When to Come to the Hospital

Nurse-midwife Bridget Lee and her patient in labor walk through the hallway of OHSU’s Family Birthing Center.
OHSU nurse-midwife Bridget Lee walks the hallway with her patient in labor. When you come to the hospital, we’re ready to support you.

We know you might be nervous about knowing when you’re in labor and when it’s time to come to OHSU. We’ve developed these guidelines to help you decide.

If you need to call:

  • Reach labor and delivery 24/7 at 503-494-7534.
  • During business hours, call 503-418-4500 to speak to a clinic nurse.
  • For emergencies when the clinic is closed, call 503-494-8311 to speak to the OB-GYN or nurse-midwife on call.

Signs you should come in

Your contractions are:

  • Regular, steady and increasing
  • Five minutes apart for one or two hours
  • Uncomfortable; you can’t talk or walk through them

Other signs:

  • Your baby is moving less than usual.
  • You have vaginal bleeding.
  • Your doctor or midwife tells you to go to the hospital.
  • Your intuition tells you to go to the hospital.

Signs you should call

Your contractions are:

  • Five minutes apart for one hour, and this is your first baby.
  • Five to 10 minutes apart for one hour, and this is not your first baby.
  • Hard to talk or walk through.
  • In your lower back and moving to the front, with a hardening belly.
  • Not slowing when you rest or lie down.

Always call your childbirth provider if:

  • Your water breaks, or you are leaking fluids.
  • You have pinkish or bloody vaginal discharge. This could be the mucous plug that blocks the opening to the cervix during pregnancy.

Symptoms you should never ignore

  • Bad headaches
  • Changes in vision, such as blurred vision
  • Sudden weight gain
  • Pain or burning when you urinate
  • Bad abdominal pain

If you are concerned about your health or the health of your baby, call your prenatal care provider right away.

Special cases

Contact your prenatal care provider immediately at the FIRST signs of labor if you:

  • Are pregnant with twins or multiples.
  • Have a condition that makes your pregnancy or delivery high risk.
  • Are less than 37 weeks pregnant.

If you have a high risk of complications or it is not safe for you to go into labor, you will be monitored closely throughout pregnancy. Your prenatal care provider will give you specific instructions about signs to watch for and when to come to the hospital.

Labor and delivery FAQ

Several signs mean labor is near.

Contractions: These feel like intense period pains and come in waves. They get stronger when you move around and don’t go away if you change position.

Bloody show: You might have a stringy mucus discharge, streaked pink or brown with blood. This means that the mucous plug, which blocks the opening of the cervix, has come loose.

Water breaks: The bag of amniotic fluid that surrounds the baby bursts. This could feel like a gush or a trickle.

It’s impossible to predict because every birth is different. Usually, labor lasts longer for people delivering their first baby.

The National Institutes of Health divides labor into three stages.

Stage 1

  • Early labor: First-time parents can spend hours to days at home in early labor as the cervix softens and opens, and as contractions begin.
  • Active labor: This more intense phase usually happens at the hospital. Your cervix dilates from about 6 centimeters to 10 centimeters. Some labor experts estimate an eight-hour average.

Stage 2

Your baby is born. The pushing phase can last minutes or hours. First-time parents often spend longer pushing than those who have given birth before.

Stage 3

You deliver the placenta. This usually lasts five to 30 minutes.

Try to rest and relax. You might:

  • Take a shower or bath if your water hasn’t broken.
  • Try to sleep if it’s evening.
  • Eat light snacks that appeal to you.
  • Drink plenty of water.
  • Get a massage from your support person.
  • Read a book or watch TV.

Start timing after you’ve had a few contractions in a row. Note how long they last and how often they happen.

To measure how far apart they are, count from the start of one to the start of the next. (There are apps available to help with this.)

If this is your first baby, use the 511 Rule to decide when to come to OHSU. Contractions are 5 minutes apart for 1 hour, and each contraction lasts about 1 minute.

If you’ve had a baby before, go to the hospital when your contractions are between five and 10 minutes apart for one hour.

Always call your prenatal care provider as soon as your water breaks. Your provider will guide you on next steps.

Be sure to note:

  • The time it happened
  • The amount of liquid (was it a gush or a trickle?)
  • Smell, if any
  • Color, if any

If you’re asked to labor at home for a while longer, don’t:

  • Bathe
  • Use tampons
  • Have sex

Your main provider may not be present for delivery unless they are on call when you go into labor or you have special arrangements. The on-call provider from your prenatal care team (OB-GYN, nurse-midwifery, family medicine) will help with your delivery.

Learn more

Who to call

  • Call 503-418-4500 during business hours to:
    • Speak to a nurse
    • Make an appointment
    • Address urgent needs
  • After business hours, send nonurgent messages through MyChart.
  • For emergencies when we are closed, call 503-494-8311 to speak to the OB-GYN or nurse-midwife on call. Call if you:
    • Can’t keep down fluids for 8 hours or longer
    • Have vaginal bleeding, severe cramps or pain
    • Have a fever over 100.4F (or 38C)
  • To reach labor and delivery 24/7, call 503-494-7534.


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