How to Labor at Home as Long as Possible
Many women in my childbirth classes and those that hire me for doula support often ask for tips on how to labor at home as long as possible. In fact, one of the big reasons they may hire a doula or take a childbirth class is to facilitate laboring at home for the majority of their labor, and arriving at the hospital for transition and pushing.
On This Page
13 minute read
↓Why Labor at Home?
↓Time Out!
↓Tips to Arrive During Transition
↓Notice the Timing of Contractions
↓411 Contraction Rule
↓Notice These 3 Things
↓Try to Stop or Slow Labor
↓Signs of Transition
↓You'll Just Know
↓No Car Baby, Please!
↓Want More?
Why Labor at Home?
Before we get into the nitty gritty on how to labor at home as long as possible, let's discuss why laboring at home is an option many pregnant women desire.
1. Encourage Oxytocin
One reason some women labor at home as long as possible is to keep their labor as straightforward, smooth and short as possible. Hormonally speaking, the further a woman is in her birth experience, the harder it is to disrupt the flow of oxytocin (the hormone which causes contractions) and therefore her labor pattern.
According to the hormonal blueprint of labor, if a woman heads to the hospital as soon as signs of labor begin, in early or even sometimes in active labor, things might fizzle out. Her contractions will stop and she'll be sent home, frustrated and exhausted. Not cool!
However, if a woman experiences long, hard contractions that are close together before going to the hospital, odds are that the act of leaving home, getting into the car, and showing up at the hospital won't affect her labor or disrupt the release of oxytocin.
2. Less Pitocin
In my experience, women who labor at home for the majority of their birth experience and "show up at the hospital to push a baby out" are WAY less likely to need pitocin to augment or strengthen their labor.
Frankly, the labors of the women who do most of their work at home in a serene birth environment, are strong and impossible to stop! By laboring at home and getting into a good labor pattern before going to the hospital, pitocin is less likely a possibility.
3. Unmedicated Birth
Women wanting to labor at home as long as possible are planning for an unmedicated birth. And in my experience, women who labor at home as long as possible are WAY less likely to need IV pain meds (narcotics) or an epidural to get them through the rest of their labor. Often, there's just no time to get an epidural because things are moving quickly once she arrives.
Other times, she's learned to cope through her contractions while at home and continues coping just as well even when admitted to the hospital. She's got this!
4. Pain Coping
Many women that labor at home as long as possible do so because it is easier for them to cope through their labor pains in the comfort of their own homes. These women were more comfortable and less fearful at home and therefore better able to cope through their intense contractions. Natural birth can be less painful by following some basic tips!
5. Planning a VBAC
Another reason to labor at home as long as possible before heading to the hospital is when planning a VBAC (vaginal birth after cesarean). This may seem like odd advice, however, even my local hospital midwives tell their patients that "their best bet for a successful VBAC is to show up at 39 weeks ready to push".
VBAC patients are monitored more closely and therefore have more opportunity for interventions, which unfortunately increases the possibility of other complications (this is called the cascade of interventions). For example, many care providers require constant internal fetal monitoring during a VBAC. Sounds reasonable, right?
Well... with constant internal fetal monitoring comes breaking the water (amniotic sac) and laboring in bed. By doing these two interventions the risk of infection has increased and also the need for an epidural (because her range of pain coping has decreased by limiting her movement).
Therefore, under the careful guidance of a trusted care provider, laboring at home as long as possible may be a key component to achieving a VBAC.
Time Out!
... which leads me to my next point. It's ok to go to the hospital! If you need to go to the hospital, you should go. If something isn't right, you should go. It's ok to utilize your support team and care provider. If you need medical advice, call your care provider or a nurse.
If you are laboring at home as long as possible because you are fearful - of the hospital and/or staff - you are laboring at home for the wrong reasons. Making decisions based on love - for yourself and your baby - instead of fear, is the way to go. Birth without fear!
If you don't feel safe, comfortable or trust your care provider or hospital, choose a new one! It's never too late to fire your OB!
(I know someone that switched care providers... DURING LABOR! Be brave and do what you gotta do to get things done safely and effectively.)
If you need to brush up on how to talk with your care provider and make decisions check out this post about the brain acronym!
Tips to Arrive to the Hospital During Transition
If you are hoping to labor at home as long as possible before heading to the hospital, odds are your goal is to arrive at the hospital at the end of the first stage of labor while in transition, or right before transition. The following are tips on how to do just that. Good luck!
