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.
Great article. I went to the hospital when my contractions were about 6 minutes apart. The hospital was an hour away. By the time I got there they were 3 to 4 minutes apart. I was dialated a six. I was still talking and laughing. My mood didn't change till I was about 8 and a half cm. But even then when I got a break from contractions I was still talking. I had back labor too. I hated that! My baby girl was born 2 hours after I got to the hospital. Pushed for about 15 minutes. It all happened way to fast. But totally worth it. Baby girl is a week and 2 days now
At 41.5 weeks my labor started at 11.30pm. I woke up to use the restroom (of course!) and then I "just knew." I let my husband know and called my best friend who lives 3hrs away to let her know to start driving as she was my birthing coach.
Contractions weren't too strong at first but by the time my friend arrived they had picked up a bit. By 6pm we called my OB to fill her in and she said so long as I was comfortable and contractions weren't consistently close together I should stay home as the only thing that would happen at the hospital was monitoring and possibly drugs which she knew I was trying to avoid.
I continued laboring all night with contractions getting MUCH stronger but not any closer together. By 8am, my doc asked me to come to her office to check on the baby since it had been 32hrs...all was good and I was only 2cm 🙁
I went home and continued with them getting even stronger.
By 7pm I was beyond exhausted as I hadn't slept for about 60hrs which was making it harder to breathe through contractions.
My doc told me it was up to me but her suggestion was to come to hospital and have the epidural so I could sleep a bit to have enough strength and energy to push.
Off we went!
Due to crazy circumstances, I ended up not getting the epidural until midnight--by then the relief was immense and I passed out within seconds.
By 9am, I could feel the epidural wearing off enough to feel contractions coming and I was ready to push.
Took three hours and at long last 60 (LONG!) hours after the whole thing started, my son was finally born 🙂
I'm so grateful that most of that time was spent in the comfort of my home with loved ones and my own shower and bed and food. It really does make a difference and though I didn't get the drug free birth I was hoping for, I feel that waiting as long as possible to get those drugs likely resulted in less interventions than had I gone in earlier.
I labored mostly at home with my son! I got to the hospital at 7cm diliated & 3 hours latter my son was born! I plan to do the same with my second (due April) I defiantly could've used these tips the first time around, I am worried about this labor going to fast, with my son Everything happen so fast there was no time for me to even think !
I went into active labor at 4;30pm on my due date. by 7pm, we hit the 4-1-1 mark and called the hospital. The nurse told hubby that i couldn't be in active labor yet as a first time mom, and that in order to determine whether i was in "real" labor, he needed to have me get in a lukewarm bath for 1 hour, then sit in a recliner for 30 minutes, all while drinking a glass of water every 20 minutes. She told him my contractions would probably slow down after all this - ha! As soon as i hit the bathtub, transition started. I couldn't open my eyes and contractions were a minute apart. Hubby called the hospital again, and was told again that he needed to go through the whole routine. He got me upstairs and into a recliner somehow, while i was shaking uncontrollably and vomiting. He called the nurse again and told her screw you, we're coming cause this is real. We live exactly 1 block from the hospital and we barely made it! I still don't know how i managed to get out of his truck or into the bed, but when they checked me, I was already a 9. Nobody even called my midwife, they didn't think she would make the drive in time. A dr. i had never met came in and told me the only thing holding baby back was the fact that my water hadn't broke, and was holding baby in there. I said "BREAK IT!" all while the same nurse from the phone hovered over me and repeatedly told me to stop screaming because "your thraot is gonna be so sore, sweetie!". 1 hour of pushing and my 6lb7oz daughter was born. All in all, just under 7 hours from start of active labor to meeting my daughter. I never planned on laboring almost entirely at home, but in hindsight, would do it again, and now we also know to go in when WE think its time, not when a certain nurse says so.
Wow, I'd like to smack that nurse!! Hahaha.
Great article! My due date (first time mom to be) is in less than 3 months and there's that one thing that I keep wondering about: if I get into a bath tub how will I know whether my water broke or not? 🙂
Some women say they felt a pop or a gush. It feels like you've peed... but you didn't pee.
Thank you 🙂 Just so you know - your website is being read in Poland 🙂 Best wishes.
Great article. Thanks I am due in two weeks. A bit anxious as I laboured mostly at home without really knowing it. I got mild contractions at about 2am in the morning but slept to 5am then I called hospital and was told to take 2 paracetamol (mild over counter pain relief) and go back to bed. I couldn't sleep so did some house keeping. At 6am I called our lift to the hospital telling them that I would like to head in but there was no rush. At 6.20am I called again screaming for them to get here. We rushed into hospital getting there at 6.48 at which time I was 8cm dilated. 12 mins later i was fully dilated and 27 mins later I had my daughter without epidural and no tearing either due to doing the perinum massage faithfully every day! I would like to stay at home as long as possible this time too as I want a drug free birth but i live further away so don't want to risk not making it in time! I think I need to time the contractions better as we def did not do it right but it felt as if they were all over the place: every 3 mins then every 10?? Any other advice?
