Labor

Call 911 if: 

• The woman has heavy vaginal bleeding.
• The woman has severe stomach or pelvic pain.
• The woman has a seizure.
• The woman loses consciousness.
• The umbilical cord is bulging into the vagina with gushing or leaking fluid.

1. Look for Signs of Labor
Signs that labor has begun include:

• Contractions that come at regular intervals, increase in frequency, do not stop when the woman changes position or relaxes, and may cause pelvic pressure and discomfort or dull ache in the back or lower abdomen
• A sudden gush or a steady trickle of fluid when the amniotic membrane ruptures ("water breaks")
• Pink or slightly bloody mucus discharged into the vagina
• The fetus lowers into the pelvis, which may cause more frequent urination

2. When to Call a Health Care Provider
Call the health care provider right away if:

• In first pregnancy, contractions are very uncomfortable and coming every 5 minutes for 1 hour. This timing, however, may vary. Ask your health care provider what they recommend.
• In subsequent pregnancies, contractions are coming every 7 to 10 minutes for an hour. This timing, however, may vary. Ask your health care provider what they recommend.
• The woman's "water breaks," even without contractions. She should avoid baths, douching, tampons, or sexual intercourse.
• The woman has vaginal bleeding (more than spotting).

SOURCES:
Ma, O. Emergency Medicine Manual, American College of Emergency Physicians, McGraw Hill, 2003.
Cleveland Clinic: "Labor and Delivery."
Harvard University Health Services: "Labor and Delivery."