When to call?
The vast majority of all labour will start with contractions. In most cases it will be irregular painful but short contractions (Braxton Hicks contractions). As long as contractions stay away of the frequency of them goes down for a while after changing positions or any other outside influences, they tend to not be strong enough to make you dilate. They will soften the cervix and it will flatten (‘verstrijken’).
Call us when you need us. This might sound difficult but trust your intuition. To give you some guidelines when it’s time to call when labour has started:
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.
Some deliveries will start with the 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). From this moment onwards you will have 24 hours in which you will have to get into labour/have regular contractions. If this doesn’t happen, we will have to refer you to a obstetrician of your choice. 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.
Are you over 37 weeks pregnant, the water is clear en the head of the baby is engaged? 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 wait for spontaneous contractions and when a referral to the obstetrician is necessary.
Call us directly if the membranes break if one of these situations occur:
- before 37 weeks
- already having regular contractions
- the amniotic fluid is not clear but greenish, brownish, yellowish or you are in doubt about the color
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.
Call the midwife if you don’t feel well or if you are worried:
- less/no fetal movements
- strong headache
- strong abdominal pain
- feeling unwell/having a fever
- if labour has started before 37 weeks