1. Take a Good Childbirth Class
The foundation to laboring at home as long as possible is quality childbirth education. If a laboring mom is ignorant of her body, pain coping, the labor process, etc., how in the world is she going to navigate labor at home?
After completing a good childbirth class series you should have a solid understanding of how labor progresses, pain management for labor, and birthing tool options.
2. Hire a Doula
The next layer to successfully laboring at home is to hire a doula. A doula has witnessed many labors and is an invaluable asset when determining when to head to the hospital.
If I have a doula client that is unsure about whether to go to the hospital or not sometimes I'll just head on over to their home to check things out myself. FaceTime works too! Usually in less than 5 minutes I will know if it's time to go or not. A doula is so helpful in this situation!
3. Be Ready to Go
as long as possible is to be 100% ready to go at a moment's notice. When laboring at home, parents should not be packing a hospital bag, it should already be done. Phone chargers, wallets, pillows, a towel to sit on, etc., should be in the car ready to go while mom is laboring inside at home.
If the decision to go to the hospital is made, everyone should be able to get in the car and go in just a couple of minutes.
4. Notice the Timing of Contractions
An extremely effective tool to help determine when to go to the hospital is timing contractions. If you are unsure on how to time contractions, you can download an app! There are so many of them, and most are free.
Time Between Contractions
The first thing you need to look for is how far apart the contractions are. Contractions are measured from the start of one to the start of the next. Some parents wanting to labor at home as long as possible may go when their contractions are around 3-4 minutes apart.
Length of Contractions
Another way to know when to go is to notice how long each contraction is lasting. In early labor, contractions average around 30 seconds. During active labor, they increase in length to around a minute. During transition, they may be even longer at 90 seconds.
When your contractions are around 4 minutes apart and lasting 60 seconds or longer it might be time to head in to the hospital.
Duration of Contractions
One last aspect of contractions to consider when laboring at home is how long a particular series of contractions has been taking place. If you have been having contractions 3 minutes apart, each one lasting a minute, but this has only been going on for 20 minutes, you might need to time a few more contractions to make sure this is the real deal.
When in doubt, see if this pattern continues for an hour. If things are progressing, remaining intense, and not going away for the last hour, you might want to head to the hospital!
4-1-1 Contraction Rule
To put it all together, I suggest remembering the 4-1-1 contraction rule. When your contractions are 4 minutes apart, lasting for at least 1 minute, and this has been going on for 1 hour - you might want to go to the hospital.
Even then, there are more things to take into consideration when the goal is to labor at home as long as possible.
5. Notice These 3 Things
1. Notice Mom's Mood - Between Contractions
Sometimes, even when contractions are a solid 4 minutes apart, it's might not time to head into the hospital. One way to know what to do is to observe mom's mood BETWEEN contractions.
Normally, during a solid active labor contraction a mom works hard at coping, breathing, etc., but between contractions she's in a good mood, talkative and generally her normal self. However, when a laboring mom's mood BETWEEN contractions changes, that's when I start paying attention.
Here are some things to look for BETWEEN contractions that might signal it's time to take the drive to the hospital:
- She closes her eyes and goes within, even when not having a contraction.
- Stops chatting with family, friends or the birth team even between contractions.
- Annoyed at the chatter of birth companions, even between contractions.
- Becomes irritable, agitated and easily annoyed even when experiencing a break between contractions.
If her contractions are close together AND her mood between contractions has shifted, it's probably time to go to the hospital.
(If you look as pleasant as the woman above on the couch, it's not time to go to the hospital. 😉 )
2. Pay Attention to Mom's Pace
Another thing to notice when determining when to go to the hospital is how fast or slow the laboring mom is moving. In my experience, as a woman progresses through labor she moves increasingly slower.
I remember arriving at a doula client's home to help determine if it was time to head to the hospital or not. My client was in the tub, laboring through her contractions. At one point she got out of the tub to head on over to her bed. It took her forever to get to her bed! I quickly realized that she was progressing and suggested heading to the hospital.
Just as I anticipated, it took her awhile to get dressed, downstairs and into the car. Thankfully, she made it to the hospital with perfect timing and wouldn't you know it? She arrived in transition and soon pushed out her baby. Nailed it!
3. Notice When Mom Powers Off and Checks Out
If you are in labor but are able to continue texting and staying connected via social media, it's probably not time to head to the hospital.
