Signs of labor: when to call us

As you approach your due date, it is particularly important for you to be in close communication with your care team: don’t hold back! We want to know all of your symptoms and concerns so we can help determine what’s normal and what may be a cause of concern.

Here are examples of areas you should call us about:

Contractions  

If your contractions are painful (often in the low belly, or the low back, or both), they do not go away with rest and hydration, and they become more intense or more frequent, you might be in labor, and you should give us a call.  Generally, if you notice that you are contracting as frequently as every seven to ten minutes, we want to hear from you. 

Painless uterine contractions that cause tightening (“Braxton Hicks” contractions) are common in the third trimester.  If you notice that your belly is getting tight, we recommend that you drink a lot of water and rest. Braxton Hicks contractions should go away with rest and hydration. 

Leaking Amniotic Fluid

When your water breaks, we want to hear from you.  Remember that not everyone gets the “Hollywood gush”, and sometimes you might just notice a trickle of watery discharge coming from your vagina.  

Normal amniotic fluid is quite watery and can be clear or blush colored.  If it is greenish or mustard colored, it means the baby had a bowel movement inside the uterus. If it looks like red wine, it means the fluid is mixed with blood.  Please take notes! What time did you notice the leaking, how much fluid, what color was it, and does it have a foul odor (useful acronym: TACO – time, amount, color, odor).  

Vaginal Bleeding

Some spotting or brown mucus is normal in labor, but if you are having vaginal bleeding with a flow to it (like a period), we want to hear from you.  If you are hemorrhaging (blood pouring out of your vagina), please call 911 and then call us.  You do not need to call us to tell us that you lost your mucus plug, but any bright red vaginal bleeding should be reported. We recognize it can be hard to know whether the amount of bleeding is normal or not, so please don’t hesitate to call us if you’re unsure. 

Fetal Movements

It is always important for you to be aware of your baby’s movements because this will reassure you that the baby is well.  Usually by the third trimester (28+ weeks), the baby will start to settle into some predictable sleep/wake cycles and you’ll start to have a sense of what feels normal for you and your baby.  If the movement patterns feel abnormal, or if you have a sense that you haven’t noticed movement in a while, please take the time to sit quietly and count the baby’s movements.  Set yourself up for success by having something cold to drink, having something to eat, giving your belly a few pokes to encourage the baby to move.  We would expect you to feel four or five movements in 30 minutes.  You might feel that much movement in the first few minutes of your “kick counting” session.  In that case, the baby’s movements are reassuring and you can stop counting.  If you count for 30 minutes and don’t feel four or five movements, call us right away and we’ll have you come to the hospital for monitoring. 

Fever 

If you have a fever higher than 100.4 at any point, call us.  

Oula is committed to being part of your support system throughout your pregnancy. If you are experiencing anything that feels out of the ordinary (whether it’s on this list or not), do not hesitate to call us. We are your team and your concerns are ours as well.