This post is going to tell you when to call labor and delivery, if you CAN call L&D for questions, some of the reasons to go in — and, we’ll talk about the reason to go to the hospital for labor.
When to Call Labor and Delivery
Being pregnant is such an exciting time. However, there are times that an emergency situation can arise and pregnant women need to know when to call their providers or head into labor and delivery.
How do I know all of this?
Hi, I’m Hilary — many people know me as The Pregnancy Nurse 👩⚕️. I have been a nurse since 1997 and I have 20 years of OB nursing experience, I am also the curly head behind this website Pulling Curls and The Online Prenatal Class for Couples. 🩺 I have also triaged thousands of pregnant families with concerns that bring them into labor and delivery.
Fun fact: Almost everyone who is pregnant (and past a certain # of weeks) comes to labor and delivery first. From there, we help decide what’s wrong and if you need further help from other areas in the hospital, or if you are safe to go home.
Grab my hospital packing list while you’re here:
So, in a sense labor nurses not only deliver babies, but we also basically run an ER for pregnant women.
Reminder: Please don’t take the advice on this website over the advice of your physician or a professional.
Also because everyone is an individual — please ask your doctor these questions for your specific circumstances. I also really liked Kaiser’s tips for when to go in for labor.
Table of contents
Can you call labor and delivery for questions?
The per-policy answer: no.
You have to remember that labor and delivery nurses are concerned with one thing (besides your health and safety) — liability.
We aren’t really supposed to answer questions on the phone. We also don’t know anything about you or your health history when you call, so in general it’s not safe for us to give advice.
Hence, we mostly tell you to call your doctor, or to come in if you are concerned.
OB doctors should have someone on for them 24/7. It might not be YOUR doctor who replies to your call, but it should be someone.
This is something you should ask your OB at your first visit. Ask them if there is a number you can use to get ahold of them 24/7.
Normally, you’d call the number and the answering service will give your number to the on call OB, who will return your call. Now, keep in mind that in the evenings and nights that return call may take a while to get back to you.
That doctor may be in surgery or delivering babies consecutively, so don’t freak out if you don’t get a call right back.
ALSO, use that line very sparingly. That isn’t the place to call if you need a refill or have a question that can easily wait til’ the next appointment with your OB.
Your provider or your health care team may have different ways to get in touch with them when it is urgent, so be sure to find out what they recommend.
Do you need to call labor and delivery before going in?
Absolutely not. We take everyone that is pregnant. If you feel like what you have going on is an emergency that can’t wait for a phone call with your provider please head on in. We are required to call your provider when you get there anyway (and they are required to call us back faster).
Reasons to go to labor and delivery
Make sure to have your support person read through these as well (which is why I recommend a couples prenatal class, so one of you can remember them when you’re feeling crazy).
As your due date approaches, a LOT of things are going to seem concerning, so be sure to stay in touch with your provider.
1. If your baby isn’t moving
Make sure you’re doing kick counts — and if you aren’t making the 10 movements in 2 hours (or if it’s off a LOT from what it is normally) call your doctor, and if they’re not back to in a few minutes, I’d call L&D — or go in.
We take decreased fetal movement very seriously, and we want you to as well.
2. Severe Vomiting
If you really can’t keep anything down for a full day I’d call your doctor. This is different than morning sickness.
However, even with morning sickness, you should ask your doctor at what point you should be concerned, based on what he/she has you on.
Regular vomiting/stomach flu/food poisoning can still be helped with the info in this post.
3. A headache that won’t go away
This can be an indicator of preeclampsia. It can also be dehydration or the hot dog you ate, so before you freak out:
- Take a Tylenol
- Drink 3 GIANT glasses of water
- Eat something
- Try to take a nap
If none of those work, I’d call your doctor (and if a headache is REALLY bad, I’d just go to L&D).
BTW, I have a whole post about if it’s OK to drink Gatorade during pregnancy.
You don’t want to call your doctor for any little contraction.
But, if you’re less than 36 weeks of pregnancy, Md’s like to see less than 6 contractions in an hour. If you’re having more than that, I’d call your MD.
If you’re feeling contractions — make sure you:
- Drink two GIANT glasses of water (often, they are caused by dehydration)
- Eat something with a good balance of protein and carbs
- Take it easy — don’t over-do it!
If you’re still feeling them, call your doctor!
Remember, this is a very SURFACE review of what to call L&D or your provider for. I have seen pregnant couples SO much happier when they get a prenatal class so they really understand all these things. This one can be done in just three hours (so, even if you’re due soon — there’s TIME!!!!!).
5. Facial swelling
If you suddenly wake up and your face is REALLY swollen. I’d call your doctor. This can be another sign of preeclampsia.
I probably wouldn’t go racing into L&D for this, but it’s worth a call and likely a follow-up appointment with your doctor.
** Gradual facial swelling is normal — I’m talking you wake-up and your face is suddenly very swollen.
6. If you think your water broke.
I have a whole post on a few ways to tell if your water broke. When in doubt, we have a test to see if it really is amniotic fluid.
Depending where on your amniotic sac your water breaks you can have a GUSH or just a trickle of fluid, so it can definitely be confusing.
If anything falls into your vaginal (like an umbilical cord) after your water breaks, get your bottom in the air (get on all 4’s and put your head on the floor) and call 911.
7. Problems with your pee
- You can’t pee
- You feel like you need to pee all the time
- Lower abdominal cramping
- Flank pain
This can be an indicator of a bladder infection. Often you can just drop off a urine sample, and they can see if there are issues.