When did you start doing the perinum massages?
This is my 4th term pregnancy, and this time around I am determined to do it natural. Mainly b/c the epidural slows me down a ridiculous amount. I was 6cm and 100% at 10am, epidural happened and i delivered 7pm same day with last one :(. This was very very helpful. I plan on having my husband read it when I get closer to delivery. Thank you!
I am a first time mom-to-be who just hit her second trimester. This article is awesome. I've always wanted to go as natural as possible and not be laboring in a hospital for hours on end like I saw my sister do. After reading this and all these other stories I am feeling more empowered to do this the way I would like. I am saving this article to re-read as I get closer to the end of my pregnancy. Thank you for this great information and to all the moms who shared their stories.
I was reading this article 2 days prior my birth. And thanks to you i was able to get my natural, unmedicated birth that i wished for.
Arived at hospital at 14:55. Baby was born at 15:03.
And i felt and still feel like a superwoman.
So thanks again.
My recovery and breasfeeding are going so smooth, i couldnt wished for better outcome.
I am due this summer with my second child. First one I had natural with some trouble pushing will be trying new techniques this time! Had a question about bleeding I was bleeding quite a bit right after giving birth. Any suggestions to help with this or tips to ease my anxiety!!?? Very nervous about tearing and bleeding this time around.
I tore horribly with my first. My second I listened to the nurses. When they said don't push let the contraction do the work, LISTEN! It worked so much better and no tears! The human body is an amazing thing and can do amazing things!
I am a little nervous for when we embark on number 2. I labored at home for 7 hours with the first until my water broke and it felt like the contractions were right on top of one another. We had a 45 minute drive and I was in transition during the drive. I was 9 cm dialated, though I feared Tgey would tell me I was only 3 or 4 since I heard labor was so intense. Thankfully I was sent right in and pushing as my husband walked in the door. My mom had driven me and was worried we might not make it in time. All in all, active labor was only 3 hours, with early labor starting the day before. They said with number 2 to just head on in right away.
You may need to head in sooner for the second time around! That or have a homebirth. 🙂
I just want to note that with my second delivery, my contractions never got closer than 7 minutes apart, but they were super intense and lasted 60-90 seconds or more. By the time I was triaged and in the delivery room, the contractions never got any closer together but I was 9.5 cm dilated, nauseous, sweating, cold, hot, shaking, vomiting, etc. Wish I knew this list of signs for transition. Baby was safely born a couple of hours after I arrived at the hospital.
Wow! This time is so helpful! I was following the instructions of my midwife but after my water broke and my contractions were about 4 mins apart I was still only 3 cm. I ended up getting sent home and was very discouraged and that's probably why my labor stalled. I was in labor a total of 42 hours. The last 6 I had pitocin and then epidural and eventually delivered via emergency c section. Hoping for VBAC this time and to learn from my first labor. Would you say this one will progress more like a first labor since I had a c section? Or faster like a second labor because I did labor for a while. I think the most I dilated was 7
We primarily went based on overall progress. My doula's mantra was longer, and stronger. I woke up around 1:30am with my first real contractions (had been having stomach cramping the whole day before). Had irregular contractions for several hours and coped by walking around, standing and leaning on the kitchen counter and then laying in the recliner for a little while to try and get some rest. Got in touch with my doula around 7:30 to discuss what was going on. At the time I was probably around every 6 minutes 45 seconds to a minute long. She suggested I get in the shower, which I did, and my contractions intensified. My doula was on the phone once we got to 5-1 and was listening for how I was responding to the contractions. My reaction was definitely different than earlier in labor. I'm pretty risk averse so at 5-1 with increasing intensity we decided to head to the hospital. I arrived at the hospital around 9, I was 6cm and 80% but -3 station. After all my checks my doula suggested a series of lift and tuck contractions. Almost immediately after that my water broke and I entered transition. Started pushing around 12:45pm and after an hour baby came!! Overall I was in the hospital just over 4 hours before she came and that was perfect for me.
Fantastic but........you have left out the BABY
Please make sure your baby is moving every so often.......this is vital while deciding how long to stay at home.
If in doubt if your baby is moving enough.....its much safer to go in.. have baby checked and go back home
Its great to come in as late as possible ....but its a lot more important at the end of the day to be going home with a healthy baby