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Unlike the song from My Fair Lady, getting to the church on time for your wedding is a piece of cake compared with timing your arrival at the hospital when you're in labor. Get there too soon, and you run the risk of somebody getting impatient, which can lead to interventions -- IV, Pitocin, even a cesarean section -- that you might not have really needed. Arrive too late, and you may end up perilously close to giving birth in the back of your minivan.
Pregnant women often get the following generic advice: “Stay home as long as possible” (whatever that means), or “Come in when your contractions have been five minutes apart for an hour or two,” which isn’t that helpful, either. What if you can still chat with your husband during a contraction? What if you live five blocks from the hospital? Instead, consider these five factors when you're deciding whether to head out the door:
Do you have any medical condition or risk factor that would have your doctor or midwife wanting you at the hospital sooner rather than later? If so, head there early -- and bring books, your laptop or your iPod to pass the time before labor seriously kicks in. Accept that your stay will be longer, and don’t let yourself or your support team fall into the “Why is it taking so long?” trap.
Are you a first-timer? There are no guarantees, of course, but subsequent labors tend to take about half as long as first labors. If you've had a baby before, once you are sure you're in labor, you'll probably want to make your move a bit sooner than you did last time. If your first labor was unusually short, adjust accordingly.
How long will it take you to get to the hospital or birth center? Consider not only how far away you live, but the time of day and the weather conditions.
What are your contractions like? To get the job done, you need contractions that are strong enough that you can’t walk or talk while you're having one, that last about a minute, and that come along every five minutes or less (timing from the beginning of one to the beginning of the next). Before making your move you should have this pattern for at least two hours if this is your first baby or one hour if it isn't.
Do you have any feelings about where you want -- or ought -- to be? Trust your instincts. If you have a sense that you should be on your way, go with it. Conversely, don’t let the anxiety of others push you into moving if you still feel comfortable being at home.) Just explain to the nurse or midwife that you don’t want to be admitted unless your progress warrants it. If it turns out not much is happening, or contractions fade away, you can always go back home.