8. If you have a fever over 100.4
9. Bright red bleeding
Some vaginal bleeding can be normal — especially after:
- an internal exam (done by your doctor)
But, if you’re getting bright red bleeding that is much larger than the size of a quarter, I’d call your doctor. If you’re soaking a pad — just go right into L&D.
“Bloody Show” isn’t unusual if you’re in labor, but if it’s a lot be sure to call.
10. Crazy Itchy
Now, mosquito bites are one thing, but itchy palms and feet can often be an indicator of an issue with your bile ducts, which can be problematic. Call your MD. If you just feel REALLY itchy and benedryl isn’t doing anything, call your MD.
In general this can be handled by your health care provider vs coming into labor and delivery (they just need to order some lab tests).
11. You have alarms going off in your head
Now, this is one that’s kind of hard to write about — but if you really feel like SOMETHING IS WRONG, call your doctor or head to L&D.
Now, on your way in — you need to be able to articulate what it is that is causing this. Is it pain, lack of movement, anything like that?
Pregnancy can be full of anxiety, so I really wouldn’t recommend coming to L&D for any little thing, but sometimes mamma hearts just know. And we want you to have a safe baby.
In this type of situation we will quickly monitor baby’s heart rate and make sure everything is OK there, and then move on to any other issues.
12. Whatever else your doctor says to watch for.
Pregnancy is full of complications, and everyone’s situation is very different. Your doctor may have specific things that YOU need to watch for — so watch for those, and take action if need be.
When to call labor and delivery if you’re high risk.
If you have something going on during your pregnancy — you need to have some clear guidelines as to when you should call him/her or when you should go into labor and delivery.
Medical conditions like this can be:
- Placenta Previa
- Breech Baby
- High blood pressure
- And the list goes on….
So, make SURE to talk to your doctor about all of these things!
If you have more questions about when to go to the hospital, or what they will do there the prenatal course will answer almost every question you have (you can even ask questions from within the course and get answers pretty quickly!)
When to go to the hospital in labor
I wish there were hard and fast rules on this, but I would 100% make sure you ask your doctor about this once you hit about 23 weeks or so. It will be based on:
- How far you are from the hospital
- What number baby it is for you (first babies are often slower)
- If you’re preparing for a cesarean delivery or a vaginal birth
- Your past history (like if you’ve had previous cesarean deliveries)
- Your current obstetrical history, and if there is anything you need to be watching out for.
- Doctor preference
They should give you an idea of how long and how fast regular contractions are happening before you come in.
Most often you want to show up after you’re in active labor. Early labor is best managed at home where you can have the comforts of home, move more and enjoy your own things, but definitely talk with your provider.
Many women show up when they aren’t tolerating labor at home, and would like some pain medication. Keep in mind that we don’t usually offer epidural anesthesia until you are in active labor (and your cervix is opening).
Once your water breaks, you’ll want to call your provider to see when they recommend you head into the delivery room.
And yes, this issue is gone into detail in this prenatal class if you want more info — but since every situation is different, I’d recommend asking your doctor at your OB visit.
Not sure the signs of early labor? >> check out this post on signs of labor — but early labor can feel like pain in your lower back and then progress from there (if you’re actually going into labor).
The main difference between braxton hicks contractions vs “true labor contractions” (or the real thing) is that one goes away (false labor), and one progresses into active labor. So, sometimes you just have to be patient to find out.
What to Do When Your Labor at Home:
Some ideas of things to do if you’re laboring at home and not quite ready to go to the hospital.
- Clean – -get the house ready for baby
- Take a warm shower (or a bath if you like baths and can do it safely this far into pregnancy)
- Pack your hospital bag
- Use your breathing techniques to help you relax into the contractions (and let your cervix open)
I have a whole post on what to do in natural labor that might help, and I go into this in depth in my prenatal class.
I also have a whole bonus video where I share breathing and relaxation techniques in here.
What to Expect When You Go to the Labor and Delivery Unit
You will likely hit the admitting desk. Unless you are there for a scheduled procedure they should take you back to a room or a triage area. Sometimes patients are triaged in a private room, and sometimes they are in a curtained area.
The nurse will start fetal monitoring, take your vital signs, and will proceed to ask a lot of questions about what brought you in as well as your health history.
Then, she will call your provider and make a plan of care after that.
I talk ALL about what to expect when you get admitted in this class.
When do you go to Labor and Delivery Instead of the Emergency Department During Pregnancy
Every hospital I have worked at had differing rules. Some take moms past their first trimester, some not until 20 weeks, so as your provider what you should do depending on what hospital you’re going to.
When in doubt show up at the ER — and they can direct you (and get you help if you need it from the minute you walk in the door).
How to get admitted to labor and delivery
This one gets googled a lot.
Yup, you can come in and lie, but we like mammas to go the full 40 anymore. SO it really is hard to cheat the system of L&D at this point.
You can’t fake contractions, you can’t fake preeclampsia, you can’t fake a lot of stuff. Usually, the nurse that runs triage is one of the most experienced nurses (and is also a delivery nurse). Don’t undervalue that experience and be thoughtful to show up only when their care is necessary.
I’d love to know what kind of questions you have in the comments (I can’t answer individual questions, sadly — but it might make others feel better). Pregnancy is ALL so weird, sometimes it is hard to know what’s OK and what is not.
Ok, this was just surface information, now is the time to jump in the class so you can get TOTALLY prepared.
- Only takes 3 hours
- Has 3 price points to fit your budget
- Is the #1 online hospital-based prenatal class to help you have confidence in talking with your healthcare team.
I can’t wait to see you inside with me!
Or, if you’re not quite sure you’re ready for that full class, grab my Free Beginning Prenatal Class. SO much good info in there. I think you’ll love it too.