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When to go in
There is no universal "go to the hospital now" moment that fits every pregnancy. Your gestational age, whether this is a first birth, whether your waters have broken, how far you live from the hospital, and any medical complications all matter. The safest rule is to use your own clinician's instructions first and use general public guidance as the backup, not the other way around 12.
Start with your own plan
If your team gave you thresholds for contractions, rupture of membranes, vaginal bleeding, blood pressure symptoms, or reduced fetal movement, follow those. Many clinicians recommend that first-time parents call or come in when contractions are regular, painful, and close together for a sustained period, but the exact timing varies 12. That variation is normal because labor does not progress identically from one person to the next.
If you are scheduled for an induction or planned cesarean, you may have separate instructions about eating, drinking, when to arrive, and what to do if labor or ruptured membranes happen before your scheduled time. Keep those instructions somewhere both parents can find quickly 3.
Common reasons to call now
Call labor and delivery, your obstetric team, or the on-call line if:
- contractions are becoming regular and painful enough that talking through them is difficult
- your waters may have broken, even if contractions have not started yet
- you have vaginal bleeding heavier than light spotting or bloody show
- the baby is moving less than usual
- you have symptoms your pregnancy team already flagged as urgent, such as severe headache, vision changes, chest pain, or possible high blood pressure symptoms
- you are less than 37 weeks and think labor may be starting 124
Plain descriptions help. Tell them how far along you are, how long symptoms have been happening, whether fluid is leaking, and whether fetal movement feels normal. "Contractions every five minutes for the last hour, lasting about a minute, and I cannot walk through them" is much easier to triage than "I think maybe this is it" 12.
Go in urgently rather than waiting for a callback if
Go in or seek emergency care immediately for heavy bleeding, severe constant abdominal pain, seizures, loss of consciousness, signs of a prolapsed cord, or a major decrease in fetal movement when you cannot reach your team quickly 14. If membranes rupture and you see green or brown fluid, or you have a fever or feel unwell, that also deserves prompt evaluation 12.
Route and logistics matter more than people expect
Before labor starts, know which entrance to use after hours, whether you should go straight to labor and delivery or through emergency, where the drop-off point is, and who is driving. If you live far away, have winter-weather issues, or traffic is unpredictable, your team may want you to leave earlier than the generic contraction rule suggests 24.
It is also worth knowing whether your hospital wants a phone call before arrival. Some units prefer it because they can review your chart, advise you about triage timing, and tell you which door is open overnight 2.
Small U.S./Canada note
The medical reasons to call are the same on either side of the border. The difference is more often the workflow: whether you are contacting an OB office, midwifery service, centralized labor triage line, or hospital unit directly. If you may deliver in a different health system than the one managing the pregnancy, save the labor unit number separately instead of assuming you will locate it easily later 24.