As lame as it sounds, at my births... especially my homebirth, I had considered posting updates on social media via my phone. However, once things picked up and got intense, I honestly did not have the ability and/or brain power to stay connected. My phone was abandoned and I focused on my one task - have a baby!
If you're able to stay connected via your phone, it might not be time to head to the hospital.
Try to Stop or Slow Labor
If you're still unsure of when to go to the hospital, try to see if you can slow or stop your labor. If you can slow things down, you definitely should stay home.
Ways to Slow Labor
- Drink a glass of water
- Take a bath
- Take a shower
- Lie down for a nap
- Go to bed for the night
- Take a walk
If after trying the above activities labor has slowed or stopped, that can it's probably not time to go to the hospital. However, if you find labor remaining the same or becoming even stronger, it might be time to head to the hospital.
Signs of Transition
Here is a list of symptoms or signs of transition. If you are experiencing these things, coupled with the signs listed above, it's definitely time to go.
(For help coping through transition without an epidural read this.)
- Long contractions lasting around 90 seconds (in comparison, the average active stage contraction is around 60 seconds)
- Contractions become longer, stronger, and closer together - around 2-3 minutes apart
- Instead of completely going away contractions sometimes “double peak”
- Because of all this ^ it feels like you’re not getting a break. You may hear yourself say, “I’m not getting a break.”
- Hot and sweaty
- Cold and shaky
- Nausea
- Vomiting
- Crying
- Can’t find a comfortable position
- Contractions increase when changing positions
- Afraid to change positions
- Looking for a way out
- Water breaking
- Discouragement and/or giving up
- Irrational thoughts and behavior
- Asking for pain medication
"You'll Just Know"
A few times in my doula career I have received a phone call to go over to my client's home in order to help determine whether or not it was time to go to the hospital. While on my way there, I received yet another call saying that they decided to go in because it became obvious that it was time to go. They "just knew".
Sometimes, you just know. If you have a gut feeling that it's time to go to the hospital, then listen to that voice! Go make like a baby and head out! (lol lol lol)
No Car Baby, Please!
Of course, this article wouldn't be complete if I also explain how to get to the hospital without having a car baby. This is an important topic, especially for those that live out of town. Nobody wants to have a car baby! Use the link in this paragraph to learn more.
Want More?
For more juicy articles about rocking the hard parts of birth, try the how to's below.
Labored at home- On a Tuesday evening, started having back labor while we were buying a car. Found myself in the showroom's luxury sedan doing slow deep breaths all hunched over and the salesman really wanted us to leave, so he said we could finish signing papers the next day. Picked up a pizza and went home. Left 3 slices from a large for my husband to eat while I ate the rest. Went to bed with contractions 7-9 minutes apart. Once fed and laying in my bed the pain was less intense. Woke up the next morning and they hadn't let up. They were now 5-7 minutes apart. Stayed home all day shaving my legs, painting my nails, watching funny movies, making sure my bag was packed and lounging until 5 pm that day when my water broke. 30 minutes later we got in the car & drove 30 minutes to the hospital with 5' o clock traffic... Got to triage and was checked and was 60% effaced and dialated 1/2 cm but they wanted me to stay. They told me I would likely deliver this time tomorrow. I knew I wouldn't be able to eat once I was admitted so, I freaked out. I was all of a sudden hungry even though I ate 2 almond butter jelly sandwiches on the way to the hospital. Turns out, they were a lil off. I dialated 2 -2.5 centimeters every hour after that and delivered at 1 am. I was in active labor + pushing for a total of 8 hours. Not too bad in my mind! I was pleased with that.
Whoa you were such a trooper! I gotta ask... what did you eat after you had your baby?
I did this with my first and it worked wonderfully!
I would add that as a second time mom things will go much faster! So 4-1-1 might be too late. It was for me!
Yes! That's why it's important to look at more than just the timing of contractions.
In your opinion, what else are you looking for besides timing of contractions? That's how I knew with my first; Baby #2 is due tomorrow and I feel a little lost with what to look for if I don't have a pattern to my contractions.
I'm a second time mom but not sure how this labor will progress bc with my last I was induced for pre-e and had a c section. Even then could labor go fast?
