to full relaxation | Longer contractions suggest labour is progressing |
| Strength | Can you talk through it? | Contractions you cannot talk through are a useful marker |
| Trend | Compare the last hour to the hour before | This is what your midwife asks first |
The 5-1-1 guideline and its limits
The pattern taught in many antenatal classes is 5-1-1: contractions five minutes apart, each about one minute long, keeping that up for one hour. It is a decent shorthand for “this is probably established labour, ring now”.
It is a guideline and nothing more. Some units advise 4-1-1 or 3-1-1 for a first baby; some tell people with a history of quick births to call at the very first regular tightening; some want you in earlier because of distance. If the pattern is met but you have been told something different, follow what you were told.
When to go in now, whatever the timings say
Contact your midwife, maternity unit or doctor immediately, at any hour, if any of the following happens, regardless of how your contractions are behaving:
- Your waters break, or you think fluid is leaking, especially if it is green, brown or bloodstained.
- You have any vaginal bleeding.
- Your baby’s movements slow down, change or stop.
- You have severe or constant abdominal pain that does not come and go.
- You have a severe headache, changes in your vision, or sudden swelling of your face, hands or feet.
- You have a fever or feel generally very unwell.
- You feel the urge to push, or the birth feels imminent.
- Regular tightenings or cramping start before 37 weeks.
None of these wait for a five-minute pattern, and none of them wait until morning.
Early labour versus established labour
The early or latent phase can last a long time, and the NHS notes it can take hours or even days, particularly with a first baby. It tends to feel like period-like cramping, backache and irregular tightenings, with long gaps and plenty of time to talk, eat and move around.
Established labour usually feels different in kind rather than just degree: contractions become regular, you cannot talk through them, they demand your full attention, and the gaps stop feeling restful. The useful question is not “how many minutes apart am I” but “can I still hold a conversation through one”.
What to have ready when you call
Have these to hand before you dial, because they are what you will be asked:
- How many weeks pregnant you are.
- When contractions started, how far apart they are now, and how long each one lasts.
- Whether your waters have broken, and the colour of any fluid.
- Whether you have felt your baby move normally today.
- Any bleeding.
- Anything in your notes they should know: your blood group, planned birth, previous births, or a condition being monitored.
Timing contractions in PreBaby
PreBaby has a contraction timer that records the start of each contraction, so frequency and duration are calculated for you and the history stays on one screen. That matters at 3am, when doing subtraction in your head is the last thing you want to do, and when the person on the phone asks how the last hour compares to the one before. It works offline, so no signal in a hospital corridor does not lose your record.
Sources
This article is general information, not medical advice. Anything that worries you is a reason to contact your own midwife or doctor.
Questions and answers
How far apart should contractions be before I go in?
NHS guidance on the signs of labour suggests calling your midwife or maternity unit once contractions are coming in a regular pattern, using a rough guide of contractions that last around 60 seconds and come roughly every five minutes. Antenatal classes often teach the same idea as 5-1-1: five minutes apart, one minute long, sustained for one hour. Both are starting points for a phone call, not a legal threshold, and your own team may give you completely different instructions based on your history, how far you live from the unit, or how your pregnancy has gone. Ring them and let them decide.
How do I time a contraction correctly?
Time from the start of one contraction to the start of the next, not from the end of one to the beginning of the next. That interval is the frequency. Separately, time how many seconds each contraction lasts from the first tightening to the point where the muscle fully relaxes, which is the duration. Note both for several contractions in a row rather than judging from one, because early labour contractions are often irregular. Also note whether they are getting longer, stronger and closer together over time, since that trend matters more to your midwife than any single measurement.
Can I be sent home again if I go in too early?
Yes, and it is common. Many people are assessed in early labour, found to be in the latent phase, and advised to go home where most people cope better, rest more and eat normally. It is not a failure and it is not a wasted trip: you have been checked, your baby has been checked, and you now know where you stand. If you are sent home, ask exactly what should bring you back and write the answer down. If anything changes before then, including reduced movements, bleeding or waters breaking, call again immediately rather than waiting for the agreed signs.
What if my contractions start before 37 weeks?
Contact your midwife or maternity unit straight away, and do not wait to see whether the pattern settles into something regular. Regular tightenings, period-like cramping or lower back pain before 37 weeks can be a sign of premature labour, and it is assessed urgently rather than managed at home. The same applies if your waters break early, if you have any bleeding, or if you have a sudden increase in vaginal discharge before 37 weeks. Being assessed and told that nothing is starting is the normal and expected outcome of that call, so make it early rather than late.
Sources
This is general information, not medical advice. It does not diagnose or treat, and it does not replace your own midwife or doctor. Anything that worries you is a reason to contact them.