Contact Vicki
If you have any questions or would just like more information please don't hesitate to get in touch by clicking the button below and filling out the contact form.
Contact Vicki
One of the most common questions women ask as they approach the end of pregnancy is: When should I go to hospital?
It sounds like a simple question, but the answer isn’t.
That’s because labour is not linear. There is no set formula. And while timing contractions might seem helpful, it often creates more stress and confusion than clarity.
There is no universal “right time” that applies to everyone. All women, all births, and all babies are different. Yes, even second or third births can unfold in ways that surprise us. This includes VBAC (Vaginal Birth After Caesarean) births, which may bring an extra layer of decision-making because of prior birth experiences.
So how do you really know when it’s time to head in?
Many women are told to use contraction timer Apps — but here’s the problem. Those Apps reduce the complexity of labour to a mechanical pattern: “five minutes apart, lasting one minute, for at least one hour.” While this might give a general guide, it’s not a one-size-fits-all rule. Some women can have regular contractions that appear textbook yet still be in early labour. Others can have irregular contractions, but their baby is well on the way.
Even in my childbirth classes, I often share a general guideline similar to the Apps: when contractions are about three minutes apart, lasting around a minute each, and this pattern has been consistent for at least an hour — that’s usually a good time to consider heading to hospital. But I always include a disclaimer: there are always exceptions. Labour doesn’t follow a strict timeline, and what’s “right” can vary from woman to woman. We simply can’t predict how each birth will unfold.
Midwives are often looking for a different pattern altogether — typically around 2 to 3 strong contractions in every 10-minute window, sustained for at least an hour. This can be a more helpful benchmark, but again, it still doesn’t account for how individual each woman’s labour will be.
Contractions should not be your only focus. Pay attention to how you feel, what your body is doing, and whether the sensations are growing in intensity. Are they becoming longer, stronger, and closer together — both physically and emotionally? Are you finding it harder to talk through them, move around, or stay distracted? Are you starting to retreat into yourself and follow your primal instincts — becoming quieter, more focused, and less aware of what’s happening around you?
That internal shift is often a clearer indicator than anything an App can give you.
When the sensations shift from manageable to demanding, from random to rhythmic, it’s a good sign your body is doing its thing. Some women describe this moment as “not wanting to be anywhere else but where they can feel safe” — and for many, that might be at home for as long as possible. For others, that may be the hospital earlier on, especially if they feel more at ease knowing support is nearby.
If you’re planning a VBAC, you’re likely tuned into every sensation, wondering if it’s normal or significant. That heightened awareness can sometimes lead women to go in earlier “just in case.” While caution is understandable, particularly in the context of previous birth experiences, it’s also important to avoid unnecessary interventions that may come from arriving too soon.
It’s worth remembering that the earlier you arrive at hospital, the more time there is for your labour to be monitored, and potentially managed. While this might seem helpful, it often leads to more frequent interventions, especially if you’re not “progressing” according to hospital timelines.
Hospitals tend to work within structured protocols, and the longer you’re there, the more likely staff are to start nudging things along: a vaginal exam here, a membrane sweep there, or a suggestion of induction or augmentation. These steps can cascade quickly, especially in VBAC labours, where there is often a lower threshold for action. And once the cascade begins, it can increase the likelihood of another caesarean.
That’s not to say hospitals aren’t safe or supportive places to give birth – they absolutely can be. But timing matters and so does understanding the system you’re entering.
Women planning a VBAC are often advised to come to hospital earlier in labour than those having a spontaneous, first-time vaginal birth. This recommendation is typically based on a heightened level of caution from hospitals and care providers.
The key reason?
Concerns about the rare but serious risk of uterine rupture.
Hospitals may want earlier admission so they can:
In theory, this is about managing risk by having the woman on-site in case an emergency develops.
Uterine rupture is rare.
Research consistently shows that the risk of uterine rupture in VBAC is low – between 0.2% and 0.7% in spontaneous labours.
The risk increases slightly with induction or augmentation, but spontaneous labour carries the lowest risk profile.
There’s no strong evidence showing that coming in earlier improves safety or outcomes for VBAC births.
In fact, earlier admission often increases the chance of interventions, which can lead to a cascade: artificial rupture of membranes, synthetic oxytocin, epidurals, and eventually caesarean, often for “failure to progress.”
Monitoring can still happen later.
Continuous monitoring is often cited as the reason for early admission, but intermittent auscultation (listening to the baby’s heart rate with a Doppler at regular intervals) is also safe and evidence-based for many VBAC labours, particularly in low-risk, well-supported environments.
Asking a woman to come in too early can increase stress, reduce her ability to labour in a calm and familiar environment, and place her “on the clock,” which in turn raises the risk of repeat caesarean – the very thing VBAC mothers are trying to avoid.
Telling all VBAC women to come in earlier “just in case” is a precaution, not a proven safety strategy, and one that often comes with unintended consequences. While it’s important to monitor and support VBACs appropriately, blanket recommendations without context or flexibility aren’t backed by strong evidence and can undermine the chances of a successful VBAC.
We need to move away from the idea that there’s a perfect stage or dilation to be at when you walk through those hospital doors.
You could arrive at hospital and be 4cm dilated and considered to be in active labour but still not birth your baby for another 12 hours or more. Or you could be told you’re “only” 1cm and birth an hour later, which is what one of my doula clients did. Cervical dilation is a snapshot in time – not a forecast. Babies haven’t read the textbooks, and they don’t follow the rules.
Even in VBAC births, where many women are told to come in early for monitoring, we must remember progress can vary. What’s more important is how you feel, how your baby is doing, and what your instincts are telling you.
The most valuable thing you can do is stay connected to your body and your baby. Birth is not a set of numbers or checkboxes – it’s a physiological unfolding. If you stop watching the clock and start tuning into your body and your baby, you’ll often find the answers you’re looking for.
If you have any questions or would just like more information please don't hesitate to get in touch by clicking the button below and filling out the contact form.
Contact Vicki