A VBAC will progress like a first time labor... which could go fast or slow! Ha! I hope that's somewhat helpful. 😉
Mood was a huge factor in both my first and second pregnancies. My husband says he knows exactly when transition hits bc of my mood and ways a talking to him. lol I remember getting the feeling of I can't do this anymore, it just hurts too bad. Both were born within the hour of having that thought and maybe communicating that a little on the mean side to my ever supportive husband! 🙂 both birth were unmediated
This is an awesome article - I felt myself nodding the whole time I was reading it.
My husband and mother in law kept asking my doula - how will you know when we need to go to the hospital? She just kept saying - I can't explain it but we'll just know. It was pretty text book (but you explained it well) based on what you've said here. I left for the hospital when I could no longer talk between contractions and was irritated when others spoke. I was 3-1-1. Got to the hospital at 3:30 and had my baby at 4:16, no interventions or pain meds. I credit my doula with knowing exactly when to leave for the hospital, and my intervention-free birth with labourin at home as long as possible.
Great article!
Thanks, Kate!
I did it with my first and hope to do the same with my second. Contractions started at 9pm, I thought it was Braxton hicks and I laid down, tried to relax and hoped they went away. After a few hours (didn't realize how much time went by) it was getting worse and worse, I went from laying down, to standing up, swaying back and forth, laying down again. (my not very nice ex, insisted I wait, not having the brain capacity to make sense of things, I kept breathing through the pain) I finally felt a lot pressure down there, felt like she was ready to come out, I insisted that it was time to go, I got to the hospital (about 20minutes away) at 2:15a.m, when I arrived I was fully dilated and she was out at 2:50am on what my doctor said was the second push (I remember pushing at least a couple more times).
It all worked out well enough, I had a medication-free labor and plan to do the same with the upcoming birth. In retrospect, waiting that long I definitely risked having a "car-baby", I remember thinking to myself "don't even try to push, don't do anything resembling pushing, keep your legs closed, breath, breath"
side note: I'm no longer with that guy, and married an Amazing, Wonderful, Caring man!
WOOOHOOO! Happy you avoided a "car baby" AND found an amazing, wonderful, caring man!!
What a great article! Good job! I also found myself nodding throughout. Everything you said is true. I had my first child 15 months ago. I had what I thought were Braxton hicks all evening. We were timing them but they were all over the place, 5 mins apart, 7 mins apart, 2 mins apart, etc. We finished watching a movie and went to bed. I woke up to pee at 2am and had a strong contraction, 3 mins later another. My husband called the midwife to come check things out. By time she got there I was having pretty regular, strong contractions and couldn't speak through them any longer. She checked me and I was 8 cm dilated. The drive to the hospital was only 5 minutes...thank goodness. I got to the hospital around 5am and had my son at 7am. No medication. Wonderful experience. We are currently trying for our second!
Lindsay
Awesome!!!
Hi Lindsey. What is the best thing to do if you have a 2 and a half hour drive, maybe longer? I would love to labor at home as long as possible but I think that may not be possible!
I'd probably get a hotel room close to the hospital. 🙂 I know people who have done that.
Thanks for the reply! I think that's what we may have to do!
What about a 45 min drive? The last hospital I delivered at was only 10 minutes, but there's no way I'd ever go there again!
I found that some of this was true but I had a lot of differences personally. With my second I was 35 weeks and had taken my toddler to the park. I was uncomfortable (thought it was Braxton hicks) and went home to rest. My son was transverse so being uncomfortable wasn't uncommon in my pregnancy with him. I rested and went on throughout my day. That night I took a bath and went to bed. I woke up still uncomfortable but it was tolerable. I had a follow up appointment that morning so I wasn't too worried. I drove myself to the hospital. When I got there they hooked up the monitors and did an ultrasound (baby flipped to full breech). The nurse asked me if I was feeling the contractions she saw on the monitor. I told her yea they are uncomfortable but nothing like my first labor so they were probably from the baby flipping in a different position. She had the doctor come check me just to be safe. To my suprise the doctor said I was at 8cm and was going to be having a csection in the next 30 mins. Luckily my husband showed up at my appointment right when she checked me because he didn't get a phone call from me like he normally does after my appointment. Baby boy was born 15 minutes later. That was the most crazy, scariest day of my life!
Oh my word!! Birth can be so unpredictable. Sounds like you were in the right place at the right time.
