A simple rule for when to go to the hospital for labor is the 5-1-1 rule for timing contractions. That said, it’s not always easy to recognize labor.

Let’s hope you have a timer handy because if you’re reading this, you may need to time your contractions, grab your bag, and head to the hospital.

If your contractions happen at least every 5 minutes, last for 1 minute each, and have been consistent for at least 1 hour. This is called the 5-1-1 rule

That said, it’s sometimes tricky to recognize true labor. As the calendar hovers close to your due date, you notice every little twinge. Is that gas, the baby kicking, or a sign you’re about to meet your little one?

Or maybe you’re experiencing signs of labor a bit earlier than expected. How can you tell whether it’s go-time, or if your body is just preparing for what’s to come? Here’s a rundown on what to expect and when you should head to the hospital for labor.

For most women, labor starts much differently than in the movies. On screen, labor comes on as a big surprise when the character’s water breaks. But it’s important to note that — in real life — only about 10 percent of women experience their water breaking.

Usually, the signs of labor are much more subtle and gradual. Your process will be different from a friend’s and even from your other pregnancies.

Labor normally has two parts: early labor and active labor.

Early labor

Early labor (also known as the latent phase of labor) is usually still some time away from the actual birth. It helps your baby get into place for birth. During early labor you’ll start feeling contractions that aren’t too strong. The contractions might feel regular or come and go.

This lets your cervix (the opening to the womb) open and soften. According to the American College of Obstetricians and Gynecologists (ACOG), early labor is the period of time when your cervix dilates up to 6 centimeters.

During this phase, you might also feel your little one move around and kick more than they usually do, or feel additional pressure of the baby “dropping” into place. This is because they’re trying to move down head first (hopefully) into the birth canal.

As your birth canal opens the mucus plug to your cervix may pop out. This is a completely normal part of birth. You might have a clear, pink, or even red glob or discharge in your underwear, or notice it when you wipe after using the toilet.

At this point in early labor you might feel achy and a little uncomfortable, but it’s too soon to go the hospital. Recent research has shown early labor is much longer and slower than previously believed.

Early labor can last from hours to days. One 2010 study found that labor can take 9 hours to progress just from 4 to 6 centimeters, though it can vary widely from person to person.

Sometimes, early labor will start and then stop for a little while. Along with making sure you partner has your hospital bag ready to go, here’s what you can try to do once you start early labor:

  • Try to relax (easier said than done, of course!).
  • Walk around the house or yard.
  • Lie down in a comfortable position.
  • Have your partner gently massage your back.
  • Try breathing techniques.
  • Meditate.
  • Take a warm shower.
  • Use a cold compress.
  • Do anything that keeps you calm.

If you think you’re in early labor, try to relax and allow your body to progress naturally, at home. Researchers of at least one large study believe that women who allow early labor to progress naturally without intervention may have less risk of cesarean delivery.

Active labor

Per ACOG, the clinical definition of the start of active labor is when your cervix has reached 6 centimeters in dilation. But, you won’t know how dilated you are until you’re checked by a doctor or midwife.

You’ll be able to tell you’re entering active labor when your contractions are stronger, more regular, and happening closer together. It’s a good idea to time them. Write down when your contractions happen and how long they last.

You’ll know you’re in active labor if you have symptoms like:

  • painful contractions
  • contractions that about 3 to 4 minutes apart
  • each contraction lasting about 60 seconds
  • water breaking
  • lower back pain or pressure
  • nausea
  • leg cramps

During active labor your cervix (birth canal) opens or dilates from 6 centimeters to 10 centimeters. Your contractions might happen even faster if your water breaks.

You should definitely be on your way to the hospital or birthing center when you’re in active labor — especially if you’ve been pregnant or given birth before. A large 2019 study of more than 35,000 births showed that labor progresses doubly quick when you’ve already gone through it.

Sometimes you may think you’re starting labor, but it’s just a false alarm. You might feel contractions, but your cervix is not dilating or effacing.

False labor (also known as prodromal labor) can be pretty convincing and it’s fairly common. A 2017 medical study found that more than 40 percent of pregnant women had false labor when they thought they were in labor.

False labor typically happens pretty close to your due date, at 37 weeks of later. This makes it even more confusing. You may have contractions for up to several hours that happen at regular intervals. False labor contractions are also called Braxton-Hicks contractions.

The difference between false labor and true labor is that false labor contractions won’t make your cervix open up. You can’t measure down there, but you might be able to tell if you are in false or true labor by checking your symptoms:

SymptomFalse LaborTrue Labor
ContractionsFeel better after walkingDon’t feel better after walking
Contraction strengthStay the sameGet stronger over time
Contractions intervalStay the sameGet closer together over time
Contraction locationGenerally only at the frontBegin at the back and move to the front
Vaginal dischargeNo bloodMay have some blood

Shannon Stallock, a midwife in Oregon, recommends letting your OB-GYN or midwife know if you’ve started early labor. You might move along into active labor faster than you expect. A rule of thumb is that labor usually lasts for a shorter period if you’ve had a baby before.

If you are having a planned C-section you may not go into labor at all. This might be the case if you’ve delivered a baby via C-section before or if you have some complications that make a C-section birth a safer choice.

Call your doctor and go to the hospital if you go into early or active labor before your planned C-section date. Going into labor does not mean that you’ll have to deliver your baby vaginally, but it may mean that you’ll need to have an emergency C-section. Getting to the hospital quickly means more time to get ready for the procedure.

Go to the hospital if you’re not sure whether you’re in false labor or true labor. It’s healthier for you and your baby to err on the side of caution.

The worst that can happen is that you might be in false labor and have to come home and wait. But, that’s safer than if you’re in true labor and delay going to the hospital.

It might feel like an emergency, but skip the emergency room and make a beeline for labor and delivery when you get to the hospital. A very useful tip, especially if this is your first baby, is for you and your partner to do a practice drive to the hospital so you know exactly where to go.

Once you’re at the hospital, your doctor or nurse can tell whether you’re in real labor with a physical checkup. You might also have an ultrasound. The ultrasound scan shows the length and angle of the cervix. A shorter cervix and a bigger angle between the uterus (womb) and cervix mean you’re in true labor.

If you are delivering at home or at a birthing center, you still need to practice a dry run to make sure you are prepared and have everything you need.

For example, if you’re planning on a water delivery, get into the inflatable pool well before your due date and make sure you like it! Always plan ahead for emergencies. Have your doctor on speed dial and a car ready to take you to the hospital if needed.

Go to the hospital immediately if:

If your contractions are 5 minutes apart, lasting for 1 minute, for 1 hour or longer, it’s time to head to the hospital. (Another way to remember a general rule: If they’re getting “longer, stronger, closer together,” baby’s on their way!)

If you’re feeling contractions, but they’re not strong and lengthy yet, you might be experiencing the early phase of labor. Resting and letting your body progress at home may help you deliver vaginally in the long run.

False labor is fairly common. Call your doctor if you are unsure. It’s best to be extra careful to protect your health and the safety of your new little one.

Regardless of what stage of labor you’re in, take a deep breath and smile, because you’re about to meet the newest love of your life.