If you are pregnant with your first baby, your doctor or midwife has likely told you that contractions can be a sign of labor and that at a certain point, you should come to the hospital to be seen. But how exactly do you time them, and how do you know when it’s the real thing?
In general, most providers will go by the 5-1-1 rule. This means that if your contractions are 5 minutes apart (or less) and last for about 1 minute—and this has all been going on for 1 hour—then this could very well be labor, and you should give the hospital a call.
It’s important to realize that this rule applies to women who are term (37 weeks or more along). Women who are preterm should check in if they are having contractions that are strong and somewhat regular, even if they aren’t every 5 minutes. This could be a sign of preterm labor and as such, your doctor or midwife would want to know much sooner than waiting until they are this frequent.
For most women, a contraction feels like a tightening across the lower abdomen. Many describe it as a severe menstrual cramp. Pain in the lower back can also be common, and it can also be accompanied by intense vaginal pressure. True labor contractions in general will be difficult to talk through, as compared to Braxton Hicks, which might be noticeable but not really painful.
To time a contraction, note the time that one begins and ends to figure out how long they last. Write down the start time of each one to figure out how often they are coming. You can do this the old-fashioned way with paper and pen, or use any pregnancy app that will automatically track this for you.
Real labor is usually pretty intense. This means that while you may have an hour of contractions every 5 minutes that are noticeable but don’t hurt, it might not be the real thing yet. It’s perfectly OK to check in with your obstetric provider, but they may not have you come in until they really take your breath away. On the other hand, if you live very far away, have a history of fast labors, or have any high-risk complications, you may be told to come in sooner rather than later.
You may notice that contractions start up and really hurt for 20 minutes only to space out after that – and this might really discourage you. While this means that you are probably not in true labor yet, don’t worry! Your body is preparing, and it may start up soon. Take this time to rest up, make sure your hospital bag is packed, and set up any child care that might be needed.
Reviewed by Dr. Jen Lincoln, April 2020
- Contractions that come every 5 minutes and last for about a minute over the course of an hour can be a sign that labor is beginning.
- True labor contractions in general will be difficult to talk through.
- Sometimes contractions really kick up and then space out.