I did most of my laboring at home. At about 36 weeks I went to the hospital w/ latent labor after not being able to get contractions to stop. I was fully effaced by 33 weeks so they were keeping a close eye on me for early labor. Long story short I was forced in to taking a steroid that I didn't want b/c a doc insisted I would birth that night. I delivered at 40weeks +4. Slept through most of my labor (tossing and turning between
Contractions) then woke up and went to the hospital. I had the baby less than 3 hours after arrival. I refused to even let them put an IV line in. The birth was 100% intervention free!
Wow! So was the steroid for 33 or 36 weeks?
Generally steroids are used to speed up development of the lungs in babies that are likely to be born early - poorly developed lungs are a high risk situation, and the lungs are slow to develop in utero.
Second time mom - was induced with an epidural on the first so had no idea what to expect! Contractions started at 1:45am and continued every 15-30 mins all day. Finally from 10:45pm - 11:45pm they were consistently 5-1-1. Got up from bed to walk and sway for relief and rapidly went to 2-3 mins apart lasting 90 seconds. By 12:10am I told hubby this is moving too fast, we need to go NOW! Started pushing involuntary in the car, arrived to ER at 12:26am and my daughter was born upstairs in L&D at 12:30. My husband hadn't even gotten to my room from parking the car, the doctor wasn't even there! One more contraction at home and we would have had a car baby!
WOW! What a story.
Wish my "midwife" would have read this. I had many of the signs listed of transition, and she told me I was hours and hours away from birth. I couldn't handle that kind of pain for 5+ more hours, so we decided to transfer from the birth center to the hospital for pain medication. Half an hour later, my baby was born in the car
I have to say im obviously nervous, today is my due date. My first baby. We live about 45 minutes from the hospital. Ive had so many little instances where my contractions will start, theyll be a little abnormal and far apart but pretty darn painful (3-4 in an hour) but then stop. Yesterday, they were getting more intense with every one, but still over 10 minutes apart. Then stopped once i changed positions. Talk about confusing. How am i supposed to know when to go? I dont want to be sent home and although my husband is super supportive and caring, i would feel horrible making him close our coffee shop to head to the hospital for yet another false alarm! This article did help me feel a little more confident but damn, girls grow up thinking youre water breaks, you go to the hospital lol. So not the case for 85-90% of women!
Courtney - it is confusing for sure. I had my first baby 15 months ago and I definitely didn't know when to go to the hospital either. I must say you will KNOW when they are real contractions! I had Braxton Hicks for months and then intermittent contractions for a few days before the delivery. Listen to your body. that is the best advice I can give. Good luck!!!
I'm 5 months and I'm starting to get nervous! When your water breaks does that mean it is time to go to the hospital or do the contractions really start after the water breaks?
Your water can break at any point - before labor, during or even while pushing. Your baby can even be born in the amniotic sac! SO COOL. Ask your care provider what they'd prefer you to do when your water breaks... I've found that every care provider says something a little bit different.
My water broke at home (it was like a movie- felt like a 5 gal bucket of water gushing out) and I had no previous signs of labor. I wish I would have stayed at home and labored longer before going to the hospital but, my water breaking with no other labor signs really threw me off!! I plan on using this article as a guide and staying home as long as possible this next time! I’m 33+2 weeks now!
Agreed! My water broke at 36 weeks at home and my doctor wanted me to come in immediately even though I didn't have any other signs. I labored for 24 hours and then had c section because the number or cascade of interventions. Even my 2nd shift nurse said it could of helped laboring at home longer (get oxytocin going). Planning for next baby and will print this and keep it in my folder.
I live 30-40 minutes from my hospital depending on time of day/traffic. I had a natural hospital birth with my last child, but then we were 10 minutes away from the hospital. I'd love to labor at home as long as possible, but I'm a little nervous I'll stop labor during the car ride by being uncomfortable - or that I'll end up delivering roadside. How should I judge when to leave?
I'd stick with 411 and make sure you're ready to go so when it's time you can just pop on in the car.
As a mommy of FIVE boys, ages 16, 12, 8, 4, & 3.. With every one of my labors (except for baby number 2, because the Dr needed to induce) I labored at home, and was in active labor upon arriving to the hospital. With most of my births I gave birth between 2-6 hours after arriving to the hospital. Pretty good I might say, no epidurals, some I had minimal meds, while others, I had NO meds at all. Sitting in showers allowing the warm water hit the lower part of my back, watching comedy movies, and eating with family, and moving around helped to calm the pain, the moment, my attitude changed, and I could no longer move about actively told me it was time to head out to the hospital.