You are in labour…when to call the midwife?

The vast majority of all labour will start with contractions. Often labour starts with irregular painful contractions that vary in duration and strength. As long as the contractions still stop or come less often due to external stimuli (a ringing telephone, change of position, a hot shower) they are usually not yet strong enough to lead to dilation of the cervix. When the contractions do continue, they will turn into regular, powerful contractions. During the contraction, you need all your concentration to breath them away. Now is the time to start tracking how often the contractions come and how long they last. Some deliveries will start with breaking of the water/membranes i.e. losing (a part) of the amniotic fluid. After the first “drops” (only sometimes it gushes out) you will continue to lose small amounts of water (when you stand up or sit down or when the baby moves).

When to call with contractions?

For a first delivery you call us after two hours of having had contractions every 3-4 minutes that last for 60-90 seconds. (1 min contraction – 3-4 min pause/break)

For a second or subsequent delivery you call us after one hour of regular painful contractions of about one minute, approximately every 5 minutes.

Blood loss

A small amount of bloodloss or loss of bloody discharge/slime is normal when you are due. It comes from the cervix and might be a sign that labour will start in the following days. When you only have a small amount of bloody discharge you don’t have to call us, this is due to the mucusplug. Losing the mucusplug won’t say anything about when you will deliver.

Do you lose the amount of a pad full of blood within 30 minutes call us immediately as we’d like to check what is causing the blood loss.

Before 37 weeks pregnancy

If you think about started and you are less than 37 weeks, always call the midwife on call.

When to call when you water broke?

Check the color…

Amniotic fluid/water should be clear (transparant, whitish, pinkish or containing white flakes). Sometimes it contains bits of slime/mucus plug or blood. This is all normal. Try to catch some water in a glass or keep the pads/underwear that contains the water for us to look at. You are now not allowed to swim/bathe or have intercourse.

When are your due?

Are you over 37 weeks pregnant and the water is clear?

Call us preferably in the morning

We will come to your house for a consultation that day to check you and the baby. We will check the amniotic fluid en listen to the heartbeat of the baby. Together we will make a plan how long we can wait for spontaneous contractions and when a referral to the obstetrician is necessary (usually after 24hrs of broken membranes and no contractions).

Call us directly (24/7)…If the membranes break:

• before 37 weeks
• and you already have regular contractions
• and the amniotic fluid is not clear but greenish, brownish, yellowish or you are in doubt about the color